Cat Balding

[Athena_d]

Yeah it was a lot whiter, but like you said, it could be changing as she gets older. She does groom the area often, as it’s usually where she prefers a good scratch. Trying to get our scent off her I guess .

 

[PushPurrCatPaws]

Hi Athena_d !
I wanted to check in with you again to see how your kitty, Athena, is doing!

I've been trying to get to the root of my cat Milly's bald ears ("Bat Girl"!), and I think I am finally getting somewhere.

I wanted to update you and alert you before a lot more time has passed, in case you were still having any issues with your cat, Athena. My cat was really helped by getting a second opinion from another vet (see below). And I wanted to encourage you to find a better vet or even a specialist (dermatologist) and have them do skin scrapings and tests to see if your cat's experience(s) may continue to parallel my cat Milly's. Hopefully Athena is doing well (and doesn't have spots of itching and hair loss on her body, like Milly started to get!).

I hope giving you some of the below information will help you and others reading this.


Okay, so... I think we last interacted in PMs in March 2018 when we talked about the fluticasone inhalers we used for our kitties asthma. I was curious then if you were using a flixotide type versus a Flovent brand name one, and further, if it was a flixotide from Turkey which did not state it was CFC-free versus a brand name Flovent HFA (e.g. no CFCs), or a flixotide type that specifically had "CFC-free" shown on the container itself. At that time I was using a Turkey-sourced flixotide canister via a Canadian pharmacy, but one that did not have "CFC-free" on its labeling. It was actually a generic I wasn't feeling too much confidence in as being trustworthy but which I had bought via the Canadian pharmacy route because it was inexpensive, relatively-speaking, compared to the Flovent brand name.

But in any case, the theory I was trying to figure out at that time was if our cat's balding ears might have to do with the type of propellent used in a fluticasone inhaler. Most countries phased out CFCs 6-8 years ago, but some didn't, apparently. You and I worked out in our private messages that you were using the brand name GSK Flovent HFA as it was sold in Canada, and your cat was still having similar balding ears as my cat, so maybe that theory of mine went nowhere. However, I decided to pay attention to my gut feelings and distrust of the particular flixotide I was using on my cat, and by the end of March, I started buying her the "real" GlaxoSmithKline Flovent HFA/ metered dose inhaler (costs more) and using that on Milly instead. It did seem less harsh and she had miniscule hair regrowth on her ears... but basically, her balding ears stayed about the same. It sure costs a lot, ugh.

So, by early Spring of this year (2019), I was deciding to taper her off of the Flovent inhaler (working with the vet on this) and just rely on systemic Pred as it worked the best against her asthma cough attacks. I did a slow taper of the Flovent HFA over a few months' time. Her last Flovent was July 21st, all the while I still kept her on her daily small dose of oral Pred, of course. Anyway, she had some more mild hair regrowth while we tapered and stopped the Flovent, so it really did seem like the inhaled steroids and the fact that Milly was cleaning and grooming her face, whiskers, then wiping the steroid-laden saliva over the backs of her ears repeatedly as she groomed, could really be contributing to the balding ears.

Meanwhile, though, Milly had been really scratching her right jawline area even before we began tapering her off of the Flovent. Pretty soon she was getting some small hair loss on that spot on her jawline. She was scratching her ears, top of head, her chin more too. Sometimes she didn't feel like eating much, and would chew on one side of her mouth. I had no idea why. I thought maybe all this itchiness and stuff was a food intolerance to possibly fish or another protein (turkey? rabbit?), and tried some food trials but that didn't stop the scratching (she was also licking and nibbling a bit on a few places elsewhere on her body, under her arms, on her forearms, a bit on her tummy plus ears and top of head -- although NOT anywhere else besides her jawline to the point of any hair loss).

Then in June 2019 or thereabouts, we started seeing this weird dark spot "grow" right next to her hairless spot on her right jawline. Yikes! What was that?! It seemed to get bigger. Was it hyperpigmentation caused by her ferocious scratching?
Circular, dark, crusty-looking, weird-



We took her to the regular vet early July and end of July, in two separate vet visit rounds of testing, surface skin scrapes, cytologies, sent samples of for RealPCR tests for ringworm... all negative for ringworm, and the regular vet couldn't find fungi, mites, ringworm or bacteria. We did a week of Animax ointment. Not a lot of progress and we still didn't know what was going on.
(after animax, not much improvement, just more moisturized)-




Time to go to a veterinary dermatologist. I'm so glad we did! Turns out the dermatologist said, yes, the balding ears are from chronic steroid use, she has seen that before. She also redid all the tests, but did both surface scraping and deep skin scraping tests, trichogram(s), acetate tape tests, etc. (I'm not sure of all the details, I'm just a hapless cat owner, not a vet, lol!)

