Snake remedies and eosinophilic granuloma complex in cats

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ORIGINAL PAPER

Snake remedies and eosinophilic granuloma

complex in cats

Ronit Aboutboul

Animan Veterinary Clinic, Jabotinsky 1, Tel-Aviv 63479, Israel

Eosinophilic granuloma complex (EGC) is a syndrome occurring in cats, characterized

by lesions affecting the skin and the oral cavity. Conventional treatment is mainly

symptomatic and may have undesirable side effects.This paper summarizes homeo-

pathic treatment with snake remedies of cats suffering from EGC. Snake remedies were

chosen by individual repertorizations and administered in different dilutions. Reactions

were mostly quick, leading to significant improvements, including complete recover-

ies. Homeopathy (2006) 95, 15–19.

Keywords: homeopathy; veterinary homeopathy; eosinophilic granuloma; EGC;

cats; snake remedies

Introduction

During the last few years, in our veterinary

practice, we have made interesting observations con-

cerning the homeopathic treatment of a chronic skin

syndrome in cats known as eosinophilic granuloma

complex (EGC).

EGC includes three clinical entities characterized by

various lesions affecting the skin and oral cavity of the

cat:1–3

Linear granuloma or eosinophilic granuloma is a skin

condition occurring mainly in young cats and present-

ing as erythematous, alopecic, well-circumscribed,

linear lesions found mainly over the caudal thighs

and in a nodular pattern in the oral cavity. Other sites

include the bridge of the nose, chin, lips and paws.

Eosinophilic Plaque is a well-circumscribed, raised,

exudative lesion that is very pruritic and generally

found over the abdomen or groin. Eosinophilic Rodent

Ulcer is a well-circumscribed, ulcerated lesion most

commonly found on the upper lip of the cat and is

generally non-painful and non-pruritic.

Any combination of lesions, symptoms and loca-

tions can be observed in individual cases. Suspected

aetiologies for EGC are numerous and varied. Under-

lying causes or predisposing factors include al-

lergies (mainly to food, biting insects and inhaled

substances, but also to parasites), infectious diseases,

genetic predisposition and immune-mediated diseases,

and in quite a few cases the cause is unknown.

Diagnosis of EGC is based on history, physical

symptoms, blood tests and histological findings. Full

blood count may reveal peripheral eosinophilia asso-

ciated with parasitic and allergic disorders. Skin biopsy

is the most important diagnostic test, often confirming

a suspected clinical finding. Specific histological

patterns have been associated with the three clinical

entities, all presenting tissue eosinophilia as a constant

finding.

Conventional treatment is mainly symptomatic,

aiming at controlling the suspected underlying infec-

tious or parasitic agent or minimizing the allergic

reaction with corticosteroid, antihistamine or hypo-

sensitization therapies. These treatments do not

usually cure the cat and may have undesirable side

effects. Symptoms often recur if therapy is interrupted.

Avoidance of allergenic factors is problematic too,

since most of them exist naturally in the cat’s

environment. A chronic condition with a significant

incidence in cats, EGC is a pathology that can cause

major discomfort to the cat and upset their owners.

Homeopathic treatment of EGC in cats is usually

based, as in other chronic conditions, on repertoriza-

tion and individual case taking leading to a specific

matching remedy. In some cases, symptomatic reme-

dies are also used.

ARTICLE IN PRESS

ÃCorrespondence: Ronit Aboutboul, Animan Veterinary Clinic,

Jabotinsky 1, Tel-Aviv 63479, Israel.

E-mail: ronitvet@zahav.net.il

Received 11 March 2005; revised 8 August 2005; accepted 5

September 2005

Homeopathy (2006) 95, 15–19

r 2005 The Faculty of Homeopathy

doi:10.1016/j.homp.2005.09.001, available online at http://www.sciencedirect.com

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We first used homeopathic treatment for EGC at our

clinic in the summer of 1996, when the first EGC case

was referred to the clinic by the treating veterinarian,

for homeopathic treatment. The patient, Swissa, a

male cat aged 2 years, had been suffering from pruritic

lesions from the age of 6 months. He had been treated

regularly with corticosteroids since the symptoms had

appeared. At the first consultation the cat seemed sad

and nervous, presenting with a dull, thin fur and

pruritic excoriations. The owner said that his cat had

become sad because of the corticosteroid treatment,

reacting more and more aggressively to the frequent

injections he was receiving. The skin condition had not

improved, which is the reason why an alternative

treatment was considered.

