Skin Problems in Cats

Skin disease that worsens at home and clears when cat is boarded

Question: Dear Dr.Mike,

My friend's cat has created the lesion pictured by licking his abdomen this problem has been treated with Panalog ,as well as Tinactin antifungal ointment. She has also tried an anti lick preparation available through her veterinarian. I have sent your reply asking the woman to rule out the possibility of abdominal pain or cystitis. When the cat is being boarded at the veterinarian's the condition improves which might indicate?? A psychogenic cause at home? Or allergy at home? Do you have any ideas?

Thank you, Diana

Answer: Diana - When skin diseases clear up at our office and get worse again at home, we tend to think that three or four things are possible as underlying causes.

The first thing we think of is flea infestation or mosquito bite sensitivity. These are the most common causes of skin disease in the area in which I practice. I do not know how much of a problem they might be where you are. We have had several patients whose skin would improve a lot while they were in our car whose problems seemed to be entirely due to flea bite or mosquito bite hypersensitivity. Trying to avoid letting the cat out at times when mosquitoes are at their peak activity (usually dawn and dusk) and using a good flea control product will usually help.

If we are changing the diet when the cat comes to our clinic, we also consider the possibility of food allergy. This is ruled in, or ruled out, by using a diet that contains proteins that won't cause allergic reactions (hydrolyzed proteins, such as Hill's z/d (tm) diet) or unusual proteins for pet food, like rabbit, duck or venison. The diet has to be used for at least three weeks and eight weeks is better. If there is great improvement on the diet that is a strong hint that food allergies are the problem. If the skin disease returns when a normal diet is fed that makes it more certain.

Some cats do have inhalant allergies or sensitivities to things like cigarette smoke. If these things are present in lower numbers in the clinic than at home, the allergic skin disease may clear up while in the veterinary hospital. This seems to be a lot less common than flea allergies, in our practice, though.

The last thing that happens is an improvement in a condition that is partially psychological in origin or even completely psychological. Bored cats and stressed cats will sometimes lick at themselves excessively, leading to sores. A veterinary clinic is usually less boring but more stressful. It can be better to try to reduce stress at home (separation from pets that are aggressive, closing curtains and/or doors, reducing noise levels when possible -- things like this. Medications can be helpful in cats with this problem, usually anti-anxiety medications or anti-depressants, such as amitriptyline (Elavil Rx) or fluoxetine (Prozac Rx).

The first thing to do is make a really objective evaluation of the likelihood that fleas are present on the cat and in its environment.

Good luck with this.

Mike Richards, DVM 3/28/2001

Black specks on Skin of Cornish Rex

Question: My Cornish Rex cat has what looks like blackheads on his tail and also they seem to be a few on his feet. On his tail it is quite clear that there are little black specks that are in his pores or hair follicles.. They do not seem to be insects or dirt or anything I can identify -- just black crud. He didn't have much hair to start with and his coat is getting thinner over time; he gets regular prednisone shots because he has plasmacytic stomatitis. Could the shots be contributing to the problem? They don't really seem to bother him, but I'm just curious.

I realize you're probably swamped with questions, and this is not urgent. Thanks for your help and do keep sending the newsletter, just do it by e-mail. I've subscribed to several of the commercial letters and yours is the only one that doesn't talk down to the reader.

Your fan, Stephanie

Answer: Steph-

The first thing that came to mind when reading your note was that flea excrement looks like small black dirt particles or crystals in the hair. It is composed mostly of digested blood, so if you comb off a few of these particles and place them on a wet paper towel, the paper towel will turn red in the area around the particles. Cats can be extraordinarily efficient at removing fleas from their body and sometimes the only way to tell that fleas are present is the presence of black debris in the hair coat or tapeworms (carried by fleas) showing up in the stool or in the hair around the rectum.

My second thought after reading your whole note was that the cortisone injections (prednisone and methylprednisolone are cortisones) might be causing signs the problems, since cortisone levels that are too high induce signs similar to hyperadrenocorticism (Cushing's disease). These signs would include drinking more, urinating more, hair loss, a pendulous appearance to the abdomen, thinning of the skin and sometimes an increased susceptibility to skin infections. These problems are less common in cats being treated with cortisones than in dogs or humans, but they can occur. Since you are seeing something resembling blackheads on the feet and tail, this possibility seems a little more likely, even though it is not a common problem.

