SIT and diabetes in a cat

RE: SIT and diabetes in a cat

Rebecca Marchewka — Wed, 17 May 2017 14:22:07 GMT

Hi,

thank you for your thoughts.

The cat has had skin issues since at least 2008. Has always responded beautifully to systemic steroids.

He has had dermatophyte culture (negative) in the past and has good flea control. Did have have full derm work up a few years ago.

I am a bit nervous to remove the lesion in case I make things worse, so I think I will persevere with topicals for now as is stable at the moment.

Will try different distraction methods for the topiclas and wait and see for bit longer.

thank you

Becky

RE: SIT and diabetes in a cat

Beats — Tue, 09 May 2017 20:58:10 GMT

[quote user="Rebecca Marchewka"]

Hello,

I am currently treating a cat who appears to be going into remission for diabetes. Has been on insulin injections and I have slowly tapered the dose. Last curve was normal at 0.5 unit sid so have stopped the insulin.

The cat has a history of SIT on the side of his neck which we are unable to control with topical steroids. I am reluctant to give him systemic steroids / ciclosporin in case I tip him back into diabetes.

Any thoughts would be appreciated.

Thank you

Becky

[/quote]

If it's been there for months, is causing a problem, is an isolated lesion, topical steroids have made not difference and known diabetic-risk:

I'd most likely cut it out (assuming an abundance of free skin) with buster collar for 2 weeks, having trimmed the back nails on that side short.

Dermatophyte test is a sensible suggestion also given lack of response to steroids.

Impression smear to check for secondary infection could be worth considering.

I believe apoquel is an option also re stopping the itch, though not all cats respond.

I don't think ciclosporin would risk upsetting the diabetic remission.

RE: SIT and diabetes in a cat

Anthony Todd — Mon, 08 May 2017 23:11:36 GMT

dupl.

RE: SIT and diabetes in a cat

Anthony Todd — Mon, 08 May 2017 23:10:19 GMT

[quote user="Anthony Dennison"]Do you think that is advisable given the cat was until recently, diabetic? [/quote]

Er, it is if you've forgotten that it is [sorry]

RE: SIT and diabetes in a cat

sharon rankin — Mon, 08 May 2017 20:17:50 GMT

A few thoughts,

From the photo, it does look like an eosinophilic plaque, although not very clear. (That is what you are thinking?) There is only the one lesion? And a history of these? What is the flea control like? Would agree with being reluctant for systemic steroids.

Btw has ringworm been ruled out?

RE: SIT and diabetes in a cat

Rebecca Marchewka — Mon, 08 May 2017 17:35:18 GMT

[quote user="Anthony Todd"]

Sorry I thought the picture had the lesion on the side of the neck so couldn't be licked!

Seen these get to 6cmsx6cms in a day or two.....

S.L, therefore, in effect, S/C depomed, always worked and you can use a lower dose. As you know cats will lick anything off anywhere if they can.....

Do the Sellotape on a distant foot to distract for a while, repeat the Dmed at the first sign of irritation.

[/quote]I was reluctant to use systemic steroids due to the DM. The lesion is on the side of his neck but he can reach it. Hasn't really changed in size for weeks.

Maybe the sellotape would help to allow the isaderm to work.

RE: SIT and diabetes in a cat

Anthony Dennison — Mon, 08 May 2017 17:04:10 GMT

[quote user="Anthony Todd"]S.L, therefore, in effect, S/C depomed, always worked and you can use a lower dose. As you know cats will lick anything off anywhere if they can.....[/quote]

Do you think that is advisable given the cat was until recently, diabetic?

RE: SIT and diabetes in a cat

Thomas Johnson — Mon, 08 May 2017 16:11:24 GMT

[quote user="Rebecca Marchewka"]Have tried cortavance, the cat hates the spray. The owner did put the liquid on cotton wool and then on the lesion but I didn't think that sounded like a very good idea so advised she didn't.[/quote]

When I prescribe Cortavance to use on paws I advise owners to put on a disposable glove, spray it onto the glove and then run it over the paws, would that be an option?

