Cat acne, infections on chin

[WG]

Hi Traci -

I don't know why the vet latched onto stress as an issue. She asked if anything had changed in our house and I mentioned the new cat we brought home at the beginning of January. I don't feel that the acne-cat (her name is Molly ) is particularly stressed. I did mention that I'M stressed about the cat's long term illness and the vet said that my stress is contributing to the cat's stress so I should stop being stressed. Because, you know, that's easy. I mean, I think Molly is stressed NOW, because she's being hauled off the vet all the time and has been through months of being pilled and having her face messed with. But I don't think she was stressed before. She's quite a calm, pleasant cat when she's not ill, which has been all of her life until recently.

I'll try to get a pic if I can but our digital camera isn't great so I'm not hopeful. If I can get a decent pic I'll post it. What her chin looks like now is mostly very scabby, with most of the scabby bits pulled away from her face and caught in her fur, with fresh pink skin underneath. It looks pretty yucky to me, but I don't think she's got a raging infection or anything, and now that I know about the OxyDex being a likely contributor and am stopping with that I'm hopeful that it at least won't get any worse in the next week or so.

So if I'm going to dab the surgical scrub on, do I rinse it afterwards? Or just leave it?

The vet suggested poking the DermCaps open and squeezing the oil onto the cat's food... I squeezed a tiny bit onto my fingertip and showed it to the cats and they both recoiled in horror. Is there reason I can't just shove the caps down Molly's throat the way I normally pill her? At least that way I'd know she was getting it.

Am I right in my understanding that EGC can't be diagnosed by the culture? So if the culture doesn't show anything, we can tentatively assume that it's EGC and treat for that, which would be Pred and/or allergen-free diet?

Thank you SO MUCH for your help.

[Traci]

A culture is not appropriate for diagnosing EGC. Physical appearance of the lesions, a CBC to detect inflammatory cells, and a tissue sample or biopsy are the definitive diagnostics.

If the culture is negative for any bacteria or fungal, then I would suggest starting kitty on the hypoallergenic diet first, as opposed to steroid treatment. If the lesions are severe, that is, if they are crusting, oozing, spreading to other areas of her face and mouth, only then would I reccommend steroid therapy.

The food trial should be implemented for at least 4 weeks to determine response. A short-term course of oral antibiotics may be warranted (i.e., liquid oral clavamox).

If kitty improves and responds to the new diet, chances are, this is a food allergy. In which you'd want to continue feeding the hypoallergenic diet. Do not feed treats or any other food.

If kitty does not respond to the new diet, then either a different hypoallergenic diet (with a different protein source) should be attempted, or, additional diagnostics may be warranted, to rule out mites or microscopic parasites, flea allergy dermatitis, (or other insects), environmental allergen, or immunological problems.

As for the scrub, depending on what the type, it can probably be used full-strength (did she tell you to dilute it with water or not?). Do not rinse. Remember, gentle dabbing or blotting only, no rubbing, no scrubbing.

As for the DermCaps, no, do not give in capsule form. Capsules have the potential of lodging in the esophagus, this can create two problems, choking and substance adhered to the lining of the esophagus, or insufficient distribution of the substance. Do as yuor vet said, break the capsules, pour over the food, mix the food thoroughly. If the cats avoid the food for whatever reason longer than a day, call your vet back and ask for a different type of EFA supplement, such as Linatone, with a fish flavor, etc.

It is true that stress can exacerbate any condition. If you're outwardly showing your stress, your kitty may be picking up on that and reacting. Stress can indeed delay the healing process, so keep both hers, and your stress reduced at all costs. It isn't helping that she has to undergo daily treatment, but with minimal manipulation using the scrub at this point, her stress and apprehension of treatment should reduce.

Don't use the OxyDex at all anymore, depsite the vet's comments. Wait for the culture results and proceed from there. I would definately suggest at least seriously considering getting her on a hypoallergenic diet before any steroids are considered, start the diet directly after the culture results are in. If steroids are given, your kitty must have bloodwork done on a frequent basis to monitor the drug's effect on her system. While it is a good choice for EGC and for severe lesions, it shouldn't be used long term. Hypoallergenic diet, and elimination of offending allergens are the best course of action.

[WG]

A short-term course of oral antibiotics may be warranted (i.e., liquid oral clavamox).

Is there a reason it should be liquid clavamox as opposed to pills? We did give her (try to give her) liquid Cefadrops originally and it was a nightmare. She fought like crazy, spit out half the meds, the sticky liquid got all over her chin, which just made her chin worse, and she got very aggressive and attacked me on more than one occasion. Plus it was hard to restrain her for the meds without hurting her chin.

If the cats avoid the food for whatever reason longer than a day, call your vet back and ask for a different type of EFA supplement, such as Linatone, with a fish flavor, etc.

Does that mean I need to use two capsules, "one for each cat," to make sure Molly gets enough? At $13 a bottle for 60 capsules, that's going to get very expensive. I also hate the thought of having to abandon $13 worth of capsules after one day if the cats won't eat the food. Are there any other options you can think of for getting the oil into Molly? Could I coat a few pieces of her food in the capsule's worth of oil and put them in her mouth as if I was pilling her (without forcing them down her throat?)

It is true that stress can exacerbate any condition. If you're outwardly showing your stress, your kitty may be picking up on that and reacting. Stress can indeed delay the healing process, so keep both hers, and your stress reduced at all costs.