A skin biopsy was performed and histological

findings confirmed the suspicion of eosinophilic

granuloma. After repertorization, Lachesis was se-

lected. Treatment with that remedy brought a swift

improvement of both skin lesions and the general

condition of the cat. The owner ‘‘got back his old cat’’

as he termed it, the cat became happy and playful

again and his fur became dense and lustrous. Several

months later Swissa came back presenting with a

singular, atypical symptom of swelling of one of his

paws .The cat could not use the paw that had tripled in

size(!). Treatment with the remedy Crotalus cascavella

brought a quick and total recovery. This cat has been

fine since, with no other symptoms.

A short time after Swissa was cured, another cat was

brought to the clinic, also presenting with typical EGC

symptoms. After repertorization, Lachesis was given

again and the symptoms disappeared swiftly. These

two cases of quick and lasting recoveries raised some

questions and thoughts concerning snake remedies and

EGC, ie the possibility that other eosinophilic granu-

loma cases would respond well to snake remedies

because of the similarities in symptoms. This assump-

tion was, from then on, always taken into account

when treating cases of confirmed or suspected EGC in

cats, even though individual repertorizations were

done in most cases.

Methods and remedies

Over a period of 8 years, 20 EGC cases were seen at

our clinic; of these 15 were recorded. All were treated

with homeopathic snake remedies. The cats were all

young adults, 70% males and 30% females. The first

EGC symptoms appeared at ages ranging from several

months to 2 years old. Diagnosis of EGC was based on

the clinical observation of characteristic dermatologi-

cal lesions and usually confirmed by biopsy.

Most snake remedies were chosen through repertor-

ization, using the RADAR program.4 Symptoms for

repertorizations of EGC cases were chosen from

several sections of the repertory, usually Mind

symptoms accompanied by local characteristic symp-

toms of Mouth, Face, Skin and Extremities.

In each case, five to seven individual symptoms were

chosen.

Results

Out of the 15 recorded cases, medication was refused

by the owner in one case, three were lost to follow-up

(owners discontinuing contact or treatment) and one

did not improve (treatment discontinued after several

weeks). Ten cats were cured.

The remedies used were Lachesis (9 cases), Crotalus

cascavella (1 case), Crotalus horridus (1), Cenchris

contortrix (1), Elaps corallinus (1), Naja (1) and Vipera

(1). In the two cases where Lachesis was replaced by a

second snake remedy, only the second is counted here.

The remedies were given in various centesimal (12CH

to 30CH) and LM dilutions, in varying frequencies,

according to the dynamics of each case. Follow-ups

were conducted every 1 to 6 months.

Out of the 11 cases of which we have follow-ups,

amelioration of clinical condition was achieved with

the first snake remedy in eight. In two cases, the first

remedy, Lachesis, was replaced by a second snake

remedy; no case required a third remedy to achieve full

cure. In one case, the snake remedy Crot-horr was

given after Lycopodium, thus achieving cure (medica-

tion repetition is depicted in Table 1).

In the cured cases, effect of the remedy was noted

early on in the treatment, in the first 2 weeks, and

symptoms completely disappeared in a period ranging

from 2 weeks to 3 months. In two of the cases,

symptoms tend to reappear periodically, with stress

(anaesthesia, vaccinations, long absences of the

owners, etc) and disappear again with or without

administration of the remedy. In one case only,

despite good cooperation of the owners for several

weeks, the treatment was discontinued because of lack

of response (time schedule for improvement is depicted

in Figure 1).

All the cats treated with homeopathy presented

typical local EGC symptoms (Table 2). Their local

ARTICLE IN PRESS

Table 1 Outcome in 15 cases of EGC in cats

Lost to follow-up

No response

Good response (cure)

Did not take Remedy given once—lost to follow-up Remedy given once Remedy changed Remedy repeated Remedy given once

The numbers denote no. of cases.

