Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
If he had fleas or scabs he would be intensely itchy and grooming all the time. You probably would also see some sign of skin lesions
like small pinpoint scabs or something. If he is not on monthly flea control then this is certainly a start, but not all flea control products work in cats any more. Over-the-counter there only one I would trust is Advantage II. From your vet you could get Revolution or Advantage Multi.
This type of hair loss is unfortunately not typical for one particular skin problem. It could indicate one of many possibilities ranging from ringworm
to allergies (food
, environmental) to sign of internal disease to behavioral (stress related). I wish I had an easy solution for you that will cure this but this is one of those issues that takes some times to work through with your vet. IF he was my patient I would recommend starting with a skin scraping to look for mites, bacteria and yeast. If anything is seen, then we treat this. Second, we should do a ringworm culture. And if not done in the past 2-3 months some screening lab work (CBC, chemistry profile, thyroid check and urine check) to look for underlying problems that could lead to internal pain. If all is normal then you could consider a trial with a steroid to see if this is an itchy problem (he is over grooming from itchy); this can be given by your vet as injection or medication, depending on what your vet thinks would be safe. As well starting monthly flea control for a few months is a good idea.
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