Miliary dermatitis, which is a condition characterized by small scabs on the body, usually around the neck and the base of the tail, might also fit the description. This can occur as a secondary effect of allergies and be associated with fungal infections (ringworm), feline leukemia virus infections and herpes virus infections in cats, as well.

Those are the things I can think of. There are probably other possible problems. If you do not use one of the new flea control products (Frontline tm, Advantage tm, Revolution tm) you might consider doing this, as they are really helpful in controlling fleas, which always helps when dealing with skin disease.

It is tough when injections necessary to aid one problem may be contributing to another problem or inducing unwanted changes by themselves. It might help to try another approach to the plasmacytic gingivitis, to allow a break from corticosteroids. We haven't had a high degree of success with alternative products, but some cats respond to antibiotic therapy, some seem to respond to bovine lactoferrin administration and when it is absolutely necessary we have used megestrol acetate (Ovaban Rx, Megace Rx) with good success. This last medication has its own serious side effects, including induction of diabetes or cancer in a small number or patients, so we use reluctantly but this might be a situation in which you have to consider alternatives to corticosteroids and this is one.

A skin biopsy including some of the lesions that look like blackheads might be helpful in sorting through these possibilities, although I do think it would be reasonable just to try some of the alternative therapies for the plasmacytic gingivitis and seeing if the skin problems improved as corticosteroids are withdrawn.

Hope this helps some.

Mike Richards, DVM 11/26/2000

Staph skin infection

Question: Hi, my 12 yr old Aby was just diagnosed with a staph infection. We found the lesion on Thursady and the vet couldn't see us until Monday. I thought it was ringworm or a rodent ulcer; he has had ulcers before. On Monday, it looked much better but it had been responding to an herbal preparation (calendula, comfrey, mullein, plantain, St. John's wort in a beeswax base) that I used over the weekend. We saw that it didn't show up under a black light and ruled out ringworm. The vet gave me Hexadene to scrub on the spot and leave on for 15 minutes then wipe off, plus Cephalexin. She told me that if he licked the Hexadene, he will drool and gag, but not to reapply it. Okay, here are my questions -- what is a staph infection (my books don't explain well) and can I skip the shampoo and continue with the herbs since he can lick this, it was working and I can reapply as often as I need. Lauri

Answer: Lauri-

The majority of skin infections in dogs and cats are due to Staphylococcus species of bacteria. These are usually referred to as "staph" infections, since it is easier to say. These bacteria are normal residents of the skin in many cases but if they get out of hand they can cause skin infections or sores.

It really isn't possible to rule out ringworm based on whether or not a lesion fluoresces under a Wood's lamp (black light), since only Microsporum canis, one form of ringworm, fluoresces and it doesn't do it all the time. If you find, over time, that this lesion returns or spreads you may wish to

Topical therapy, such as chlorhexidine shampoos like Hexadene (tm), is of limited usefulness in either ringworm or staph skin infections. However, if it is easy to shampoo Aby it would be worth continuing to try the shampoo. If it is not, it probably isn't useful enough to worry about.

Of the ingredients of the herbal remedy, only comfrey poses a risk if ingested. It has been associated with liver failure in at least one human patient and liver toxicity signs in others. I do not know what sort of dosage would be necessary to cause liver problems but if you use the ointment sparingly I suspect the odds of a problem are very low. Both St. John's wort and marigold (calendula) can cause skin reactions in some patients but if the medication is helping it is not likely that Aby is having skin problems resulting from the medications.

Hopes this help some. Again, I am sorry for the delay.

Mike Richards, DVM 10/26/2000

Skin problems in elderly cat

Question: Dear Dr. Mike:

I was wondering if you could give me a second opinion. My mother's cat, TC, is around 14 yrs old. Over the last three years, she has been licking her stomach and back legs completely bare, and within the last month or so, she has started to lick the hair off her front legs as well. Further, within the last year, she has lost her hearing; otherwise, she is healthy for her age. The vet my mother takes TC to says it is allergies. Once a month she takes TC in to get a shot of Depo Medrol (20 mg/ml) to help stop the licking--which usually doesn't work. If you could provided me with any other information on this odd behavior, I would greatly appreciate it.

