5 month old very itchy cat

RE: 5 month old very itchy cat

Aine Seavers — Thu, 23 Feb 2023 21:46:28 GMT

Its food until proven otherewise wit the caveat you address less likely zoonosis re parasites and fungal. That preauricular alopecia is a huge marker for food. Would love a restricted diet but unlikely if it roams-and give the involvement of the eyelids-that always puts beef to the top of the d/d of my food trigger list. Only 5mths old and its lifestyle not compatible with its disease control. Suggest rehoming. The crusts are really itchy-I get those cats in-sedate, shave, debride, clean up and apply a Cortavance spray with an emollient 20mins later or you could try a one off Elacon cream application to sites whilst cat can't lick it off. Can check for mites etc when under esp with sticky tape for demodex around the eyes, do deep and superficial as some demodex shows on lighter scrape. Would love to get an FIV/FELV bloods on it as well. Cerenia a good anti-itch meds for those cats-even for the orofacial pruritus syndrome-check teeth when under. A short course of gabapentin might keep the cat quieter and more home based but again sounds like the wrong owners for this cat.

RE: 5 month old very itchy cat

Richard Carter — Sat, 11 Feb 2023 09:08:53 GMT

If lesions basically between ears and eyes and around mouth I would probably be talking food and drug reaction. What they using for worm/ flea products? Something systemic? Are they applying any pet shop meds to lesions? Look slightly bilaterally symmetrical or is that just the picture?

Sometimes just coming off a pouch food or dry or vice versa is enough because the chemical could colouring or preservative?

otherwise as others already suggested- dex to see if pruritis responds ( allergic/ auto-immune) , ringworm common but not always the cause, teenager (?) other soil, environmental chemicals ( air freshener, super enthusiastic cleaning sprays)

my 2 p worth

RE: 5 month old very itchy cat

Kate Richardson — Fri, 10 Feb 2023 13:45:09 GMT

I'd prob go for 1mg/kg twice daily initially for anything up a week, and then reduce the dose to once daily, if minimal response to initial dose and no signs it is worse at all, I'd jump up to 1.5-2 mg/kg (or go for depomedrone at that stage if no worse and compliance possibly an issue)

RE: 5 month old very itchy cat

Neil Wheadon — Fri, 10 Feb 2023 13:39:42 GMT

OK cat in today

E-Swab, scrape, coat brush and hair pluck

Talked about histology, one step at a time especially as may come back as 'inflammatory'

What dose preds?

Neil

RE: 5 month old very itchy cat

Kate Richardson — Fri, 10 Feb 2023 11:07:45 GMT

Agree, (although the cost may be significant for some people!) but also depends if they can do 100% hypoallergenic ie cats that go out, hunt, multi cat house etc

RE: 5 month old very itchy cat

Sarah Wheadon — Fri, 10 Feb 2023 10:18:15 GMT

I researched one of these recently, and it seemed the most likely cause of severe facial/head pruritis in a young cat with good parasite control is food allergy. Using a hydrolysed diet (alongside steroid to reduce the intense pruritis) will not cost a lot.

RE: 5 month old very itchy cat

Kate Richardson — Thu, 09 Feb 2023 17:37:16 GMT

That's a good shout, so maybe stick with oral pred rather than depomedrone so you can at least stop it if things look worse. But agree, higher dose needed

RE: 5 month old very itchy cat

ian bates — Thu, 09 Feb 2023 10:23:37 GMT

I've seen cowpox look similar.....if so, preds could make it worse!!

RE: 5 month old very itchy cat

Rob Loxley — Thu, 09 Feb 2023 08:28:28 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/30579/5-month-old-very-itchy-cat/240794#240794"]the steroid dose is a bit low, but this is a kitten[/quote]

would a smaller animal need a higher mg/kg dose (converse of those big dos that need a lower mg/kg dose)?

