Cat acne, infections on chin
Re: Cat acne, infections on chin
that too
Yeah, I'd agree there. The OxyDex was small potatoes cost-wise when compared to all the oral antibiotics and just the cost of the repeated vet visits. Visits every two weeks for 6 months add up FAST, and in one case a two week course of one antibiotic cost $60.Traci wrote:I'd say lack of knowledge and comittment
Traci, do you think there's any chance the cat could be reacting to the steroid asthma inhaler our other cat is on? They aren't very affectionate with each other so it's not like she's grooming the asthmatic cat's face (although she occasionally gives her a lick or two on the forehead before remembering that she hates her and hissing at her) but I know steroids can cause yeast issues. I know, I'm probably grasping at straws here. I did check out photos and descriptions of EGC online and it doesn't sound or look like what she has, but I'll definitely bring it up with the new vet tomorrow. Thank you SO much for all your help so far. All of this has taken a lot out of me emotionally and I feel a little bit of hope for the first time that we might be able to sort this out.
(Edited to add something I failed to say before, which is that the cat DEFINITELY had blackheads on her chin -- she doesn't now because, you know, that would require actually having SKIN on her chin, poor darling -- but from what I can tell she does HAVE feline acne, although whether or not the infections are because of the acne or something else entirely is another story.)
- WG
Re: Cat acne, infections on chin
Very doubtful of the inhaler from the other cat.
I think the main problem has been improper treatment, that is, a bad treatment plan was approached, the symptoms persisted and worsened, and now healing has been delayed considerably. Your vet, had she been thinking correctly, would have asked herself: "hmm, why's it taking so long for this to heal?....hmmm, well, that didn't work, I wonder if I've diagnosed this correctly/rule-outs.....hmmm, now we have open sores/lesions, perhaps this treatment should be ceased, since it is obviously aggrivating the problem..."
The skin and lesions need to be left alone, for the most part.....just gentle dabbing to remove excess dirt/debris/bacteria....then topical antibiotic applied, this would have been so simple at the beginning! But also, other rule-outs must be done!
May I ask what you're feeding her?
I think the main problem has been improper treatment, that is, a bad treatment plan was approached, the symptoms persisted and worsened, and now healing has been delayed considerably. Your vet, had she been thinking correctly, would have asked herself: "hmm, why's it taking so long for this to heal?....hmmm, well, that didn't work, I wonder if I've diagnosed this correctly/rule-outs.....hmmm, now we have open sores/lesions, perhaps this treatment should be ceased, since it is obviously aggrivating the problem..."
The skin and lesions need to be left alone, for the most part.....just gentle dabbing to remove excess dirt/debris/bacteria....then topical antibiotic applied, this would have been so simple at the beginning! But also, other rule-outs must be done!
May I ask what you're feeding her?
..........Traci
Re: Cat acne, infections on chin
You know, after a week during the first bad bout of infection I did stop the OxyDex because it seemed like it was making things worse, and after that we stuck to the antibiotics and she slowly -- very slowly -- got better. I stopped the OxyDex, also, because with her wearing the Elizabethan collar thing it seemed like her chin was always WET, being pressed against the plastic collar, and it didn't seem possible that that was helping.Traci wrote:I think the main problem has been improper treatment, that is, a bad treatment plan was approached, the symptoms persisted and worsened, and now healing has been delayed considerably. Your vet, had she been thinking correctly, would have asked herself: "hmm, why's it taking so long for this to heal?....hmmm, well, that didn't work, I wonder if I've diagnosed this correctly/rule-outs.....hmmm, now we have open sores/lesions, perhaps this treatment should be ceased, since it is obviously aggrivating the problem..."
She's eating the same thing she's eaten pretty much the whole time we've had her -- Hills Science Diet. They're currently both on the older cat formula, I think it's called Senior? I'll admit there've been a few times when we've run out and had to buy cat food from the supermarket to tide them over, but even then it's been Iams.Traci wrote:May I ask what you're feeding her?
