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Hi this is Dr. Dani and I'm happy to help answer your questions. It is so great that you have taken over care of this stray kitty! Megesterol is great at decreasing inflammation and reducing allergy symptoms, and we often see positive responses to this drug; however, the side effects can be great, and it sounds like the effects weren't long lasting, so I understand why, in a young cat, your vet preferred to have him on Atopica. If that is not working, there are other things to consider. Have you been consistent with a prescription strength (not an over the counter product) flea treatment? This is very important to do, even if you do not see fleas. Have you done a diet trial? This is 8 weeks of a prescription hypoallergenic diet that you can get from your veterinarian. A dermatologist is great idea, but before pursuing that, I recommend a strict diet trial, and a strict program of good quality flea control. After 8 weeks of these treatments, or sooner if the condition worsens during the trial, then a dermatology consult is certainly in order.
Please let me know if you have follow up questions.
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Thanks for the follow up. I see that doing a diet trial will be difficult in a cat with a history of urinary problems. Given his history of concurrent problems (urinary and skin), then I understand why your vet suggested a dermatologist. A dermatologist will be able to perform testing to find out if the skin disease is due to an underlying environmental allergy. If there is an environmental allergy (pollen, house dust mites, fleas, etc), then they will be able to treat him accordingly. There is no test for food allergy, but if he does not have environmental or flea allergies, then food allergy is very likely. If that is the case, then your vet or the dermatologist can consult with a veterinary nutritionist that can suggest a diet appropriate for both lower urinary tract disease as well as skin disease.
Hi there I am just following up to make sure that you were satisfied with the information you received. If so, please make sure to rate me as this is the only way I am compensated for my time. If not, please let me know how I can further assist you.Thanks!