RE: SIT and diabetes in a cat

Anthony Todd — Mon, 08 May 2017 15:53:49 GMT

Sorry I thought the picture had the lesion on the side of the neck so couldn't be licked!

Seen these get to 6cmsx6cms in a day or two.....

S.L, therefore, in effect, S/C depomed, always worked and you can use a lower dose. As you know cats will lick anything off anywhere if they can.....

Do the Sellotape on a distant foot to distract for a while, repeat the Dmed at the first sign of irritation.

RE: SIT and diabetes in a cat

Rebecca Marchewka — Mon, 08 May 2017 15:20:49 GMT

Have tried cortavance, the cat hates the spray. The owner did put the liquid on cotton wool and then on the lesion but I didn't think that sounded like a very good idea so advised she didn't.

Currently on isaderm and the lesion is fairly static. He does lick it off so I have advised the owner to apply it before she feeds him but still only really gets a couple of minutes to work. He goes to lick immediately even in the consulting room or while being moved in his carrier.

RE: SIT and diabetes in a cat

Anthony Todd — Mon, 08 May 2017 11:39:32 GMT

I thought of the spray but thought the ointment/cream would be easier to apply and wouldn't freak the cat out so near to the head [had a lovely sweet cat I couldn't spray!!]

RE: SIT and diabetes in a cat

Thomas Johnson — Mon, 08 May 2017 11:09:02 GMT

[quote user="Rebecca Marchewka"]The cat has a history of SIT on the side of his neck which we are unable to control with topical steroids. I am reluctant to give him systemic steroids / ciclosporin in case I tip him back into diabetes.[/quote]

Which topical steroids have you used? Have you tried Cortavance Spray?

RE: SIT and diabetes in a cat

Anthony Todd — Mon, 08 May 2017 10:35:56 GMT

I imagined it would beat least 5cm in diameter.... Topical steroid should do it, triamcinalone in a human prep unless it's rapidly getting worse.

The trick is to distract the cat with sellotape or electrical tape wrapped around a front foot roughly and loosely which you are probably doing. Distracts them long enough for the stuff to work or they forget.

Need to apply until the lesion is obviously gone or they start again, sudden relapse is worth a shot of Dex.

Sorry if this is teaching the obvious.

RE: SIT and diabetes in a cat

Rebecca Marchewka — Mon, 08 May 2017 09:51:07 GMT

Here is a picture, sorry it isn't great.

RE: SIT and diabetes in a cat

Rebecca Marchewka — Wed, 03 May 2017 09:36:21 GMT

I will try and get a picture today.

He is now off insulin and had a normal glucose curve yesterday.

RE: SIT and diabetes in a cat

Anthony Todd — Fri, 28 Apr 2017 19:11:52 GMT

99 times out of 10 they are self-perpetuating, independent of cause or diagnosis, but there are ways of breaking the cycle.

Love a picture, seen loads of these, have some tricks and tips.... [not steroids either]

RE: SIT and diabetes in a cat

Kate Richardson — Fri, 28 Apr 2017 18:32:55 GMT

I guess it depends on the cause of the SIT; try amitryptilline?

RE: SIT and diabetes in a cat

Rebecca Marchewka — Fri, 28 Apr 2017 18:21:37 GMT

Apologies, self inflicted trauma.

RE: SIT and diabetes in a cat

Martin Atkinson — Fri, 28 Apr 2017 17:58:02 GMT

You think you've got it tough? I have a diabetic cat with hypothyroidism due to I131 therapy for hyperthyroidism, CKD, DM, agromegaly, and autoimmune skin disease which the owner can't treat topically or with tablets so had Depomed injections (before the DM I hasten to add) but which I've stopped.

I'd say cyclosporin is a better bet for a cat with DM if if can tolerate it.

RE: SIT and diabetes in a cat

Emily Rainbow — Fri, 28 Apr 2017 17:16:59 GMT

What's SIT?