Polydipsia and skin disease

RE: Polydipsia and skin disease

Clive Ansell — Sat, 01 Dec 2018 10:20:57 GMT

[quote user="Anthony Todd"]I wonder if Clive is allergic to something [maybe not fleas, but he might get a midge-bite etc??][/quote]

No. Chronic idiopathic urticaria is an autoimmune condition, which in my case was thought to have been triggered by and a cross reactivity to something that caused a severe GI infection about 8 weeks prior to showing signs. It is a diagnosis based on exclusion of all other differentials.

[quote user="Anthony Todd"]I assume Clive won't lick his C/S or antihistamine creams off[/quote]

That really depends on where they are applied.

RE: Polydipsia and skin disease

Anthony Todd — Thu, 29 Nov 2018 18:19:13 GMT

[quote user="Clive Ansell"]That said she will accept short term use to stop an animals excoriating itself. [/quote]

[Sigh] That's all I've ever, ever done; if it's not needed, don't give it!

A jab of short-acting should give you and the owner proof of effect then as little pred or other oral C/S once as necessary, only when necessary, as I've been saying from the start of vet-surgeon.org and before!!

After I have learned that the latest flea treatments, even oral, ingested by fleas, are very effective it may well be that oral pred may not be needed for long in each case.

I assume Clive won't lick his C/S or antihistamine creams off, which is why orals work better in animals and are unnecessary in humans.

I wonder if Clive is allergic to something [maybe not fleas, but he might get a midge-bite etc??]

PS Still the abhorrence of steroids though even though I know of animals on high doses for yonks [unnecessarily, of course] with no side-effects at all.....

RE: Polydipsia and skin disease

Clive Ansell — Thu, 29 Nov 2018 16:29:03 GMT

[quote user="Anthony Todd"]Just add some C/Ss until the irritation is relieved and check the urine for sugar, just in case, or I'll be pilloried and the cat will still be unhappy[/quote]

May not be needed once the fleas are removed and any secondary infection has been addressed? I would give a one off injection if the cat was pruritic though.

I work with a dermatology certificate holder occasionally, and she shouts (In the nicest way possible) at me if I use c/s . That said she will accept short term use to stop an animals excoriating itself.

In human dermatology c/s are a very last resort. I have been under the care of a consultant since 2008 with chronic idiopathic urticaria. Even in the early stages before diagnosis when it was really bad at times systemic c/s were out of the question pending a diagnosis. Different anti histamines were used, along with topical c/s creams as and when needed.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 23:02:22 GMT

[quote user="Clive Ansell"] I see nothing wrong in Linda's choice of flea control at all.[/quote]

Yes, fair dues; this latest evidence and argument makes me agree that I was wrong, and modern flea control with tablets may be the best now.

[Just add some C/Ss until the irritation is relieved and check the urine for sugar, just in case, or I'll be pilloried and the cat will still be unhappy]

RE: Polydipsia and skin disease

Clive Ansell — Tue, 27 Nov 2018 21:32:15 GMT

[quote user="Anthony Todd"]

Jeepers, I'll have to try again!

1. This cat has a flea saliva allergy.

2. It reacts when it is bitten by a single flea .

3. Comfortis is taken orally by the cat and the flea then dies when it takes in Comfortis.

4. Coincidentally with this intake of Comfortis the flea injects saliva thus continuing the allergic reaction by the cat.

5. This does not happen with a topical drop-on, as no saliva is injected.

6. Comfortis may well be better , as this paper shows, for non-allergic dogs or cats who do not have an allergic reaction to flea saliva.

[/quote]

I think the point is that Comfortis contains a fairly novel active ingredient that kills fleas so quickly, and is claimed to be so effective, that the route of drug delivery and its mode of action is not that important?

Given that 100% efficacy within 24 hours is claimed, a short acting c/s could be used in the interim to suppress the allergic reaction (Although ideally not in this case as DM was one of the primary differentials for his pu/pd), although the cat has been like for months to years, so what's the rush!?

"In a well-controlled laboratory study, COMFORTIS began to kill fleas 30 minutes after
administration and demonstrated 98% effectiveness within 4 hours. COMFORTIS kills
fleas before they can lay eggs. In a separate well-controlled laboratory study,
COMFORTIS demonstrated 100% effectiveness on the first day following treatment"

Are any of the spot-ons that effective at killing fleas, that there will be NO bites at all post application?? surely not. Lets not forget the importance of environmental control and other pets too.

Also, don't forget that this cat has possibly had fad over a time frame of years, rather than months or days so comparing the speed of Comfortis vs spot ons is no more than an academic consideration really. I see nothing wrong in Linda's choice of flea control at all.

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 21:29:10 GMT

I'll try this one more time. Spot ons don't instantly kill the fleas, so they will still bite the animal. Also a flea bites the cat within seconds of landing on it. Comfortis kills 98 to 100 per cent of fleas within hours.

Here's another paper showing higher efficacy of Comfortis versus another spot on.

https://www.sciencedirect.com/science/article/pii/S030440171200458X

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 21:03:11 GMT

[quote user="Robin Grimmer"]You're wrong as this paper shows. [/quote]

Jeepers, I'll have to try again!

