WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Mon, 15 Jan 2024 17:07:21 GMT

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243395#243395"]Err... dermatology there are some good experts here[/quote]

Doh - my brain in reverse gear. Thanks!

Starting new thread now.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Neil Wheadon — Mon, 15 Jan 2024 10:49:35 GMT

Err... dermatology there are some good experts here

Davids turn

Young dog with seizure

Neil

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Mon, 15 Jan 2024 10:36:47 GMT

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243388#243388"]So..... the next one?[/quote]

Neil Wheadon, yes, lets!

Synopsis - was thinking whether this would be above my pay grade, or if I need to get someone else to do it (and then I am struggling to think who).

View of an expert - simpler for me to organise. But in this case, from which discipline??

As to our next WHAT WOULD YOU DO, these are the suggestions so far:

from Gillian Mostyn

Acute onset lameness in a hind limb where cruciate disease is suspected
Spontaneous chronic corneal epithelial defect (SCCED)
Cat over grooming ventral abdomen
First presentation of otitis externa
Chronic otitis externa (and likely media)
Sudden onset of seizures in a 4 month old puppy
oh... and obviously... PUPD in an older pet with no other symptoms...

and from David Mills

Acute onset vomiting
Acute onset diarrhoea
Young dog with seizure
Dog with a cough
Haemorrhagic gastroenteritis
Back pain
Young dog with forelimb lameness
Corneal ulceration
Conjunctivitis
Older cat with PUPD
Older cat with weight loss
Dog or cat with a heart murmur

Which would you all like to go with next?

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Neil Wheadon — Sun, 14 Jan 2024 20:39:58 GMT

So..... the next one?

Synopsis?

View of an expert?

Neil

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Mark Holmes — Thu, 04 Jan 2024 09:21:35 GMT

I’ve only just seen this thread. I would pretty much do the same however flea allergies and ONLY grooming the caudo-ventral abdomen has never made much sense to me. If there was no evidence of broken hairs or trauma elsewhere I would probably encourage urinalysis. Particularly if an older patient pressing without previous history.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Thu, 21 Dec 2023 09:00:44 GMT

[quote userid="8991" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243258#243258"]Someone's overgrooming their ventral abdomen...[/quote]

[quote userid="8991" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243258#243258"]I would go with both, with the understanding you would need broad categories as people may have slight different (but broadly similar) approaches.[/quote]

I suppose the main thought in my head is whether this is a job I can actually do (ie a non-vet summarising clinical opinion ... it may be better if a vet did it).

[quote userid="8991" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243258#243258"]Good start to this type of thread I'd say.[/quote]

Yeah, I think so.

[quote userid="8991" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243258#243258"]Merry Xmas etc[/quote]

And to you too.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

David Mills — Wed, 20 Dec 2023 19:12:09 GMT

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243218#243218"]Cor, blood out of a bleeding stone![/quote]

Someone's overgrooming their ventral abdomen...

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243218#243218"]Or should I just run them free range, so to speak (though I cant help feeling it would be useful to try and summarise the main points raised in each discussion?)[/quote]

I would go with both, with the understanding you would need broad categories as people may have slight different (but broadly similar) approaches.

Good start to this type of thread I'd say.

Merry Xmas etc

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Clive Ansell — Wed, 20 Dec 2023 09:13:53 GMT

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243228#243228"]In this case, scrapes would be great but you still need the time to look at it, and the 15 minute consult clock is ticking, especially when you have another 13 or so slots stacked up behind this one, as only so many hours in the morning.[/quote]

I would do so if I had the time without being pressured or rushed. If not, book as an admit for another time.

I rarely do skin scapes anyway only now really for unresponsive cases or second opinions. Tend to just treat and monitor response in the first instance

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Clive Ansell — Wed, 20 Dec 2023 09:11:05 GMT

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243218#243218"]

Anyone have any thoughts about my earlier post?

Arlo Guthrie said:
Two thoughts in my head for ways we could develop the current format ...

1. When the discussion has run its course, I create a post which summarises what people have posted (ie the majority recommendation and any others)

2. When the discussion has run its course, perhaps run a quick poll survey to see which is the majority course of action. This case may not be the best suited to that, as it looks reasonably clear cut! But others may be less so.

[/quote]

Do both

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Sat, 16 Dec 2023 07:41:02 GMT

Thanks Neil Wheadon - and agree completely about non-judgemental.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Neil Wheadon — Fri, 15 Dec 2023 10:26:11 GMT

I thought there was pretty broad agreement in the approach with a few interesting points. You probably won't get this in other cases.

