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Dr Pete
Dr Pete, Cat Veterinarian
Category: Cat Veterinary
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Experience:  Bachelor of Veterinary Science University of Melbourne
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My cats paw pads have been swollen and dark red/purplish for

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My cat's paw pads have been swollen and dark red/purplish for several weeks. There are also a few open areas that look similar to the cracks in chapped lips. He doesn't act like they hurt. Should I take him in to be checked, or is there an OTC creme I can put on them?
Can I ask a few questions first to try to assist you with this
1. How old is he?
2. Is he an indoor or outdoor cat?
3. Did this develop suddenly or slowly?
4. Can you look at the image on this site and tell me if that looks like his problem
Customer: replied 7 years ago.

Hi Dr. Pete,


Thanks for your info request.


1. 11 months


2. indoor only


3. not sure - I first noticed it about 4 weeks ago, and it has remained about the same since I noticed it (I've made 2 appointments to take him to a local vet, but he always manages to elude me by hiding under the bed when it's time to go)


4. yes - it looks almost exactly the same, but possibly even more swollen or "puffy"



Stay on line...this will take me a few minutes to type up.
Sorry I took so long
Almost certainly this is pododermatitis...classic signs

Feline Plasma cell pododermatitis (Pillow Foot) is a foot pad disease of cats that is poorly understood but well recognised. The condition involves the infiltration of one or more foot pads by plasma cells, a type of lymphocyte (white blood cell). The problem is considered to be an immunological problem. Occasionally affected cats are infected with the Feline Immunodeficiency Virus (FIV) but not always so it is important to blood test for this although a definite link has not been established.

Affected pads become puffy and swollen and may develop a purplish tint. Usually the pads of more than one foot are affected. Generally there is no pain associated with the problem but occasionally ulceration will occur and that can cause lameness and a potential for secondary bacterial infection. There is no particular gender, breed or age predisposition.

Diagnosis is often simply made on the appearance of the lesions and the distribution (multiple pads) but biopsy can confirm it.

Traditionally corticosteroids (eg prednisolone, prednisone) have been used for this condition with varying results but often the response is only temporary. For several years I have now been using the more recently recommended medication doxycycline. This is an antibiotic that has an unusual anti-inflammatory side effect. It is well tolerated by cats, rarely causing any side effects. To be effective it must be used continually for a month or two at a dose of around 5mg/kg (2 mg/lb) twice daily. Use it for at least 2 weeks after the pads have returned to normal. The first signs of a response usually occur within 7-10 days.

Some owners elect to not treat. In milder cases this may be reasonable but there are no topical medications that will control the problem. I would definitely treat if it was my cat.....drag him out from under the bed!

I find almost 100% success with this treatment. Of course you will need to see your vet about it. Be warned that I have found that some vets have not heard of this so take the name with you “Feline Plasma Cell Pododermatitis”.

I hope this has been of help. Please contact me back if I can assist further.

Kindest regards, Peter

Dr Pete and 4 other Cat Veterinary Specialists are ready to help you
Customer: replied 7 years ago.
Thanks for your prompt & detailed reply! He tested negative for FIV & FeLV a few months ago when I first brought him in (I have been doing rescue for the past year & test all the kittens/cats when I bring them in so I don't think he would have picked it up here). I'll take him in & get him going on the doxycycline.
Customer: replied 7 years ago.

Just an update. . . I took Coda in to my vet Friday & when the vet didn't seem to recognize the symptoms, mentioned that I had found the feline plasma cell pododermatitis online & it looked like it might fit the bill & was treatable with doxycycline. She hadn't heard of the condition & wouldn't prescribe anything without first doing a blood panel. sigh. Blood panels are so expensive! Tonight she called & said the white blood cell count was elevated & we should put him on "an antibiotic" & wants me to call back & let her know whether I want liquid or pill form. I'm afraid when I call her & say i want doxycycline, she'll balk & just want to give me clavamox or amoxidrops or something. Any advice on getting her to let me have the doxycycline without making her feel like I'm questioning her judgement?




Hi Laura
Thanks for keeping me up to date
Unfortunately vets can sometimes react a bit when their clients make their own suggestions. I guess I have been there!
However it is your cat and you pay the bill so we need to respect your feelings.
Plasma Cell Pododermatitis is well recognised by vets throughout the world (and if your vet consulted her texts or even simply Googled vet sites she would see that)

I see and treat it regularly and doxycycline is now the recommended medication. This is not is sound and well recognised veterinary fact.

The Veterinary Information Network, (VIN) is a vet only subscription site that caters to vets in general practice and specialist. Very well respected. They have a client education offshoot called the Veterinary Partner

This has some general information on the condition. Pass it on to your vet

I cannot give you a direct VIN link as it is vet only and by subscription but your vet may use that.

I strongly suggest that if your vet refuses to recognise the existence of this condition you seek another opinion. It must at least be considered!

Doxycycline is regularly used in cats for a variety of conditions. However it is the only antibiotic that has been shown to affect this condition. You are right…Amoxycillin would be a waste of time.

Please contact me back and let me know how you get on Laura.


Hi Laura
Just interested to know if you've made any headway in receiving treatment for you cat.
Customer: replied 7 years ago.

Hi Dr. Pete-

Thanks for the reply & the link to the Vet Partner site - I'm out of town & just happened to have the opportunity to check email.


The vet who had left the message about putting Coda on the antibiotic was the senior partner, not the one who had originally seen him - when I called back the next day, I talked to the one who had seen him (the junior partner), and she said she had looked up the Plasma Cell Pododermatitis, and it did indeed look like that's what it could be. But since this condition is new to her, she wants to do a biopsy to be sure (another $240 US) to see if we need to use steroids too. I was about to fly out of town when I talked to her, so I said I'd take Coda in next week when I return.


Later, though, I was thinking I'd suggest we go ahead & try the antibiotics, then worry with a biopsy on the off chance they don't work. I suspect the senior partner in the practice would be ok with that - she's more experienced & less inclined to order every test under the sun up front. If not, I may talk to some of my rescue group friends to see if they know a vet who would prescribe the Doxy without doing a bunch of tests first.


I'll be sure & let you know the outcome!



Keep at it Laura
The doxycycline is a far better alternative to cortisone (and side effect free) if this is pododermatitis. I used to use cortisone all the time on this condition until doxycycline became recognised as a better treatment several years ago. I see several of these cases a year.
Biopsy can confirm it but I rarely do that...only if they don't respond to the medication.
The more senior vet might be a bit more inclined to "short cut" things here.
Kepe me informed. I want your cat fixed!

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