FELINE DERMATOLOGY

Introduction
Compound follicles – greater number of secondary hairs
 Less contact dermatitis

Epidermis – very thin

 Careful with topical therapy – shampoos

Lack melanocytes except on lip, footpad, nose, scrotum and

circumanal
 Lentigo Simplex

Dorsum of tail – collection of sebaceous glands

 Feline stud tail

Inflammatory response different

 Less folliculitis

 Response to steroids, decreased (higher doses)

 Feline Acne
Comedones to folliculitis/furunculosis to
chin edema
Etiology – unknown. Seborrheic
disorder?
Infection – secondary in more chronic
cases
 Feline Acne
Clinical signs
 Comedones on chin and lips
 Erythematous papules and pustules

 Folliculitis/furunculosis/cellulitis of chin with

hemorrhagic exudate
 Pruritus variable

 Severity of disease variable

 Fat Chin – swelling – part of EGC

 Feline Acne
Diagnosis
 Clinical signs
 Rule out demodex, dermatophyte, contact
(?), Malassezia derm and food allergy – if
pruritic
 Bacterial culture/sensitivity if exudative

 Biopsy(?)
 Feline Acne
Treatment
 DO NOT OVERTREAT!!!!!!!!!!!
 Do nothing if black heads (pick it off)

 Clip, warm soaks and gentle washings

 Systemic antibiotic for pustular/infected

 Recurrent cases – Topical Vitamin A?

 Mycobacterial
Infections
Higher bacteria – mostly saprophytes
Non tuberculosis/non leprosy – atypical
Atypical
 Ubiquitous saprophytes – classified
according to culture characteristics
 Can be opportunists
 Type IV – rapid growing M. fortuitum most
common
Atypical Mycobacterial
Infections
Clinical signs
 Single or multiple SQ nodules, ulcerate
and drain
 Chronic non-healing and draining wounds,
non-responsive to surgery or antibiotics
 Both types tend to recur and cause
dehiscence of suture line – may enlarge
after attempt to “cut it out”
Atypical Mycobacterial
Infections
Diagnosis
 Can be difficult
 History

 Culture – special media – alert lab;

Sensitivity
 Biopsy – special stains – very few
organisms! – Pyogranulomatous
panniculitus
Atypical Mycobacterial
Infections
Treatment
 Antibiotics – based on C & S; however in-
vivo and in-vitro don’t always match
 Aminoglycosides – toxicity

 Sodium iodide therapy?

 Lamprene 8 mg/kg SID

 Long term fluoroquinolone – Not Baytril –

retinal problems/blindness
 Sporotrichosis
Cats are unique – high numbers of
organisms
Zoonotic potential highest in cats
Handle carefully
Flea Allergy Dermatitis
Clinical signs – not as classic as dogs
Lumbosacral dermatitis – like dogs
Facial or generalized pruritus
Self-inflicted alopecia
 Bald belly cat
******Miliary dermatitis
Miliary dermatitis – collar only
 Cutaneous Reaction
Pattern Based Diagnosis
Cats respond to cutaneous insults in a
limited number of ways
Diagnosis helped by recognizing
reaction pattern – use to make DDX list
Most patterns have similar list – but
order of probability is different
 Cutaneous Reaction
Pattern Based Diagnosis
Miliary dermatitis
Eosinophilic Granuloma Complex
Head and Neck Pruritus
Scaling/Crusting
Self-inflicted alopecia
 Cutaneous Reaction
Pattern Based Diagnosis
Miliary dermatitis
Eosinophilic Granuloma Complex
Head and Neck Pruritus
Scaling/Crusting
Self-inflicted alopecia
 Miliary Dermatitis
Very common
clinical presentation
VERY LONG DDX
LIST
 Miliary Dermatitis

FLEA ALLERGY Pediculosis

Food allergy Ticks
Atopy Cat fur mite
Otodectic mange Drug eruption
Cheyletiellosis Internal parasitism
Trombiculidiasis Hypereosinophilic
Notoedric mange syndrome
Demodectic mange Biotin deficiency
Dermatophytosis Fatty acid deficiency
Staph folliculitis Hormonal
Idiopathic
 Miliary Dermatitis
Clinical Signs
Papule surmounted by a crust
Edematous – exudes serum
Distribution is variable
Pruritus is variable/self inflicted alopecia
MILIARY DERMATITIS
Diagnosis
Clinical signs
Search for underlying etiology –
initially..
 Skin scrape
 Ringworm culture
 Fecal exam
 Flea allergy test/flea control
MILIARY DERMATITIS
Further work up
Antibiotics for several weeks
Food allergy trial
Intradermal skin test
CBC
Response to ivermectin
Intestinal parasite deworming
Discontinue drugs
Biopsy?
MILIARY DERMATITIS
Treatment
Treat underlying disease
Steroids (rule out demodex,
dermatophyte, staph)
1 mg/lb prednisone daily then taper
10 – 20 mg Depo-medrol EOM or less!
Ovaban/Megace????? YUCK
 Cutaneous Reaction
Pattern Based Diagnosis
Miliary dermatitis
Eosinophilic Granuloma Complex
Head and Neck Pruritus
Scaling/Crusting
Self-inflicted alopecia
 SYMMETRICAL
ALOPECIA
Self-inflicted alopecia- MUCH MORE
COMMON THAN…..
Non self inflicted alopecia