Pretty soon the dermatologist came back to us in the exam room with a low magnification photo of one of the culprits: an adult demodex cati mite. She (Milly, not the vet!) had some hiding in her ears, too. She said Milly had many demodex mites, an overpopulation of demodex cati probably due to the longterm corticosteroid use, since her blood work and stuff looks pretty good and she's not been diagnosed with any major diseases and the like (so far). These mites are considered a 'natural' part of the cat's system, they get them from their mom around the time of birth and nursing, but if a cat is immunocompromised or immunosuppressed, these mites can turn into a real parasite problem and overpopulate on cats, causing a lot of issues. I think we caught Milly's troubles near the start of things, and with the Bravecto topical and 4-5 weeks of Douxo mousse for her jawline area, the turnaround is amazing!

No more bat ears!

One week after taking Bravecto,


Two and a half weeks after taking Bravecto,


Three weeks after,


(^ notice her catnip Bat toy )

And that is just showing the progress on her ears! All of her hair is more glossy, she is not licking and scratching as much at all, she is happier and more playful. She is still continuing to eat her favorite foods. She did well on the Bravecto, no huge side effects noticed by me so far (and I'm a helicopter mom when she is having issues, so I would know. )

Her sore on her jawline is healing too, hair growing back (although it's still a bit itchy),




and she tested negative yesterday for the d. cati mites, and we'll be working with an internal med specialist next month to go over what to do about Milly's asthma and with continuing the oral Pred, etc. In three months we have another recheck with the dermatologist. (This has not been a cheap process $$, so I am hoping to help others know a bit more about all of this -- so that they can just head straight to a chosen vet to help with certain issues instead of spinning your wheels like we did, thinking some things might be food allergies or environmental allergies. Let's not forget about the microscopic world living on a cat's skin! The culprits could be right there!)

I may start another thread about this whole topic of demodex cati, demodicosis and immunosuppressed cats, and how Bravecto has helped combat those mites, at least in Milly's case (I was thinking of calling it, "Asthmatic Bat Girl on Corticosteroids Encounters a Demodex Cati Flash Mob!", haha.) -- but I really wanted to put this info in this thread especially because of the balding ears factor here, tied into steroid usage, and my worries for the kitty Athena.(<that's a head's up to the Mods so they don't move my long post!)

I have been doing a lot of reading up on Bravecto/ fluralaner too, and have bookmarked a lot of links, good and bad, scholarly and not, trying to get a well-rounded picture. There are several things about bravecto that concern me moving forward, but it has been a good thing for Milly so far, for sure. Alas, I'm having a hard time writing up a good post about it, for another thread, as there are a few things going on in my life right now and I haven't a lot of extra time!

Anyway, it will be a balance between steroids and fluralaner usage for Milly (but I'm saying that before we have also met with the internal medicine specialist, so I aim to know more months down the road, too).

caveats: **I am not a veterinarian. I don't intend to diagnose any issue with anyone else's cat or recommend any type of medicine or drug, but only to describe just a few issues that my own cat experiences and to only partially talk about what has helped her so far. I definitely recommend that you take your cat to a licensed veterinarian, and even to a board-certified specialist -- especially the latter, as the dermatologist has really helped in my cat's case. I expect the Internal Medicine specialist, when we meet with her in October, will help immensely too. Only your cat's vet(s) knows your cat's particular case and health issues the best, and things I write here are from my own experiences, opinions, understandings, and anecdotes, or time spent researching. It could be that none of what I write about here will help your cat, but I do think it is something you could discuss with your vet if you have an immunocompromised cat, and you and your vet must decide how to diagnose and help your cat. I am not recommending any drug or medicine for your cat, but only that if your cat, or a cat you are helping (feral or stray), is having certain issues, to go see your vet or a board-certified veterinary specialist for advice and care and diagnosis.**