Haircoat Problems in Cats


Haircoat Problems in Cats

Vitiligo or possibly periocular leukotrichia

Question: Dr Richards Our siamese cat Jamie, 5 years old, chocolate point, recently started to become less "chocolate" around the nose, and paws. There are many white hairs growing, between the dark ones of the snout and paws. It looks like him becoming very much older than he is. I thought the dark color of the points was due to the lower temperature of the skin, so may be the decoloration is because of warmer temperature. But it is not warm here (The Netherlands, in Europe, in winter). Furthermore he hasn't got fever. My local vet doesn't know the answer. Do you? Evert

Answer: Evert-

Siamese cats get two conditions that might explain what you are seeing.

One of these conditions is vitiligo. This is a loss of pigment that usually affects the facial area and the feet. This condition has only been reported in female Siamese cats according to "Muller and Kirk's Small Animal Dermatology, 6th ed." by Scott, Miller and Griffin and would have to be considered rare, since only a few cases have been reported. The small number of reported cases also makes it likely that the condition could occur in males and just hasn't been proven to have occurred in one, yet. From your description, this seems possible. As far as I know, there is no harm in having vitiligo.

The other condition, which is seen more commonly, is referred to as periocular leukotrichia. As the name implies (periocular = around the eyes), this condition normally affects the face. It sort of looks like the cat has goggles on or has a reverse pattern compared to a raccoon (lighter around the eyes instead of darker). This condition occurs in both sexes and at varying ages. I have not seen a reference to it affecting the feet. This condition may be associated with Horner's syndrome (constriction of one pupil, prominent third eyelid) and sometimes with frequent upper respiratory infections.

We see white areas in the dark pigment of Siamese cats who have many fight wounds or other traumatic injuries that cause scarring. For some reason the hair growth around old scars is often white, even in some Siamese cats, who would ordinarily have darker pigment to the haircoat around a wound or other area that had poor circulation (cool skin areas are darkly pigmented in Siamese cats).

These are the things that I can think of or find in the literature that cause pigmentary changes in which portions of the haircoat are gray or white. Older cats often get gray hair just like older humans but Jamie is a little young to expect gray hair.

Mike Richards, DVM 2/17/2001

Contradiction on cat flea information and Hairloss?

Question: Hello,

this is an information error, but Dr. Mike contradicts himself in two of the answers about cat hair loss. i was on the site looking because my sister's cat loses hair when she is out of town for a long time and now (she was out of town recently for 10 days) has what appears to be excessive scabbing that seems to be getting worse.

In one answer under the heading Excessive shedding he states,

"I know that it is hard to believe that fleas can be present when they are not seen but veterinary dermatologists report that most cats with flea allergy will not have fleas present on their body at the time of examination. It is necessary to consider this possibility strongly."

in the answer to the question directly below, under the heading Losing clumps of fur, he states,

"Most flea and tick shampoos do not help with hairloss unless the hairloss is caused by fleas which you should be able to see."

you can see how he contradicts himself, please pass this on to him as i would hate for people to be confused about the care of their cats.

Thanks, Scott

Answer: Scott-

Flea shampoos only work to kill fleas that are present on the cat's body at the time of the flea shampooing. So if you can see fleas, they are will work to kill them. If there are no fleas visible it does not mean that fleas are not the problem but it does mean that some other method of flea control is better -- and in truth, with the availability of the new flea medications such as imidocloprid (Advantage Rx) and fipronil (Frontline Spray, Frontline Topspot Rx) which work very well, it is better to use these than to use shampoos.

I have a few clients who refuse to use the newer flea products even though their pets have clear signs of possible flea allergy. I truly think that most of these people pay me more to treat unnecessary skin disease than they would pay to eliminate the fleas.

Thanks for your note, it will give us a chance to further clarify this situation on the site.

