New Guidelines for Helping an Itchy Cat

A healthy cat scratches himself for a total of about one minute per day, and he spends about one hour altogether grooming himself by licking his coat. Much more than that, and there’s a good chance something is wrong.

Unfortunately, something is wrong relatively often. Excessive scratching and licking due to itchiness, medically known as pruritus, is one of the most common reasons people seek veterinary care for their cats, according to the American Animal Hospital Association (AAHA).

The cause is generally some kind of allergy, but which kind can be tricky to figure out. The cat remains miserably uncomfortable in the meantime. His skin can become not only itchy but also inflamed or pimply-looking and crusty. And in literally assaulting his skin with his claws and tongue to try to relieve the discomfort, he can create significant ulcerations in his coat. That in turn leaves the cat open to infiltration by bacteria that can cause infections on top of the allergy — a misery twofer.

To help facilitate diagnosis and treatment of an itchy cat, the AAHA has developed a new set of guidelines for managing allergic skin diseases in our pets. Read on for what you need to know.

The initial exam

You can reasonably expect the following at your cat’s first visit to the doctor to try to determine the cause of the itching.

1. Flea combing. Flea allergy dermatitis is one of the most common allergic skin diseases. For that reason, the AAHA guidelines say that flea combing by the veterinarian is a crucial part of the examination (although if nothing is collected with the combing it does not rule out a flea allergy — sometimes it takes more sleuthing). If your cat does have fleas, it doesn’t mean you keep a dirty home. Fleas happen. In allergic cats, typically just a few flea bites can be enough to trigger an itch. General recommendations include year-round flea control, even in cats who live entirely indoors.

2. Ear exam. An ear infection, medically termed otitis, can go hand in hand with a feline skin allergy. You can expect that the vet will check both your cat’s outer and inner ears.

3. Prescription to control the itching. Your cat should be given a drug to make him less itchy right away. It can take a while to nail down the cause, particularly in the relatively rare case of an allergy to a particular food or even to fleas, and your pet does not need to be in discomfort and ripping into his skin during the diagnostic period. Cats often respond quickly to glucocorticoids, namely prednisolone, methylprednisolone, or dexamethasone. Cyclosporine does not provide immediate relief. It can take several weeks to kick in (but can prove effective for long-term treatment if and when certain allergies are diagnosed). Antihistamines are usually not prescribed at all as they’re not effective for an allergic itch.

4. Cytology to check for secondary infection. If harmful bacteria have entered the cat’s body as the result of an ulceration in the skin because of  the excessive scratching and licking, cytology will help find it. A cytological exam is conducted by pressing a cat’s coat to some Scotch tape or a glass slide, staining the sample, and putting it under a microscope to help identify the harmful pathogens. That way, the correct antibiotic can be prescribed.

5. Skin scraping. The vet will use a scalpel to collect and examine debris, hairs, and cells from the top layer of skin and then look via microscope directly at what has been collected. That will help the doctor understand better if mites or other parasites are causing the problem. If not, the culprit could be an environmental allergen or, in less common instances, a food allergy.

Your vet may also ask a number of questions, including whether the itching is seasonal, whether other pets in your home feel itchy, whether you regularly give your cat a flea preventative, and whether your cat has recently come in contact with stray cats or cats at a boarding facility. Your answers can help determine what’s going on.

But for all that, it can sometimes take two to four months or even longer to figure out the specific problem and find the right combination of treatments. The AAHA suggests that if adequate control of symptoms cannot be achieved by the third visit to your primary care vet, referral to a veterinary dermatologist should be presented to you as an option.

It’s a situation that requires a “communication-rich approach” with the vet to arrive at a solution for your pet’s condition, says the AAHA. In most cases that solution will probably involve a lifetime of ongoing treatment to have good control of the allergy and avoid relapses. But with patience and leaving no stone unturned, your cat should be restored to a state of comfort and relief from what can be incessant, exasperating itchiness.