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VetInternist
VetInternist, Board Certified Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1181
Experience:  Staff Internist and Medical Director
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My cat has a sore spot on his back between his shoulder blades.

Customer Question

My cat has a sore spot on his back between his shoulder blades. He doesnt go outside at all. The area is circular and all the hair is gone and there seems to be some redness on the skin in the exposed area. I can't see any hair balls anywhere in the house. HOw should this been treated?
Submitted: 4 years ago.
Category: Cat Veterinary
Expert:  VetInternist replied 4 years ago.
Chat Conversation Started
ResidentVet :

Welcome to JustAnswer!

ResidentVet :

Does the spot seem to bother him?

ResidentVet :

I see you have joined me, welcome!

Customer :

He can't reach it to scratch it and it doesn't seem to bother him

ResidentVet :

OK

Customer :

Thanks for being there. I have never had any problems like this with any of my cats before

ResidentVet :

So there are a number of things that can cause hair loss or itchiness

ResidentVet :

sometimes these go together, but not always

Customer :

The area is almost a full circle about the size of a small dime

Customer :

On first glance, I thought it was an abrasion but it is between the shoulder blades, but is not bloody other than some redness

ResidentVet :

I will post a good summary of the possibilities, but my initial impression is that this may be ringworm

Customer :

Wow. That comes up on the back like that?

ResidentVet :

It sure could

ResidentVet :

the face and neck are the most common place for ringworm, but it can happen anywhere.

Customer :

Cool. How do I treat it? He doesn't travel well and I work all the time.

ResidentVet :

In cats it is often not itchy.

Customer :

After it is treated, will the hair grow back?

ResidentVet :

Ideally you would get a diagnosis before treating since treatment is best done with oral medications, lime-sulfur dips, and agressive environmental cleaning

Customer :

I am not much of a housekeeper, but again, he doesn't travel well and I won't have another day off until the 14th

Customer :

Will it be OK to wait a week on this?

ResidentVet :

The problem with topical treatments is that there are usually fungal spores all over the cat and local treatment won't get all of these

ResidentVet :

It isn't life threatening, but it can be spread to you

ResidentVet :

If this is even what the problem is

ResidentVet :

There are other things

ResidentVet :

I will post them here

Customer :

Wow. I guess I better see a vet?

ResidentVet :

Have you had him to the vet in recent history?

Customer :

No. He doesn't travel well at all.

ResidentVet :

If you have seen a vet recently you could get a new toothbrush and gently rub the affected area and other areas with the bristles, put the toothbrush in a ziplock back and bring it to your vet for ringworm testing

ResidentVet :

They may be willing to try to grow the fungus and prescribe treatment.

Customer :

Thanks. I have to go now and I thank you for your help tonite.

ResidentVet :

Here are the other things that should be evaluated

ResidentVet :

Hair loss (alopecia) and/or itchiness (pruritis) can be due to a multitude of causes. One of the most common causes we see in cats is flea allergies. Other causes include mites, dermatophytes (fungal organisms also known as ringworm), bacterial infections, and responses to certain endocrine diseases. To get a diagnosis we usually start by trying to find the presence of organisms that may be hiding in the rashes. Skin scrapes for mites, tape preps for bacteria, and fungal cultures for dermatophytes are all first line diagnostics.

Flea allergies are very common and cause a lot of pruritis. Usually we notice alopecia over the base of the tail, but we can see alopecia anywhere. It is often very hard to convince owners that fleas may be the problem because they often report that they use flea preventative and have never seen fleas on the cat or anywhere in the house. Unfortunately it only takes ONE flea bite to set off a cat because the cats develop a sensitivity to the saliva of the flea. Aggressive flea control to include medications prescribed by your veterinarian and environmental control are recommended. If the cat's problems improve after flea treatment, we pretty much have a diagnosis.

Mites, like sarcoptes,can be very itchy. Unfortunately sarcoptes is also very hard to find on skin scrapes. Often dermatologists will recommend a trial with prescription medication to kill the mites and get rid of the itching. Sarcoptes can affect people so if there are any itchy people in the house, this increases the suspicion.

Demodex is another mite that can cause itching. Skin scrapes are required to find this mite and the treatment usually entails lime-sulfur dips and oral ivermectin. Treatment generally takes months a long time, but many cats can respond well to therapy. Your veterinarian can talk to you about treatment.

It may even be a skin infection that is causing the hair loss or pruritis. Cytologies of the bare areas or bumps my show bacteria that needs to be treated. Your veterinarian can do this test in his office and recommend treatment as necessary. Cultures with susceptibility testing may be necessary to determine the correct antibiotic if initial therapy isn't successful. Ringworm is a type of fungal infection that can also be very itchy. Fungal cultures are performed to diagnose this problem. Treatment usually entails oral anti-fungal medications, topical antifungal "dips," and aggressive environmental cleaning (bleach, steam, etc).

Biopsies of the affected skin is typically the last testing modality used to determine a cause for the problem. This can diagnose a number of auto-immune or neoplastic problems in the skin that can lead to hair loss.

My guess is that some initial testing may reveal the cause. It isn't likely that you will have to go through all of these tests to find the problem.

I realize this is a lot of information. If you have any other questions, let me know.

ResidentVet

VetInternist, Board Certified Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1181
Experience: Staff Internist and Medical Director
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