1. This cat has a flea saliva allergy.

2. It reacts when it is bitten by a single flea .

3. Comfortis is taken orally by the cat and the flea then dies when it takes in Comfortis.

4. Coincidentally with this intake of Comfortis the flea injects saliva thus continuing the allergic reaction by the cat.

5. This does not happen with a topical drop-on, as no saliva is injected.

6. Comfortis may well be better , as this paper shows, for non-allergic dogs or cats who do not have an allergic reaction to flea saliva.

[Resisting sarcasm or aspersions but it's getting more difficult]

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 20:40:58 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]It's a tablet, so how do you think it works?[/quote]

Either turboing or, better, this time, making my entire point!

If a flea bites an allergic cat the cat absorbs the flea's injected saliva and gets it's allergic reaction.

Coincidentally the flea will ingest the insecticide in the cat's blood and eventually die, of course, but too late for the allergic cat.

Do I need to go on?

[same fate befell the last tablet flea treatment.....]

I have never seen a cat with such an allergic reaction that the skin on the top of it's head or the neck is so damaged, [or even damaged at all], that a drop-on cannot be applied, which is the obvious solution for this long-suffering cat.

[/quote]

You're wrong as this paper shows.

https://veterinaryrecord.bmj.com/content/170/4/99

Ok, it's dogs but it shows better efficacy of Comfortis than a spot on. Comfortis kills fleas very quickly before they are able to lay eggs.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 20:04:52 GMT

[quote user="Robin Grimmer"]It's a tablet, so how do you think it works?[/quote]

Either turboing or, better, this time, making my entire point!

If a flea bites an allergic cat the cat absorbs the flea's injected saliva and gets it's allergic reaction.

Coincidentally the flea will ingest the insecticide in the cat's blood and eventually die, of course, but too late for the allergic cat.

Do I need to go on?

[same fate befell the last tablet flea treatment.....]

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 19:47:57 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]

I give up. Yet again a thread is derailed by turbo posting.

[/quote]

Well, hardly, you have just avoided answering the vital question as, cleverly, so has the manufacturer!

Unchallenged rational argument is hardy "turbo posting", just an easy way of avoiding the obvious answer, and even the question..........

[/quote]

It's a tablet, so how do you think it works?

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 19:22:49 GMT

[quote user="Robin Grimmer"]

I give up. Yet again a thread is derailed by turbo posting.

[/quote]

Well, hardly, you have just avoided answering the vital question as, cleverly, so has the manufacturer!

Unchallenged rational argument is hardy "turbo posting", just an easy way of avoiding the obvious answer, and even the question..........

RE: Polydipsia and skin disease

Clive Ansell — Tue, 27 Nov 2018 19:11:59 GMT

Getting back to the original post, this is not one for the prednisolone king!

To me the priority would be to address the chronic flea problem and anaemia, and then investigate the pu/pd with bloods and urinalysis (wouldn't trust this value of water consumed from a client that cannot treat for fleas and "has done everything")

I wouldn't want to give a c/s on initial presentation here until I had excluded DM, although I would probably give a one off short acting one if the cat was very pruritic and excoriating itself (If not I would say c/s are c/i). He may also have a steroid hormone producing tumour of course??.

Then get booked in for castration and histology (testes are asymmetrical and cat is pu/pd with normal bloods, so abnormal, and would certainly advise that histology is justified to try and reach a diagnosis - owner could opt out if they wished, but I tend to advise what I consider best practice and work backwards from that)

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 19:02:17 GMT

I give up. Yet again a thread is derailed by turbo posting.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 18:53:40 GMT

[quote user="Robin Grimmer"]Thanks for that, but how does it work?[/quote]

Yup, read all I can but nowhere, that I can find, [also in NOAH] says how it gets into the flea, but implies that it is ingested which implies saliva being injected and therefore a possible allergic reaction but I'm happy to be corrected.

Maybe it is absorbed off the skin through the fleas exoskeleton??

As long as it does not involve a flea-bite!!

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 18:41:16 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]Comfortis is licensed for treatment and prevention of flea infestation and for flea allergic dermatitis.[/quote]

Thanks for that, but how does it work?

[/quote]

Mode of Action:
The primary target of action of COMFORTIS in insects is an activation of nicotinic
acetylcholine receptors (nAChRs). Spinosad does not interact with known binding sites
of other nicotinic or GABAergic insecticides such as neonicotinides, fiproles,
milbemycins, avermectins, and cyclodienes. Insects treated with spinosad show
involuntary muscle contractions and tremors resulting from activation of motor neurons.
Prolonged spinosad-induced hyperexcitation results in prostration, paralysis, and flea
death. The selective toxicity of spinosad between insects and vertebrates may be
conferred by the differential sensitivity of the insect versus vertebrate nAChRs.
Effectiveness:
In a well-controlled laboratory study, COMFORTIS began to kill fleas 30 minutes after
administration and demonstrated 98% effectiveness within 4 hours. COMFORTIS kills
fleas before they can lay eggs. In a separate well-controlled laboratory study,
COMFORTIS demonstrated 100% effectiveness on the first day following treatment and
>90% effectiveness on Day 30.
If a severe environmental infestation exists, fleas may persist for a period of time after
dose administration due to the emergence of adult fleas from pupae already in the
environment.
In a field study conducted in households with existing flea infestations, flea count
reductions of 97.5% were observed one month after the first treatment and 99.3% after
three monthly treatments with COMFORTIS. Cats with pre-existing signs of flea allergy
dermatitis showed improvement in erythema, papules, scaling, alopecia,
dermatitis/pyodermatitis, and pruritus as a direct result of eliminating the fleas.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 18:35:31 GMT

