Hi! My cat is 4 years old. She has problems with her skin, where it gets itchy very often. She scratches a lot and it causes her to have rough bumpy patches of skin and scabs. These usually appear on her neck, around her ears, and occasionally on her lower back.
My vet said it's some kind of dermatitis I believe? She has gone in many times over the years, two specific visits for this. All she recieved was a shot that was supposed to help, but only lasted 2 or 3 weeks and was very expensive.
What is causing this? What can I do to help?
Hi Lillianna,
I've spotted that Dr Wooten hasn't had a chance to reply so I thought I'd get in touch in case I can be of assistance. My name is Dr Joanna Woodnutt, I'm an experienced small animal veterinarian and I spent a couple of years working in feline-only practice.
What you're describing sounds like miliary dermatitis. This is an itchy rash that happens in cats, usually as a response to an allergen. In other words, this dermatitis is likely to be an allergic reaction. Poor kitty!
There are several things that could be causing these signs, but working out what it is may help you to avoid it.
1) Flea allergy.
Some cats are allergic to fleas, and miliary dermatitis is a classic flea bite hypersensitivity reaction. The cat doesn't actually have to have a lea infestation to have an allergic reaction - a single bite from a flea is enough to set them off because they're so sensitive. This is the most common type of allergy in cats, causing about a third of all skin problems in cats. And, because it's a single flea, you may not even see the usual signs of a flea problem. Getting all pets in the house on a veterinary-recommended flea prevention product for life is the first thing to do. Your local vet will be able to suggest the best treatment for your pets.
2) Food allergy
Food allergies are not common, but they are easy to manage. About 1-5% of cats with skin problems will have food allergies. Signs include a rash and many cats will have occasional stomach upset or loose stools. Beef, chicken, and fish are common allergies in cats. To diagnose a food allergy your vet will put your cat on a hypoallergenic diet trial for 8 weeks. If the symptoms improve, it's likely to be food - if they reoccur if given their old food again, it's definitely a food allergy. Whilst your cat can stay on a hypoallergenic food for life, you can also work out what they're allergic to by feeding proteins and observing the effects so that you can move them back onto a normal adult food at a later date. Please note that blood tests are not reliable tests for food allergies and should be avoided.
3) Feline atopy
Cats can be allergic to their environment just like people and dogs can. They may be allergic to weeds, grasses, trees, pollen, dust, and dander. This is called 'Non-flea, non-food hypersensitivity dermatitis', but is usually referred to as 'feline atopy' or 'allergic dermatitis'. Diagnosing this type of allergy requires flea allergy and food allergy to be ruled out, so you'll need to be patient. If flea treatment and an 8 week diet trial doesn't work, it's likely your cat has atopy. Blood tests or skin tests can be done which will help you to work out what your cat is allergic to, but it's worth understanding that your cat will always have this condition, and will need to be managed on a combination of allergen avoidance, vaccinations, and lifelong drugs.
I do hope that helps you decide on next steps. I wish it was an easy answer but I'm afraid allergies are difficult to diagnose and treat, especially in cats. If your vet doesn't enjoy dermatology, it might be worth looking for a referral to a veterinary dermatologist or a feline specialist, who will be able to guide you through the diagnosis and treatment more easily than a GP vet.
Dr Joanna Woodnutt MRCVS
Hi Lillianna! Thank you so much for submitting a question! I can see that Dr. Woodnutt did a good job of providing a complete answer that would have been a lot of the same things I would say. In addition, I can provide the following information:
The 'shot' your cat is getting is likely a steroid shot - probably depo medrol, which is a long lasting steroid and provides relief from allergies for several weeks. The upside to a steroid shot is that it stops the itching, temporarily. The downside is that it does not cure the itching or the allergy, and steroids have negative effects on the body, including increased eating, drinking, urinating, decreased immune response, and if a cat receives steroids shots frequently, can interfere with sugar metabolism. Not good.
It's good to NOT use steroid shots in cats if we can avoid it. Fortunately, there are several short-acting medications out there that can be used in cats for itching. Apoquel is the main one that comes to mind - it is not licensed for use in cats, but can be used 'off label' for allergies in cats.
The most common cause for miliary dermatitis in cats, which is what you are describing, is flea allergy. It just takes one flea to make a cat itchy, and you may not even seen any fleas. Flea allergy dermatitis is usually seasonal (unless it is warm year round where you live), where food allergy problems are year round. Seasonal allergies (atopy) is also seasonal.
To control fleas, talk to your vet. There are lots of good products out there, and you have to treat all pets in the household because any one of them can be harboring the blood suckers! Dr. Dryden is the leading expert on fleas (he is even called Dr. Flea!) and his website has a ton more information on how to keep fleas out of your house and off your pets: http://drmichaeldryden.com/fleas/.
Good luck, and let me know how it goes!!