In August 2019, we spotted a little white kitty in our pasture. Fortunately for him, he made the wise decision to be caught in our barn that same night, and his path to a better life began. Casper was scared and shy, so it wasn’t until we got him to the vet the next day that we realized the condition of this little guy:
Pets are often abandoned or given up due to skin issues as they can be quite tricky and expensive to address. This is probably why this lovely cat ended up homeless. IMPORTANT: the following is our particular experience, and the advice given for our cat, may not apply to yours.
We took him to our regular vet (Uncas Veterinary Clinic), where he was neutered, vaccinated, given antibiotics, and treated for parasites. Slowly many of his scabs began to heal, but his ears continued to be a bother to him, and his back still scabbed. We returned to the vet and he was put on different ear drops, and after a few different ear treatments, the ears were mostly better. Still, we were having issues with his back skin cracking, occasional acne, and his ears still seemed itchy – so we were referred to a Veterinarian specializing in Dermatology – and three months later, off went!
The vet already had Casper’s history and prior vet records, but even so, the appointment was a full 90 minutes long – so much to take in. It started with the basics: weight and heart rate, and then I was asked to rate his “Itch Score” .
- 10 – Extremely severe itching / almost continuous: itching does not stop whatever is happening, even in the consulting room. Has to be physically restrained from itching
- 8 – Severe itching / prolonged episodes: Itching might occur at night and also when eating, playing, exercising or being distracted
- 6- Moderate Itching / regular episodes: Itching might occur at night, but not when eating, playing, exercising, or being distracted.
- 4 – Mild Itching / a bit more frequent: would not itch when sleeping, eating, playing, exercising or being distracted.
- 2- Very Mild Itching / only occasional episodes: The (cat) is slightly itchier than before the skin problem started.
- 0 – Normal / not itching
I rated Casper as being a six at the time of his visit as his one ear was in a bit of a flare and he had been waking me up early to scratch him, but I hadn’t seen him stop eating or playing to scratch.
The vet then came in and inspected Casper: when she looked in his ears he let her know his ears were itchy by thumping his back foot, but she said his ears looked clean and polyp free (at which point she gave me an in depth explanation of what ear polyps are, and where they develop), although he had obvious scabbing in front of his ears. She noted he may have some very mild over grooming of his belly, but nowhere else. She also felt his deeply damaged back skin.
I am going to try to break down the key points I brought home from the appointment in hopes it may help others decide if their cat could benefit from a dermatologist!
THE GOAL: Our realistic goal for Casper is to completely stop his self mutilation and that his itch score will remain 5 or less. She said expecting a complete cure is unrealistic and that unfortunately, he will have a life of being a bit itchy. We go back March 13th for a 45 minute follow up.
1) Cat Acne: Casper sometimes gets little black heads on his chin, and they have developed into minor cysts in the past. Apparently there are only two research papers addressing cat acne, so it is not well understood, other than to know there is no known cause. The vet addressed the myth that plastic bowls are a cause – they aren’t (I haven’t found that to be the case either). Severe oozing cysts may need antibiotics (and he did have an antibiotic treatment for them in November). Treatment during a flare up: Benzoyl Peroxide (found in some shampoos). Preventative cleaning of the affected area is also not helpful or needed – basically it will come and go regardless of what you do nor do not do, and is only of concern if there is oozing. Casper’s acne is not related to his other issues.
2) Insect Bite Hypersensitivity: Casper’s nose scabs (and now scarring) is likely from a reaction to insect bites. He may need to be kept in away from mosquitos, and she recommended a monthly flea control (Advantage Multi) in the warm weather seasons. Apparently even though we don’t typically have flea infestations here, all it takes is the saliva from one flea to cause a reaction!
3) Cellulitis: Poor Casper appears to have itched his back so vigorously at some point in his young life, that he caused a deep enough wound leading to cellulitis and permanent scarring on the back of his neck/shoulders. He will never grow hair back completely, and the skin will remain thick and prone to cracking. The solution? Simply to moisturize! She recommended something simple like Vaseline massaged into his neck.
4) His Itching: his ear and body itchiness is most likely at least in part, a food allergy. We talked a bit about the foods containing only hydrolyzed proteins (proteins broken down so far the body cannot recognize them as allergens), but as well as the cost, she said that she doesn’t feel there has been enough research done into these diets for cats for that to be her first choice. Rather, she suggested a novel protein food trial for a minimum of 8 weeks.
The idea behind the novel protein food trial is to feed a protein that the cat would never before have been exposed to. This helps identify if food may be part of his allergy. In cats, 90% of food allergies are to: chicken, chicken egg, beef, dairy and fish. At the end of the food trial, if his symptoms have been eliminated, we may try reintroducing certain proteins to narrow down the allergen.
For our food trial, she recommended a prescription diet with Rabbit meat as the protein…at just under $70 per 3 kg! Good thing he is a very sweet cat… I will go into more details about his food trial separately.
5) His ears: Our regular vet had prescribed Casper Alum Acetate / Hydrocortisone ear drops to clear up the last of his ear scabbing. They then said we could use it as needed. What the dermatologist recommended however was different: she recommended a PULSE treatment. We are to treat his ears with the ear drops two days per week, and treat his pre-auricular region (skin in front of his ears) with over the counter Hydrocortisone cream two days per week. The idea of the PULSE treatment is that we will stop a flare BEFORE it happens, without over using hydrocortisone (which will damage the skin!).
6) Immunotherapy: Unfortunately allergy medication (such as similar to Benadryl) don’t remain effective for long term use in cats, so if the above treatments are not enough to keep Casper comfortable, then it likely indicates an environmental allergy. If this is the case he will need an environmental allergy test and begin allergy shots every 10 days. This type of treatment takes up to 12 months to be effective (usually results are seen at 6-10 months), and has a 60-75% success rate. Unlike people who get this type of treatment, cats typically need it for life.
7) Steroids: Systemic steroids (vs topical) can stop the body’s reaction to an allergen, unfortunately in cats, steroid use can result in the cat becoming diabetic either short or long term, so they aren’t the best first choice remedy. Short term use in the event Casper becomes significantly uncomfortable and begins to scratch uncontrollably may be needed. Remember, we don’t want self mutilation and further scarring.
Casper will be going back to the Dermatologist in two months to assess the success of the food trial and ear treatments: fingers and claws crossed it’s working!