Mike Richards, DVM 1/23/2001

Hairloss and Amitriptylline

Question: Dear Dr. Mike, I've written to you a couple of times regarding Lucy, my 4.5 year old, spayed cat. She has been losing hair slowly for about 6 months, and it keeps getting worse. I brought her to my vet (again) and he did a complete blood testing which came back normal. We ruled out mites, fleas, food allergies, and probably airborn allergies. I say probably because the seasons have changed and there has been no change, or if anything, her bald spots have become worse. My vet has come to the conclusion that her hair loss is probably due to stress from playing with my other cat, as the hair shafts are broken. He is a 2 yr. old altered male, very playful, but not aggressive, to the best of my knowledge. I've been reading behavior books and neither of them put their ears flat or get puffy tails or use their claws. They bite each other, but don't draw blood. My male is usually the aggressor, but they usually nap together and eat together, so I've been assuming they like each other. My vet has recommended 2.5 mg of amitriptylline each a.m. She's usually O.K. taking pills, but I'm having ALOT of trouble getting her to take them. My real concern is that she has lost interest in everything. All she does is sleep. And her "brother" has been walking around the house meowing at her, I think to get her to get up and play. I've only had her on medication for 5 days, but I'm really worried. Is the dosage correct? Is there an alternative which may have less side effects? I asked my vet and he told me to wait at least 10 days. If something else would cause less side effects I'd rather use it, or maybe just resign myself to a bald cat...... Thanks so much for being such a wealth of information...I wish I lived in VA! Sandi

Answer: Sandi-

Amitriptyline in usually dosed at 5 to 10mg per cat, once or twice a day. So 2.5mg once a day is actually a pretty low dose. We use this medication several times a year for cats in our practice and have found that it is very hard to administer these pills, making us think tha the taste must be pretty bad. We have had some luck having a local compounding pharmacy make gels out of the tablets with strong flavors like anchovy. Some of our clients also purchase small empty gelatin capsules and put the pills in them so that cats don't get hit with the flavor right away. We have had two or three clients whose cats reacted about like yours and all of them gave up on the medication after a couple of weeks, which seemed perfectly reasonable to us. Many cats have very little discernible effect but most get a little sleepy. We use this medication mostly for cats with urinary tract problems and we recommend giving it at night before bed time. Most cats get a little sleepy but it doesn't matter at that time of night.

I am not sure how food allergy was ruled out. This is usually done by feeding a diet that has a protein source the patient has never been exposed to, such as rabbit, venison or using one of the new hydrolyzed diets (Hill's z/d (tm) is the only one I know of for cats). The diet is fed for six to eight weeks and if there is improvement in the skin condition, then the most likely diagnosis is food allergies. If return to the normal diet induces problems and they clear up with change in diet again, the pretty much confirms food allergy. If you have not tried a food trial it might be worth doing that, although you would probably have to feed both cats the trial diet in order to see if it works.

If there is not an adequate response to amitriptyline, or if the side effects of amitriptyline are too severe to tolerate, it might be worth doing a skin biopsy just to make sure there isn't something like demodectic mange or a disorder that can be diagnosed by a pathologist.

You may find that buspirone (Buspar Rx) works as well as amitriptyline, if this is a problem in which Lucy is just nervous because of conflicts with your male cat. Some cats who seem to have hair loss from behavioral causes (psychogenic alopecia) will also respond to fluoxetine (Prozac Rx) or clomipramine (Clomicalm Rx) according to case reports I have seen but we have not tried these medications so I have no personal experience with this. Megestrol acetate (Ovaban Rx) works in many situations when other medications will not but it has very high potential for serious side effects, such as the induction of diabetes and mammary tumors. So it has to be looked at as a last resort and we use it very reluctantly.

I hope that things are improving some at this point. If so, there is a good chance that you will eventually be able to wean Lucy off the medications. We usually try to do this about sixty days after there is obvious improvement and we take some time to taper the patient off the medication to try to prevent quick relapses. Your vet may have a different approach based on his experiences and it is best to follow his advice if that is the case.

