Feline eosinophilic keratoconjunctivitis: nonsteroidal vs corticosteroid topical treatment

ABSTRACT

Background: Feline eosinophilic keratoconjunctivitis is a proliferative eye lesion of chronic aspect with usually unilateralpresentation that may initiate as a superficial vascularization that evolves to a proliferative, granular, irregular lesion ofwhitish-pink aspect. With its association with an immune-mediated response, nonsteroidal anti-inflammatories do notappear to be efficient, although few studies describe its use. This case report describes a case of a feline eosinophilic keratoconjunctivitis with its clinical evolution since the use of nonsteroidal topical anti-inflammatory drug in an undiagnosedpatient and the transition to a topical corticosteroid and cure after 14 days since diagnosis.Case An 8-year-old female cat was attended at the Veterinary Hospital of the Dom Bosco Catholic University (UCDB),with main complaint being an eye injury with at least 36 days of evolution and unresponsive to treatment (topical tobramycin 0.3% every 12 h / ketorolac trometamol 0.5%/ every 12 h and ophthalmic lubricant/every 4 h). Since the patienthad free access to the street, the owners suspected of trauma-induced lesion. At physical examination, it was observed aproliferative lesion at the peri-limbal superotemporal quadrant of the right cornea with approximately 0.4 cm diameter,with color varying of pale to pink, with irregular surface and low vascularity, the adjacent conjunctiva was also affectedwith similar multiple nodular lesions (0.1 cm). Fluorescein test was negative as well as FIV/FeLV immunochromatographytesting. Feline herpesvirus investigation was not possible. The patient was anesthetized and a lesion specimen was acquiredwith a cotton swab scraping and a fine needle aspiration. Cytology showed predominance of eosinophils and mast cells,with rare corneal epithelial cells, with smear background containing mast cell...