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My cat is older ~16 years and has generally licked

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My cat is older...

My cat is older ~16 years and has generally licked compulsively. More recently we realized it was his friskies wet cat food and once we switched over to BLUE grain free wet food he was better. However recently if has stared again and he has no scabs but licked off long patch of hair along spine and his legs just as he has done before. The only thing I can think of is that he had gotten loose outside and for a few hours and then he had this again.

Veterinarian's Assistant: I'm sorry to hear that. The Expert will know if your cat will be able to digest that. What is the cat's name and age?

Bebop and I wrote above 16 yrs old

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Bebop?

He has had urinary tract blockage when he was 9-13 years old and again was lack of enough wet food and the type so has been ok for the last 3+years

Submitted: 10 months ago.Category: Cat Veterinary
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Answered in 4 hours by:
10/1/2017
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 35,490
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

I'm sorry that your question wasn't answered in a timely manner. There are quite a few consideration in such a cat and so I'll post my entire synopsis of the pruritic cat for you. Please take your time perusing it and then return to our conversation with additional questions or concerns if you wish. Not all will apply to Bebop, of course, but it will give you a good overview of what we need to consider...

Pruritic (itchy) cats are suffering from an allergic dermatitis in the great majority of cases.. 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 and is diagnosed with skin scrapings examined microscopically. Skin infection (pyoderma) is under-diagnosed. Bepop's vet can perform a cytology (microscopic exam of a small sample of his skin surface) looking for abnormal numbers of either bacteria or yeast.

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 Bepop's vet even if fleas aren't seen. It would be prudent to switch to one of the newer flea products in a different class of insecticide such as Activyl (indoxacarb), Cheristin (spinetoram), Comfortis (spinosad), or Vectra (dinotefuran & pyriproxyfen). These are all prescription products available through his vet. You can purchase the oral Capstar (nitenpyram) over the counter in pet/feed stores, however, which will kill any fleas on Bepop within minutes of your dosing him. Be sure to treat your premises with an over the counter area treatment spray that contains an insect growth regulator (IGR) such as Siphotrol Area Treatment Spray containing the IGR methoprene. The IGRs don't allow flea eggs and larvae to develop into adult fleas and so the life cycle of the flea is broken. 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 or As the weather warms 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 glucocorticoid (steroid 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 Bepop'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 because it removes the possibility of my patient being intolerant to even a novel 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. Food intolerance is not as steroid-responsive as is either a flea saliva allergy or atopy.

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.

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