How to Scratch Your Kitty’s Itch

Lick, scratch, thump, thump – your kitty is keeping you up at night because he is itchy and cannot relax. You question why you let him sleep in your bed in the first place. You try to discourage him, but you can only redirect him for a short time before he starts up again. Lick, scratch, thump, thump. This is a frustrating and familiar experience, if you have an itchy kitty.

Cats itch for a variety of reasons, and the severity of the itching can range from a little excessive grooming to the creation of open sores and red, bald spots on their bodies.

Last month I attended the International Society of Feline Medicine conference in Porto, Portugal. Veterinarians from 35 countries were in attendance. Itchy kitties were featured in a session presented by a well-known boarded veterinary dermatologist. I treat itchy kitties every day, so it’s always good to hear other perspectives and see if new treatments are available.

One of the main challenges with itchy kitties is that a variety of causes all create the same clinical signs. Cats that have fleas might look similar to cats that have environmental allergies. Cats cannot tell us what is aggravating their itchiness, so we have to be detectives and get good histories and perform thorough exams.

Every itchy kitty needs to be checked for fleas. I am often told by owners that their cat never goes outside, so it would be impossible for him to have fleas. I take out my trusty flea comb, take a few strokes, and find the evidence of the black, peppery flea dirt and even live fleas in the cat’s coat. In these situations, owners are horrified that fleas have gotten into their home.

Fleas are very pesky. They can come in through screens, hitchhike on your clothes, or come in inadvertently by visitors who have pets. The good news is that fleas are the most treatable and curable cause of itching, since we have so many effective products to rid our pets of them. Make sure that you use a product that is specifically labeled for cats, and ask your vet for advice.

Fleas aren’t the only parasite that causes cats to itch. Skin mites, ear mites and feline lice are other bugs that cat live on your cat and cause problems. A simple test called a skin scrape helps identify skin mites. Microscopic examination of ear swabs and an exam of the ears will identify ear mites.

Lice are usually large enough to be seen in the coat or picked up by a tape impression of the coat. A skin mite called Demodex gatoi can be difficult to find. To rule out fleas and D. gatoi as causes of itchiness, a six-week trial with weekly application of a product containing imidaclopid and moxidectin is recommended.

Fungal infections cause itchy skin. To check cats for the most common ringworm fungus, a special black light called a Wood’s lamp is used to screen the coat, then a culture is taken of potentially infected hairs. The culture can take up to two weeks to grow. Malassezia is a yeast infection that can be found on the skin and may be seen when ear swabs or skin impressions are examined microscopically. Fungal infections are treated with antifungal shampoos, dips, mousses and oral medication.

Bacterial infections of the skin cause itchiness. These infections don’t always look bad and may be superficial but require treatment for two to four weeks to resolve. Medicated baths, special disinfectant mousses and rinses and injectable or oral antibiotics are used to treat skin infections.

When parasitic, fungal and bacterial causes are ruled out as the reason for your cat’s itchy skin, a food allergy may be considered. Studies have shown that only 10 percent of cats actually have food allergies, and many that have food allergies also have gastrointestinal signs, not just itchy skin. It is difficult to test for food allergies. Tests for antibodies to certain food proteins in the blood are available; sensitivities to one or more of these ingredients would indicate they are somthing to avoid. Independent research hasn’t clearly supported these findings.

Historically beef, dairy, and fish have been considered the most allergenic proteins in cat foods. In the veterinary world, there hasn’t been much research into whether gluten, soy, GMOs or other grains cause food allergies.

The standard way to determine the presence of a food allergy in cats is with an elimination diet that contains a “novel” or hydrolized protein, one the cat has never eaten before or that is broken down so the body doesn’t recognize it. It is becoming harder and harder to find novel proteins since all pet food manufacturers are jumping on the bandwagon to offer more unique foods.

When unique proteins (duck, venison, rabbit) are part of a diet with other proteins (chicken meal, fish broth, etc.) or manufactured at a plant where other proteins are mixed into foods without strict cleaning practices between food batches, the diet is no longer hypoallergenic. If a cat has a food allergy, he will generally have an improvement with his itchiness within six to eight weeks of an exclusive and complete diet change.

The last and potentially most common causes of itchiness in cats are environmental allergies/atopy or immune-mediated diseases. Allergy testing does exist for cats. Intradermal skin testing is considered the gold standard and involves injecting small amounts of allergens under the skin and looking for an inflammatory response.

This type of testing is not routinely performed in cats. Blood tests looking for IgE antibodies to allergens are often used. Cats, like people, can be allergic to numerous items including molds, house dust mites, ants, tress, grasses, and weeds. Even indoor cats can be allergic to things that grow outdoors around their homes. If specific allergens are identified, hyposensitization injections or oral immunotherapy serums can be used.

Steroids, antihistamines, and cyclosporine are all drugs that decrease itchiness, especially when caused by allergies. Allergies are managed but not cured, so long-term therapy is needed in most feline patients. The goal is using the lowest dosing of medications to control the itchiness. Long- term use of certain medications can have side effects, so in severely affected patients, several different types of treatments may be combined to lower doses and achieve better results.

It is important to work up the cause of itchiness in a cat so that he is treated properly. This often takes more than one visit to your vet, several tests, and potentially some therapeutic trials to see what works the best for controlling the itching.

If you have an itchy kitty, be patient and see if there is an underlying problem such as parasites or an infection that can be cured before just treating his symptoms. You’ll get a better night’s sleep if your feline friend is resting comfortably and doesn’t need to scratch. You’ll also be a lot happier when he is comfortable.

Copyright © 2015 The Cat Care Clinic

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About Dr. Elaine Wexler-Mitchell

Dr. Elaine Wexler-Mitchell is the owner of The Cat Care Clinic in Orange, CA

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