Bandit is constantly licking the fur off his belly. The vet derm thought it was allergies and we put him on a hypo-allergenic diet but that did not stop it. This is now going on for two years. It started when he had been scratching his ears and had a growth on his face and neck. His regular vet gave him a long term steroid shot and betamethasone dipropionate cream usp 0.05% and everything cleared up but his belly licking. He exhibits no other strange behaviors and is a very affectionate (a real lapcat even to strangers) and otherwise well adjusted, keeps himself well groomed and plays daily with his brother. He's indoor only and very large, about 20 lbs and long and tall. We put the beta stuff on about 3 x week when we see it getting bad and also use neosporin so it's not been getting worse but it s a pretty large affected area and some places get very reddened.He gets brushed every other day and Advantage flea tx once a month year round. We spend 6 months each in FLorida and PA and the cats travel abck and forth in the car with us over 3 days and stay in hotels, are very good travelers and adjust well when they get to their respective home. We are at our wits end to get him to stop and he knows he shouldn't be doing it, when he sees us come in the room he quits and gets a real sheepish look on his face like he did something wrong. Please let me know what you're suggestion may be, we are very concerned about him.
Some of these guys are really zealous about grooming! It seems as if you've been very thorough with his care. One suggestion I would make is having a veterinarian get a urine sample with a syringe and do a urinalysis. I've had cases of inappropriate urination in which only mild bacteria were present and the infection was treated. The pet was then acting normal, but then upon re-evaluation of the urine up to 3 months later, crystals have been present in the bladder. These crystals can form and reform and are quite irritating to the bladder wall and can be a cause for the over grooming. Weight concerns also contribute to cystitis (bladder lining irritation) and can be a concern for over grooming. A skin biopsy can be a beneficial test when analyzed by a veterinary pathology dermatologist lab. If Bandit were not already being treated with a hypoallergenic diet and have a history of megacolon (ie no need for a specialized diet), I would suggest you try Royal Canin Urinary SO wet/moist food for 4-8 weeks to see if that helped, as it is the only diet that can help with idiopathic (unknown cause) cystitis. Please talk with your veterinarian and stay on the same diet at this time. Your veterinarian can also help you design a weight loss plan (food bags overestimate how much to feed) for Bandit to help. Let me know if you would like me to help develop this feeding plan for you, but first I would ensure the urine is normal to ensure that's not playing a role with the over grooming.
Cats which overgroom the belly causing sores usually suffer from allergies, either fleas, food, or pollen/dust. Less common reasons include bladder or colon pain as Dr. Mathis mentioned, feline demodex mites, and behavioral problems. Since he is on year round flea control and has not responded to a hypoallergenic diet, the diagnosis is likely pollen/dust allergies. Psychogenic alopecia is overgrooming due to anxiety, and would not be expected to improve with a steroid cream, since steroids work by reducing allergic skin inflammation. The differentiation can also be made by skin biopsy or more easily by microscopic analysis of moist inflamed areas of skin: allergic inflammation is found in cases of allergy, and little to no inflammation is found in cats with behavioral causes of overgrooming. You would need to stop the steroid cream for 2 weeks prior to obtaining meaningful skin diagnostic results (an elizabethen collar would be needed to stop further self trauma, and oral antibiotics may be needed for secondary skin infection which can make the skin itch/inflammation worse). As an aside, applying that very potent steroid three times a week to a large area on the belly is going to cause side effects such as thinning and tearing of the skin or even systemic absorption of the steroid and internal side effects, so I cannot recommend that you continue to use it. I would suggest getting a urinalysis as Dr. Mathis suggested and, if the urine is normal, I would suggest calling the veterinary dermatologist back to discuss further diagnostic and treatment options such as skin biopsy and/or allergy skin testing and desensitization injections for pollen and dust allergies--if the hypoallergenic diet is not working, you need to take the next step to find out what the real cause of the problem is.
