Cat with Pruritic neck lesions

Re: Cat with Pruritic neck lesions

Julie Innes — Mon, 23 Feb 2015 13:02:41 GMT

I've seen these quite a bit over the years, and they can be frustrating, as you get them almost healed then the cat undoes all your work in 30 mins! I had a really bad one a while ago- previous vets had had it on steroids/ ovarid for years until it became diabetic, so owner was reluctant to go back that way! I tried everything, and eventually, as a just-before-we-put-her-to-sleep, tried amitryptilline- completely sorted, has never looked back!

Re: Cat with Pruritic neck lesions

Anthony Dennison — Mon, 23 Feb 2015 12:12:33 GMT

[quote user="Anthony Todd"]

Love to see another picture. should be healing nicely?

[/quote]

I've been off for a week being pulled around the lake district by my dog, will check the records when I'm at the branch tomorrow.

Re: Cat with Pruritic neck lesions

Anthony Todd — Fri, 13 Feb 2015 18:03:43 GMT

Love to see another picture. should be healing nicely?

Re: Cat with Pruritic neck lesions

Richard Carter — Wed, 11 Feb 2015 18:33:49 GMT

can you smell the lesion? I find that if I cannot smell any infection, then probably doesn't need antibiotics and so need to concentrate on getting the pruritis under control

Re: Cat with Pruritic neck lesions

Anthony Todd — Wed, 11 Feb 2015 11:00:09 GMT

[quote user="Anthony Dennison"]Plan is to increase the steroid dose, long course of antibiotics and improve flea control further with comfortis.[/quote]

Maybe "Ovarid" 5mg weekly will work better. Repeat at first signs of recurrence [make sure the owner has a tab or two for Saturday or Sunday.]

Never ever used antibiotics and never had a failure as I figured the bacteria present would just be commensals which, judging by the inevitable response, they were. [You'd be very lucky to swab a lesion like that and not get anything!]

Maybe the new spray of steroid may be a good idea thou, particularly before the scab forms, like the picture?

If you bathed off the scab the irritation got much worse!

Re: Cat with Pruritic neck lesions

Anthony Dennison — Wed, 11 Feb 2015 10:44:12 GMT

Update - the day after these photos were taken (and a steroid injection was given) the lesions had scabbed over. Cytology shows profuse cocci and neutrophils, with intracellular cocci. Consistent with bacterial pyoderma.

Still awaiting aerobic and fungal cultures. I suspect this may be a pyoderma with a flea allergy component, that just hasn't been properly sorted so the 'flare ups' we're seeing is just the pyoderma spreading and taking effect. Plan is to increase the steroid dose, long course of antibiotics and improve flea control further with comfortis.

Re: Cat with Pruritic neck lesions

Anthony Todd — Wed, 11 Feb 2015 10:40:12 GMT

[quote user="villagevet"]delvosterone[/quote]

Back in the day, around the time of the "progesterone-like" Ovarid, and before, there was a "justification" for it's efficacy in that, apparently, pregnant rabbits, with the influence of progesterone in pregnancy caused all their fleas to leave......

Therefore giving progesterones would cure FAD [without mentioning the potent other action of megestrol!]

Of course Joan Joshua got round her "hormone deficiency" by giving testosterone and pred ,but didn't mention the pred!

[quote user="villagevet"]could diagnose all of them online without having to examine at all![/quote]

Sorry, but this one you can, just by looking.

Re: Cat with Pruritic neck lesions

Lindsey Edwards — Tue, 10 Feb 2015 21:56:58 GMT

Have inherited a number of cases that are well controlled on delvosterone every few months / as and when signs recur. Again with histories of limited improvement with flea control, steroids or antibiotics. It would be an easy profession if every derm case was fleas, "steroid deficiency" or undiagnosed hormonal issue ... could diagnose all of them online without having to examine at all!

Re: Cat with Pruritic neck lesions

Braden Collins — Tue, 10 Feb 2015 03:52:37 GMT

Managing a cat at the moment which didn't respond to steroids but a similar presentation. Flea control appeared excellent. Food trials were done with no success. Ovarid had it sorted within a week. Good old dino-medicine in that case did the trick.

