Can you help with this difficult cat dermatology case?

RE: Can you help with this difficult cat dermatology case?

Marianne Thomas — Wed, 01 May 2024 17:57:02 GMT

How's he doing now? Just curious.

Atopica cat could be an option if steroids made it worse & dermatophytosis & demodex ruled out. If that did improve him I'd consider allergy testing. Man, I hate AB resistance

RE: Can you help with this difficult cat dermatology case?

janine redman — Wed, 17 Apr 2024 22:22:12 GMT

No problem biopsies even if infected . It helps confirm underlying pathology before high doses of immunosuppression

RE: Can you help with this difficult cat dermatology case?

Utlendigur — Wed, 17 Apr 2024 13:55:58 GMT

Has had 2x bravecto so demodex unlikely. Nothing on dermatophyte culture. Only 18mth so neoplasia unlikely. Must admit I don't fancy biopsying something with a raging skin infection. Been away from work for few days during which a colleague did an internal med consult with idexx. They advised steroids + apoquel for 3-4wks then reassess (plus owner is now managing to bathe the area), so that's currently the plan

RE: Can you help with this difficult cat dermatology case?

janine redman — Sat, 13 Apr 2024 08:19:02 GMT

In difficult cases I would go for biopsies to look at the underlying histopathology. Then probably either steroids or cyclosporin . Rule out dermatophytosis / Pemphigus / neoplasia / demodex etc . Look at underlying reaction and treat accordingly

RE: Can you help with this difficult cat dermatology case?

Kate Richardson — Fri, 12 Apr 2024 13:09:11 GMT

[quote userid="8991" url="~/f/clinical-questions/30931/can-you-help-with-this-difficult-cat-dermatology-case/244285#244285"]Sounds as if the cat hasn't had a good dose of steroids for long enough. My go to in almost every case is depo[/quote]

This would be my thoughts too. I've had cases where cat has been on decent doses of oral pred with no response, but then responded to depomedrone, so compliance is definitely something to consider.

RE: Difficult cat dermatology case.

Utlendigur — Wed, 10 Apr 2024 17:40:11 GMT

I did last visit - just masses of cocci, mainly neutrophils, very scant eosinophils

RE: Difficult cat dermatology case.

Utlendigur — Wed, 10 Apr 2024 17:39:28 GMT

Thanks. It's currently on doxycycline - may switch to TMPS as seems to be having little effect. I was hesitant about using flamazine because of the large size of the area/absorption. Will try the vaseline - thanks. Had held off steroids because he had been put on apoquel and then because I wasn't sure if skin biopsies might be needed (photos really don't show it well enough)

RE: Difficult cat dermatology case.

Noweia — Wed, 10 Apr 2024 17:38:46 GMT

Impression smear from the exudative areas when it is in would rule in/out eosinophilic lesion?

RE: Difficult cat dermatology case.

David Mills — Wed, 10 Apr 2024 15:57:36 GMT

For scabs and removing exudate vaseline or other petroleum products work well though they are messy around the house - normally need to be left on for 15-20 minutes or so then wiped off. Applying something topical afterwards can help e.g. flamazine.

Sounds as if the cat hasn't had a good dose of steroids for long enough. My go to in almost every case is depo as can give it and forget about it, 100pc compliance and sufficient coverage. Most common cat skin conditions will respond. Tmps I've found difficult to get cats to take so improving compliance (unless sure it's getting the tmps) with another abx may yield better results

RE: Difficult cat dermatology case.

Utlendigur — Wed, 10 Apr 2024 15:48:25 GMT

It started off round the neck where the owner had put on a flea collar. That was removed but the lesions continued to gradually spread over the rest of the body - not a sudden onset like a chemical reaction. The owner just bathed with cotton wool and water initially - no other skin treatments. Then we dispensed dilute iodine solution, later duoxo mousse. No other source of irritant in house. Photos were some time after bravecto, has since had next dose. Had convenia and dexafort initially when thought to be FAD + pyoderma. There was then a couple of months gap but he came back worse than ever. Photos don't show the extent of the exudate. Scabs on the lateral sides of HL are quite dry and starting to lift off but ventrally is just one sticky mess (which I think is part of the problem in that topical treatments just sit on top of exudate). Have restarted steroids - was holding off as hoping to refer but nothing earlier than late May. Planning on having him in every other day at the end of surgery to try to bathe here. If still no better was going to try TMPS and/or flamazine

RE: Difficult cat dermatology case.

Utlendigur — Wed, 10 Apr 2024 15:27:51 GMT

No to both on Idexx extended skin screen

RE: Difficult cat dermatology case.

Clive Ansell — Tue, 09 Apr 2024 19:06:47 GMT

I've come across people in the past that have used neat TCP, Dettol and Germolene in/on cats

Off on a tangent, but I once had a guy who applied a large (>40Kg) dog Bob Martin flea product divided between his 3 cats, even with large bold underlined capital letters saying "DO NOT APPLY TO CATS" . 3 seizuring cats, and I just remember him standing there and saying "But they will probably be alright though won't they?" A weekend at Vets-Now, a multiple £1000 bill, 2 survived and one died.

RE: Difficult cat dermatology case.

Richard Carter — Tue, 09 Apr 2024 18:55:45 GMT

Malicious or stupidity in the form of jeyes fluid apparently a well known flea treatment??

RE: Difficult cat dermatology case.

Richard Carter — Tue, 09 Apr 2024 12:51:01 GMT

So looking like this before or after the bravecto? Looks like a chemical reaction to me with opportunistic problems on top. Been bathed in savlon, (dog) flea shampoo, new carpet cleaner, air freshener, neighbours annoyed about entire Tom? Was a webinar on atopy recently where hydrating washes were discussed- not sure if suitable for cats? Anything toxic in E45? Or rub over with sunflower oil? Be a bit of mess but softening up the scale might make pusscat more comfortable? I would probably stop oral antibiotics if eating and drinking.

Bit old for genetic skin problems like the collagen/ elastic issues?

RE: Difficult cat dermatology case.

Anthony Dennison — Tue, 09 Apr 2024 09:52:20 GMT

Definitely no fungal elements noted on cytology or culture? I've seen a couple of cats like that with malasezzia and intrafungol made a big difference

RE: Difficult cat dermatology case.

Utlendigur — Mon, 08 Apr 2024 14:17:46 GMT

Thanks. As far as I can remember (only saw cat recently) he had bravecto at the start of treatment. I think he had a short course of steroid/dexafort injection initially and seemed to get worse - which may have been why apoquel was used - but will double check (I'm not at work). I'm aware of the contra-indications for osurnia and apoquel in cats.

RE: Difficult cat dermatology case.

Kate Richardson — Mon, 08 Apr 2024 12:46:54 GMT

Apply Bravecto and start corticosteroids.

As an aside, both Osurnia and Apoquel are contraindicated in cats, so I'd avoid these in the future

RE: Difficult cat dermatology case.

Michael Woodhouse — Sun, 07 Apr 2024 22:08:57 GMT

Has this cat had steroids?