Kimberly Coyner, DVM DACVD
Thank you for your comment. What I left out in Bandits medical hx is that he did have a urinary problem. One morning he jumped up in bed and urinated on the blanket with a painful look on his face for a very long time, and the urine looked bloody. We took him the vet right away (of course it was Sunday and required an emergency visit) and xrays revealed a bladder crystal. I think he was given an injection and put on antibiotics, and was given the SO to dissolve the crystal. That's when he started with the constipation and eventually the enemas, stool softener, and laxatone keeps him pooping regularly. He never had a urinalysis though. I can't remember the reason but the vet did not want him on the SO for more than a month so he went back to his regular diet. I guess we were so worried about his colorectal health that we paid less attention to the licking. We did at one point try to put him on a diet food but thought the licking picked up because the food contained chicken and fish so we took him off. I will have my vet try to get a urine sample and test for this. Thank you for your reply.
Thank you Dr. Coyner. When I took Bandit to the dermotologist, the vet did scrapings on the growth that he had on his neck and area that he scratched around the ears but not on his belly. He dx'd food allergies based on his microscopic exam and said the belly itch was most likely due to the same thing. In the meantime, I believe that pollen and dust are less likely because Peanut, Bandit's brother, is highly allergic to pollen and dust along with just about everything else. Peanut has asthma so his allergy is life threatening and we have put just about every kind of air filter and bacterial light on both furnaces, minimal carpeting in the house, and when the lawn mowers start humming all the windows and doors are closed and cats are brought in off the porch. They're stictly indoors, we have screened porches. Dust is constantly removed from the floors because if Peanut starts an asthma attack we're talking about oxygen tents, IV's, near death ER visit's, and we've been through 2 of those and some less scary ones that we were able to catch early. So we don't want any more of those.
Back to Bandit, my husband and I had the same concern about the steroid cream so we try not to use it often and will take your advice on that point and discontinue. We use neosporin more often when we see sore spots. Right now, he is concentrating on the inside of his left leg so he's moved off his belly some. What I do with the neo is rub it in and brush and pet him for 10 minutes so it has a little time to soak in. I try for 20 minutes but he wants to run away and lick it off. We also have a medicated shampoo that we were given for Bandit's chin to cleanse after his dental cleaning called Pyoben and wondered if that would be helpful. Or some other human shampoo like Nizoral which seems to clear up everything on humans, would that be safe or helpful? Can cats get fungal infections, and what can Bandit have that Peanut doesn't catch. Peanut is on Prednisone for his asthma so maybe that's not why he is catching it. Your comments are appreciated, I think Bandit may be in need of both tests and may have a dual problem which has made it so difficult to stop this. Thank you.
You certainly take very good care of both your kitties! I think you may have misunderstood the veterinary dermatologist--food allergy is not diagnosed based on microscopic exam, but if allergic inflammation is found, then some type of allergy is the problem. The only diagnosis and treatment for food allergy is the hypoallergenic diet trial with no other foods for 8 weeks, and if the itch problem goes away, then the diagnosis is food allergy and the hypoallergenic diet is continued lifelong. If the symptoms persist despite the hypoallergenic diet, then the diagnosis/reason is pollen/dust allergies (atopy). Pets can be allergic to indoor allergens (housedust mites, human dander) and outdoor allergens (pollens) which come into the home with the air every time the door is opened; you are doing an excellent job of environmental allergen management, but this does not mean you cat is not allergic to environmental allergens. I have performed allergy skin testing and desensitization injections in many allergic (and asthmatic!) cats with very good success in reducing or eliminating the need for steroids. To answer your other questions: I would not recommend Pyoben shampoo in cats, as it can be irritating and drying. And yes, fungal skin infection (also known as ringworm) can certainly occur in cats, but is not usually particularly itchy. Animals with suppressed immune systems such as cats on steroids tend to much more susceptible to fungal skin infection/ringworm, so since your asthmatic cat is not affected, ringworm is unlikely, but easily ruled out with a fungal skin culture. A mild oatmeal shampoo would be the safest. In a nutshell I highly recommend that you contact your veterinary dermatologist to schedule a recheck and to talk about further diagnostic and treatment options for your cat. Make sure to take a copy of the urinalysis results as well.
Kimberly Coyner, DVM DACVD
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