Crusty scab on cat.

Dr. Marie replied:

Sorry to hear that you are dealing with this frustrating problem with Bubelah.

It sounds like your vet is doing all of the right things. Sometimes skin problems in cats can be very frustrating.

A diagnosis of "neutrophilic crusting dermatitis" doesn't always tell us a lot. Sometimes that can just mean that there is scabbing or scarring present because the cat has been scratching at the area. It doesn't necessarily tell us what the cause is.

Usually when we have an area of skin that is affected like this we need something stronger than a cream. (Sometimes if we catch things early we can use a cream but I find that most cats with a large itchy area need something stronger.)

If your vet has prescribed cyclosporin then I would highly advise using it. Cyclosporin is not an antibiotic but it is a medication that tells the immune system to stop over reacting. It works in a similar way to steroids but doesn't tend to have the side effects that steroids do. But, as you have likely found out, it can be expensive.

It can sometimes take a while for the cyclosporin to start to be effective so your vet may advise that you continue with the methylpred cream for a while. This is something you will need to have the advice of your vet on though as I can't make decisions on medications for you online.

There are several ways you can go from here. You may want to ask your vet if there is a veterinary dermatologist in your area. A dermatologist sees all of the "unusual" things.

You may unfortunately have to consider another biopsy. Sometimes a second biopsy can give us more complete results.

You may want to ask your vet about the possibility of this being pemphigus. If it is, then you may need to stay on the cyclosporin.

You can also ask your vet if they feel that you should be trying a hypoallergenic food. And, if not already done, I would advise a flea treatment even if there are no obvious fleas.

Finally, has your vet done a fungal culture to look for ringworm? This is a possibility as well.

I wish I could give you more hopeful advice. I have had cases like this that are frustrating! I hope things are improving soon!

Dr. Marie.


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Dr. Marie replied:

You're very welcome Corinne. I sympathize with you as this is really a frustrating problem! I am really happy that you have an appointment with the dermatologist. This is really the best thing you can do!

I don't think there will be any benefit to starting the cyclosporin now, if you have an appointment tomorrow. The drug will take a few days to even a couple of weeks to really start to be effective so it's probably best to wait for your dermatologist to advise you on what to do.

I would love to be updated after your dermatology consult. I hope everything goes ok!

Dr. Marie.