Mike Richards, DVM 1/24/2001

Bald spots on cats

Question: I've just begun to subscribe to VetInfo, and I've decided to ask a question. I have a four year old indoor cat and I noticed a bald spot on her left hind leg about two months ago. It's not red, or swollen, or sensitive. It doesn't seem to bother her, but it's not going away. My vet checked it for mites and the test came back negative. Should I be concerned, and what could it be?

Thanks, Sandi

Answer: Sandi-

It can be pretty hard to figure out why a bald spot like this occurs and then stays around, in a cat.

It was a good idea to check for mites and if the spot continues to be present, it might be a good idea to check this again. It is also reasonable to test for ringworm in this circumstance since that would be another cause of isolated spots of hair loss and can be contagious to humans. After these tests, it gets harder to figure out how much to worry over a small area of hairloss that isn't itchy and doesn't seem to be changing much.

These spots can be due to self trauma, although the most common inciting factor for this would be itchiness. A few cats appear to develop these due to obsessive-compulsive behavior, a situation sometimes referred to as "psychogenic alopecia". To determine if self-trauma is occurring some vets use an Elizabethan collar to prevent self damage. This doesn't give a clear idea of why the problem is occurring but it can rule out hairloss that is occurring without the cat's help. If that doesn't help, skin biopsies can be helpful in determining the cause of skin problems in many cases.

I do not pursue a diagnosis in every case of a small spot of hairloss but I do think it is probably best to rule out mites and ringworm, since the first is likely to spread to other areas and the second might spread to other family members.

Mike Richards, DVM 9/15/2000

Hairloss on hocks and elbows

Question: Hi. I wrote to you a couple of weeks ago regarding my cat's bald spot on her leg. She now has two small one's on her two back elbows (is that her hock?) as well and the one on the side of her left back elbow is slightly larger. They're not discolored or sensitive and her behavior and eating habits are normal. I guess my question is, when should this become alarming enough to warrant a trip to the vet? I'm hesitant in taking her as she becomes very stressed out there and sometimes the visit does more harm, in the form of diarrea and stressed behavior.

Also, it has been brought to my attention that this may be allergy related. She just went through an allergy that manifested brown ear wax (which she normally doesn't produce). This allergic reaction just ended (with no treatment) about 1 1/2 months ago. My vet deduced it was an allergy because he did not find any other cause. Could it have been something else which has hair loss as another symptom? Is there something which displays these two symptoms? Thanks for your time, Sandi

Answer: Sandi-

The hocks are the joints that look like elbows on the rear legs. It can be hard to figure out how seriously to take hair loss on the elbows and hocks. This can occur due to pressure from laying on a hard surface a lot which does not usually require treatment. This can also be a sign of serious problems, though. This kind of hair loss sometimes occurs with the hormonal diseases in cats, such as diabetes and hyperadrenocorticism (fairly unusual in cats). It is also a common sign of atopy (inhalant allergies) and food allergy in cats. If there is only hair loss and if your cat shows no other sign of problems, such as drinking more, urinating more, lethargy, loss or increase in appetite or other worrisome symptoms it is probably reasonable to wait until your next vet visit for other reasons.

We believe that there is a correlation between chronic herpes virus infection and accumulation of ear wax in cats, but it is an observation based solely on our practice experience and comments from observant cat owners. We do not see hair loss associated with this. Cats with a tendency to develop upper respiratory symptoms, conjunctivitis ( redness or mucous exudate in eyes) or other eye problems often seem to have ear problems, too. This would also be a possible complication of allergies and that might explain both problems.