[quote user="Robin Grimmer"]Comfortis is licensed for treatment and prevention of flea infestation and for flea allergic dermatitis.[/quote]

Thanks for that, but how does it work?

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 18:24:10 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]Then maybe refrain from commenting on things you have no knowledge of?[/quote]

Or, alternatively , as the mode of action is obviously omitted, it just maybe that the active ingredient is ingested by the flea and this no good in allergic cats.

[/quote]

Comfortis is licensed for treatment and prevention of flea infestation and for flea allergic dermatitis.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 18:09:51 GMT

[quote user="Robin Grimmer"]Then maybe refrain from commenting on things you have no knowledge of?[/quote]

Or, alternatively , as the mode of action is obviously omitted, it just maybe that the active ingredient is ingested by the flea and this no good in allergic cats. Please tell me, I may have missed the mode of action.

[quote user="Robin Grimmer"]Also, you say the owners aren't flush - nowhere in the OP does it say that, so don't make assumptions.[/quote]

No flea control, no vet. attention made me guess, and anyway even if rich or poor the histology adds little apart from cost, as I said.

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 17:57:33 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]Assuming you know what Comfortis is[/quote]

No it's new for me, so no experience at all, but see below.

There was a tablet treatment for fleas ,BITD, which quickly died because, in allergic cats, the problem continued 'cos the cats still got the allergic reaction when the fleas injected their allergy producing saliva......

[Can't find any reference in the datasheet as to how Comfortis works. Can you help?]

[/quote]

Then maybe refrain from commenting on things you have no knowledge of?

Plenty of info on Comfortis it's not new - just Google it, I know you're capable of that.

Also, you say the owners aren't flush - nowhere in the OP does it say that, so don't make assumptions.

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 17:49:15 GMT

[quote user="Robin Grimmer"]Assuming you know what Comfortis is[/quote]

No it's new for me, so no experience at all, but see below.

[Can't find any reference in the datasheet as to how Comfortis works. Can you help?]

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 17:41:17 GMT

[quote user="Robin Grimmer"]Because they are asymmetrical, so maybe there's a testicular tumour?[/quote]

Fair enough, but pathology was pretty obvious from the size??

Better out then, but that's been done, what follows, apart from petrifying most owners by emphasising "cancer", and increasing cost with histology??

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 17:41:10 GMT

[quote user="Anthony Todd"]

[quote user="Linda Filshie"] (skin too sore looking for topicals) [/quote]

No chance of relieving his "sore looking" skin with some humane Csteroids I suppose...? Start with a shot of your favourite injectable shot-acting then pred as necessary.

Must be able to get a drop-on flea control on the top of his head surely?

[/quote]

Why would you want to use a spot on on a cat which has widespread skin disease affecting almost the whole cat? When it's already been treated with Comfortis? (Assuming you know what Comfortis is?)

RE: Polydipsia and skin disease

Robin Grimmer — Tue, 27 Nov 2018 17:36:06 GMT

[quote user="Anthony Todd"]

[quote user="Evelyn Barbour-Hill"]

I'm sure Linda is quite capable of looking after herself, but it's this sort of crap stuff that would put a newbie right off posting.

[/quote]

What, exactly, is this sort of "crap" stuff that would put a newbie off posting.

Use this thread as an example if you want?

Or start a "seniors only" tangent so that newbies are protected.....

[this'll upset the purists] Why do histo on retained testicles?

Will there be a fee for the histo, particularly in a client who's not too flush ??

[/quote]

Because they are asymmetrical, so maybe there's a testicular tumour?

And as testicular tumours can cause skin changes maybe it's worth looking for?

RE: Polydipsia and skin disease

Anthony Todd — Tue, 27 Nov 2018 17:32:32 GMT

[quote user="Evelyn Barbour-Hill"]

I'm sure Linda is quite capable of looking after herself, but it's this sort of crap stuff that would put a newbie right off posting.

[/quote]

What, exactly, is this sort of "crap" stuff that would put a newbie off posting.

Use this thread as an example if you want?

Or start a "seniors only" tangent so that newbies are protected.....

[this'll upset the purists] Why do histo on retained testicles?

Will there be a fee for the histo, particularly in a client who's not too flush ??

RE: Polydipsia and skin disease

Evelyn Barbour-Hill — Tue, 27 Nov 2018 16:26:04 GMT

I'm sure Linda is quite capable of looking after herself, but it's this sort of crap stuff that would put a newbie right off posting.