You know, I really, really appreciate all your help so far, and I honestly can't imagine how to stop being stressed. If it were that easy, I'd just do it. The cat, who loves my husband but really doesn't care about me one way or the other, has been ill with this for six months, and I've been her sole caretaker this whole time, in addition to caring for another chronically ill cat and my 6 year old, on a very tight budget that's being stretched to its limit. Believe me, if I could stop being stressed, I would!! I do my best to be sweet and relaxed around the cat, to speak gently and soothingly to her when I'm taking care of her, to spend quality time with her -- in short, to not show my stress around her. But I *am* stressed. I'm severely asthmatic myself and every time I have to restrain her, brush her, wash her, etc (okay, I'm just venting, this has nothing to do with you, I just so DESPERATELY need someone to understand how difficult this is for me) -- every time I take care of her, it's at the expense of my own health. My asthma and allergies have been worse over the past six months, since she's been ill, than they have in ten years.

So yeah. I'm doing the best I can. Really.

- WG

[Traci]

I prefer liquid antibiotics to pills, because it is easier and less stressful on the cat. Administration is easier, and if you are gentle, it only takes a second to administer.

Clavamox is the mainstay in treating mild bacterial infections, combined with other treatment, it can keep secondary infection barred. Some EGC cats do benefit from clavamox on an intermittent schedule. That's not to say all cats need it, or warrant it, but during flare-ups, it can be helpful.

The cefadrops are very bitter...the clavamox isn't as bad as far as bitter tasting is concerned.

Call your vet, tell her you want to exchange the bottle of DermCaps for a bottle of liquid Linatone or similar (whatever she has on hand). If she doesn't have Linatone or whatever, simply tell her you would like a refund, then get the Linatone at Petsmart or other pet store. It costs a heck of alot less than DermCaps and is equally comparable for EFA supplementation. Most cats tolerate the Linatone, it is 1/2 to 1 teaspoon mixed in with the food. You don't have to seperate the administration or the food, the Linatone can be given in one food dish and the cats can share.

No, do not coat a food kibble and pill her that way. This will only add to the stress, and she'll associate her food with a stressful or negative effect, and you don't want her starting to avoid her food or associating it with a bad experience.

I know we humans have a difficult time controlling stress. But, for the sake of our pets, we have to keep our stress/body language/etc in check, because cats are keen to that and will pick up on it and react with their own stress. Stress is a pre-cursor for any health condition to exacerbate, so we really have to be careful and be as calm, patient and forgiving as we can with our pet's medical administration. It's bad enough they don't understand what it is for, but when they start associating medications with a bad experience, things can domino and get worse. So, try to make everything as positive an experience as you can. After the administration of medications, give her special time, cuddling, playtime, etc, so she can associate it with a positive experience.

The entire problem is that the condition was not treated appropriately 6 months ago, and your first vet allowed it to persist by not addressing the underlying cause. So, one step at a time now....use the surgical scrub, wait for culture results....if culture is negative, start her on a hypoallergenic diet and demand a triple-antibiotic ointment for the skin lesions. If symptoms improve, problem likely solved. If symptoms worsen, try new hypoallargenic diet, and possible trial of prednisolone. Continue the hypoallergenic diet to gauge results.

[WG]

I prefer liquid antibiotics to pills, because it is easier and less stressful on the cat. Administration is easier, and if you are gentle, it only takes a second to administer.

Okay, so it's a personal preference on your part? Because I can say from experience that giving liquid Cefadrops to this particular cat was FAR more stressful on both the cat and me than the Clavamox pills she had after that. Pills were quick and easy, and I knew she had been dosed the proper amounts. Liquid was difficult, messy, and resulted in the cat being terrified and me being bitten and scratched, not to mention she essentially never got a full dose. We tried many different methods of getting the liquid into her and none of them were successful -- the one that was most successful was required two adults and wrapping her in a towel, and that was only a good option because none of the people involved ended up getting hurt.

Call your vet, tell her you want to exchange the bottle of DermCaps for a bottle of liquid Linatone or similar (whatever she has on hand). If she doesn't have Linatone or whatever, simply tell her you would like a refund, then get the Linatone at Petsmart or other pet store. It costs a heck of alot less than DermCaps and is equally comparable for EFA supplementation. Most cats tolerate the Linatone, it is 1/2 to 1 teaspoon mixed in with the food. You don't have to seperate the administration or the food, the Linatone can be given in one food dish and the cats can share.

Do you really think the vet will give me a refund on an already-opened, one-capsule-missing bottle of DermCaps?

- WG

[Tambrey]

my vet does...because many times he will have a big bottle of pills there, and then dole out however many we need and put into a smaller labeled bottle...

maybe your vet will do the same for you?
It can't hurt to ask, that's for sure!

[WG]

This was a small, sealed bottle, but you're right, Tambrey -- it can't hurt to ask! Of course, I don't even know for sure that she won't eat the food with the oily stuff on it, so maybe she will.

- WG

[Tambrey]

all you can do is try!!

[Traci]

Yes, it is a personal preference, but in my experience with hundreds of cats, it is most cats' preference as well.

If she tolerates antibiotic pills, then by all means, use the pills instead. My point is making the experience a tolerable, positive one for any medication administration.

Yes, the vet should take back the bottle....she can use it for other purposes around the clinic. Yes, you can ask for a refund or credit if you take the bottle back.

Take one capsule, open it, and mix it with the food. Give the cats today and overnight to eat the food. Chances are they will. If they don't, then take the bottle back and ask for a refund or credit.

[MonaJ]

I agree, I had changed vets twice, before I found a very compentent, thorough, caring one. She will recommend a specialist if she cannot thoroughly treat a condition.

I do hope you get to the bottom of this infection. I find that washing bowls thoroughly with hot soap and water (gentle dishwashing liquid) keeps my two girls clean. I also check their faces and wipe them down with warm water if necessary and brush their teeth too!!

Let us know how the new vet treats your cat. Mona