Re: Cat acne, infections on chin
I think I've been washing her face waaaaay too fervently, so I'm partially responsible, too. 
Even though the vet did tell me to do it.
- WG
Even though the vet did tell me to do it. - WG
Re: Cat acne, infections on chin
Uggg...I hate vets who tell the client to "vigorously" clean or "scrub" the affected area. They wouldn't do such a thing with their own faces, would they! It really defeats the purpose, since the tissue gets aggrivated, promotes inflammation, spreads bacteria, delays healing.
The sores and lesions you describe could very well be a reaction to her food. While I wholeheartedly recommend Science Diet, there could be an ingredient your kitty is sensitive to.
You saw pictures of EGC, but you have to know that severe food allergies can also cause the same appearance, oftentimes these cases are so severe, with postules, lumps, oozing sores all over the face and head, very easily treated with appropriate diet change, short-term use of oral antibiotics, and proper care of the lesions. Please remember, minimal manipulation with the affected skin!
When you see your new vet tomorrow, ask him/her about Panalog, Bac-Neo-Poly or Forte Topic, I swear by the latter. But again, don't undermine the importance of ruling out severe bacterial infection that may not respond to mild (oral)antibiotics, rule out EGC, or food allergies. If you want to stick with Science Diet, your vet can simply opt for a comparable diet (comparing ingredients) or opt for a temporary trial diet of a prescribed hypoallergenic diet (Hill's Rx D/D or Z/D are excellent choices).....she probably also has Purina veterinary diets available that are comparable as well.
Given kitty's age, if you haven't had bloodwork done on her within the last year, it might be a good idea to do so, including thyroid function testing. The diet, too, will have to take her age into account (i.e., lower protein, lower fat)
The sores and lesions you describe could very well be a reaction to her food. While I wholeheartedly recommend Science Diet, there could be an ingredient your kitty is sensitive to.
You saw pictures of EGC, but you have to know that severe food allergies can also cause the same appearance, oftentimes these cases are so severe, with postules, lumps, oozing sores all over the face and head, very easily treated with appropriate diet change, short-term use of oral antibiotics, and proper care of the lesions. Please remember, minimal manipulation with the affected skin!
When you see your new vet tomorrow, ask him/her about Panalog, Bac-Neo-Poly or Forte Topic, I swear by the latter. But again, don't undermine the importance of ruling out severe bacterial infection that may not respond to mild (oral)antibiotics, rule out EGC, or food allergies. If you want to stick with Science Diet, your vet can simply opt for a comparable diet (comparing ingredients) or opt for a temporary trial diet of a prescribed hypoallergenic diet (Hill's Rx D/D or Z/D are excellent choices).....she probably also has Purina veterinary diets available that are comparable as well.
Given kitty's age, if you haven't had bloodwork done on her within the last year, it might be a good idea to do so, including thyroid function testing. The diet, too, will have to take her age into account (i.e., lower protein, lower fat)
..........Traci
Re: Cat acne, infections on chin
Would her thyroid being messed up cause or contribute to this? She lost a little bit of weight when she first developed the infection because she felt awful, but she's now put on a pound or so since she was feeling better.Traci wrote:When you see your new vet tomorrow, ask him/her about Panalog, Bac-Neo-Poly or Forte Topic, I swear by the latter. But again, don't undermine the importance of ruling out severe bacterial infection that may not respond to mild (oral)antibiotics, rule out EGC, or food allergies. If you want to stick with Science Diet, your vet can simply opt for a comparable diet (comparing ingredients) or opt for a temporary trial diet of a prescribed hypoallergenic diet (Hill's Rx D/D or Z/D are excellent choices).....she probably also has Purina veterinary diets available that are comparable as well.
Given kitty's age, if you haven't had bloodwork done on her within the last year, it might be a good idea to do so, including thyroid function testing. The diet, too, will have to take her age into account (i.e., lower protein, lower fat)
I was reading about the Hills Z/D earlier in other websites etc that were discussing food allergies in cats. Should we feed it to both cats, do you think, if we decide to give it a try? It seems like that would be easier, plus our other cat has asthma and seasonal allergies so it probably wouldn't hurt her.