Sincerely, T.

Answer: T-

It is important to understand your definition of not working for the methylprednisolone DepoMedrol (tm) injections. If they stop the itching for several days and then it starts up again, that is a poor response. If they stop the itching for several weeks and then the itching starts again, that is the expected response for an ongoing problem, such as allergies. If they injections really do not have any effect at all, that is a really important clinical sign, since methylprednisolone is a pretty reliable medication for itch control and it will usually work at least partially for itchiness, regardless of the cause. In most cases, itchiness is the cause for licking hair and hair loss in cats. In a few cats, the licking and hair loss occur due to psychological reasons (psychogenic alopecia). Many more cats have hair loss and licking behavior due to itchiness than due to psychogenic alopecia.

Itchiness is most commonly due to allergies. Food allergies, allergies to fleas and mosquito bites and inhalant allergies (atopy) are the most common causes of itchiness in cats. A limited antigen diet (one protein source) or a hydrolyzed protein source, can be helpful in ruling out food allergies. It takes about six to eight weeks of feeding the special diet, in most cases, to rule out a food allergy. Food allergies are the least common cause of prolonged itchiness but they are treatable just by controlling the diet, so it is worth figuring out if a food allergy is present.

Fleas must be strictly controlled in any situation in which skin disease is evident. Imidocloprid (Advantage Rx) and fipronil (Frontline Rx) have been consistently effective products when we have used them. Selamectin (Revolution Rx) may also work well but we have no experience with this product. In any skin disease it is a good idea to use one of these products consistently. Mosquito bites can also cause severe itchiness but it is almost always seasonal.

Demodectic mange occurs in cats and will cause itchiness that is not responsive, or is only partially responsive, to corticosteroids. Ruling out these mites is a good idea. Skin scrapings sometimes show the mites. Skin biopsy is sometimes necessary to rule them out, though. We have even had one patient who required skin biopsies on two separate occasions before we finally found the mites. So persistence is important when looking for demodecosis in cats.

Bacterial skin infections are not very common in cats, but once in a while they occur. Antibiotic therapy can be helpful in these cases. In frustrating cases of prolonged itchiness it is worth trying antibiotic therapy if there are any skin lesions, such as scabs or sores, that might indicate a bacterial infection.

It is possible to test for inhalant allergies (atopy) through skin testing in cats but usually it is necessary to go to a veterinary dermatologist to have this done since the testing is somewhat difficult to do in cats. If it turns out that allergies are present, there are alternative treatments to corticosteroids. In cats, fatty acid supplementation using something like 3V Capsules (tm) in conjunction with an antihistamine such as chlorpheniramine (Chlortrimeton tm) will often control itching. These can be used in conjuction with corticosteroids in difficult cases.

Psychogenic alopecia, hair loss due to self trauma unrelated to itchiness, does sometimes occur in cats. Usually the hair is "barbered" with well defined margins and the skin does not appear to be damaged. It is best to rule out as many of the other possible causes of hair loss as possible prior to settling on this diagnosis, though. Treatment of this condition may require long term administration of medication. Amitriptyline (Elavil Rx), fluoxetine (Prozac Rx) and megestrol acetate (Ovaban Rx) are used to treat this condition. Amitriptyline is most commonly used, because it is inexpensive vs. fluoxetine and has less side effects than megestrol acetate.

If your mom would consider asking for referral to a veterinary dermatologist, if that is possible where she lives, that might be the best approach to getting a diagnosis and finding a treatment that is more successful.

