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Ask Roger L. Welton, DVM Your Own Question
Roger L. Welton, DVM
Roger L. Welton, DVM, Veterinarian
Category: Cat
Satisfied Customers: 1451
Experience:  Licensed Veterinarian, Practice Owner, and Book Author
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Hi,I have adopted a Bengal cat (female) she is approximately

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Hi, I have adopted a Bengal cat (female) she is approximately 6 years old and has only recently been spayed (June 2013). The Bengal has a bald nose, meaning it is pink coloured and without hair, between the eyes. She got an anti allergy shot and the week after I got her her first vaccine. It seems that a little crust is appearing on the area above her nose (both sides), which becomes a bit more brown as the colour of her fur. The vet first gave me ointment (BNT and Betacourt cream) to put on her nose and right ear (she has a little balt spot there as well). As I have noticed she has quite a lot of tear flow from her eyes (especially after she wakes up) I started browsing the internet as I noticed the bald area starts directly where the tears flow. The tears are clear or a bit like clear beta dine. No crusts or anything comes from her eyes, they are really tears. I really would like to know what it could be. I don't know if it is an allergy or the overflow of tears results in the bald spot or perhaps it is something worse. I had her blood tested and nothing came out.



Beautiful cat, bald nose not withstanding! The nose looks to me like a fairly classic case of eosinophilic dermatitis. That is an autoimmune skin disease of cats that can manifest anywhere on the body, but we most commonly see them on the lips (they are called "rodent ulcers" when found on lips), the nose, or the bridge of the nose.


I have seen all manner of severity, from bald patches and some thickening of the skin at the bridge of the nose like we see with your kitty, to full out ulceration and scabbing of the nose.


Eosinophilic are a line of white blood cells in the body that are involved with inflammation related to allergic stimulation. Hay fever, allergic skin disease, asthma, etc., is all mediated by eosinophil infiltrates. In the case of feline eosinophilic dermatitis, the eosinophils particularly hyper-respond to particular areas of the body, the bridge of the nose being one of them. Essentially, the kitty's own immune system is targeting the pigment and hair follicle cells in that region and causing loss of pigment and hair. Luckily in your kitty's case, it has not yet progressed to outright ulceration, but it could over time.


I do not believe that the tears are a cause for the issue, but a result of it. The nasolacrimal ducts open at the corners of the eye, and the junctions of the ducts and the skin are likely secondarily inflamed, leading to the excess tears.


Here is my advice to you, coming from a veterinarian who has a lot of experience treating this disease:


1.) Continue the limited ingredient diet, as these kitties tend to have multiple allergic pathways, some of which could be food induced.

2.) Ask your veterinarian to prescribe tacrolimus ointment, 0.1 %, applied two times daily. This ointment is an excellent remedy for autoimmune skin disease in dogs and cats, and I have had a g reat deal of success in treating this condition with it.

3.) Consider a round of systemic antibiotics concurrently, as secondary infection is often a complicating problem. There is an antibiotic called Convenia that I love for cats with skin problems, as it has great activity against common skin bacterial infection, and requires only one single injection.

4.) Use year round veterinary grade flea prevention, even if the kitty is indoors strictly. Even one single flea bite in cats prone to this disease can set off an outbreak, and the flea that we most commonly associate with dogs and cats actually is the "cat flea," which has the greatest affinity for, you guessed it, CATS. The cat flea will readily feed on a dog, but given the choice, it will go to a cat, as that is the definitive host.


Thank you for including a was most helpful in this consultation. Please feel free to print out my suggested diagnosis and recommendations to show your veterinarian for discussion.

Roger L. Welton, DVM and other Cat Specialists are ready to help you
Customer: replied 3 years ago.

Dear Dr. Welton,


Thank you for your reply.


The cat is originally from the US.

I live in Aruba and took her from the shelter as she was already staying there for about two years. Her owners brought her there because of the skin problems. The bald nose comes and goes as I understood. She wasn't really for adoption but I have seen her so many times looking depressed, that I wanted to give her a second chance. I have only had her for 4 weeks now.


She eats Taste of the Wild right now, before Whiskas at the shelter. She does seem to like soft food too.


At the shelter she was staying with other cats the whole time (probably with fleas/ a.o. things). I think she hasn't been treated as she could have been all that time.

I have given her an anti-flea prevention immediately as I do with all our pets. I give it monthly.

I have written earlier about the area on her ears that has a bald spot as well. In my opinion that area smells a bit too, but I can't really describe the smell. I was given the BNT and Betacourt cream for that as I wrote, do you think that is appropriate to use on her? It looks like the Betacourt cream makes the fur less full and doesn't make it better.


When I brought her home I first went to the Vet because we already have other pets and I wanted to have her checked first. At that time she did have a little bald/wounded area on her left thigh. That completely disappeared with the creams I described above.


I hope the vets here in Aruba have the medicines you have suggested, otherwise I will try get them through friends in the US.


I really would like to help her. Is there anything you can suggest me to do to make her nose less bald/ make her feel better? Next week I have an appointment for her 2nd vaccine, so I would like to inform them about your suggestions.

Thanks again.