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Dr. Kara
Dr. Kara, Veterinarian
Category: Cat
Satisfied Customers: 15914
Experience:  Over 20 years of experience as a veterinarian.
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my cat appears to be very sensitive around his lower back and

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my cat appears to be very sensitive around his lower back and sides of his back (top Hinds) also sits on his side rather than his bottom, worried he may have some internal issues
Submitted: 2 years ago.
Category: Cat
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am very sorry to hear about Ramices's discomfort.
Has he always been like this or is this new?
Does he go outside unsupervised?
Flea allergy is a common allergen and it seems to affect the tailhead and back area most so it is definitely a possible cause for his symptoms. 
I'd use excellent flea protection every 3 weeks on all pets in your home to try and prevent bites and the allergic reaction that they cause. Both Advantage II and Frontline Plus work quite well at killing fleas and are less likely to create a skin reaction.
To treat his allergic reaction to the flea bites (or any allergy) I recommend antihistamines and omega-3 fatty acids. Some antihistamines to try are:
1) Benadryl at 2mg to 4mg per kilogram of body weight or 1/2 of a 25mg tablet per 4 to 8 kilogram cat 2 to 3 times daily. You can crush the pill up and hide it in something tasty like his canned cat food or you can give it directly. Make sure whatever you use is diphenhydramine only as the combination products with decongestants and acetaminophen are toxic to cats.
OR
2) Chlorpheniramine 4mg per cat once or twice daily.
The omega-3 fatty acids will work synergistically with the antihistamine to soothe his itch and as a bonus will improve his hair coat and skin condition in general. I like the products by Derm Caps or 3V. These come in pump form to put on the food or you can puncture the capsules and dribble it on his food.
 I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 20mg to 40mg of EPA per kilogram of body weight per day. For example a 4 to 8 kilogram cat could take 80mg to 160mg of EPA per day. Antihistamines and omega-3 fatty acids work synergistically. Be aware that antihistamines can cause drowsiness or hyperactivity which should resolve with continued use.
If he goes out unsupervised or likes to climb high in your home and could have had a fall then he could have sustained tailhead injury. This occurs when a cat falls and lands on his tailhead/back of the pelvis or the tail gets caught (by another animal or a car) and pulled hard enough that the caudal spinal cord is stretched. Sometimes the nerves are just stretched, but in some cases they break and when that happens the damage can be permanent. Cats may not show the full extent of their injury for several days as secondary inflammation and nerve death occur. Treatment is with steroids and rest.
Cats with kidney infections may run a fever, show signs of lower back pain and become lethargic. These are much less common in male cats, but it is possible.
Another possibility for his discomfort is a condition called hyperesthesia. Hyperesthesia is a poorly understood syndrome which is difficult to diagnose. These cats have pain and hypersensitivity to touch on their back and tails. They sometimes will bite at themselves because they are so uncomfortable. It is a poorly understood disease process with no definitive test for diagnosis and so other problems (such as spinal arthritis or infections or allergic reactions) should be ruled out first. We do know that stress does seem to make this disease process worse or flare more frequently. Sometimes mood altering drugs and steroids can be helpful.
Here are a couple links discussing hyperesthesia syndrome if you are interested: http://www.veterinarypartner.com/Content.plx?P=A&A=1998&S=4&SourceID=62
http://www.cathealth.com/hyperesthesia.htmI
Another condition which initially causes pain, but can later lead to urine and stool incontinence is lumbosacral stenosis. This is a narrowing of the bony canal that the spinal cord travels through, either due to weak ligaments holding the vertebrae in place or arthritis changes in the vertebrae. It is more common in dogs than cats but it can occur in cats. 
Has he has ever had radiographs of his spine?
Finally it is possible that he has a slipped intervertebral disc (the soft cushions between the vertebrae which allow spinal flexibility). When this happens pressure is placed on the spinal cord which is quite painful.
LS stenosis and a slipped disc can be diagnosed with regular radiographs sometimes but many times an MRI or myelogram (dye study of the spinal cord space) is needed.
If your fellow seems uncomfortable but is passing urine and stool normally and able to walk and jump normally I would start with trying to control allergies and if that doesn't work then he needs a thorough examination, as well as bloodwork to make sure internal organ function is normal, and a urinalysis with culture to look for a urinary tract infection, as well as radiographs of his pelvis/spine.
If that all looks normal referral to a neurologist for an MRI may give you the answers that you need.
Let me know if you have any further questions.
Dr. Kara, Veterinarian
Category: Cat
Satisfied Customers: 15914
Experience: Over 20 years of experience as a veterinarian.
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