Mike Richards, DVM 10/1/2000

Hair loss in cats

Question: Hello Dr. Richards, We suspect that my cat has psychogenic alopecia and the vet wants him to wear a blue cone for a couple of weeks. She ruled out eosinophilic granuloma complex and said that if this doesn't help, she will do a biopsy to check for endocrine problems. Larry, my cat, is 12 and has always been skittish. Last year his lifelong companion and brother died, and slowly Larry has lost some of his skittishness, but is still scared of our children. When school stopped for the summer and the kids were home constantly, Larry began losing his fur. The cone made him upset and he worked it off within a couple of hours. He could also have a flea allergy -- after 12 years of being exposed to fleas seasonally it would be odd to develop like this. I read in one of your answers that antihistamines do help the alopecia. I assume they would help an allergy. Is this something I should suggest to the vet before she does a biopsy for endocrine problems? And what would she be looking for in the endocrine system? Thank you, Lauri

Answer: Lauri-

It sounds to me like your vet has a good starting plan, to me, except that I hate Elizabethean collars and try not to use them. They just bother too many pets. This is a very good way to discover if the hair loss is self inflicted, though. This is helpful information but does not give a definite answer as to the cause of the problem. It is a reasonable starting point, though.

There are a number of possible causes of alopecia in cats but most of them do show up earlier in life. Despite this, it probably makes sense to think about all of them and then try to figure out which ones are unlikely and which ones might possibly be present.

The first question that is usually asked is whether the cat is itchy, or not. It can be very difficult to tell if itching is present but most of the time, if there is chewing or licking on the fur it is better to assume that it is.

If itchiness is not present, the most likely diagnoses are a systemic problem leading to hair loss, endocrine disorders, bacterial skin infections, ringworm and immune system disorders.

In cats, there are some reports of sex hormone related hair loss, hyperadrenocorticism can occur and some vets believe that there are cases of hypothyroidism in older cats, although this is pretty difficult to be sure of since it is usually based on response to thyroid hormone supplementation rather than changes in thyroid hormone levels on lab tests.

If itchiness is present, the most likely diagnoses are skin parasites, bacterial skin infections, ringworm, (I know that some things show up in both lists), skin cancers, and immune system disorders.

It is important to have some information as just a general database to start from when hair loss occurs in older cats. A general blood chemistry panel and complete blood cell count should be done, to try to rule out systemic illness such as liver disease contributing to skin disease. A feline leukemia test should be done, even if this has been done previously, since this is a disease that can lead to hair loss problems. It may be a good idea to check for feline immunodeficiency virus, as well. It may be reasonable to test for the hormonal diseases as well. In cats, a low dose dexamethasone suppression test may detect hyperadrenocorticism. I am not aware of a good test for the suspected hypothyroidism that occurs in cats because thyroid values are reported to be in the normal ranges even in cats that do respond to replacement thyroid therapy. As an alternative, it is reasonable to biopsy the skin and see if the pathologist detects signs of endocrine related hair loss and then try to figure out which hormonal skin disease might be present.

Skin scrapings to rule out demodecosis, testing for fungal infections, using good flea control medications to decrease the possibility that fleas might be present, treating for any bacterial infections and even considering the use of cortisones to rule out itchiness as a possible contributing factor can all be helpful.

In Larry's case, I would worry a lot about the possibility of fleas, if you are not using a good flea control product, such as Frontline (Rx), Advantage (Rx), Revolution (Rx) or Program (Rx). There might be a change in the number of fleas or they may attack Larry now where they preferred your other cat in the past. Fleas seem to have preferences for one pet over another sometimes.

These are the things that I can think of that cause hair loss in cats. In sorting through these in a cat of Larry's age with a previous history that doesn't include hair loss I lean towards doing the general lab testing first, including at least feline leukemia testing. Then a skin biopsy does make sense, or some effort to diagnose the endocrine problems through lab work. If nothing can be found it is reasonable to try some therapies, including antibiotics, corticosteroids or even thyroid hormone supplementation, although I have personal doubts about that last option.

When everything else has been eliminated then it is time to consider pyschogenic alopecia, unless somewhere along the line you feel really strongly that this is the most likely problem and decide to try treating for it prior to doing some of the other testing.

Antihistamines help in cats to control itchiness. They are most successful when hair loss is occurring due to itchiness from allergies leading to the cat pulling its own fur out. The one advantage of using antihistamines early in problems like this is that they can provide relief, if itchiness is the problem, without causing problems interpreting lab tests and skin biopsy results for hormonal illnesses.

