Eosinophilic Gastroenteritis in Cats

Eosinophilic gastroenteritis describes an infiltration or migration of eosinophils from their origin. Specifically, the white blood cells move into the lamina propria (layer closest to the surface of the intestinal lining) and occasionally the muscularis (muscular layer) or submucosa (tissue layer that sits on top of the muscular layer) layers of the tubular organ which is the intestine. A cat with eosinophilic gastroenteritis will experience symptoms of weight loss, a decreased appetite and tar-like black or blood covered stools. Although many cases of eosinophilic gastroenteritis are idiopathic (unknown cause), conditions such as leukemia, immune-mediated disease, and parasitic disease have been linked to this intestinal disease.

When we break down the term, Eosinophilic Gastroenteritis, we can better understand what the condition it refers to. Eosinophilic is a word veterinarians use to refer to a type of white blood cell known as an eosinophil. Gastro- is the medical term for stomach and –enteritis in the term medical professionals’ use for intestinal inflammation. Therefore, we can concur that Eosinophilic Gastroenteritis in Cats is a type of inflammatory intestinal and stomach disease involving white blood cells.

Eosinophilic Gastroenteritis in cats shares similar clinical signs as other gastroenteritis conditions. The most common symptoms of eosinophilic gastroenteritis are a change in the feline’s defecation habits and the appearance of the passed stool. Due to the inflammation inside the stomach and intestinal tract, the feline will only be able to pass small bowel movements that are often in the form of diarrhea. Additional telltale signs of eosinophilic gastroenteritis in cats include: 

• Intermittent vomiting 
• Anorexia (absence of appetite) 
• Weight loss 
• Melena (black, tarry stools): melena is the term used for digested blood found in a passed stool. 
• Hematochezia (bright red blood-covered stools) 

Upon physical examination, the veterinarian may be able to feel the inflamed tissues upon palpation. In other cases, such as in the case of hypereosinophilic syndrome, the vet may note an enlarged spleen, liver and lymph nodes. These portions of the cat’s body enlarge due to an elevated number of white blood cells produced by the bone marrow, which go on to invade the intestines and stomach tissues. 

Eosinophilic gastroenteritis in cats often occurs for unknown reasons (idiopathic), but can also be caused by a number of underlying causes including: 

• Eosinophilic granuloma: a nodular lesion or growth that contains eosinophils. 
• Eosinophilic leukemia: cancer caused by abnormal eosinophils.
• Hypereosinophilic syndrome: a condition in which the bone marrow makes a large number of white blood cells that invade various tissues. 
• Systemic mastocytosis: The presence of mast cells within the body’s tissues which, when stimulated, release histamine that will trigger the secretion of stomach acid. 
• Immune-mediated disease (adverse drug reaction, food allergy) 
• Parasitic disease (hookworms, tapeworms, roundworms)

The diagnosis of eosinophilic gastroenteritis in cats is based on clinical findings the feline presents, combined with a review of the medical history and at-home symptoms reported by the cat owner. The veterinarian may ask for a stool sample to confirm the appearance of a tarry, black or blood-covered stool, which is a sure sign the cat is unwell. Upon physical examination, the veterinarian may notice an enlarged intestine due to inflammation or enlarged lymph nodes upon palpation. The feline may express pain, by vocalizing during the veterinary palpation exam. Following the physical exam, your veterinarian will likely run a CBC (complete blood cell count) on your cat’s blood and a serum biochemistry profile. A urinalysis may follow the blood work as well as an abdominal ultrasound and radiographs using a barium contrast element.

In the case of dehydration, a decreased level of blood protein albumin or other types of conditions which have left the cat unstable will require hospitalization. To stabilize the feline, the veterinarian may administer a lactated Ringer’s solution to restore hydration and/or colloids to aid in circulating blood volume. If an underlying cause has been pinpointed during the diagnostic examination of your cat, the veterinarian will attend to treating that condition specifically. Administration of steroids are the mainstay of treatment options for felines with eosinophilic gastroenteritis, but an immunosuppressant may also be prescribed based on your cat’s specific needs. Ask your veterinarian about the best treatment option for your cat, as each condition requires a different method of medical treatment. 

The prognosis for felines with Eosinophilic Gastroenteritis depends on the severity of the underlying disease. Expect a follow-up appointment with your veterinarian from 2-5 weeks after treatment has started. The vet will likely request blood work and a urinalysis to be taken from your cat, which will allow him/her to evaluate the feline’s current state. Most cats diagnosed with eosinophilic gastroenteritis do not usually require long-term treatment.