Mike Richards, DVM 10/6/2000

Skin problems and diabetes in Abyssinian

Question: my vet has kind of given up and i'm wondering if you might have any ideas....i have an 18lb ruddy abyssinian male who is five yrs old.....all his life he has had skin problems and i did take him to a specialist in seattle to no avail....he essentially has food allergies and i feed him eukanuba chicken/rice dry food and boiled chicken now. but over the years he has been fed other food which he has had a reaction to. he would break out on his face and nothing would work until he was given a cortisone injection....unfortunately he now has diabetes as a result and his most recent skin eruption has not healed. i have two questions....1. my vet has tried antihistimes to control the itching on his facial lesion but that has not worked...anything else i might try? and 2. i inject my cat 2 times a day with pzi insulin....5 units. these vials cost 100dollars there any other insulin i might try....and any way to buy pzi less expensively......thank you stephanie

Answer: Stephanie-

To answer your second question first, veterinarians like PZI insulin because it can often be used once a day. In addition, some vets feel that it helps regulate difficult cases of diabetes better than other insulins. We have had good success using Humalin N (NPH insulin) on a twice daily basis in our practice and the insulin costs less than $20 a vial. So if you are not having good success using PZI insulin, switching seems reasonable. If your cat's blood sugar is well controlled at this time it may be better not to make a change, unless the cost of the PZI insulin is prohibitive at this time. I have not tried to buy PZI insulin in some time so I can't give you any suggestions as to where to buy it for the best price.

There are some really frustrating skin diseases that cause itchiness or scabbiness on the face and around the neck of cats. Food allergies are possible. It is conceivable that changing to another diet that contains a new protein source that he has not been exposed to might be helpful. There are several companies that make hypoallergenic diets for cats and it should be possible to find another one.

If it has been some time since he was seen by a dermatologist it would be a good idea to consider another visit. Sometimes new problems occur or the original problems develop additional symptoms that make it easier to identify them or to provide treatment. Often, eliminating food allergies, if possible, is the first step in a diagnostic process and it may be that the specialist had additional ideas, in case that stopped working.

Due to the number of problems that can lead to itchiness around the face, it is often helpful to pursue a diagnosis somewhat aggressively. Examination of the teeth, biopsy of the skin, skin scrapings to rule out mites, checking carefully for fleas and using good flea control products, testing for ringworm (usually doesn't itch) and making a careful examination for other skin disease or systemic illnesses, such as feline leukemia virus, can all be helpful in making a diagnosis. Cats do not get bacterial skin infections quite as often as dogs do, but when they are present they can cause itchiness. Phemphigus (an immune mediated disease) occurs in some cats, too.

There are only a couple of non-specific treatments for itchiness in cats but if you want to try something prior to looking for a specific diagnosis, it is OK to use antihistamines (chlorpheniramine (2mg twice a day) is easy to administer and works sometimes). Fatty acid supplements help some cats. 3V capsules (tm), OmegaDerm capsules (tm) and DermCaps (tm) are examples of these products.

It really is best to get an accurate diagnosis, if possible, in a diabetic patient with a secondary problem like this. Treatments for some of these conditions will make it hard to regulate insulin. Therefore, the condition should be confirmed before going through the trouble of readjusting the insulin to compensate for another medication.

I wish that I could think of an easier solution. Your vet should be able to do skin biopsies, feline leukemia testing and skin scrapings, if you do not wish to visit the dermatologist again. That would help to rule in or rule out many of the possible problems.

Mike Richards, DVM 8/7/2000

Skin problems - Persian cats

Q: Dear Dr.Mike,

I have a kind of persian cat (not pure bred). When they gave him to me, the vet had to had to shave him completely, because he was full of knots. This was more or less 5 months ago. Since then, he has skin problems, he scratches a lot and his wounds are bleeding. The wounds are mostly on the backside of his neck and between his eyes and his ears. His ears are clean ( no parasites). Also there is now a small wound on his leg. Another strange thing is that he eats the litter from the litterbox. My vet give him an injection of "raprobet", but after some time he began scratching again. perhaps you could advise me.


A: Dear Ana-

There are a number of skin diseases that could produce the symptoms you are seeing. Many of them would respond to treatment with a corticosteroid injection but the effect would wear off, usually in 2 to 6 weeks. I am assuming that Raprobet is probably a corticosteroid but I do not recognize the brand name and am not certain.

