Cat itchy on neck.

Recently my cat has been scratching in the area just below her neck at the top of her back. She has scratched away the hair. The vet gave me a topical cream called neo-methylpred .25%. The first little patch of lost hair was about the size of a nickel and when I applied the cream, she stopped scratching right away and it healed within a few days.

But then another patch started 2 days ago below and became much bigger. I went to the vet on Wednesday and they advised to keep using the cream and to also give her an antihisthamine 2 times a day (1/2 of 5mg tablet twice a day) So I started Wednesday night. She seemed to be itching less yesterday but then this past night she's been scratching more again throughout the night and the wound is getting worse. The fur is all gone and the skin is getting rawer and rawer as she scratches.

She also has had some kidney problems since she was kitten and has been on K/D prescription diet since then. It's under control but she has always drunk lot of water and since the past few days she's been drinking even more and eating less. Although she's eating less, she's still eating and is actually more active than usual.

The vet says a biopsy is the only option to check what it is but I'm wondering if a swab or just a scraping of the skin would be helpful? They also said that steroids would help but in case we do the biopsy, they don't want to give them to her yet because it'll prevent the biopsy from working.

I'd like to avoid the biopsy if possible becuase of the invasiveness and the cost. But I realize it's important to diagnose before treating it.

So here are my questions,
1. Should I keep using the cream in the meantime and giving the anti-histamine?
2. Should I do the biopsy or is there another way to diagnose, perhaps a less definitive way? The vet said that even a biopsy may not give definitive results.
3. Is there some topical steroid cream that may help better in the meantime?
4. Do you think this is going to be a life time problem for her? The first and last time she had this was just a little spot when we were living in Japan and again I applied ointment and it healed right away. That was about 4 years ago.

I'm so upset seeing her suffering and I'd appreciate any help you could give.

Thank you,

Corinne

Thank you so much for your reply.

I will try the flea bite treatment you suggested, Revolution or Advantage.

I forgot to mention that the vet thought it might be eosinophilic plaque and she said it was an auto-immune thing.

I would go for the steroid shot but now that you say it could cause kidney disease makes me very worried because she already has kidney problems. She was already drinking over 3 cups of water a day before this started.

I'm sure that if bloodwork were done, it would show, like it has before, that her kidneys are problematic.

So here are my questions:

Does it sound like this eosinophilic plaque?

If she has a steroid shot, considering she already has kidney problems, would it make them worse?

If so, if the biopsy comes out that she needs steroids, is there no other option than steroids?

Do you think it could be a skin infection? Can't these be diagnosed by a scraping? When I had a skin irritation in Japan, they took a scraping and put it under the microscope and diagnosed it right away.

Is the neo-mehylpred a steroid cream? If not, can you suggest a steroid cream I could try?


A little Background:

This problem started the day after I took her to the vet for a physical. She's always been nervous about going go the vet but this last time she had a traumatic time. I let her off the examination table because I thought we were finished. We were not so she hid under the chairs. To get her back on the table they used a blanket to throw on her and she freaked out started screaming and then peed in the vet's arms. She'd never had an episode like that before.

The next day the patch was there so I'm wondering if it was triggered by nerves. However that one healed and now a much bigger one is there.

Thank you again.

Corinne

Hi Dr. Marie,

Thanks again for your reply. Just to clarify, if there is no other choice than the oral or injected steroid, then why bother doing the kidney blood test? If there is no other option, then it sounds like the cyclosporin is the way to go, no?

Before going for the oral or injected steroid, is there maybe a stronger steroid cream we could try first?

She sometimes licks at the cream I put on her wound. Is that bad for her? I guess there's no choice though. Is it more effective if I put it on more than 3 times a day especially if she's licking some of it off?

And finally, do you think I should continue with the anti-histamine? It doesn't seem to be helping.

Sorry for so many questions. Your help is much appreciated. I haven't been able to sleep and your input is very helpful.

Sincerely,
Corinne

Okay, I understand about the blood tests. I guess that will be my next step.

Thanks for all your help. This is a great service.

Take care,
Corinne