Self –inflicted
 Pruritic
(VERY COMMON)*****
 Psychogenic (MUCH LESS COMMON)
SYMMETRICAL ALOPECIA
Various areas affected
Ascertain if hair loss is self inflicted
 Historical information: owner noting
licking, chewing etc..
 History or hair balls or constipation

 Derm exam: hair epilation, broken hair,

dermatitis?
 Exam hairs microscopically

 E-collar (usually not needed)

 SYMMETRICAL
ALOPECIA
If self-inflicted then: pruritic vs
psychogenic
Explore pruritic disease first
Skin scrape, fungal culture, fecal exam,
flea test/control
If no answer then.. Food trial, skin
testing, ivermectin response,
deworming
 SYMMETRICAL
ALOPECIA
Treatment
Treat underlying pruritic disease
After extensive search then try steroids
 Steroids may help to differentiate between
pruritic and psychogenic alopecia
 SYMMETRICAL
ALOPECIA
Psychogenic
High strung breeds:
Siamese, Burmese,
Abyssinian, Himalayan
Historical information-
change in physical or
mental environment
R/O self inflicted pruritic
 PSYCHOGENIC
Alleviate the stressor
Mood modifying drugs
Most commonly used
 Prozac (Fluoxetine)
 Elavil (Amitriptylline)

Taper gradually
 NON SELF INDUCED
ALOPECIA
Temporary stresses: antimitotic drugs,
surgery, high fever
Systemic Disease
 Cushing’s
 Diabetes

 Hyperthyroid

 Advanced kidney disease

 Chronic hepatic disease

 Paraneoplastic alopecia
 Cutaneous Reaction
Pattern Based Diagnosis
Miliary dermatitis
Eosinophilic Granuloma Complex
Head and Neck Pruritus
Scaling/Crusting
Self-inflicted alopecia
 HEAD AND NECK
PRURITUS
Extremely pruritic!!!!
May need steroids initially or placement
of E- collar because of self trauma
Difficult to make diagnosis
DDX: Otodectes, Notoedres, Food
Allergy, Atopy, Flea Allergy,
Dermatophyte, Demodex, Other Ear
Disease
SEBORRHEIC DISEASE
Total body seborrhea: systemic
disease, chronic inflammatory dz,
FeLV, FIV, malnutrition, environmental
problem, endocrinopathy
Sticky cat syndrome – idiopathic
Localized seborrhea: feline acne and
stud tail
SEBORRHEIC DISEASE
Stud tail
Most common – intact males
Comedones/inflammation of dorsal
sebaceous glands
Treatment: ignore, wash with benzoyl
peroxide, treat with antibiotics, treat with
ketoconazole
 PLASMA CELL
PODODERMATITIS
Rare idiopathic disease
Footpad swelling – sometimes
ulceration
May occur with hyperglobulinemia,
lymphocytosis, GN
Soft non-painful pad swelling, pads
balloon and then collapse, may then
ulcerate and be painful
 PLASMA CELL
PODODERMATITIS
Diagnosis
Histopathology: massive plasma cell
infiltration
R/O neoplasia, autoimmune
Treatment: glucocorticoids, possibly
gold salts
 LENTIGO SIMPLEX
Orange cats: Macular areas of
hyperpigmentation
Lips, eyelids, gingiva and nose
Completely asymptomatic
 STEROIDS
Cats harder to pill
More resistant to adrenal
suppression
Don’t respond as well to oral
steroids
Iatrogenic Cushings is rare
Commonly use long acting
injectables: Depo-Medrol,
Vetalog
MEGESTEROL ACETATE
Megace, Ovaban
More effective
antiinflammatory agent than
steroids in the cat
Mood altering
MANY SIDE EFFECTS:
adrenal suppression, PP,
PU/PD, personality
changes, pyometra or
stump pyometra, mammary
gland cysts or hyperplasia,
DM