- WG
Re: Cat acne, infections on chin
If her thyroid is disfunctional, yes, this can affect the body systemically (and delay bacterial eradication/healing). This is true of any primary or secondary health condition. Full bloodwork, including urinalysis and thyroid function testing should be done yearly on any cat over the age of 7. Bloodwork helps detect subtle signs of illness related to specific organ disfunctions, best to catch problems early on in order to provide the most effective treatment.
Both the D/D and Z/D can be fed to both the cats, providing diagnosis is appropriate to require the food. The Z/D is better to be fed long term. However, when switching diets, particularly in an older cat, do make sure you can schedule bloodwork in the event your new vet feels kitty might need a low protein/low fat diet exclusively. For example, if renal disfunction were diagnosed, you'd want to start on the low protein/low fat diet before opting for a hypoallergenic diet, depending on the extent of the problem. If she and your other cat are in otherwise good health, there should be no problem feeding the Z/D. If your asthma/allergy cat has any other health problems, consult your vet first about any new diet. Otherwise, I'm sure he would recommend Z/D will be fine for both.
Both the D/D and Z/D can be fed to both the cats, providing diagnosis is appropriate to require the food. The Z/D is better to be fed long term. However, when switching diets, particularly in an older cat, do make sure you can schedule bloodwork in the event your new vet feels kitty might need a low protein/low fat diet exclusively. For example, if renal disfunction were diagnosed, you'd want to start on the low protein/low fat diet before opting for a hypoallergenic diet, depending on the extent of the problem. If she and your other cat are in otherwise good health, there should be no problem feeding the Z/D. If your asthma/allergy cat has any other health problems, consult your vet first about any new diet. Otherwise, I'm sure he would recommend Z/D will be fine for both.
..........Traci
Well, we're back from the new vet and I'm not sure what to think.
She agreed that OxyDex is too strong to be using twice daily, but felt that using it sparingly once a day for 2-3 days at a time was okay (ETA she meant in general, not in our current case, where she thinks we should stop with the OxyDex for the time being.) She agreed that face-washing should be done with as little rubbing as possible and sold me some surgical scrub to use for doing that. She also sold me DermCaps (fatty acid dietary supplements) to put on the cat's food.
She did a culture of her chin and is sending that off to see what the heck is going on. When I brought up the EGC she said it could be that, and when the results of the culture come back we'll know whether to treat with antibiotics (if it's a lingering bacterial infection of some kind) or with prednisolone (if it's EGC.) She said the culture would also show if it's fungal?
She feels that stress is probably what brought this on (we did bring our 2nd cat home in January) and her biggest suggestions for the time being are to get more litter boxes and spread them around the house (which we're limited in, as I have severe asthma that's set off by litter and can't have litter boxes in living spaces of the house, although I guess we can spread them out in the basement?) and to get Feliway plug-ins. She didn't feel that blood work or low-allergen food are needed. (ETA - She also didn't think the cat needed antibiotic cream.) She said if there's no bacterial stuff found in the culture then a course of Pred should clear things right up.
*Sigh* Another $137 down. At least we'll get the results of the skin culture out of this. I'm not feeling particularly hopeful, though.
- WG
She agreed that OxyDex is too strong to be using twice daily, but felt that using it sparingly once a day for 2-3 days at a time was okay (ETA she meant in general, not in our current case, where she thinks we should stop with the OxyDex for the time being.) She agreed that face-washing should be done with as little rubbing as possible and sold me some surgical scrub to use for doing that. She also sold me DermCaps (fatty acid dietary supplements) to put on the cat's food.
She did a culture of her chin and is sending that off to see what the heck is going on. When I brought up the EGC she said it could be that, and when the results of the culture come back we'll know whether to treat with antibiotics (if it's a lingering bacterial infection of some kind) or with prednisolone (if it's EGC.) She said the culture would also show if it's fungal?
