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Cat Allergies and Feline Urologic Syndrome

Cat - Allergies

What are allergies and how do they affect cats?

One of the most common conditions affecting cats is allergies. An allergy occurs when the cat's immune system overreacts to foreign substances called allergens or antigens. Your cat’s allergic reactions are likely to show up in one of three ways:

  1.  Itching of the skin. This can be in one area or all over your pet’s body.
  2.  Respiratory issues like coughing, sneezing, and wheezing. You might also see drainage from the nose or eyes.
  3.  Digestive issues like vomiting, flatulence or diarrhea.

How many types of allergies are there?

There are four common types of allergies in the cat: flea, food, inhalant, and contact. Each has common clinical signs and unique characteristics.

Flea Allergy

Normally a cat only experiences minor skin irritation from a flea bite. However, if your cat is allergic to fleas, you will see severe scratching and chewing, to the point of hair loss and maybe even open sores or scabs on the skin.

The best treatment for flea allergy is to eliminate all fleas. Unfortunately, this may be challenging in warm and humid climates, where a new population of fleas can hatch out every fourteen to twenty-one days. Monthly flea products that kill fleas before they can bite are available. If these products don’t work, steroid shots may be the best way to block the allergic reaction. Steroid shots are often a necessary part of the initial treatment of flea allergies. Antibiotics will be needed if your cat develops a secondary bacterial skin infection from the open sores.

Food Allergy

Cats can develop allergies from eating the same food for a long time. Food allergies are now estimated to be the second leading cause of allergic dermatitis in cats. The allergy is often caused by the protein in the food. This could be animal protein like beef or pork. Or it could be vegetable protein found in plants like corn or wheat. Food allergy can cause any of the itching, digestive problems, and respiratory issues mentioned above.

We will recommend testing for food allergy if your cat shows clinical signs for several months, has a poor response to steroids, or is a very young cat that itches without other apparent allergy causes. Testing consists of feeding an elimination or hypoallergenic diet for eight to twelve weeks.

It is extremely important that the special diet is fed exclusively during the test period. This means you cannot give your cat any treats, other foods, people foods, or flavored medications during this time. None, zero, zilch! Even if your cat accidentally gets a tiny amount of the offending protein, it can invalidate the test.

If your cat’s symptoms improve after the food trial, we’ll recommend feeding your cat an exclusively hypoallergenic diet from that point forward. This treatment has been very successful for many cats. If your cat has year-round allergy problems, in addition to food allergy, inhalant allergy testing may also be advised. Many cats are allergic to many things – pollens, fleas, and foods. Therefore, a combination of therapies may be necessary to keep your cat comfortable.

Inhalant Allergy

Inhalant allergy or atopy is estimated to be the third most common type of allergy in cats. When itching is the primary clinical sign, the term atopic dermatitis is often used to describe the condition. It is also referred to as 'seasonal allergy' when believed to be related to pollens and grasses.

Just like humans, cats may be allergic to inhaled allergens like pollens, molds, mildew, and the common house dust mite. Many of these allergies are seasonal, such as ragweed, cedar, and grass pollens. However, others like molds, mildew, and house dust mites affect your cat year-round.

When humans inhale these allergens, we express the allergy as a respiratory problem. Your cat's primary reaction to atopy is severe, generalized itching.

Most cats with an inhalant allergy are allergic to several allergens. If the number of allergens is small and they are seasonal, your cat may be bothered by itching for just a few weeks a couple times a year. However, if the number of allergens is large or they’re present year-round, your cat could constantly be itching and could even develop skin lesions.

How is atopy treated?

Treatment depends largely on the length of the cat's allergy season. It involves one of two approaches:

The first approach involves the use of corticosteroids (steroids) and medicated shampoos in acute or sudden cases. Steroids will dramatically block the allergic reaction in most cases and bring about rapid improvement in the cat's clinical signs. Steroids may be given orally or by injection, depending on your cat's condition. If steroids are appropriate for your cat, you will be instructed in their proper use.

Hypoallergenic or medicated shampoos may also help provide relief to your cat. Frequent bathing will reduce the amount of antigen exposure through the skin. In addition to removing surface antigens, bathing alone will provide some temporary relief from itching and may allow the use of a lower dose of steroids or other treatments. Omega-3 fatty acids (fish oils) might also be recommended to see if they lessen future flare-ups and symptoms.

The second approach to chronic inhalant allergy treatment is desensitization with specific antigen injections or 'allergy shots.' Allergy skin testing is first used to identify the specific allergens. The allergy shots given over time are intended to reduce your cat’s allergic response to the allergens. If desensitization appears to help the cat, injections will often continue for several years.

For most cats, a realistic goal is for the itching to be significantly reduced in severity rather than be completely cured. In some cats, the itching and associated clinical signs may completely resolve while others may experience minimal improvement. This therapeutic approach is usually recommended for the middle-aged or older cat that has year-round itching caused by inhalant allergy. This approach is not used with food allergy.

Although desensitization is the ideal way to treat inhalant allergy, it does have some drawbacks and may not be the best choice in certain circumstances.

