Goals of Treating Atopy in Cats
The goals of feline atopy are to eliminate or at least minimize the cat’s exposure to whatever in the environment is causing its condition and to enhance the animal’s comfort and quality of life. Most cats will need lifelong treatment for this chronic problem.
Treatment Options for Feline Atopy
The appropriate treatment protocol will depend on the underlying cause of the cat’s atopy. Key factors will be the nature and intensity of clinical signs, seasonality of symptoms, severity of skin lesions, patient acceptance of treatments, client compliance and cost considerations. Most atopic cats can be treated at home. Owners need to know that this is a progressive disorder that rarely goes into remission and can’t be cured. The itchiness associated with atopy often can be managed with oral antihistamines and omega fatty acid supplements. Antihistamines can cause drowsiness, lethargy, anorexia, vomiting, diarrhea and even nervousness, so owners should watch for these side effects. Antibiotics can help cats with sores and secondary bacterial skin infections. Shampoos and topical treatments are available to help control fungal, yeast and other infections as well.
In severe cases, corticosteroids can be quite effective in controlling the itchiness associated with atopy and breaking the itch-scratch cycle. Long-term steroid use can have adverse side effects, and steroids should be tapered to the lowest daily dosage necessary to manage the cat’s condition. Steroids are best used to provide short-term relief until atopic symptoms are brought under control. A combination of corticosteroids and antihistamines may control itchiness more effectively than steroids or antihistamines alone, and at much lower doses. Cyclosporine is another immunosuppressant drug available to help control symptoms of atopy in cats. It is expensive and can cause vomiting, diarrhea, gingival hyperplasia, excessive hair growth, acne and other skin problems. Sometimes, allergen-specific immunotherapy (called hyposensitization or desensitization) is beneficial. This involves injecting gradually increasing doses of the offending allergens under a cat’s skin; the allergens must first be identified by the cat’s positive reactions on intradermal skin tests. Hyposensitization therapy is known to be helpful in atopic dogs. While its efficacy in cats hasn’t been as well-established, it probably is similar to that in dogs. Hyposensitization is best used when an animal has non-seasonal atopy and when anti-inflammatory treatment isn’t effective, causes unacceptable side effects or doesn’t provide enough relief. Physical restraint with Elizabethan collars, foot bandages, T-shirts or sweat shirts can help reduce self-inflicted wounds, although they won’t reduce the underlying itchiness that makes atopic cats scratch and chew in the first place. A warm bath every few days can provide relief simply by rehydrating the cat’s skin.
Prognosis for Atopy in Cats
With good owner compliance and individualized treatment, most cases of feline atopy can be well-managed on a long-term basis. Routine veterinary examinations, at least twice a year, are important to life-long control of this condition, especially for cats on prolonged or protracted steroid therapy.