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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24466
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Brought in from our group of outside cats, we had her

Customer Question

Brought in from our group of outside cats, we had her spayed, she has ear infection, which we give pills for,plus inject stuff in her ear. BUT SHE now links almost constantly, and has licked off areas on back and sides to skin? She eats well, and plays, we have 6 inside cats, all fixed, and there does not seem to be any problems, with getting along. She uses kitty litter, She is just making us a little crazy with all the licking?
She has a traumatic time, getting to vet, and when there, if taken out of crate, without first some kind of callming effect, she goes berserk in office. So difficult to return her This has been going on for about six weeks. Any help?
Submitted: 10 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 10 months ago.

I'm sorry to hear of this with Mini. Pruritic (itchy) cats are suffering from an allergic dermatitis the great majority of the time. Allergies to flea saliva, environmentals such as pollens, molds, dust and dust mites, and foods should be considered. In rare instances the mange mite Demodex might be responsible.

Our dermatologists tell us to apply an effective over the counter flea spot-on such as Advantage or a fipronil-containing product such as Frontline or one of the newer prescription products available from Mini's vet even if fleas aren't seen. Cats can be such effective groomers so as to eliminate all evidence of flea infestation. Indoor cats can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. Turning on the heater at this time of year then hatches the eggs. Flea saliva allergy is usually most evident on the saddle area – the area between the edge of the rib cage and tail. In severe cases, an anti-allergenic prescription corticosteroid such as prednisolone will work wonders for cats allergic to the saliva of the flea. Your other pets may not be allergic to the saliva of the flea.

Environmental allergies are usually addressed with prednisolone as well. In some cats an over the counter antihistamine such as chlorpheniramine (Chlor-Trimeton) dosed at 2mg/cat daily or diphenhydramine (Benadryl) dosed at 1-2mg/lb twice daily may be effective.

Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Mini's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. There are many prescription novel protein diets and the prototypical hydrolyzed protein diet is Hill’s Prescription Diet z/d ultra (I prefer a hydrolyzed protein diet). We usually see a positive response to these foods within a few weeks if we’ve eliminated the offending food allergen. A food intolerance can appear at any age and even if our cats have been eating the same food for quite some time.

We used to diagnose these cats with psychogenic alopecia - a neurotic over-grooming - but have come to realize that most of these cats truly are allergic cats. Feline psychogenic alopecia is overdiagnosed but does exist. Excessive and out-of-context grooming is thought to be an obsessive-compulsive behavior that's triggered by environmental stresses and anxiety. The condition is uncommon in cats, with purebred cats that have high-strung nervous temperaments being possibly predisposed.

This type of alopecia may occur anywhere on the body where the cat can lick but it most commonly involves the medial forelegs, inner thighs, perineum, and ventral abdomen. Hair loss is often bilaterally symmetrical but remaining hairs don't epilate easily. The top differentials are flea allergy dermatitis, food allergy, dermatophytosis (fungal infection), other ectoparasites (mange) and atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites, etc.).

The underlying cause of the psychological stress (e.g., separation from owner, moved to a new house, animal companion died, new pet in household, formerly outdoor cat denied access to outdoors) must be identified and appropriate environmental modifications made, if possible. A good flea control program should be instituted to prevent fleas from aggravating the symptoms. Use of a mechanical barrier (e.g. Elizabethan collar, T-shirt) for 1-2 months to prevent grooming may help break the habit. Behavior-modifying drugs may help stop the abnormal grooming behavior. In some cases, treatment may be discontinued after 30-60 days of therapy; in others, lifelong therapy is required for control. Drugs that may be effective include the following: amitriptyline, clomipramine, buspirone, phenobarbital, diazepam, and naloxone.

I understand your reticence in bringing Mini to the vet and so feel free to share our conversation with the vet as a phone consult and perhaps the two of you can come up with a plan not necessitating a vet visit.

Please respond with further questions or concerns if you wish.