She feels that stress is probably what brought this on (we did bring our 2nd cat home in January) and her biggest suggestions for the time being are to get more litter boxes and spread them around the house (which we're limited in, as I have severe asthma that's set off by litter and can't have litter boxes in living spaces of the house, although I guess we can spread them out in the basement?) and to get Feliway plug-ins. She didn't feel that blood work or low-allergen food are needed. (ETA - She also didn't think the cat needed antibiotic cream.) She said if there's no bacterial stuff found in the culture then a course of Pred should clear things right up.
*Sigh* Another $137 down. At least we'll get the results of the skin culture out of this. I'm not feeling particularly hopeful, though.
- WG
Re: Cat acne, infections on chin
What prompted her to feel that stress was the main factor? Did you give her indications of a stressful environment?
What does the chin look like at this point? (are you able to take a pic and post it here?) Are there still postules and raw skin, and if so, is it extreme? If for example, it didn't appear to look too extreme to the vet, this may be why she didn't prescribe a topical antibiotic, although according to your posts, a topical should have been discussed.
Yes, a culture can be helpful to differentiate from different types of bacteria, yeast, fungal problems in order to choose an appropriate antibiotic which would target the specific bacteria. EGC can usually be diagnosed upon exam and the vet's experience identifiying EGC from common signs and presentation. It could be that today, there might not have been obvious postules or inflammation that would suggest EGC.
The surgical scrub was a good idea. But, I disagree on the rubbing. Just use a clean cotton ball soaked in the scrub, and gently dab at the area twice a day....NO rubbing, and NO scrubbing, just dabbing gently. Also, after she eats, do a quick gentle wipe of her chin, nothing more.
The Derm-Caps are a good idea as well and no harm in using this for now. But, I don't think they are going to target the problem specifically.
The culture is probably going to take 5-7 days for results, and at that time, if kitty's chin does not seem to be improving, or worsens, then tell your vet you want to try the panalog, bac-neo-poly or Forte Topical. Any of these should produce some favorable effect and response within a week, if they do not, then tell your vet you want to consider a trial diet of a hypoallergenic diet (Z/D)...I'm sure she understands that food allergies can develop suddenly, for no reason, in any cat....providing that EGC has already been ruled out.
Try the surgical scrub for now, until the culture results are in. Can you keep us updated?
What does the chin look like at this point? (are you able to take a pic and post it here?) Are there still postules and raw skin, and if so, is it extreme? If for example, it didn't appear to look too extreme to the vet, this may be why she didn't prescribe a topical antibiotic, although according to your posts, a topical should have been discussed.
Yes, a culture can be helpful to differentiate from different types of bacteria, yeast, fungal problems in order to choose an appropriate antibiotic which would target the specific bacteria. EGC can usually be diagnosed upon exam and the vet's experience identifiying EGC from common signs and presentation. It could be that today, there might not have been obvious postules or inflammation that would suggest EGC.
The surgical scrub was a good idea. But, I disagree on the rubbing. Just use a clean cotton ball soaked in the scrub, and gently dab at the area twice a day....NO rubbing, and NO scrubbing, just dabbing gently. Also, after she eats, do a quick gentle wipe of her chin, nothing more.
The Derm-Caps are a good idea as well and no harm in using this for now. But, I don't think they are going to target the problem specifically.
The culture is probably going to take 5-7 days for results, and at that time, if kitty's chin does not seem to be improving, or worsens, then tell your vet you want to try the panalog, bac-neo-poly or Forte Topical. Any of these should produce some favorable effect and response within a week, if they do not, then tell your vet you want to consider a trial diet of a hypoallergenic diet (Z/D)...I'm sure she understands that food allergies can develop suddenly, for no reason, in any cat....providing that EGC has already been ruled out.
Try the surgical scrub for now, until the culture results are in. Can you keep us updated?
..........Traci