In a Persian cat I would want to eliminate the possibility of a fungal infection (dermatophyte, ringworm) early in the diagnostic process because Persians seem to be prone to dermatophyte infections. Testing is done by obtaining potentially infective hair from around a wound or by using a sterile toothbrush to comb through the haircoat. This is placed on a special culture media that allows the fungus to grow.

It would also be a really good idea to be sure that you are controlling fleas. This is relatively easy here in the United States with the advent of imidacloprid (Advantage TM) and fipronil (Frontline Topspot TM) or lufenuron (Program TM) if the cat is primarily indoors.

Ear mites seem to be able to cause irritation on the head and neck region when cats are infected with them, so making sure that ear mites are not present is a good idea, too.

Some cats with the pattern of skin sores you describe have a condition known by several names including eosinophilic granuloma complex, esosinophilic plaque, linear granuloma and collagenitis. This condition may be a manifestation of allergies in cats or it may be a disorder that occurs for no known reason. It will sometimes respond to treatment with antihistamines but treatment with corticosteroids is more effective, although it can only be controlled so retreatment at variable intervals will probably be necessary. In some cases the disorder responds best to progesterone compounds such as megestrol acetate but these compounds are more likely to cause side effects than the other treatments and should be reserved for really difficult cases.

Inhalant or food allergies may produce skin lesions similar to those you describe. Restricting cat's diets to a single protein source that is unfamiliar to them is helpful in determining if a food allergy is present. Treatment is similar to the treatment for eosinophilic granuloma complex.

Sometimes feline leukemia virus (FeLV) infection causes skin disease and it may appear similar to what you are seeing. Testing for FeLV may be worthwhile.

Demodectic mange infection and other mite infestations can produce the signs you are seeing, too. Skin scrapings may reveal these parasites.

There are probably other skin disorders that can produce the scabby lesions on cats. The only way to really know which one is the exact problem is to start testing for the conditions that seem likely and continuing testing until the culprit is found. A skin biopsy helps in some cases.

When a cat responds well to injection with corticosteroids it is tempting not to try to diagnosis the underlying condition. When the sores return over and over again it seems best, to me, to at least eliminate ringworm, mite infections and fleas as possible causes since they are all treatable conditions.

Good luck with this.

Mike Richards, DVM

Circular, scaly patches with hairloss

Q: Dr. Mike, I've recently adopted a kitten that was born to a wild mother. The new kitten and my one-year-old cat get along great. They play fight by chasing each other around and rolling around together on the carpet. The older cat has received a few mild scratches in the course of action, and we're starting to notice that where the scratches are, that there is also circular hair loss and some dry and scaley skin. Since there were cuts involved, I didn't think it was ringworm, but I'm not sure because the hair-loss patches are circular and scaley. Does this sound normal? Jennifer

A: Jennifer- I think I'd want to rule out ringworm through a fungal culture in this circumstance. Cats are frequently carriers of ringworm and the sort of contact involved in play fighting would be a good way for it to get transmitted from the kitten to the cat. Bacterial skin infection is also possible, along with skin parasites and coincidental skin disease. Your vet can help sort through these possibilities. Ringworm is contagious to people so I really do think it would be best to be as sure as possible that it is not the problem.

Mike Richards, DVM

Chronic skin problems

Q: For years, my parents have had a cat that has some sort of skin allergy. The previous owners gave her up because they didn't know what it was. We previously thought they were just flea bites and it never seemed to bother her that much. Plus, she always had a nice coat. In the past 3-4 years the reaction has gotten suddenly worse. She gets bumps all over and literally pulls her hair out while scratching and makes herself bleed. Everywhere she is able to scratch or bite, she is bald. She even loses bladder control during her bouts of scratching because the itching is so strong. It's horrible to see her suffer so much. My parents have taken her to several vets who have done skin tests and prescribed all sorts of flea medications, shampoos, antibiotics, cortisone shots and diet food (I don't think they've ever tried anihistamines.). They seem to help at first - and all her fur grows back immediately - but then she seems to become immune to them and she goes back to scratching. She is an outdoor cat but never cares to venture far from home and may have fleas although we never see any on her. My parents are on a fixed income and it's gotten very expensive for them to keep trying treatments that just fail. Plus, it is difficult to see the cat so miserable. My parents have thought of putting her to sleep, but don't want to because despite all this, she is a very friendly, playful cat with a good appetite. Any suggestions?

