Casper had his follow up appointment at the vet dermatologist today! Dr. Cox first saw Casper a little over two months previously (picture far left) for his itchy skin, sores on his left ear and back, and over grooming. Although he had improved greatly since we first found him, we wanted to get ahead of the issue over the winter, assuming it will get worse in the summer with additional potential allergens. Read More Here about his first appointment, and about his food trial.
Casper has continued to make some definite improvements: his back is no longer scabby and his skin is softer. He has also stopped over grooming his belly and legs. His left ear is still a problem though. As you can see from the above pictures, it gets better for a while, but then flares up again, although not as bad as before.
Dr. Cox had recommended treating his ear with Burrows solution every weekend (pulse treatment), and this was helping at first, but Casper HATED the ear drops and would run and hide when he saw or smelled the bottle. During out appointment, when she tried to look at his ears, he was hyper sensitive about the left ear. Because of this, she feels the treatment might be making him worry about the ear, and may be contributing to his continuing to bother the area. She recommended stopping the ear drops, and instead using 1% Hydrocortisone twice daily on the surface below the ear where he is scratching for 5-7 days. (Using hydrocortisone on the actual ear is ill advised as it can weaken the thin ear tissue.)
The other recommendation she had made during our first appointment was a food trial: putting him on a protein source that he likely would not have eaten previously (rabbit). Observationally he did improve somewhat during the trial, but symptoms didn’t resolve 100%, and their re-occurrence seemed to coincide with him going outside. As the food trial with six house cats was quite expensive, the decision was made to re-introduce him to food with chicken as the meat protein. Fingers crossed he doesn’t get worse!
It seems likely that Casper does have environmental allergies, but we have chosen to wait until symptoms present themselves to do allergy testing (blood work). It’s difficult as we don’t have a history on the little abandoned guy to be able to better narrow down their initial presentation or cause. It is entirely possible his back scarring is from an injury rather than allergies.
Fun Fact: areas originally affected by allergies/irritations will continue to be the first areas to present with new symptoms. The area of irritation doesn’t always indicated that that area was in direct contact with the allergen.
As well as watching for new symptoms to present, Dr. Cox also recommended that our pink skinned kitty should either be kept out of the sun, or that we should use titanium dioxide sunscreen on his ears and nose as pink skinned cats can get skin cancer from sun exposure. She also noticed a brown dot on his nose that we need to watch as it could be an emerging hemangioma (a benign tumor of blood vessels that can be irritated by UV light.)
Additionally, she recommended treating monthly for fleas in the warmer months (Advantage Multi).
Overall, I am happy that we took Casper to a specialist for his skin issues. He is a much more comfortable kitty, and I feel better equipped to prevent issues and/or address them should they arise this summer. If you think your furry friend could benefit from the expertise of a dermatologist, please discuss this option with your vet!