Unit 2: Feline Dermatitis Flashcards by Bianca Zayas

What are the most common reasons for pruritus in cats?

Fleas, parasite hypersensitivity, cutaneous adverse food reaction, dermatophytosis, “catopy”

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What is the #1 reason for itchy cats?

Fleas (C. felis)

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What parasites contribute to hypersensitivity in cats?

O. cynotis, C. blakei, N. cati, D. gatoi, mosquitoes

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What dermatophyte affects cats?

M. canis

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T/F: It is more common to see food allergies in cats than in dogs.

True

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What is “catopy”?

Non-flea, non-food hypersensitivity dermatitis (NFNFHD)

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What is the presentation of an allergic cat?

Excessive grooming, eosinophilic skin lesions, miliary dermatitis, head and neck pruritus, recurrent otitis

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What is the most over-diagnosed cause for cats excessively grooming?

psychogenic alopecia

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What type of diagnosis is psychogenic alopecia?

diagnosis of exclusion

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How can you R/O psychogenic alopecia?

Put cat on pred - if there is response to steroid, there is inflammation present and this eliminates psychogenic alopecia as a DDx

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What do eosinophilic skin lesions look like?

Can be indolent ulcers, can be plaques that are raised and look like ulcers

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What will you see on cytology with eosinophilic skin lesions?

Numerous eosinophils

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What 2 components are required for addressing eosinophilic lesions?

Inflammation and infections

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What can be used with inflammation due to eosinophilic lesions?

Prednisolone

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What antibiotics can be used with eosinophilic lesions?

Clavamox, cefpodoxime, cefovecin

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What is miliary dermatitis?

Bacterial skin infection of cats

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What is important to ask the owner when we think the cat is allergic?

If there are other animals in the house, if they are affected, and when the last cat was added

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What should we think of if we see multiple cats with the same lesions around the same time?

parasites

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What are initial diagnostics to do for cat allergy and which 2 are most important?

Flea comb, fecal float, skin scrape, cytology, fungal PCR/DTM culture

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Why should a fecal be done when allergy is involved?

It is common to find organisms in the feces because cats groom so much

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Why should we do a fungal PCR/DTM culture with allergy?

It is stardard of care to eliminate ringworm as a DDx because it is so common in cats

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What steps are important when dealing with fleas?

Kill fleas on pet, address the environment, treat all pets, prevention, ensure resolution prior to moving on

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What is the most contagious form of demodicosis?

D. gatoi

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What is the single most effective treatment for D. gatoi?

Lime sulfur rinse - weekly for 6-8 weeks

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What are other, less evidential forms of treatment for *D. gatoi*?

Ivermectin, Advantage Multi, Bravecto, Revolution Plus

What is used to treat pruritus in *D. gatoi* cases?

Short course of steroids - methylpred or prednisolone

What is this?

*Cheyletiella*

What is this and how do you know?

*Otodectes*, has suction cups on end

What are common treatments for ectoparasites? (other than *D. gatoi*)

Revolution (plus), Adv Multi, Bravecto, Macrocyclic lactones (ivermectin, doramectin); also can use lime sulfur

Mosquito bite hypersensitivity is a _____ disease.

seasonal

Where do lesions occur for mosquito bite hypersensitivity?

Bridge of nose, pinnae, and pads

How is mosquito bite hypersensitivity diagnosed?

Clinical findings and response to mosquito-free environment

What are good treatments for mosquito bite hypersensitivity?

GCs, avoidance (dusk to dawn), nepetalactone, Avon Skin so Soft

What SHOULD NOT be used to treat mosquito bite hypersensitivity?

Pyrethrins and permethrins, Deet

What are good drugs for pyoderma?

Simplicef, Convenia, Clavamox, Clindamycin

What are good drugs for *Malassezia* dermatitis?

Fluconazole, Itraconazole, antifungal-containing mousse

What does a negative RealPCR ringworm panel result mean?

It **maybe** is negative

What are the 4 hallmarks to consider with food allergy?

1. Non-seasonal 2. Lack of response to GCs 3. Age of onset 4. Concurrent GI symptoms

What are the top 3 food allergens in cats?

Beef \> Fish \> Chicken

What are 3 diets that can be used in an elimination trial?

Novel protein, hydrolyzed, home cooked

Why may home cooked diets be better when feeding chicken?

Processed chicken might have allergens present that would otherwise not be there - due to temperature used in processing and denaturing of protein

What are some examples of novel protein Rx diets?

