Diagnosis of pyogranulomatous and neutrophilic lymphadenitis in 72 cats presenting to a referral hospital: with a focus on nine cats with steroid-responsive lymphadenitis.

Steroid-responsive lymphadenitis in cats responds well initially but requires prolonged glucocorticoid therapy with relapse risk.

This retrospective study analyzed 72 cats with pyogranulomatous or neutrophilic lymphadenitis at a referral hospital over nine years. Feline infectious peritonitis (FIP) was the most common diagnosis (35%), followed by neoplasia (15%). Nine cats (12.5%) with steroid-responsive lymphadenitis were characterized as typically middle-aged castrated males presenting with lethargy, hyporexia, pyrexia, peripheral lymphadenopathy, and weight loss. Submandibular, popliteal, and jejunal lymph nodes were most frequently affected. Cytology predominantly showed neutrophilic inflammation (57%) rather than pyogranulomatous patterns. All nine cases received prednisolone therapy (median 1.25 mg/kg) for a median of 5.75 months with initial improvement in all cases. However, 33% experienced relapse during or after treatment tapering, with two cats euthanized following relapse, one developing neurological complications. The study recommends considering steroid-responsive lymphadenitis as a differential diagnosis in cats with inflammatory lymphadenopathy when infectious, inflammatory, and neoplastic causes have been excluded.

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