To finish this off, I'd like to see a specialist answer the question of what they would do on first presentation, whilst acknowledging that your average practitioner may not have access to the equipement and back up that they would have. In this case, scrapes would be great but you still need the time to look at it, and the 15 minute consult clock is ticking, especially when you have another 13 or so slots stacked up behind this one, as only so many hours in the morning.

You could summerise it and that would be useful, but it would need to be in a non judgemental way

Neil

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Wed, 13 Dec 2023 19:31:26 GMT

Cor, blood out of a bleeding stone!

Anyone have any thoughts about my earlier post?

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243189#243189"]

Two thoughts in my head for ways we could develop the current format ...

1. When the discussion has run its course, I create a post which summarises what people have posted (ie the majority recommendation and any others)

2. When the discussion has run its course, perhaps run a quick poll survey to see which is the majority course of action. This case may not be the best suited to that, as it looks reasonably clear cut! But others may be less so.

[/quote]

Or should I just run them free range, so to speak (though I cant help feeling it would be useful to try and summarise the main points raised in each discussion?)

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Clive Ansell — Tue, 12 Dec 2023 08:37:00 GMT

[quote userid="19228" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243206#243206"]plus once it goes over the 60 pound mark a significant part of the 15 min has to go towards cost discussion .[/quote]

Where I am standard first and repeat consultations are £62

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

cairncross — Tue, 12 Dec 2023 06:25:34 GMT

This is what we are doing in our 15 min consults , whilst probably being distracted . We are processing all of this and more , even for these "simple " cases . Making multiple decisions under very limiting circumstances.plus once it goes over the 60 pound mark a significant part of the 15 min has to go towards cost discussion .

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Anthony Dennison — Mon, 11 Dec 2023 12:11:13 GMT

[quote userid="2457" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243169#243169"]

First presentation : If no abnormalities found on clinical exam other than the skin issues, then treat for fleas with bravecto and give a corticosteroid injection - dexafort if problem fairly mild or depomed V if extensive or the skin is damaged/ulcerated.

Cost - approx £120 at my current practice

I would also suggest that if the overgrooming doesn't stop within a couple of days, or if it recurs quickly, then may need to look for other causes such as pain or behavioural issues.

[/quote]

This - if its pruritic or pain, steroids should help.

Multicat households I would advise Pet Remedy (just works better than Feliway IMO)

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Clive Ansell — Mon, 11 Dec 2023 09:52:26 GMT

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243189#243189"]

Clive Ansell said:
Where I am currently working, folk simply don't have the money for anything more. We treat the obvious and the most likely and revisit if not better. Diagnosis is often a stepwise process to minimise costs.

Clive Ansell Was reading this and asking myself why you say this stepwise approach is for people who don't have money! Isn't it the right approach for most people who have loadsamoney too??

[/quote]

Maybe I could have worded it better.

The point I was trying to make was that the clients I see, mostly, have no choice but to keep things to a minimum, because of financial constraints.

Where people are more affluent, there are more options and choices; with the overgrooming cat we could 1) just treat or 2) start investigating at a cost of £x-y-z.

[quote userid="2100" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243189#243189"]Isn't it the right approach for most people who have loadsamoney too??[/quote]

In most cases, yes.

My default approach is almost always keep it simple and move along step by step.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Mon, 11 Dec 2023 09:36:22 GMT

[quote userid="2161" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243158#243158"]Great thread![/quote]

Rachel Perry - I was just thinking the same .... this might be the first time in many years when an idea I've had for a discussion format actually seems to have some legs! And don't worry about the thing of first presentation or not - this format came about because I think there is a need for a greater focus on value at a time when there are so many inflationary pressures on veterinary care, but as this thread evolved, it became clear to me that it also serves another potentially very useful purpose, which is brainstorming - so all thoughts very useful and welcome.

My thoughts now are how we develop this format.

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243157#243157"]Would these be more interesting if people couldn’t read the previous responses? Maybe 5 days to respond then reveal the responses. No idea if technically it’s possible?[/quote]

Or perhaps, for the first week, that you cant see previous responses until you've posted your own? But no, neither is technically possible right at this moment, though all things are ultimately possible.

Two thoughts in my head for ways we could develop the current format ...

1. When the discussion has run its course, I create a post which summarises what people have posted (ie the majority recommendation and any others)

[quote userid="5012" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243162#243162"]Where I am currently working, folk simply don't have the money for anything more. We treat the obvious and the most likely and revisit if not better. Diagnosis is often a stepwise process to minimise costs.[/quote]

Clive Ansell Was reading this and asking myself why you say this stepwise approach is for people who don't have money! Isn't it the right approach for most people who have loadsamoney too??

