Miliary Dermatitis in Cats

Miliary Dermatitis is that condition in your cat where it has itchy scabs on it's skin, patches of hair loss, open lesions, granulomas and/or body odor.  I have had several cats in the safehouse over the years struggling with these types of allergies.  The treatment, of course, depends on what the cat is allergic to.  I want to address how to identify dermatitis in your cat and then how to figure out what is causing it.  Once we know what's causing it, we can discuss how to treat it.

Typical Miliary Dermatitis

Right away, the number one cause of this kind of dermatitis in cats is flea allergy. You can knock that back right off the bat by simply using a flea treatment on your cat.  I recommend using something with an IGR so that the eggs don't hatch later on, when you don't retreat for whatever reason.  Many cats have allergic reactions to the flea treatments so watch closely for this.  Drooling, panting, acting wild or out of control, nipping at their backs, crying loudly or shaking are all signs that an allergic reaction is happening.  Some cats even have seizures.  So if this happens, do not use the same medication for the next treatment.  At the time of occurrence, the most you can do is try to remove the treatment from their skin by washing the neck area with soap and then blotting it dry with a towel.  This will usually stop the reaction in a few moments.  But if the reaction is severe and is not controlled easily, then give the cat a Benadryl.  This should stop it within an hour.  Seizures, if they continue, may require a visit to the vet.

So what to do if your cat is allergic to the flea medicine as well as the fleas?  I suggest trying environmental measures for flea control such as Diatomaceous Earth, Adams Flea Spray with IGR for the carpet and furniture, washing the cat with a flea shampoo, taking the cat to a groomer for treatment or other alternatives you can research online.  If you can find one treatment that the cat is not allergic to, try to obtain the version with IGR because that will end the cycle immediately and one treatment may be all that is necessary.  I do not suggest using flea collars because many cats end up with hair loss, red, sore spots on their necks and some even develop asthma from the fumes.  These collars are toxic and can really harm your cat while they are not effective in getting rid of fleas.

But not all cats are allergic to fleas and not all dermatitis is caused by flea allergy.  In fact, miliary dermatitis is often caused by food, dander, dust, pollen and any other allergen that might affect people, too.  I have a cat right now in the safehouse who is allergic to tuna / fish.  We have to hunt constantly for foods that do not contain fish or tuna.  If she is fed these things without knowledge, she vomits profusely.  When we rescued her, she had scabs all over her body, hair loss on her belly, a granuloma on her belly, lesions and she was starving from throwing up most of the food she scavenged.  We treated her, of course, and slowly discovered that tuna was the cause and since then she has been kept off seafood.  Her recovery is amazing.  So watching your cats reaction to the food he or she eats is paramount if your cat is suffering with dermatitis.

Another common cause of dermatitis is the cat litter.  They put deodorant powders full of chemicals and other compounds in most cat litter.  I have to wear a mask when I clean out the boxes because the dust makes me sick.  Imagine it might do the same to your cats.  I have a cat who chews his back feet raw and bloody because of what appears to be a litter allergy.  We switched to putting him outdoors to use the yard and his feet are a bit better.  But he will have to be treated with prednisone to end the cycle.  This cat has also had lesions on his body from scratching himself raw and has scabs on his lower backside.  Most of his skin reactions are towards the backside and lower end of his body, pointing at the litter as a problem.  However, there are probably other irritants as well.

Grass pollen is a common allergy in cats.  If your cat has a bald undersides, is losing hair on the inside of his or her legs, constantly chews the feet or hind legs or has a reddened belly where the skin shows, this is possibly a grass allergy.  This type of allergy can only be controlled by keeping the cat indoors.  After restricting the cat to the indoors, you will need to use either Benadryl or Prednisone to break the cycle and stop the itch.

Granulomas usually occur in tandem with severe miliary dermatitis.  These are smooth patches or lesions on the skin that are thicker than the surrounding skin and are raised a bit.  They can be any size but they will take over most of the skin area if they are allowed to grow unabated.  They are often visible on the bare bellys of cats with other skin lesions and scabs.  To nail down the diagnosis, check the upper lip of the cat.  If there is a channel (hole) running from the upper lip to the nose area then you definitely have a granuloma (white cell skin reaction).  This channel will be under the top upper lip and the hole or open area will run up under the lip through the skin to the nose area.  It is unmistakeable because you will never have seen anything like it before.  This is a part of the allergic reaction.  If your cat has this you will have to take him or her to the vets for special medications and treatments.  It is not horribly expensive but it is necessary to return your cat to health.  Otherwise, the cat will continue to suffer.

Granuloma on the Lip

Granuloma on the Kitty Belly

Granuloma on the Skin

Other causes of allergy are house dust, dander and tree pollen.  This will also produce a skin reaction and the cat will have itchy spots, loss of fur and generalized redness to the skin with scratching and licking.  But the cat will also have respiratory symptoms, such as sneezing and coughing.  If the cat has real trouble breathing and seems to pant at times, then your cat probably also has asthma.  You will need to get special medications to treat the asthma and you will  have to use it long term.  Otherwise, your cat could have a serious asthma attack and die.  Asthma in conjunction with miliary dermatitis points to an air borne allergy so check house dust, local trees for times of pollination, the dander of other types of pets (such as dogs, hamsters, ferrets, etc..) and try to help your cat avoid contact with these triggers.  Sometimes you can discover the problem simply by brushing your cat and checking the fur you remove for bits of dust or pollens.  Some tree pollens are heavy and large, making them readily visible and if you check the outdoors during certain times of the year, you can see the pollen on the windsheilds of parked cars or on chairs in the yard. 

It is nearly impossible to nail down the exact allergen but it is not that hard to get a general bead on the problem and to treat it.  Changing the type of litter or allowing an allergic cat to go outdoors is one solution.  Switching foods is another.  It is a bit harder to limit exposure to outdoor triggers in cats that are allowed outside so these cats should be treated with antihistamines such as chlorpheniramine maleate (Chlor Trimeton) or diphenhydramine (Bendadryl).  Just ask your vet what the dosage should be for your particular cat (size and weight).

Getting your cat groomed regularily is very helpful over the long term.  In addition to antihistamines and attempts at avoidance, which may or may not be successful, regular brushing, bathing and dusting is always a good thing.  Not only will this help keep the allergens off of your pet but it is a great soothing experience for those little guys with red skin and itchy scabs.  A good combing with get rid of a lot of the surface scabs, which the cat will appreciate.  But don't comb the cat until you have treated it for the allergy because live scabs with itchy lesions make your cat crazy and combing them just makes everything itch more.

R.I.P.  BUTTER BEAN... WE WILL ALWAYS LOVE YOU

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