Veterinarian's Assistant: I'll do all I can to help. What is the cat's name and age?
Honey, and about 4.5 yrs old. We got a kitten in sept. She is not overly thrilled but seems to be finally coming around, at least tolerating him
Veterinarian's Assistant: What is the kitten's name?
Her name is***** kitten is Stash
Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Honey?
And we have a 3 yr old mountain cur mix female
Expert: Dr. Michael Salkin is typing. Please be patient.
Expert: I'm sorry to hear of this with Honey. Does she appear to be excessively pruritic (itchy) as evidenced by licking and biting at these areas?
I honestly thought at first someone shaved her or she was getting into small spaces and was pulling it out
I have pictures
Expert: Thank you. Is she currently being treated with a flea product?
Other than a flea collar no. Finances have been hard
Expert: I understand. I would like to see pics, please. You can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/ Please check that the photo(s) is in focus prior to uploading it.
She is in and outdoors as she wants
Can I just send them on this text?
Expert: Yes, you can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/ Please check that the photo(s) is in focus prior to uploading it.
Customer attachment 1/20/2020 12:52:26 AM
Did you get them?
Expert: Thank you. Give me a moment to take a look, please...
She also has lost weight. She was a fatty now she is slender
But I do see her eating a lot
Expert: I'm more concerned with her weight loss than her skin condition. Cats that are eating a lot yet losing weight are most often either diabetic or hyperthyroid. Diabetes is more likely at her age. Is she drinking excessively and forming more urine than usual?I'll get to her skin condition in a moment.
I wouldn't say I see her drinking excessively. I do see her drink. As far a urine she is outdoors a lot so that is hard to determine
Could it have anything to do with adjusting to a kitten we got in sept? She is never been friendly with other cats and it's taken this long for her to finally tolerate the now getting bigger than her kitten
Expert: I understand. I understand your financial constraints but Honey's vet will want to perform a complete physical exam including fasted (for at least 4 hours prior to a blood draw; never restrict water, however) diagnostics in the form of blood and urine tests. Imaging in the form of X-rays or ultrasound may also be recommended. I don't see a relationship between continuing to eat well yet lose a significant amount of weight and the new kitten.As for her skin, it's important to recognize that such well-demarked alopecia is only consistent with her raspy tongue denuding those areas. The four main reasons for her doing so are flea saliva allergy, atopy, food intolerance, and psychogenic alopecia which may be most important of all because of the stress of the new kitten. Give me a moment to post my synopsis of all of these for you.
I had planned to take all the animals to vet when our tax returns come. Do you think a month is too long?
Expert: Allergies to flea saliva, environmental allergens (atopy) such as pollens, molds, dust and dust mites, and foods should be considered. The pattern of hair loss in cats is not as representative of the various allergic dermatides as it is in dogs.Our dermatologists tell us to apply an over the counter flea spot-on such as Advantage or a fipronil-containing product such as Frontline or, preferably, one of the newer prescription products to which fleas are less likely to have become resistant to, available from Honey'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 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 but that area can be affected by other types of allergy as well. In severe cases, a short course of an oral 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. Be sure to treat your premises with a product such as over the counter Siphotrol Area Treatment spray which contains the insect growth regulator (IGR) methoprene which doesn't allow flea eggs and larvae to develop into adult fleas thus breaking up the life cycle of the flea. Avoid inefficient foggers that can't reach under furniture or into cracks and crevices where flea eggs and larvae are found. Atopy is usually addressed with prednisolone as well. In some cats, an over the counter antihistamine such as chlorpheniramine (Chlor-Trimeton) dosed at 2 mg/cat daily or diphenhydramine (Benadryl) dosed at 1-2 mg/lb twice daily may be effective. Cyclosporin - a chemotherapeutic agent - is another consideration particularly when a steroid is contraindicated by concurrent disease or unacceptable adverse effects. 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 Honey'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. 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 the 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 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. Please respond with further questions or concerns if you wish.
Expert: In terms of her skin condition, another month isn't critical but her weight loss yet eating well should be investigated at your earliest convenience.
Ok I will do my best.
Expert: There's a lot of information above. See if you can print it out and refer to it at your convenience. I'll set a follow up for 3 weeks from now but please return to our conversation - even after rating - with an update at your convenience.
Great thank you
Expert: Thank you for your kind accept. I appreciate it.