I know that this is a lot to sort through. If this note causes you to have more specific questions, please feel free to ask them.

Mike Richards, DVM 8/21/2000

Bald under mats

Question: My cat Kit-Kit is17 yrs. old. she used to take good care of herself with grooming, but now she doesn't do a good job anymore. she has really bad matts and we've been brushing them out, but while i was brushing i noticed a big bald spot on her back next to her thigh and nowhere else, is there anything to be worried about?

Answer: Jill- When mats are removed a bald spot often is present under them. If the skin looks completely normal this is probably not a big problem. If there is any evidence at all of skin disease, please have your vet examine Kit-Kit.

Mike Richards, DVM

Licking fur off

Question: I came across your web site this evening and have been reading many of your answers to past questions about cats that lick their fur off. My cat bagan this same behavior about six months ago. At first it started on her belly. It was licked bald. She then moved to her flanks, lower tail area and is now starting on her legs. She is basically licking any place she can reach. We've taken her to the vet who's only suggestion is an allergic reaction to a flea bite. She has never had fleas and has always been an indoor cat. I do watch for flea dander and comb her on occassion. When the topical ointments didn't help I was told it might be "hot spots." I was given a spray which did not help either. Today I am noticing on the bald areas that there appears to be small insect bites. They are very small, red and appear to be dry, almost as if she nipped herself while licking and it's on the final stages of the healing process. Slight raised bump like an insect bite, but no scab. I am really becoming confused. I have resigned myself to living with a half bald cat. She eats, sleeps and plays well. Her elimination habits are unchanged. There has been no known stresses that we can think of. We have a very stable, uneventful family life. What would you recommend as my next steps? Do I need to worry about hair balls in the future? And what exactly are "hot spots?" Your insight and patience with continued questions on licking are appreciated.

Answer: In your situation it would be a really good idea to ask for referral to a veterinary dermatologist or to at ask your vet about doing skin biopsies and sending them to a pathologist with an interest in skin disease.

It is not unusual at all for a cat with no visible fleas, in an environment with no visible fleas, to get MUCH better with flea treatment. I would strongly consider using one of the new flea control products (Frontline (tm), Advantage (tm) or Program (tm)) even though you are certain fleas are not the problem. Cats are exceptionally good at removing all evidence of fleas from their bodies.

Cats do get mite infections and these will often show up on skin scrapings or skin biopsies. Ringworm varies a lot in appearance and might look like what you are describing. Cats get other allergies besides fleas. Some cats are damaging their own fur or even skin for pyschological reasons. If all else fails, treating for "pyschogenic" hair loss may be beneficial. Keep working at this. You don't have to live with a half bald cat..... (disclaimer -- most of the time).

Mike Richards, DVM

Hair loss in Persian kitten

Question: I have a persian kitten named simba. He was born on may 10 this year. At this moment he is suddenly loosing his hair. I can't find any other problems with him, he eats and drinks normally, he's happy and playful, what could be wrong?

Greetings, Diana The Netherlands

Answer: Diana- I am not sure whether parasites are a major problem in the Netherlands or not. Here in Virginia, I would be most worried about parasite infestation, particularly skin mites such as Demodex and fleas in a young cat with significant hairloss. This can also occur with allergies and in some instances as a behavioral problem (overgrooming). Your vet can help you sort through these possibilities.

Mike Richards, DVM

Excessive shedding

Question: We have three cats - two blacks and a grey - one black is female, the other a male and the grey is a male. The cats are all healthy, none have fleas, they live indoors and are not allowed outside. They all loose alot of hair especially the blacks. None have bald spots or scratch. What could be missing in their diet to cause this excessive shedding. I just spent a few minutes with our little female and pulled out about 1/2 cup of hair. This hair was just loose, she barely knew I had removed any hair. I think this hairloss is causing the female alot of hairballs. Any suggestions? Thanks, Donna

Answer: Donna- If you are feeding a good quality commercial cat food it is unlikely that your cats are suffering from a nutritional deficiency. It is more likely that they have a parasite infection or flea allergy. Very many people do not ever see fleas when flea allergy is a problem in cats. They are very efficient at removing them from their body but usually after they are bitten. The only way to be sure that flea allergy is not present is to use a good flea control method like Frontline (tm), Advantage (tm) or Program (tm) and to treat the house as well. If flea control does not bring about a resolution of the problem it will be necessary to do some diagnostic testing to determine if other parasites are present or if there is another problem affecting the cats.

