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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 28935
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I have a question about a 2 yr old cat that we have. Our vet

Customer Question

I have a question about a 2 yr old cat that we have. Our vet calls it an ulcer that has come on her top lip, he has given her antibiotics, steroid shots every 2 weeks. It has not gone away. What else could we do for her . Thanks.
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

A "rodent ulcer" is one of the symptoms of the eosinophilic granuloma complex. Lesions have been recognized in several cats of multicat households and experimental transmission was demonstrated from one area of a cat to another. Therefore, an infectious or allergic etiology has been suggested with lesions resulting from a hypersensitivity reaction caused by fleas or mosquitos, food, and contact or environmental allergens. Thus, in case of flea infestation, a strict flea control program should be started and a strict elimination diet should be attempted when an adverse food reaction is suspected as an underlying cause. 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 Kasey'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. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

Conventional therapy is as you've noted...either injectable drugs (2mg/lb of methylprednisolone subcutaneously 2-3 times several weeks apart) or 0.5-1 mg/lb prednisolone orally every 12 hours initially for 1 week followed by tapering it to the lowest effective dose over a period of 4-8 weeks). Intralesional injection of triamcinolone is sometimes helpful. Oral cyclosporin may be an effective alternative to steroids and should be discussed with Kasey's vet. Surgical excision and laser therapy have also been suggested for single oral lesions. I rarely prescribe antibiotics but obvious secondary infection may be treated with potentiated amoxicillin at 6.4 mg/lb orally every 12 hours for 2-3 weeks.

Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
Customer: replied 1 year ago.
We bought some hill sçience diet wet food and dry food, and took away the Fancy Feast. I think she is better, the ulcer eems to be smaller and drying up. We haven't taken her back for any more shots. Thank you for your concern.
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the good update. I never argue with success.