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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 32755
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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my cat Tom is constantly washing himself to the point that

Customer Question

my cat Tom is constantly washing himself to the point that he has bald patches over his
body he has front line flea treatment once a month the house is sprayed for fleas every two months I have feliway plugs in every room my own vet gives him steroid injections
that dont help, I also have another cat that is also treated for fleas at the same time as Tom and she is alright, please help I love them to bits and I am at my wits end and also my bank balence as i am a pensioner
Submitted: 3 years ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
Pruritic (itchy) cats are suffering from an allergic dermatitis the great majority of the time. Allergies to flea saliva, environmentals such as pollens, molds, dust and dust mites, and foods should be considered. In rare instances the mange mite Demodex might be responsible. When an allergic dermatitis is suspected but the response to steroids is unsatisfactory, a food intolerance should be considered. Flea saliva allergy and atopy (allergies to environmental allergen) are steroid responsive. Food intolerance is poorly responsive to steroids.

Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Tom's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can appear at any age and even if our cats have eaten the same food for quite some time.

For completeness sake, we do have to consider a psychogenic (neurotic) overgrooming seen in our cats. We've come to realize, however, that psychogenic alopecia is too often overdiagnosed. Most of these cats are truly allergic cats. If we've ruled out allergies, we address psychogenic alopecia with psychotherapeutic drugs such as fluoxetine (Prozac) and paroxetine (Paxil).

Please respond with further questions or concerns if you wish.