Laser-assisted removal of a feline eosinophilic granuloma from the back of the tongue

Abstract

Recently, an increase in the occurrence of oral diseases in cats has been observed. Symptoms vary from case to case, but loss of appetite or fastidiousness can almost always be noted. Proliferative inflammatory eosinophilic granulomatosis is a common disease in cats, which may be localised to the skin, the mucocutaneous junctions or the oral cavity. The disease has three different manifestations: indolent cellular ulcer, eosinophilic plaque, and eosinophilic granuloma. The last mentioned form predominantly affects the medial surface of the thigh, the cheek, the tongue and the palate. Pain is not common, the lesion is nonpruritic if localised to the skin, but the nodular form in the oral cavity may make deglutition difficult. In this case, a 10.5-year-old cat was presented in poor condition due to feeding problems. Examination revealed a mass of unknown origin with macroscopically tumorous appearance, localised to the pharyngeal part of the tongue, which made swallowing and voluntary feeding difficult. The granuloma was removed by laser-assisted surgery. After adequate preparation, a LASER diode with 6–10 W output power was used, set to continuous constant-amplitude output (CW) running in a 0.6 mm optic fibre to the site of interest. The removed tissue was examined for pathomorphological features: haematoxylin and eosin, Giemsa, Azan and PAS stainings were performed to aid diagnosis. After surgery the cat recovered fast on steroids, and its condition and quality of life improved greatly. The traditional surgical technique was inapplicable due to the heavy vasculature and corresponding bleeding of the tongue.