I know that it is hard to believe that fleas can be present when they are not seen but veterinary dermatologists report that most cats with flea allergy will not have fleas present on their body at the time of examination. It is necessary to consider this possibility strongly. Mike Richards, DVM

Losing clumps of fur

Question: This past summer my cat has been losing a lot of fur, a lot more than usual. She is an outdoor cat. Recently, she has been losing fur in clumps and her fur looks scraggly. I was wondering if she had mange and if it is treatable by flea and tick shampoo. I would rather not take her to the vet because of the cost, but I would buy mange shampoo from the vet if the cat would not be harmed by it if it didn't have the disease. Do you have any recommendation? Thanks, MD

Answer: MD- Even though you would prefer not to go to the vet, the best advice I can give you is to do just that. Most flea and tick shampoos do not help with hairloss unless the hairloss is caused by fleas which you should be able to see. The only sure way to diagnose mange is by a skin scraping and depending upon the type of mite found, the treatment can vary. There are numerous causes of hairloss in cats ranging from parasites such as fleas to allergies to underlying hormonal and other diseases. Your vet is the best person to help you sort through the possible causes to determine the underlying cause and prescribing the best treatment possible.

Mike Richards, DVM

Self grooming problems - overweight cat

Question: We have a large short haired cat (25 pounds). He is appox. 6 years old and has been nuetered. The problem: He sheds alot. He is in no way balding or thin in the hair area. Additionally, he has something similar to dandruff going on as well. He appears heathy other wise other than a little over weight. Is there something we can do to cut the sheding down and eliminate the dandruff symtom. Any suggestions or comments would be greatly appreciated. Thanks

Answer: K- Cats who get overweight enough that they can not effectively groom often have dandruff. If this is the case it can help to bathe the cat and apply a cream rinse. Just using a fine comb, moistened with water to groom the coat several times a week can be very helpful, too.

Mike Richards, DVM


Question: My cat has something that looks like dandruff on her skin. Can we use a regular dandruff shampoo on her?

Answer: Norris- It is probably safe to use any human shampoo on a pet. I think that cream rinses or conditioners do more for dandruff on cats than shampooing, though. A poor haircoat can be a sign of disease. Diabetes, allergies and hyperthyroidism are common causes of dander or oily haircoats in our practice. It may be worth having your vet check your cat if this problem continues.

Mike Richards, DVM

Haircoat changing to reddish color

Question: Dear Dr. Mike: My 10 year old grey kitty now has streaks of pumpkin colored fur. Otherwise she seems fine, but a friend said this could be serious and I should take the cat to a vet? What do you think? Thanks in advance

Answer: There are some causes of reddish tinges developing in haircoats that are serious. The most serious cause of this that I can remember offhand is severe protein loss. This can occur with kidney failure, liver failure or intestinal disease that leads to inability to absorb or to retain protein. It can also happen as a side effect of some medications. Hormonal disorders will sometimes cause hair color changes as well. More common causes are food allergies, parasite infestation, bacterial infections, fungal infections and anything else wrong with the skin that will lead to the cat licking its fur. For some reason, the saliva seems to make the hair color change to a reddish/orange tinge.

While there is also some chance that this is not a serious problem I think your friend is right. It would be best to let your vet examine your cat to be sure that there isn't a problem.

Your cat may be a lot more comfortable after a vet visit if this is a treatable skin disease.

Mike Richards, DVM

Last edited 09/17/02


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...