A: Amanda- Three things come to mind with the description you give. The first is that we have discovered that effective flea control helps even in some cases in which we thought fleas were not a problem. Since the topical products Frontline Topspot and Advantage have come out, several cats who previously had difficult to control dermatologic problems have improved dramatically with regular use of these products. The second is that some cats do have mange mites and I can't tell from the history you give if that potential has been addressed. Skin scrapings may reveal the mites and it is possible to treat them effectively in most cats. Sometimes we just resort to treating for them in the hopes that it will help and once in a while that works. Lastly, your parent's vet may be providing the best solution and your perception of its success may not be correct. Most cats with allergies or eosinophilic granuloma complex are not curable. Their symptoms have to be controlled. Short term success with medications indicates that this can be done. It may be necessary to use the medications on a regular basis. While that isn't ideal, it may be less expensive to keep up with a medication like prednisone on an every other day basis than to revisit the vet's to treat individual outbreaks of symptomatic skin disease.

In some cases it is less expensive to seek help from a dermatology specialist, too. Even though their initial visit costs may be more expensive they see the difficult skin disease cases and sometimes have an easier time recognizing an underlying cause than a general practitioner whose focus is on the "normal" presentation for various skin disease problems.

Mike Richards, DVM

Hair loss - what next

Q: My cat has a hair loss problem, her mother was put on ovaban at about three years old, my cat is now six. My cat has been spayed and I was wondering if there was anything I can do to change her diet to make this hair loss not a problem ? Can ovaban be purchased outside of a vet's office or does this have to be diagnoised by a vet ?

A: Megestrol acetate (Ovaban Rx, Megace Rx) is a prescription medication for dogs and humans. It is not available over-the-counter to the best of my knowledge.

If your cat is showing signs of hairloss the first thing to do is make sure that you are doing a good job controlling fleas. This is easier to do than it used to be, with the advent of the newer flea control medications lufenuron (Program Rx), fipronil (TopSpot, Frontline Rx) and imidacloprid (Advantage Rx). These flea control products have decreased the incidence of skin disease in our practice markedly.

If flea control does not resolve the skin problems, some cats benefit from the addition of a fatty acid supplement to their diet. DermCaps (Rx), EFA-Z (Rx), OmegaDerm (Rx) are some of the names of these types of preparations and I am sure there are several others. The essential fatty acids can reduce inflammation and make cats less likely to itch and scratch when they have allergies or other skin disease.

Some cats benefit from hypo-allergenic diets (feeding a food that does not contain "normal" cat food ingredients). There are several companies that make these diets, including Hill's and Innovative Diets. It is better to use these initially with the help of your vet, so that a good evaluation of the likelihood of food allergy can be made.

Hope this helps.

Mike Richards, DVM


Q: I have an 8 year old spayed female tabby. She has been happy & healthy up until a month or so ago. She is strickly an indoor cat. She suddenly starting getting small bald patches down her back. They seem to run along the sides of her spine, identical on each side like a domino. There doesn't seem to be any open sores or rash appearance on these sights but the fur around the bald spots feels slightly hard. She does wash herself on these areas more than normal but I don't know if this is a behavioral or medical problem. She is eating and drinking normally. I have started keeping her in the cellar isolated from our other cat and my baby because I don't know if it could be something contagious. I don't have a lot of money for medical expences but I really want to take good care of my cat. I'm afraid it could be ringworm. Any info on what types of skin conditions it could be would be greatly appreciated.

A: Ringworm (a fungal infection) is the big worry when it comes to cat skin diseases that are contagious to people. Ringworm is tough to rule out when there is patchy hairloss in cats without doing a culture for it. This is not usually too expensive to do. Ringworm can mimic a lot of other skin problems but most of the time when we see it there is some scaling or scabbiness, too.