  • Cost: This is the most expensive form of treatment.
  • Age of Patient: Because many cats develop additional allergies as they get older, young cats may need to be retested one to three years later.
  • Success Rate: About 50% of cats will have an excellent response. About 25% get partial to good response. About 25% get little or no response. The same statistics are true for humans undergoing desensitization.
  • Time of Response: The time until apparent response to allergen-specific immunotherapy may be two to five months or longer.
  • Interference of steroids: Cats must not receive oral steroids for two weeks or injectable steroids for six to twelve weeks prior to testing. These drugs will interfere with the test results.

Any cat suspected of having atopic dermatitis should also be considered for a hypoallergenic food trial. Many cats with atopic dermatitis are also allergic to an ingredient in their food, making diagnosis and treatment more challenging.

Other treatments to help relieve chronic atopic dermatitis include cyclosporine, long-term corticosteroids alternating with anti-histamines, and daily omega-3 fatty acids.

It is important to keep in mind that atopic dermatitis is a lifelong condition and frequent relapses are common. There is no 'cure' for allergic skin disease, only treatments that mitigate symptoms and improve quality of life. While cats certainly appear less likely to develop side effects associated with chronic steroid usage than dogs or humans, their prolonged use must be carefully monitored. Cyclosporine has also been used long-term in many cats to help treat allergic skin disease with fewer reported side effects than steroids.

We will work closely with you to provide the best care for your cat’s allergic condition and help you fully understand the risks and benefits of each treatment.

Contact Allergy

Contact allergies are the least common of the four types of allergies in cats. They result in a local reaction on the skin from contact with an allergic substance. Examples of contact allergy include reactions to shampoos, flea collars or types of bedding, such as wool. If your cat is allergic to something like this, you will see skin irritation and itching where contact occurs. Treatment involves removing the offending substance, but the hard part is often determining what is causing the reaction.

This information is based on material written by: Tammy Hunter, DVM; Ernest Ward, DVM
© Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license.

Cat - FUS

What is feline urologic syndrome (FUS)?

Feline lower urinary tract disease (FLUTD) is an older term used to describe a set of clinical signs associated with abnormal urination in cats. Some causes of FLUTD are urinary tract infections (UTIs), bladder stones, or bladder crystals. When the condition has no identifiable cause, it is called feline urologic syndrome indicating that this is an exclusionary diagnosis (i.e., no other causes for it can be identified).

This condition is also called Pandora Syndrome, as the underlying causes for the condition may reflect abnormalities in many organ systems (including the nervous system) and considers the effects of environmental stressors that contribute to its development. Cats will often suffer waxing and waning of clinical signs in response to stresses affecting the central stress response system.

What are the clinical signs of feline urologic syndrome?

The most common clinical signs are similar to those seen in other urinary diseases:

  • straining to urinate
  • bloody or discolored urine
  • frequent urination
  • urinating in unusual locations
  • the inability to urinate (this is a critical emergency, and your cat must be seen by a veterinarian immediately).

What causes feline urologic syndrome?

By definition, in cases of feline urologic syndrome, there are no known causes. The conditions that must be ruled out first include:

  • bladder stones and urethral blocks
  • bladder infections
  • trauma
  • neurologic disorders that alter normal urination by affecting the nerves and muscles of the bladder
  • anatomic abnormalities such as urethral strictures
  • cancer or benign tumors of the urinary tract

How is FUS diagnosed?

FUS is diagnosed by performing tests to eliminate the known causes of abnormal urination. These tests include any or all of the following:

  • thorough medical history and physical examination - especially paying attention to any changes in environment, feeding, stress, etc.
  • blood tests - complete blood cell count (CBC) and serum chemistries
  • complete urinalysis
  • urine culture and antibiotic sensitivity tests
  • abdominal radiographs, which may include contrast radiographic studies to see if the bladder appears abnormal or contains bladder stones
  • abdominal ultrasound to check the structure of the bladder and to look for bladder crystals or bladder stones
  • cystoscopy or endoscopy (video examination) of the urethra and bladder
  • bladder biopsy

How is FUS treated?

The most effective approach for treating FUS is to address the stressors that triggered the clinical signs in the first place. This often involves the use of anxiety-relieving medications. Additionally, consider using several of the following strategies to reduce or eliminate environmental stressors:

  • keep water dishes clean and filled with fresh water
  • keep a regular daily schedule including times for feeding, play, affection, and rest
  • keep 'rules' for your cat consistent: don’t let your cat climb on the counter one day and scold it the next
  • use a puzzle feeder occasionally for dry food, if your cat eats dry food
  • gradually introduce necessary changes to your cat’s schedule
  • create a stimulating and stress-relieving environment with toys, scratching posts, and cat condos
  • try to keep strange cats off your property as they can create stress, even if your cat stays indoors
  • lower competition between your cats by having one more litterbox than the number of cats in your home, providing multiple resting places, and ensuring every cat has easy access to food and water.

FUS is considered to be painful. Therefore, pain medications are often used to relieve discomfort during flare-ups. Anti-spasmodic medication may also be necessary to prevent urethral spasms.

What is the prognosis for FUS?

Unfortunately, recurrence of FUS is common. However, medical treatment can relieve your cat’s discomfort by reducing the frequency or severity of clinical signs. It’s essential to monitor for clinical signs, and even more important to learn and manage the environmental stressors that trigger the condition in your cat.

This information is based on material written by: Ernest Ward, DVM; Updated by Malcolm Weir, DVM, MSc, MPH
© Copyright 2017 LifeLearn Inc. Used and/or modified with permission under license.

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