Pet care: Cat's skin problem is driving it crazy

Q: A year ago, I emailed you about Amber, my female tortoiseshell cat. She had an ear mite infection and severely scratched the right side of her head. The veterinarian gave her an injection to kill the mites, and steroid and antibiotic injections for the wound. The wound on her face is still a problem. Every time it heals and I remove the cone, Amber ends up scratching it again, thusly requiring wound care and the cone.

After your response in the Journal, the veterinarian put Amber on a special diet for sensitive stomach and food/skin allergies. The results were negative. I’ve gotten the wound to heal many times, but when that cone comes off, Amber scratches the newly healed flesh and tears it apart, always in the same place. I have her wear the cone all the time.

Dr. Nichol: Amber’s skin is driving her @#$%& crazy, whether she’s wearing the cone (Elizabethan collar). Her angst is even worse when she can’t reach that infernal wound to scratch it. You love this girl, and you want her to get better. Everybody’s wellbeing is suffering, so I consulted a specialist.

Dr. Rebecca Mount is a veterinary dermatologist who, along with me, cares for pets at Thrive Pet Healthcare Specialists in Albuquerque. The good doctor’s response: “Poor Amber. Mites are unlikely now, especially with her historical therapy. This kitty has either atopic skin syndrome (environmental allergies) or idiopathic ulcerative dermatitis. A biopsy would be helpful. If this isn’t feasible (for cost reasons) I would consider a gabapentin trial in case there is pain, atypical itch, or a behavior disorder.”

Translation: Taking a small sample of Amber’s skin (biopsy) would be a relatively minor, day procedure intended to reveal the underlying cause(s) of her incessant itching and self-mutilation. Idiopathic ulcerative dermatitis results from overstimulation of nerves. Biopsy results may also indicate resistant infection, inflammation, or maybe a behavioral cause. Amber’s treatment should evidence-based, not a shot in the dark. Put differently: diagnose first, treat second. Light the rocket — get the skin biopsy.

For help with behavior problems, you can sign up for a Zoom group conference at drjeffnichol.com

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