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Kate Richardson — Sun, 10 Dec 2023 21:14:31 GMT

Another vote for effective flea treatment and corticosteroids, investigate if no response or recurs. Although if just ventral abdo, FAD less likely, more likely other allergens. If head and neck only involved in a young cat (<2yo) advise hypoallergenic diet early on. Not really convinced by stress/pain overgrooming although would never rule it out completely but 99.9% are allergies until proven otherwise.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

David Mills — Sun, 10 Dec 2023 20:15:55 GMT

Pretty much what everyone else has suggested.

Treat for fleas in the consult including any other pets in the house. Advise enironmental control, though with the ones that last for 3 months this is less important these days if money is tight.

Depomed will give a few weeks relief whilst the flea cycle spins around.

Steroids will also deal with other sources of inflammatory pain to an extent so may deal with other underlying causes, but as said most (99%) of these have an allergic complaint or aspect. Interestingly steroids seem to help with 'behavioural' ones too (either by breaking the cycle or chilling the cat out I suspect).

Cost price for drugs approx £10, bravecto £10, so in private practice around £100-140 charge to client would be expected in the SE.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Rachel Perry — Sat, 09 Dec 2023 16:26:14 GMT

Thanks Beats, I got all excited about the thread and forgot it was about first presentation. My bad for creating a tangent. I remained skeptical about this cat, but it did create a curiosity and open-mindedness about possible behavioural presentations of pain in cats.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Gillian Mostyn — Sat, 09 Dec 2023 15:00:45 GMT

Cost - approx £120 at my current practice

I would also suggest that if the overgrooming doesn't stop within a couple of days, or if it recurs quickly, then may need to look for other causes such as pain or behavioural issues.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Martin Hamilton — Sat, 09 Dec 2023 14:28:58 GMT

[quote userid="5012" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243167#243167"]Does anyone still do skin scrapes?[/quote]

I have a friend who's in a dermatology residency here in Cananda.....even in referral, they're not often done any more as the isoxazolines are so effective at eliminating ectoparasites

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Clive Ansell — Sat, 09 Dec 2023 13:37:09 GMT

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243165#243165"]

Stephen Maxwell said:
119. Bald Belly Cats The Derm Vet Podcast Apple https://podcasts.apple.com › podcast

Good listen, thankyou

The lady mentioned that psychogenic causes were very very rare

She also mentioned that Urinary and GIT pain can play a part

Neil

[/quote]

I listened too, very useful, thank you.

It still remains the case though, that common things are common, and in keeping with the OP I would probably not be looking or investigating for these at the first appointment.

The cornerstone of all this is, of course, the history and clinical examination?

Pruritic vs non pruritic?

History or any signs of urinary tract issues, or arthritic pain?

I would be very unlikley to recommend skin scrapes or allergy testing early on. Does anyone still do skin scrapes? I haven't done one in ages; good to get a positive diagnosis, but not 100% reliable, and tend to treat anyway if they are negative.

[quote userid="8958" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243165#243165"]The lady mentioned that psychogenic causes were very very rare[/quote]

I've got on of these cases on the go at the moment.

First appointment; Pedigree cat, multi cat household, this cat but not all of the cats indoor only, this one neutered but many entire females in the household, history of behavioural issues/aggression towards the owner and other cats, history of urinary tract and gut issues too.

Suspicion of fleas, only previously treated with OTC products, so treated with Bravecto initially, but made little or no difference.

At least 4 previous vets, and spent £1000's on investigations including allergy testing, gut biopsies, endless blood tests often the same ones repeated, to get nowhere not very fast.

Doing very well on Clomicalm at the moment.

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Neil Wheadon — Sat, 09 Dec 2023 12:20:26 GMT

[quote userid="29537" url="~/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen/243163#243163"]119. Bald Belly Cats The Derm Vet Podcast Apple https://podcasts.apple.com › podcast[/quote]

Good listen, thankyou

The lady mentioned that psychogenic causes were very very rare

She also mentioned that Urinary and GIT pain can play a part

Neil

RE: WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Catherine Spence — Sat, 09 Dec 2023 09:33:27 GMT

I go much the same route as Beats, except my stage 3 might involve a choice between skin scrapes and allergy testing, or a credelio tablet just in case a flea had miraculously got on to their cat.