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My cat sometimes has issues with attacking her tail as

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My cat sometimes has...

My cat sometimes has issues with attacking her tail as though it's fighting her and now for the second time in eleven years she is losing all the hair near her tail.

Veterinarian's Assistant: I'm sorry to hear that. Strange behavior is often perplexing. I'm sure the Veterinarian can help you. Is there anything else important you think the Veterinarian should know about sometimes?

She did it quite often when she was young along with a lot of hissing, growling and racing around. It only happens occasionally now.

Submitted: 1 year ago.Category: Cat Veterinary
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Answered in 21 minutes by:
7/9/2017
Cat Veterinarian: Dr. Kara, Veterinarian replied 1 year ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 18,826
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Cat Veterinarian: Dr. Kara, Veterinarian replied 1 year ago

I am very sorry to hear about your kitty's discomfort and sudden tail sensitivity/itchiness.
Allergies are the most common cause of itchy, uncomfortable skin. And flea allergy is the most common allergen that seems to affect the tailhead and back area most so it is definitely possible, especially if she goes outside or has housemates that do.
I'd apply an effective topical flea protection every 28 days. Both Advantage II and Frontline Plus work quite well at killing fleas and are less likely to create a skin reaction. The Seresto flea collar is another excellent option and has the benefit of 6-8 months of continuous protection. It is the only effective flea collar for cats.
Other allergens are inhaled (like mold spores or pollens) or food allergies.
To help dampen her allergic reaction to the flea bites (or the symptoms of any inhaled allergy) I recommend a combination of antihistamines and omega-3 fatty acids. Some antihistamines to try are:
1) Benadryl at a dose of 1mg per pound of body weight or 1/2 of a 25mg tablet per 8 to 15 pound cat 2 to 3 times daily. You can crush the pill up and hide it in something tasty like her canned cat food or you can give it directly. Make sure whatever you use is Benadryl only as the combination products with decongestants and acetaminophen are toxic to cats. Benadryl is very bitter and some cats will drool excessively or may even vomit because of that. That doesn't mean it is making her ill, she just hates the taste. If that's the case with her try a different antihistamine
OR
2) Chlorpheniramine 4mg per cat once or twice daily.
OR
3) Zyrtec (Cetirizine hydrochloride) at a dose of 5 mg per cat given orally every 24 hours. (Make sure it is NOT the formulation with a decongestant (such as Zyrtec-D) because cats cannot tolerate decongestants.)
Omega-3 fatty acids will work synergistically with the antihistamine to soothe her itch and as a bonus will improve her hair coat and skin condition in general. I like the products by Derm Caps or 3V. These come in pump form to put on the food or you can puncture the capsules and dribble it on her food.
I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example an 8 pound cat could take 160mg of EPA per day. Antihistamines and omega-3 fatty acids work synergistically. These should help reduce the itch. Be aware that antihistamines can cause drowsiness or hyperactivity which should resolve with continued use.

Another possibility for her discomfort is a condition called hyperesthesia. Hyperesthesia is a poorly understood syndrome which is difficult to diagnose. These cats have pain and hypersensitivity to touch on their back and tails. They sometimes will bite at themselves because they are so uncomfortable. It is a poorly understood disease process with no definitive test for diagnosis and so other problems (such as spinal arthritis or infections or allergic reactions) should be ruled out first. We do know that stress does seem to make this disease process worse or flare more frequently. Sometimes mood altering drugs and steroids can be helpful.
Here are a couple links discussing hyperesthesia syndrome if you are interested:

1) http://www.veterinarypartner.com/Content.plx?P=A&A=1998&S=4&SourceID=62
2) http://www.cathealth.com/hyperesthesia.htmI

Another condition which initially causes pain, but can later lead to urine and stool incontinence is lumbosacral stenosis. This is a narrowing of the bony canal that the spinal cord travels through, either due to weak ligaments holding the vertebrae in place or arthritis changes in the vertebrae. It is more common in dogs than cats but it can occur in cats.

Has she has ever had radiographs of her spine?
Finally it is possible that she has a slipped intervertebral disc (the soft cushions between the vertebrae which allow spinal flexibility). When this happens pressure is placed on the spinal cord or nerve roots which is quite painful.

If she goes outdoors she may have had some sort of trauma where her tail got caught and the nerves were stretched. As the nerves regnerate there is a tingling, sometimes painful sensation which can lead to the cat chewing or biting at the area.

LS stenosis and a slipped disc can be diagnosed with regular radiographs sometimes but many times an MRI or myelogram (dye study of the spinal cord space) is needed.
Anyway in your cat's case I would start with trying to control allergies and if that doesn't work then she needs a thorough examination, as well as bloodwork to make sure internal organ function is normal, and a urinalysis with culture to look for a urinary tract infection, as well as radiographs of her pelvis/spine. If that all looks normal referral to a neurologist for an MRI may give you the answers that you need.
Let me know if you have any further questions.

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