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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 43532
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Our cat pulls out fur in lumps why, Kittie and being astray

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Our cat pulls out fur in lumps why
JA: I'll do all I can to help. Some lumps are serious and some aren't. Let's see what the Veterinarian has to say. What is the cat's name and age?
Customer: Kittie and being astray we are unsure of age but think it may be 10 yrs old
JA: Is there anything else important you think the Veterinarian should know about Kittie?
Customer: Our local vet has given her an injection of steroids 6 weeks or so back. We detected a possible small improvement. Could she be possibly disturbed from 2 / 3 years "on the loose"

Dr. Michael Salkin is typing. Please note that experts aren't allowed to prescribe prescription drugs in this venue.

To answer you directly, "perhaps", as we do see psychogenic alopecia in cats. I'll post my entire synopsis of the pruritic (itchy) cat for you. Please pay particular attention to the section concerning psychogenic alopecia. Please return to our conversation after you're perused it with additional questions or concerns.

Pruritic cats are suffering from allergic dermatitis in the great majority of cases. Allergies to flea saliva, environmental allergens (atopy) such as pollens, molds, dust and dust mites, and foods should be considered. In rare instances, the mange mite Demodex might be responsible.

Our dermatologists tell us to apply an over the counter flea spot-on such as Advantage or a fipronil-containing product such as Frontline or, preferably, one of the newer prescription products to which fleas are less likely to have become resistant to, available from Kittie's vet even if fleas aren't seen. Cats can be such effective groomers so as to eliminate all evidence of flea infestation. Indoor cats can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. Turning on the heater or As the weather warms at this time of year then hatches the eggs. Flea saliva allergy is usually most evident on the saddle area – the area between the edge of the rib cage and tail but that area can be affected by other types of allergy as well. In severe cases, a short course of an oral anti-allergenic prescription glucocorticoid (steroid) such as prednisolone will work wonders for cats allergic to the saliva of the flea. Your other pets may not be allergic to the saliva of the flea. Be sure to treat your premises with a product such as over the counter Siphotrol Area Treatment spray which contains the insect growth regulator (IGR) methoprene which doesn't allow flea eggs and larvae to develop into adult fleas thus breaking up the life cycle of the flea. Avoid inefficient foggers which can't reach under furniture or into cracks and crevices where flea eggs and larvae are found.

Atopy is usually addressed with prednisolone as well. In some cats, an over the counter antihistamine such as chlorpheniramine (Chlor-Trimeton) dosed at 2 mg/cat daily or diphenhydramine (Benadryl) dosed at 1-2 mg/lb twice daily may be effective. Cyclosporin - a chemotherapeutic agent - is another consideration particularly when a steroid is contraindicated by concurrent disease or unacceptable adverse effects. Please note that atopy is expected to be steroid-responsive; food intolerance not so much.

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 Kittie'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. There are many prescription novel protein diets and the prototypical hydrolyzed protein diet is Hill’s Prescription Diet z/d ultra (I prefer a hydrolyzed protein diet because it removes the possibility of my patient being intolerant to even a novel protein diet.). We usually see a positive response to these foods 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 been eating the same food for quite some time.

We used to diagnose these cats with psychogenic alopecia - a neurotic over-grooming - but have come to realize that most of these cats truly are allergic cats. Feline psychogenic alopecia is overdiagnosed but does exist. Excessive and out-of-context grooming is thought to be an obsessive-compulsive behavior that's triggered by environmental stresses and anxiety. The condition is uncommon in cats, with purebred cats that have high-strung nervous temperaments being possibly predisposed.
This type of alopecia may occur anywhere on the body where the cat can lick but it most commonly involves the medial forelegs, inner thighs, perineum, and ventral abdomen. Hair loss is often bilaterally symmetrical but remaining hairs don't epilate easily. The top differentials are flea allergy dermatitis, food allergy, dermatophytosis (fungal infection), other ectoparasites (mange) and atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites, etc.).
The underlying cause of the psychological stress (e.g., separation from owner, moved to a new house, animal companion died, new pet in the household, formerly outdoor cat denied access to outdoors) must be identified and appropriate environmental modifications made, if possible. A good flea control program should be instituted to prevent fleas from aggravating the symptoms. Use of a mechanical barrier (e.g. Elizabethan collar, T-shirt) for 1-2 months to prevent grooming may help break the habit. Behavior-modifying drugs may help stop abnormal grooming behavior. In some cases, treatment may be discontinued after 30-60 days of therapy; in others, lifelong therapy is required for control. Drugs that may be effective include the following: amitriptyline, clomipramine, buspirone, phenobarbital, diazepam, and naloxone.

Customer: replied 4 months ago.
Thanks for the details and various conditions. We can now discuss and obtain actions to monitor charges in conditions. Quite a complicated course of actions required. Best regards

You're quite welcome. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Dr. Michael Salkin and 2 other Vet Specialists are ready to help you

Thank you for your kind accept. I appreciate it.