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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 33267
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My cat started with a large scab under the chin and crumble

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My cat started with a large scab under the chin and crumble black bits as if flea dirt. I then up'd her advacat and noticed large nasty scabs at the bottom of her back which have now soread to her head and ears which look very painful, although she dosnt seem to be in any discomfort or pain from any of the scabs and is happy to be stroked or scratched still. I took her to my vets yesterday and he seem to have no idea what was wrong, which always seems to be the case. He gave me the option of a skin bioop or anti bioctics. We are in the process off packing and moving house which I think is causing her a bit of stress. Anyway I opted for the tablets but feel that I need a second opinion. The tablets are marbocyl p.
What do you think, ive been looking on line most of the night and it seems like acne with sencondery infection????? Would these tablets be strong enough? What should I do?
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry to hear of this with Baloo and regret the delay in responding to you. Your question came in late at night when few vets are available. You appear to be describing a severe miliary dermatitis - a papulocrustous eruption of the skin most often found secondary to allergic dermatitis. The most common of the allergic dermatitises in cats is a flea saliva allergy. The clue that a flea saliva allergy is the etiology is the presence of lesions "at the bottom of her back". Fleas should be incriminated whenever skin lesions appear caudal (toward the tail) to the edge of the rib cage.

Secondary skin infection may well occur but will usually clear when the allergic dermatitis is controlled and so systemic antibiotics aren't usually necessary. Instead, a long-lasting corticosteroid such as methylprednisolone can be injected into Baloo or oral prednisolone may be administered daily and then tapered down to the lowest effective dose. Upping her Advacat was prudent and spraying your premises with an over the counter premise spray which contains an insect growth regulator (IGR) is indicated. IGRs prevent flea eggs and larva from maturing into adult fleas and so break up the life cycle of the flea. Siphotrol is such a premise spray in the States and contains the IGR methoprene.

"Black bits" can be wet with water and if you see them turn into bloody spots you've identified the flea feces. The scab on Baloo's chin might have occurred secondary to Baloo scratching herself raw or perhaps a feline acne does exist concomitant with her allergic dermatitis. If feline acne is present, washing the area with a shampoo containing benzyol peroxide (which is available from her vet or over the counter) daily and continuing the marbofloxacin is prudent.

Biopsy isn't indicated unless the corticosteroids mentioned above aren't effective. We would be looking for autoimmune skin diseases such as the pemphigus complex or eosinophilic dermatitis which can be considered a more severe form of miliary dermatitis in this case.

Please respond with further questions or concerns if you wish.
Customer: replied 4 years ago.

Thank you for your answer.

What would you recommend my next move to be as my vet has given her marbocyl p as treatment.

I have lost all confidence in my vet as only last year lost a very young cat under his care.

He has told me that this skin problem could cause baloo's immune system to attack itself. Should I take her to another vet?

Will these tablets help her?

My other cat is completely fine and also uses advacat?

Do I wait this out?

Sorry for so many questions but am very scared of losing her.


You're quite welcome.

Your next move is to continue the marbofloxacin because it should address a secondary bacterial infection if present but find another vet with whom you'll be more comfortable and who should be able to recognize a miliary dermatitis/eosinophilic dermatitis without biopsying Baloo. A steroid, then, will be prescribed and I would expect a very nice improvement in Baloo's skin.

There appears to have been a miscommunication. The vet is alluding to autoimmune skin disorders such as the pemphigus complex as I mentioned above. In autoimmune diseases, our patient's immune system is attacking our patient's own body. Your description of Baloo's skin condition is consistent with autoimmune skin disease but this won't be found as commonly as miliary dermatitis which appears similarly. Biopsy to identify whether or not autoimmune disease is present isn't indicated unless conservative therapy (steroids) isn't effective.

Your other cat should remain well. Allergic dermatitis (or autoimmune disease) isn't contagious. Please continue our conversation if you wish.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a week for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.