It would be unusual for the condition to be psychological with the pattern you are seeing but that is also not impossible. Most of the time, psychological licking/chewing behaviors leading to bald spots seem to show up in the abdominal and inguinal regions (on the cat's underside). If this is psychological, it might make it worse to separate her from the family, causing even more stress.

The most common problem in my area leading to hairloss on the top of the cat is flea allergy dermatitis or other allergic skin disease. This would not be contagious and there would be no risk to the family. Determining if it is going on might allow her to return to being more a part of the family.

I don't know of any sure way to help you decide which skin problem is more likely at home. It would be best to schedule a visit with your vet as soon as it is feasible. Skin disease is usually a lot easier to treat if treatment can be started early in the disease.

Mike Richards, DVM

Skin spots on Sphynx cats:

Q: Dr. Mike, I have two 2-yr old Sphynx cats. Lately, they have been sneezing copious amounts and there eyes are runny. My real concern though, is with the smaller of the two cats. She seems to be developing dark freckle-like spots, mostly on her head, but there are a few on her chest and back also. The spots are not raised, and besides her sneezing, she seems to be behaving normally. There is no change in her appetite or behavior. A couple of months ago I noticed one of these spots on her head and was curious, but, she seems to be developing a lot more of them lately. Initially, I thought that they were from the sun because she likes to sit in the window, but it's winter now and I would think that if they were from the sun they would be diminishing. My other cat has a similar spot on his back but not nearly as many as her. They are due for their shots this month, but I was wondering if I should rush to the vet or if it is o.k. to wait a couple of weeks.

A: I honestly don't know. Sphynx cats haven't found their way to my rural area yet and I don't see any of them in my practice. If I run across any information on skin disorders in them, I'll try to remember to send it. My out and out guess is that the spots are not an emergency issue since dog breeds with little hair tend to get skin spots easily but that is a guess.

Mike Richards, DVM

Hair loss

Q: I have a medium haired cat who is loosing her hair. My vet has treated her first for excema and then, when this did not work for a hormonal disorder. Alas this also appears to have failed. The hair loss began, equally to either side, to her back legs, tummy and to the underside of her back thighs. Now the underside of her magnificent fluffy tail is balding. She did major damage to her kidneys last May and is now battling to stay on a protein restricted diet. Is there possibly any supplement she is missing ? This hair loss has only occured after the kidney damage. (Cape Town, South Africa)

A: I am sorry, but I don't think I can help you much. Hairloss that is bilaterally symmetrical does suggest a hormonal disorder but the pattern would also be typical of flea allergy dermatitis or other allergic disease. I am not sure what conditions would precipitate similar problems in South Africa, although I am assuming that you probably have fleas there, too.

If you are using a commercial diet for the renal failure, the odds are very good that it is not the source of the problem and that supplementation is not necessary, as long as the company making it is reputable. Still, it does seem suspicious.

The only other thing I can think of is a psychogenic problem. Some cats lick or chew their hair out when they are distressed and renal failure can be uncomfortable and must be stressful to some degree.

I live fairly close to a veterinary dermatologist and have the luxury of referring difficult cases to a specialist. Is that possible where you are?

Mike Richards, DVM


Q: Dear Dr. Mike, I have a six-year old neutered cat (male), eats only canned Whiskas. About 3 months ago he started loosing his hair on the abdomen, inside and back of his hind legs and the base of his ears. The hair loss is absolutely symmetrical on both sides of the body. His skin on the other hand is totally healthy, no signs of injuries, irritation, parasites or anything else (although he does have fleas from time to time). He has absolutely no other symptoms. Do you have any idea of what this could be? I would very much appreciate any enlightenment. Thank you very much for your attention.

