1887

Overgrooming and pruritus

image of Overgrooming and pruritus
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Abstract

The most common underlying cause for overgrooming in cats is pruritus and this chapter discusses the approach to pruritic skin disease in cats and considers history, clinical examination, differential diagnoses in overgrooming and pruritus, diagnostic tests required, treatment recommendations, when to refer and what to do when finances are limited. : Coat brushing; Skin scrapes; Skin cytology using tape strips and impression smears.

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Figures

Image of 5.26.1
5.26.1 This 4-year-old DSH cat presented with a 6-month history of symmetrical flank alopecia. Hair pluck examination was used to confirm that this cat was overgrooming, and a diagnosis of atopic dermatitis was made by exclusion, as discussed later in the chapter.
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5.26.2 A cat with flea-allergic dermatitis. There are extensive signs of overgrooming on the caudal dorsum and the ventral abdomen and medial thighs. Flea dirt was found on a coat brushing sample, confirming the diagnosis. A strict flea control regime was instituted for all pets in the household and the environment was also treated. Prednisolone was used initially to control the patient’s pruritus; this was then gradually tapered and discontinued.
Image of 5.26.4
5.26.4 Two small white plaques consistent with eosinophilic granulomas are evident on the roof of the mouth of this cat with atopic dermatitis. The cat presented with alopecia, due to overgrooming and pruritus, of the ventral abdomen. This cat was not showing any clinical signs related to the lesions in the oral cavity. A large eosinophilic granuloma is present under the tongue of this cat with atopic dermatitis; initial presentation was of overgrooming and pruritus of the hindlegs only. However, upon further questioning regarding the cat’s eating habits, it was found that some dysphagia was evident.
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5.26.5 Alopecia on the ventral abdomen of a cat with flea-allergic dermatitis; this type of alopecia is sometimes referred to as ‘fur mowing’.
Image of This cat had multiple small eosinophilic plaques on her distal ventral abdomen (the tail is at the bottom of the photo); these lesions were intensely pruritic. The surface of the lesions was moist, and an impression smear revealed large numbers of eosinophils with some coccoid bacteria. The bacteria indicated secondary infection, which is commonly seen in these cases.
This cat had multiple small eosinophilic plaques on her distal ventral abdomen (the tail is at the bottom of the photo); these lesions were intensely pruritic. The surface of the lesions was moist, and an impression smear revealed large numbers of eosinophils with some coccoid bacteria. The bacteria indicated secondary infection, which is commonly seen in these cases. This cat had multiple small eosinophilic plaques on her distal ventral abdomen (the tail is at the bottom of the photo); these lesions were intensely pruritic. The surface of the lesions was moist, and an impression smear revealed large numbers of eosinophils with some coccoid bacteria. The bacteria indicated secondary infection, which is commonly seen in these cases.
Image of Severe rodent/indolent ulcer of the upper lip, a manifestation of the eosinophilic granuloma complex; this lesion had been present for 6 months. This is a very classical appearance, although not all lesions are this severe. If the lesion is very extensive and affecting the nasal planum, as here, skin biopsy is recommended to ensure that it is an indolent ulcer and not a neoplastic lesion such as a squamous cell carcinoma.
Severe rodent/indolent ulcer of the upper lip, a manifestation of the eosinophilic granuloma complex; this lesion had been present for 6 months. This is a very classical appearance, although not all lesions are this severe. If the lesion is very extensive and affecting the nasal planum, as here, skin biopsy is recommended to ensure that it is an indolent ulcer and not a neoplastic lesion such as a squamous cell carcinoma. Severe rodent/indolent ulcer of the upper lip, a manifestation of the eosinophilic granuloma complex; this lesion had been present for 6 months. This is a very classical appearance, although not all lesions are this severe. If the lesion is very extensive and affecting the nasal planum, as here, skin biopsy is recommended to ensure that it is an indolent ulcer and not a neoplastic lesion such as a squamous cell carcinoma.
Image of A linear granuloma on the caudal aspect of a cat’s thigh; the cat was subsequently diagnosed with atopic dermatitis. An impression smear revealed large numbers of eosinophils and this, combined with the classical presentation which is pathognomonic, allowed a diagnosis of an eosinophilic granuloma to be made.