Snake remedies for EGC in cats

R Aboutboul

Homeopathy

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homeopathic symptoms chosen for repertorization

surprisingly brought to the forefront various snake

remedies (Table 2). Although local symptoms played

an important role in repertorizations of the EGC cats,

MIND symptoms, as well as a few GENERALS, were

also used in the case taking (Table 3). The frequency of

snake remedies in all the chapters used for repertoriza-

tions of EGC cases is visualized in Table 4.

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2 weeks 1 month

2 months 3 months 4 months

Time to improvement

Time from begining of treatment

Number of cases

Time to achieve

100% improvement

Time to achieve

50% improvement

Figure 1. Time to achieve 50% and 100% improvement.

Table 2 Comparison of symptoms of EGC cases and snake remedies

Symptoms of EGC

in cats

Corresponding

symptoms in the

repertory

Matching snake

remedies in

repertory

Frequency of use

of symptom in

repertorizations

Skin lesions:

SKIN—

ITCHING

cench.Crot-h. Lach.

Linear, alopecic, erythematous, well-

circumscribed lesions on caudal region

of thighs, usually pruritic

Alopecic lesions on various parts of the

body (abdomen, back ...), sometimes

accompanied by erythema and pruritus

ITCHING—scratching-raw; must scratch

until it is

ITCHING—violent

EXCORIATION–scratching; after-must

scratch it raw

ERUPTIONS—herpetic

ERUPTIONS—herpetic-corrosive

ERUPTIONS—itching

Lach

lach

Lach

crot-h. lach.

lach

Lach

Mouth lesions:

MOUTH—

ULCERS

Crot-c. crot-h.

Ulcerated lesions localized on lips,

gums or around the mouth

Swelling of lips

ULCERS—Gums SWELLING

SWELLING—Gums

FACE—SWELLING—Lips—upper

LACH.

Crot-c. Lach.

vip.

Crot-h. LACH. Naja

Crot-h. Lach

Foot and pad lesions:

EXTREMITIES—

SWELLING

crot-h, lach, vip

Swelling of the foot, sometimes up to

double or triple size ...

Erythematous, usually very pruritic

lesions between the foot pads

SWELLING—Hand

SWELLING—Foot

ERUPTIONS—Hand

ERUPTIONS—Foot

ERUPTIONS—Lower limbs

crot-c. crot-h. elaps,

Lach, naja, vip.

Cench.crot-h. elaps

Lach. naja vip.

Lach

Crot-c. lach

Crot-c. elaps lach.

ÃIntensity of symptoms is denoted by type of letters (as in the Radar program): 1—lach.; 2—Lach.; 3—LACH.

Table 3 Mind and general symptoms chosen for repertorizations

Symptoms in repertory

Frequency of use of symptom

in repertorizations

MIND

ACTIVITY—Desire

AFFECTIONATE

COMPANY—aversion to

COMPANY—desire for

CONTRADICTION—

intolerant of contradiction

CURIOUS

DICTATORIAL

EXERTION—Physical—

desire

HIDING—himself

JEALOUSY

OBSTINATE

PLAYFUL

POSITIVENESS

REPROACHING others

RESERVED

RESTLESSNESS

SENSITIVE—Noise to

STARTING, startled—easily

TOUCHED—aversion to,

being

TIMIDITY

VIOLENT

GENERALS

FOOD and DRINKS—

farinaceous—desire

FOOD and DRINKS—milk—

desire

RUBBING—amel

SIDE—left

VACCINATION, after

Snake remedies for EGC in cats

R Aboutboul

Homeopathy

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Clinical case

Ella, a female cat aged 2.5 years, was brought to the

clinic in April 2003, for homeopathic treatment of

EGC symptoms from which she had been suffering

since the age of 6 months. The symptoms included

itching, red lesions between the footpads, erythema-

tous alopecic lesions over the caudal thighs (see

Figure 2a), thinning of fur on the abdomen (due to

constant licking of the area by the cat), ulcers on the

lower lip and alternating swellings of the paws. She was

being treated with corticosteroid injections every 1–2

months, whenever these symptoms aggravated.

Symptoms taken for repertorization were the follow-

ing:

MIND—COMPANY—aversion to

MIND—AFFECTIONATE

MIND—REPROACHING others

SKIN—EXCORIATION—scratching; after—must

scratch it raw

SKIN—ERUPTIONS—itching

EXTREMITIES—SWELLING—hand

Vipera 30CH, once a day for 3 days was prescribed.