A: Cats have a pattern baldness (like human baldness) in which there is hairloss at the base of the ears. This usually occurs in an oval pattern between the base of the ear which extends out close to the eye. That part of the baldness is probably not a problem but it wouldn't be a bad idea to ask your vet to check on it the next time you have an appointment for something else. Usually this type of baldness is not associated with hairloss anywhere else on the body, to the best of my knowledge. The hairloss in the inquinal region is (back of his abdomen and down the rear legs) could be occurring for a number of reasons. This is a common area for cats to lick and chew off fur if there is flea bite irritation or allergic skin disease. It is also the preferred site for cats that chew or lick their hair as a nervous habit or obsessive/compulsive disorder. Distinguishing between the causes of hairloss in this area usually requires a careful exam to judge whether there are skin lesions and to see if the hair is falling out or being removed by the cat. Sometimes it can be hard to tell the difference between hair chewing for pyschological reasons and for physical reasons. We sometimes treat symptomatically and then decide. In any case, it would be a good idea to discuss this with your vet. Since his skin looks OK, you probably don't need to rush to get there but your vet may be able to make your cat more comfortable. Mike Richards, DVM

Scabbiness and Skin Disease in Cats:

Q: Dear Dr. Mike: I have a 16 yrs. old spayed chocolate point Burmese (someone dumped) that is being treated by my local vet for a viral/bacterial infection-- she was on Clavamox liquid .05 for a week then she developed sores that have since scabbed over and she is now losing her hair where the scabs are!

Vet did not really know the cause--could have been an allergy to meds--she is also getting Gentocin eyedrops. She was losing weight but since the meds has picked up some weight and she eats ok but I am so concerned about her progress--this has been going on for two weeks now and I realize that she is older and will not bounce back as quickly but I do not want her to suffer either--she has been through so much with me and she is so precious to me--I have two other cats--one just as old but in much better health! The sores all over her body are scabbed over but I know she will lose most of her hair--and I can't keep pumping anitbiotics in her--we switched the meds to "baytril" (that is typed on label) Will this skin condition heal??

I am at my wits end-- I have been going to my vet for sometime and she knows how much this animal means to me and maybe she is reluctant to tell me everything??? I need an honest forthright answer about her condition--should I continue to treat her? Is there a chance of recovery? I do not what her to suffer-- Thank you for you time--I am really a very big animal lover and totally believe in the spaying/neutering of pets!! I would like to see the world get to a place where even the ordinary housepets would have to be bought--not just picked up at your local Wal-mart by people trying to get rid of babies!!

I take every opportunity to get on my soapbox--but I know that you don't need that lecture!! Thank you again!!

A: Just from the description, it does sound like your cat is having an allergic reaction to something. That is the the most common cause of scabbiness spread around the body in cats, at least here in Virginia. Typically, the scabs are worst around their neck, under their chin and near the base of their tail with allergies. There are a number of other possible problems, though. Cats appear to develop multiple scabs -- "miliary dermatitis" -- as a response to many skin problems.

Cats can get this scabby with ringworm infections. Sometimes scabs are the only thing seen with ringworm infections. Without hairloss or the other things that make a vet think about ringworm, it can be overlooked.

Feline leukemia virus and feline immunodeficiency virus have both been linked to persistent skin disease and often it is a scabby condition. These would be serious problems if they are present.

Some cats develop these sores because they have ear mites or cheyletiella mites on their bodies.

There is a skin condition in cats known by several names but most commonly eosinophilic granuloma complex, that can cause scabby sores on the body. It is some form of immune mediated disease. Typically, the sores look more like raised scratches with hairloss in this disease but they can vary a lot in appearance. Clavamox or Baytril should work for most bacterial skin diseases so if the response is not good, it seems like it would be beneficial to look for one of the other problems. I am not sure from your note what the Gentocin eye drops are being used for but I was just at an ophthalmology seminar in which the speaker said there was probably no indication for Gentocin eye drops in a cat --- not because they cause any problems but because cats tend to have viral or chlamydial conjunctivitis and Gentocin won't kill either one of those. Tetracycline ointment will kill chlamydia and so he recommended using it as the first choice in most cats. I think that was a pretty logical statement but your vet may be using the Gentocin to try to prevent secondary bacterial infection and she may have good reason to think it is a problem.

I am lucky enough to practice close to a veterinary dermatologist so when I get frustrated with a case of skin disease I refer it to him. If there is a veterinary dermatologist in your area, you might ask your vet about referral if the skin problem persists. Good luck with this. You're right about pets needing to have more initial value to their owners and about the spaying and neutering!

Mike Richards, DVM

Last edited 08/01/05


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...