Re: Cat with Pruritic neck lesions

Anthony Todd — Mon, 09 Feb 2015 19:43:33 GMT

[quote user="villagevet"]Put out cutaneous neoplastic issue as a last resort query; have not had enough experience in diagnosing them but remember being disappointed when I read first case report on it that I had euthanased 2 nice cats with compliant owners for chronic, none responsive, not definitively diagnosed skin issues despite work up and biopsy in one case. Both had history of some partial responses to treatment but frequent return of signs: a survey x-ray might possibly have changed course of treatment and possibly survival of cat, may have even brought a diagnosis. [/quote]

Sorry , and this really is a time when you have to listen to a dinosaur. This is a condition which I have seen so many times in so many locations on so many cats. It is so easily recognised, occurs in less than 24 hours, in fact 2 hours, is self perpetuating once it starts and can always be cured or "controlled" with steroids in all cases if given in adequate doses for long enough.

In the days before effective spot-on flea control FAD in all it's forms from "miliary dermatiis" through "eosinophilic granuloma" via "moist eczema" was so common in the "flea season" that it was impossible to miss.

It is only lately with the modern approach to the elimination of the very rare rather than the treatment of the very common that we see these long involved diagnostic processes and the scenario ending in euthanasia as cited.

It can be cured if you remove the allergen which fortunately is fleas although convincing the owner of that is much harder. then, and only then, did I proceed to food allergies and with a compliant owner these too can be sorted.

I would stand corrected if anyone could show me a case with skin that looked like,that ie acute irritation, which was not totally steroid responsive and turned out to be a tumour.

Remember I started in the days of Joan Joshua and "testosterone deficiency" via Ovarid [hormone supplement, Ho, Ho] to effective flea control, surveyed around 300 FADs to show to myself and the practice that fleas were the cause in the vast majority.

It's a syndrome dear to my heart and so easy to fix.

I must add , that to my shame, we in the practice, put down two healthy cats with "recurrent uncontrolled struvite FUS" only to find out about oxalate some time later.

No vetsurgeon.org at that time; you guys are so lucky.

Re: Cat with Pruritic neck lesions

Anthony Dennison — Mon, 09 Feb 2015 17:22:19 GMT

[quote user="Gareth C."]

its not on any thyroid meds is it?

[/quote]

Nope. awaiting skin work-up results, will keep you updated.

Re: Cat with Pruritic neck lesions

Gareth C. — Mon, 09 Feb 2015 15:48:28 GMT

its not on any thyroid meds is it?

Re: Cat with Pruritic neck lesions

Lindsey Edwards — Mon, 09 Feb 2015 12:08:51 GMT

Put out cutaneous neoplastic issue as a last resort query; have not had enough experience in diagnosing them but remember being disappointed when I read first case report on it that I had euthanased 2 nice cats with compliant owners for chronic, none responsive, not definitively diagnosed skin issues despite work up and biopsy in one case. Both had history of some partial responses to treatment but frequent return of signs: a survey x-ray might possibly have changed course of treatment and possibly survival of cat, may have even brought a diagnosis. Cat in this query had 18month history, some temporary relief to treatments - don't know why you query sudden onset? When you hear hoof steps expect to see a horse, don't forget though one day it might just be a zebra.

Re: Cat with Pruritic neck lesions

Anthony Todd — Sun, 08 Feb 2015 23:47:51 GMT

but are any sudden onset and pruritic??]

as I asked before.

Bathing just makes them so much more irritating IME and antibiotics make no difference at all. Surprisingly in the cat anyway they never seemed to get infected, just resolved quite quickly.

Cortavance straight on the weepy lesion, apart from being likely to stay long enough, may be a welcome advance though.

Re: Cat with Pruritic neck lesions

Lindsey Edwards — Sun, 08 Feb 2015 23:00:26 GMT

Cortavance spray will penetrate most lesions, especially if bathed if any crust first , absorbed within 15mins after which a antibacterial cover would prevent secondary infection from propagating problem further? As i said originally - consider x-rays for masses if nothing else relieving symptoms - if truly secondary to systemic issue symptomatic treatments won't handle 'it', whatever it may or may not be.