RC rabbit and pea, BB alligator and pea

What are some examples of Rx hydrolyzed diets?

RC HP, RC ultamino, Purina HA, Hill's z/d, BB HF

T/F: Owners can buy OTC pet food and it is jsut as effective as home cooked or Rx diet elimination trials.

FALSE

How is a food elimination trial done?

1. Choose diet - feed for 9-12 weeks 2. If better, rechallenge and let them eat what they used to 1. If not better, is not likely food allergy 3. With rechallenge, if gets worse again = food allergy --\> put them back on the diet that made them better 1. If does not get worse, allergy is seasonal in nature

What is necessary to diagnose NFNFHD?

R/O all other causes, must be seasonal

T/F: There are no existing tests to diagnose or confirm NFNFHD?

True

What are antihistamines good for in cats with NFNFHD and which 2 are used?

Good for prevention but after symptoms start; Chlorpheniramine, Ceterizine (Zyrtec)

What is the most effective treatment for feline NFNFHD?

GCs (pred, methylpred, triamcinolone)

What is the only labeled product for use in treating allergic manifestations in cats?

Cyclosporine

Why do we use antihistamines in cats?

To lower the dose of other drugs like Cyclosporine

\_\_\_\_\_ steroids are preferred to \_\_\_\_\_. Why?

Oral, injectable; Preferred because if there is a reaction the dose can be adjusted quickly

What are adverse events of cyclosporine in cats and what is the prevalence?

63%; GI related, weight loss, lethargy, concern for cancer?

How does ASIT in cats compare to dogs?

It is similar, but cats are slightly harder to test

What drug should only be thought of as a last resort in cats with allergy?

Apoquel

What organ can be affected with oclacitinib use in cats?

kidneys

What is plasma cell pododermatitis?

"pillowfoot"; Reaction pattern vs. disease - allergic, infectious, structural abnormality

What cats most commonly have plasma cell pododermatitis?

DSH and neutered males

What is the most common complaint with plasma cell pododermatitis?

Lameness - soft, swollen pads, mushy feel, possible ulcerations, fissures, and cracks

How is plasma cell pododermatitis diagnosed?

FNA or biopsy

How can plasma cell pododermatitis be treated?

Doxycycline, GCs, cyclosporine, diet trial, surgical excision (surgical excision is worst possible thing you can do here)

What is feline idiopathic ulcerative dermatitis?

Solitary crusted ulcers along the dorsal cervical region - it is of unknown etiology

Pruritus and pain in feline idiopathic ulcerative dermatitis are \_\_\_\_\_.

variable

What is a common secondary manifestation of feline idiopathic ulcerative dermatitis?

Infection

How is feline idiopathic ulcerative dermatitis treated?

Treat secondary infections (SSD cream), systemic/intralesional GCs or CsA, protective bandages, diet trials, surgical excision, Topiramate and Apoquel

What is feline lung digit syndrome?

Asymptomatic bronchogenic or squamous cell carcinomas of the lungs

What is the signalment for feline lung digit syndrome?

older cats

How does feline lung digit syndrome present?

Multiple digits on multiple paws affected; lytic and destructive process, patients present for lameness

What is the mean survival time of feline lung digit syndrome?

60 days

What is feline paraneoplastic alopecia (how does it present)?

The skin appears shiny, glistening, smooth, with or without fine scale; pads may also be involved

What is the onset and progression of feline paraneoplastic alopecia?

Onset = rapid, Progression = several weeks

What cats get feline paraneoplastic alopecia?

Older cats with pancreatic adenocarcinomas or bile duct carcinomas

What cats get feline exfoliative dermatitis?

older cats with thymoma

What signs are noticed first in feline exfoliative dermatitis?

Skin signs noticed before clinical signs as a direct result of the mass (coughing, dyspnea, anorexia, weight loss)

How does feline exfoliative dermatitis present?

Marked scaling with progressive alopecia +/- erythema and pruritus

How is feline exfoliative dermatitis diagnosed?

Biopsy and radiology

What is the treatment and survival for feline exfoliative dermatitis?

Tx = surgical excision Survival = 3 years (75%)

What is feline skin fragility syndrome?

Acquired condition of older cats with severe systemic disease where the skin tears and bruises under normal activity without bleeding

What are some concurrent systemic diseases that can be seen with feline skin fragility syndrome?

Cushing's, biliary and hepatic carcinomas, hepatic lipidosis

What is pathogenesis of feline skin fragility syndrome secondary to?

Catabolic effect of the underlying condition