Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia

Petra Černá, Cristobal Lopez-Jimenez, Kenjiro Fukushima, Ko Nakashima, Taisuke Nakagawa, Fiona Adam, Anna Groth, Andrew Denning, Nicolas Israeliantz, Danièlle A. Gunn-Moore

Background: Gastrointestinal eosinophilic sclerosing fibroplasia (GESF) is a disease in cats that causes eosinophilic masses in the abdomen, often misdiagnosed as neoplasia. The pathogenesis and prognosis of GESF are poorly understood.

Study: A retrospective, multicentric study of 60 cats with histopathologically confirmed GESF, collected from various veterinary hospitals around the world between 2010 and 2022.

Methods: The authors reviewed the medical records of the cats and analyzed their signalment, clinical signs, clinicopathological findings, diagnostic imaging, treatment, and outcome. Survival analysis was performed using Kaplan-Meier and log rank tests.

Results: The median age of the cats was 5.4 years, with Ragdolls, Exotic Shorthair, and Persian cats being overrepresented. The most common clinical signs were weight loss, hyporexia/anorexia, chronic vomiting, and diarrhea. The most common location of the masses was the small intestine, followed by the stomach, ileocolic junction, and colon. Eosinophilia was present in 50% and hypoalbuminemia in 28% of the cats. Intralesional bacteria were detected in 32% and fungal organisms in 1% of the cases. Most cats (98%) were treated with corticosteroids, with or without surgery, secondary immunosuppressive agents, or antibiotics. The median survival time could not be estimated as 88% of the cats were still alive at the time of writing. There was no significant difference in survival between cats treated with surgical resection and cats treated with medical therapy alone.

Limitations: The study was limited by its retrospective nature, the lack of standardized diagnostic and treatment protocols, the possible selection bias of the cases, and the loss of follow-up of some cats.

Conclusions: GESF is an important differential diagnosis for abdominal masses in cats, and has a much better prognosis than previously reported. Corticosteroids appear to be the mainstay of treatment, regardless of surgical intervention. Further studies are needed to elucidate the pathogenesis, genetic predisposition, and optimal treatment of GESF in cats.

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