Treating Atopy in Cats

Dog Breeds

Atopy, also known as atopic dermatitis, is a disease which can commonly occur in cats. The effects of the disease cause allergic reactions which drastically affect the skin. Cats with atopic dermatitis may suffer from a variety of symptoms which include: severe itching all over the body, sores on the paws and base of the tail caused by continual licking, hair loss, skin which becomes thick and takes on a leathery appearance, and a darkening of the color of the skin.

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Introduction

Atopy, also known as allergic inhalant dermatitis or atopic dermatitis, is a clinical syndrome in cats that involves immune-mediated skin and respiratory allergic reactions with a strongly suspected hereditary component. The most consistent clinical sign of atopy in both dogs and cats is pruritis – intense itchiness – which can lead to self-trauma, hair loss, weeping sores and behavioral changes. Unlike dogs, affected cats frequently also develop respiratory symptoms, symmetric hair loss and other cutaneous lesions in addition to pruritis.

Treating Atopy in Cats

The therapeutic goals for feline atopy are to eliminate or at least minimize the cat’s exposure to the causative environmental allergens and thereby enhance its comfort and overall quality of life. The appropriate treatment protocol will depend upon the underlying cause of the particular cat’s condition. Key factors include the nature and intensity of clinical signs, seasonality of those signs, distribution and severity of associated skin lesions, patient acceptance of treatments, client compliance with the time, effort, regularity and expense of lifelong treatment and other cost considerations. Most atopic cats can be treated on an outpatient basis. Owners need to know that this is a progressive disorder that rarely goes into remission and cannot be cured. There is no one “cookie-cutter” treatment program for feline atopy.

The pruritis associated with acute-onset and mild cases of atopy typically can be treated with oral antihistamines and omega-3 and/or omega-6 essential fatty acid supplements. Antihistamines can cause drowsiness, lethargy, anorexia, vomiting, diarrhea and even nervousness, so owners should watch for these possible side effects in affected cats. If sores or secondary bacterial skin infections are present, oral antibiotics can be prescribed. Shampoos and other topical treatments also are available to help control fungal, yeast and bacterial skin infections.

In severe or chronic cases of feline atopy, corticosteroid therapies are available and typically are quite effective for controlling the itchiness associated with environmental allergies and breaking the itch-scratch cycle. However, long-term steroid use can cause a number of adverse side effects, and steroid treatments should be tapered to the very lowest dosage necessary to control the condition. Often, steroids are prescribed to provide short-term relief until the clinical signs of atopy are brought under control. A combination of corticosteroids and antihistamines has been shown to control pruritus much more effectively than either steroids or antihistamines alone, and at much lower doses.

Cyclosporine, an immunosuppressant drug, is also available to help control the pruritis associated with severe or chronic atopic dermatitis in cats. This medication is expensive and has common side effects including vomiting, diarrhea, gingival hyperplasia, hypertrichosis (excessive hairiness) and pyoderma (pimples, acne, other purulent skin lesions).

In some cases, allergen-specific immunotherapy (also called hyposensitization) can help cats suffering from atopy. This form of treatment involves subcutaneous administration of a gradually increasing dose of allergens that are present in the cat’s environment and that cause positive reactions on intradermal allergy skin tests. This therapy is helpful in the majority of cases in dogs and, while its efficacy in cats has not been established, it is thought to be similar to that in dogs. Hyposensitization normally is used when the cat has non-seasonal atopy and when anti-inflammatory treatment is not effective, causes unacceptable side effects or does not provide sufficient relief. Physical restraint by use of Elizabethan (cone) collars, foot bandages, T-shirts or sweat shirts may be helpful in reducing self-inflicted trauma, although they will not reduce the itchiness that predisposes affected cats to self-trauma. There are a number of topical treatments that can decrease pruritus. Even a warm bath can relieve itchiness by simply rehydrating the skin.

Owners of atopic cats need to understand that the environmentally-caused allergies are likely to affect their cats for life. However, with good owner compliance and individualized treatment, most cases can be well-managed. Routine veterinary examinations, at least twice a year, are important to long-term control of this condition, especially for cats on long-term steroid therapy.

Symptoms and Types