RE: 5 month old very itchy cat

Delia Richter — Thu, 09 Feb 2023 08:06:37 GMT

Heya! So rule out parasitic things with your closer exam. I think parasites are unlikely if your patient is on bravecto, but it's worth checking. You do get those weird stickfast fleas. This doesn't strike me as ringworm - most ringworm isn't this itchy. Also you had a response to a steroid injection. I think this is probably the aptly named 'feline head and neck pruritus '. Which is really just a different manifestation of feline allergy/hypersensitivity, like miliary dermatitis or ventral abdomen alopecia.

I know he's young, but I would start with some decent strength steroids, 1-2 mg/kg prednisolone for example. I have had some cats need higher.

Once he's comfortable start a food trial,and try to wean down the steroids.

Hope that helps.

Cheers

Delia

RE: 5 month old very itchy cat

David Mills — Wed, 08 Feb 2023 19:58:59 GMT

Treat the symptoms, not the future. It’s young and may have just come into contact with something allergic. You won’t find the cause (or at least it’s unlikely with financial constraints) so give the cat and owners some relief in the meantime.

I don’t think for a second this is ringworm.

RE: 5 month old very itchy cat

Neil Wheadon — Wed, 08 Feb 2023 19:36:45 GMT

Thanks everyone

Type of confirming things that I was thinking about, but the increased detail is helpful

Yes the steroid dose is a bit low, but this is a kitten. My big fear with DMV is that it may reduce the clinical signs, but what's the future for this cat?

My main differential is food allergy, but these are so hard to talk to clients about, seemingly all just go out and buy another brand of food, thinking that will solve it and this cat goes out and about everywhere. In the consult he's all over the place, never still

Neil

RE: 5 month old very itchy cat

David Mills — Wed, 08 Feb 2023 19:32:27 GMT

Head and neck pruritus - could be

Ringworm should be easy to see under microscope or via rapid Phyte culture.

As Michael says steroid dose too low - most cats need 1mg/kg for this. Depo would be my go to for this.

RE: 5 month old very itchy cat

Clive Ansell — Wed, 08 Feb 2023 18:07:42 GMT

I think I would want to confirm or refute ringworm early on, could just treat for I suppose, but itrafungol is stupidly expensive so probably cost effective to run fungal cultures?

If money is short; DMV, antibiotics, Bravecto or Advocate - suck it and see

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/30579/5-month-old-very-itchy-cat"]Money is short on this and I have an owner that wants an answer[/quote]

If I had a pound for every time I have heard that, I would be a wealthy man.

If they want answers, or a definitive diagnosis, they have to be prepared to put their hands deep into their pockets and pay for it.

RE: 5 month old very itchy cat

Michael Woodhouse — Wed, 08 Feb 2023 12:13:25 GMT

How heavy is the kitten, because I think 1mg EOD a low dose.

If money an issue - depo and dunk for ringworm?

RE: 5 month old very itchy cat

Beats — Wed, 08 Feb 2023 12:01:45 GMT

Bravecto was a good shout: make sure hasn't "out-grown" the dose administered.

probably either too much steroid or not enough!

Allergies: more steroid needed (and diet trial)

Ringworm, herpesvirus, calicivirus, other viruses etc: stop the steroids (and treat the ringworm if present).

Biopsy may help.

Histopath prices are getting mad though. Woods lamp and cytology from under crusts may help you decide whether to give more steroids or not. if lots of eosinophils etc I would think allergy. You can check hair shafts for ringworm also and do a DTM culture plate (or fancier culture at lab); a PCR is also available, but that's maybe getting beyond what is helpful. If significant pyoderma then can treat with eg amoxibactin - pyoderma is meant to be a thing in cats, but I tend to find it resolves with resolution of the pruritus and rarely needs sepcific treatment - in a difficult case I happily would though. No harm in scraping and plucking for parasties, but unlikely to be rewarding after a bravecto. Also history: did the pruritus precede the skin lesions or the other way round.

RE: 5 month old very itchy cat

Alastair Welch — Wed, 08 Feb 2023 09:00:45 GMT

Ringworm?