A linear granuloma on the caudal aspect of a cat’s thigh; the cat was subsequently diagnosed with atopic dermatitis. An impression smear revealed large numbers of eosinophils and this, combined with the classical presentation which is pathognomonic, allowed a diagnosis of an eosinophilic granuloma to be made. A linear granuloma on the caudal aspect of a cat’s thigh; the cat was subsequently diagnosed with atopic dermatitis. An impression smear revealed large numbers of eosinophils and this, combined with the classical presentation which is pathognomonic, allowed a diagnosis of an eosinophilic granuloma to be made.
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5.26.6 A diagnostic approach to a cat presenting with overgrooming and pruritus.
Image of Flea dirt in a coat brushing sample has a characteristic red crystalline appearance.
Flea dirt in a coat brushing sample has a characteristic red crystalline appearance. Flea dirt in a coat brushing sample has a characteristic red crystalline appearance.
Image of Cheyletiella mite, as seen under the X10 objective lens, in a coat brushing sample. Note the waisted appearance.
Cheyletiella mite, as seen under the X10 objective lens, in a coat brushing sample. Note the waisted appearance. mite, as seen under the X10 objective lens, in a coat brushing sample. Note the waisted appearance.
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Image of Cheyletiella mite (white arrow) viewed under the X4 objective lens. Note the characteristic waisted body shape. Two Cheyletiella eggs are visible (black arrows). (Total original magnification X40.)
Cheyletiella mite (white arrow) viewed under the X4 objective lens. Note the characteristic waisted body shape. Two Cheyletiella eggs are visible (black arrows). (Total original magnification X40.) mite (white arrow) viewed under the X4 objective lens. Note the characteristic waisted body shape. Two eggs are visible (black arrows). (Total original magnification X40.)
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Image of Coccoid bacteria (white arrows) and neutrophils (blue arrows) under oil immersion lens (X1000 total magnification).
Coccoid bacteria (white arrows) and neutrophils (blue arrows) under oil immersion lens (X1000 total magnification). Coccoid bacteria (white arrows) and neutrophils (blue arrows) under oil immersion lens (X1000 total magnification).
Image of Very large numbers of rod-shaped bacteria (black arrows indicate a few of these) under oil immersion (X1000 total magnification).
Very large numbers of rod-shaped bacteria (black arrows indicate a few of these) under oil immersion (X1000 total magnification). Very large numbers of rod-shaped bacteria (black arrows indicate a few of these) under oil immersion (X1000 total magnification).
Image of Impression smear of an eosinophilic granuloma, viewed under oil immersion (X1000 total magnification). Neutrophils can be seen (white arrows) together with intracellular coccoid bacteria (black arrows), and eosinophils (red arrows) containing pink granules within their cytoplasm. The cat was treated with antibacterials to treat the secondary infection and prednisolone to control pruritus and treat the eosinophilic granuloma.
Impression smear of an eosinophilic granuloma, viewed under oil immersion (X1000 total magnification). Neutrophils can be seen (white arrows) together with intracellular coccoid bacteria (black arrows), and eosinophils (red arrows) containing pink granules within their cytoplasm. The cat was treated with antibacterials to treat the secondary infection and prednisolone to control pruritus and treat the eosinophilic granuloma. Impression smear of an eosinophilic granuloma, viewed under oil immersion (X1000 total magnification). Neutrophils can be seen (white arrows) together with intracellular coccoid bacteria (black arrows), and eosinophils (red arrows) containing pink granules within their cytoplasm. The cat was treated with antibacterials to treat the secondary infection and prednisolone to control pruritus and treat the eosinophilic granuloma.
Image of Impression smear of a fungal granuloma caused by Alternaria, viewed under oil immersion (X1000 total magnification). Fungal hyphae (red arrow) and neutrophils (blue arrows) can be seen.
Impression smear of a fungal granuloma caused by Alternaria, viewed under oil immersion (X1000 total magnification). Fungal hyphae (red arrow) and neutrophils (blue arrows) can be seen. Impression smear of a fungal granuloma caused by , viewed under oil immersion (X1000 total magnification). Fungal hyphae (red arrow) and neutrophils (blue arrows) can be seen.

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