Re: Cat with Pruritic neck lesions

Anthony Todd — Sun, 08 Feb 2015 09:23:38 GMT

[quote user="villagevet"]Have you tried cortavance followed by chlorhex ointment/intrasite if primary pruritic?[/quote]

Trouble is anything topical [except sprays??] won't stick to an oozy lesion and tend to make the lesion more irritating, certainly chlorhex, in my experience, particularly where the animal can get at it.

[quote user="villagevet"]Query cutaneous paraneoplastic syndrome if everything else clear?[/quote]

Wow, never heard of it, [now I have, google showed me, but are any sudden onset and pruritic??]

You'll be unlikely to make, and don't really need, a definitive diagnosis, except by treatment success and if you do the diligent "client informed" trend again, it will dilute the message which is almost always flea treatment.

Mentioning "cancer" in any shape or form, unless you are very sure, really devastates and distracts the owner .

Re: Cat with Pruritic neck lesions

Lindsey Edwards — Sun, 08 Feb 2015 02:26:52 GMT

Have you tried cortavance followed by chlorhex ointment/intrasite if primary pruritic? Query cutaneous paraneoplastic syndrome if everything else clear?

Re: Cat with Pruritic neck lesions

Kate Richardson — Sat, 07 Feb 2015 19:51:07 GMT

Mainly Burmese but not exclusive

Re: Cat with Pruritic neck lesions

Robin Grimmer — Sat, 07 Feb 2015 19:39:02 GMT

[quote user="Kate Richardson"]

All good advice so far and in total agreement. But alternatives to consider- underlying pain- may set off the initial irritation then secondary inflammation develops as a result, so consider the xrays and a full dental examination including dental xrays if owners are keen to rule out an underlying problem. Or trial meloxicam for a lengthy period and see if any flare ups whilst on it. FOPS another consdieration if all else ruled out. (Feline Orofacial Pain Syndrome). But allergy seems most likely. If so needs constant treatment to prevent, not just when has lesions.

[/quote]

I thought FOPS was only found in Burmese, or can it occur in other breeds?

Re: Cat with Pruritic neck lesions

Emily Rainbow — Sat, 07 Feb 2015 17:10:35 GMT

Yes we are in the process of weaning 'my' off them with a view to then treating as necc in the future. We are presuming fleas were the blame on my case as initially improved with tighter flea control but it's a multi-outdoor cat, multi-dog household so not sure how tight we can go!

Re: Cat with Pruritic neck lesions

Anthony Todd — Sat, 07 Feb 2015 09:26:06 GMT

[quote user="Emily Rainbow"]now on a tab every other week and doing well.[/quote]

I'd suggest a tab limmediately if symptoms even look like recurring rather than a "maintenance" dose or you'll upset the steroidophobes and results are as good.

You may find half a tab, in the very early stages is enough as the lesions are self perpetuating once they start even if the allergic trigger has long gone.

Do you think it was fleas, year round risk in heated houses with the cats indoors?

Re: Cat with Pruritic neck lesions

Emily Rainbow — Sat, 07 Feb 2015 08:08:56 GMT

Oops on phone and somehow manages to 'suggest' the above post... Sorry! I had a similar case a while back which was then seen by another vet here and given Ovarid which it responded well to. Not something I've ever used before but did the trick and he's now on a tab every other week and doing well.

Re: Cat with Pruritic neck lesions

Anthony Dennison — Fri, 06 Feb 2015 17:26:33 GMT

[quote user="Richard Carter"]

have seen feline demodex look like this and in a seperate case allergy to ear mites where if you touched the ears the scratch reflex would result in trauma to your hand. Anyone scoped the ears?

[/quote]

Ears are ok, checked them when I first saw the cat.

Re: Cat with Pruritic neck lesions

Richard Carter — Fri, 06 Feb 2015 17:25:18 GMT

have seen feline demodex look like this and in a seperate case allergy to ear mites where if you touched the ears the scratch reflex would result in trauma to your hand. Anyone scoped the ears?

Re: Cat with Pruritic neck lesions

Hannah Wynne Richards — Fri, 06 Feb 2015 12:59:57 GMT

Long strings of meaningless letters are highly annoying.

Wynne