Ella started improving immediately, and 2 months

later, with a few repetitions of the remedy, all the

lesions were healing well and fur was growing on the

afflicted areas (see Figure 2(b)). 1.5 years later, she was

well. Slight symptoms appear occasionally, usually

disappearing spontaneously or with just one dose of

the remedy. She was last examined in the summer of

2004, presenting with slight erythema on the caudal

region of the right thigh, and was given Vipera 30CH

once and the symptoms disappeared in a few days.

Summary

As this case illustrates, most of the EGC cases

treated homeopathically at the clinic respond well to

snake remedies. The dilution and frequency of repeti-

tion vary from case to case. Duration of treatment

varies from several weeks to months or years, the aim

being complete cure and disappearance of all the

symptoms. In some cases that result is achieved, in

other cases the specific remedy has to be repeated

sporadically, at months’ intervals, when owners

suspect early symptoms or when stressful situations

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Table 4 Frequency of snake remedies in the repertorizations of EGC cases

Remedy

MIND

SKIN

EXTREMITIES

MOUTH

FACE

GENERALS

Cenchris

Crot-c

Crot-h

Elaps

Lachesis

Naja

Vipera

Two other snake remedies came up in these repertorizations but were not prescribed: Bothrops lanceolatus and Toxicophis pugnax.

Figure 2. (a) Eosinophilic granuloma on thighs—before treat-

ment. (b) Eosinophilic granuloma on thighs—after treatment.

Snake remedies for EGC in cats

R Aboutboul

Homeopathy

Page 5

occur. Although food allergies are in the list of

suspected aetiologies for EGC, usually no specific diet

is given to the cats treated at our clinic, except for rare

cases when such a diet is chosen specifically by the

owners.

Discussion

Each of the cats diagnosed with EGC at the clinic

was treated with a remedy chosen through individual

repertorization. However, the high incidence of snake

remedies in the first successful cases encouraged us to

choose remedies of the same family in the cases that

followed. In light of the accumulated experience of

successfully treating EGC cats with snake remedies, as

presented above, a few questions must be put forward:

Why do homeopathic snake remedies act specifically

on EGC?

Why does a rather small, specific, well-defined group

of remedies bring a cure in most cases presenting with

the same pathology, albeit differing in character,

history and even in local symptoms?

Cases differ not only by the localization, intensity

and modalities of their symptoms but also in the

dynamics of the healing process; yet nearly all

responded well to snake remedies. All the repertoriza-

tions suggested snake remedies, and in one case, where

a different remedy was given first, with no success, cure

was achieved on changing the remedy to a snake

remedy.

How do snake remedies affect EGC in cats?

How do they relate? What is common to snake

venom and the characteristic pathology of EGC?

All snake remedies obviously present symptoms that

are caused by snakebites; some of these symptoms,

such as ulcerated lesions, excoriations and swellings

affecting skin, mouth and extremities, are also

characteristic of EGC. Interestingly, in conventional

medicine, snake venoms are used in autoimmune

syndromes, such as Lupus, for their anticoagulant

properties.

Still, it is important to note that, while focusing on

the similarities between snake remedies and EGC on

the physical level, the mental symptoms cannot be

ignored since MIND symptoms were taken into

account in all of the repertorizations. Can this

remedy—syndrome relation be found in other pathol-

ogies? How can this information be put to use in

homeopathy? Do these observations open new path-

ways to cure?

The answers to these questions may be complex and

uncertain, but the observation and research of

accidental findings such as these can lead us homeo-

paths and physicians towards new understandings

considering the concepts of sickness and cure in

homeopathy.

Acknowledgements

I thank Dr Michal Yakir and Tamar Almog.

References

1 Birchard SJ, Sherding RG. Saunders Manual of Small Animal

practice. Philadelphia: WB Saunders, 1994 pp 341–344.

2 Harvey RG, McKeever PJ. Colour Handbook of Skin Diseases

of the Dog and Cat. London: Manson Publishing Ltd, 1998.

3 Melman SA. Skin Diseases of Dogs and Cats. Dermapet, 1994.

4 RADAR 7 & 8—homeopathic repertorization program, Archi-

bel, Belgium.

ARTICLE IN PRESS

Snake remedies for EGC in cats

R Aboutboul

Homeopathy