Cat with blepharitis, stomatitis, rhinitis?

Re: Cat with blepharitis, stomatitis, rhinitis?

Utlendigur — Mon, 07 Oct 2013 13:40:50 GMT

[quote user="Kate Richardson"]Trevor Whitbread is very good, think he is from Finn?[/quote]

Isn't he at Abbey?

http://www.abbeyvetservices.co.uk/

Re: Cat with blepharitis, stomatitis, rhinitis?

Kate Richardson — Mon, 07 Oct 2013 09:56:28 GMT

[quote user="Mike Nikolaou"]

It was an anti-inflammatory dose (0.5mg/kg b.i.d.) and it didn't make any discernible difference. Would you advise trying a higher dose Kate or going for the biopsy first?

have discussed referral with the owner and although she is keen, she doesn;t have transport which is very limiting...

[/quote]

Reasonable dose used, and would have expected an improvement if a hypersensitivity/allergy. However some cats do need higher doses but it would be advisable to biopsy first as if this is immune mediated you will need much higher doses and/or other immunosuppressive medications, so best to know what you are dealing with first. You didn't say how old the cat is?

Re antibiotics, how was owner/cat compliance and how long a course did he have? Did you see him back while he was still on the antibiotics or did the owner report to you? If so be careful if they had finished the antibiotics and then reported a week later- an owner's perception of response is very different to ours- if it improved but then relapsed a week later the owner will report it as no better so imperative to actually see the cat and assess yourself and also these sort of cases really need continuity with the same vet as can be very difficult to assess changes/improvments if you didn't see the cat before treatment.

If you end up biopsying, make sure you send a sample for culture as well as histopathology and ideally send to a dermatopathologist- I believe Trevor Whitbread is very good, think he is from Finn? Also worth some fungal tests.

Remember common things are common. Immune mediated disease is quite rare.

Re: Cat with blepharitis, stomatitis, rhinitis?

Mike Dale — Mon, 07 Oct 2013 08:40:52 GMT

I agree biopsy and before increasing pred dose. May be worth re-visiting virus isolation. My own Burmese developed rhinitis and periodic sinusitis and did not show positive Herpes until third swabbing. She improved with Virbagen but remains snotty.

Your cat looks a strong case for investigating muco-cutaneous diseases with biopsy.

Re: Cat with blepharitis, stomatitis, rhinitis?

Mike Nikolaou — Sun, 06 Oct 2013 20:51:40 GMT

It was an anti-inflammatory dose (0.5mg/kg b.i.d.) and it didn't make any discernible difference. Would you advise trying a higher dose Kate or going for the biopsy first?

have discussed referral with the owner and although she is keen, she doesn;t have transport which is very limiting...

Re: Cat with blepharitis, stomatitis, rhinitis?

Kate Richardson — Wed, 02 Oct 2013 21:09:40 GMT

[quote user="Mike Nikolaou"]Have tried antibioitcs in the past (amoxyclav) with no results. A colleague tried prednisolone as well (to my horror!) but again didn't make any difference. [/quote]

Do you know doses? Lack of response to pred doesn't mean it isn't an inflammatory/immune disease if the dose used was very low, same for antibiotics if dose too low or not used for long enough.

Re: Cat with blepharitis, stomatitis, rhinitis?

Mike Nikolaou — Wed, 02 Oct 2013 18:15:58 GMT

Have tried antibioitcs in the past (amoxyclav) with no results. A colleague tried prednisolone as well (to my horror!) but again didn't make any difference.

So the consensus is biopsy I suppose. I have to admit I have never seen a mucocutaneous problem in a cat, apart from the odd squamous cell c, but never in three different m/c junction areas around the face...

Thanks to all for your input!

Re: Cat with blepharitis, stomatitis, rhinitis?

Rob Davis — Tue, 01 Oct 2013 14:03:07 GMT

Plus one for biopsy

Re: Cat with blepharitis, stomatitis, rhinitis?

Kate Richardson — Tue, 01 Oct 2013 08:48:19 GMT

I would second the biopsy, but I would also try a course of cephalexin first to treat pyoderma and assess the response. Also do a scale and polish and assess the teeth further. The gingivitis (can't see stomatitis as such?) may be unrelated to the skin.

How old is the cat?

Re: Cat with blepharitis, stomatitis, rhinitis?

Andrew Kent — Mon, 30 Sep 2013 22:40:13 GMT

I would biopsy that, looks like it's affecting mucocutaneous junction so would consider immune mediated disease, mucocutaneous pyoderma, neoplasia etc.