This week, Mimi started to show signs of improvement. Mimi is a two-year-old mostly-black calico cat. She was brought in three weeks ago when her owners noticed hair loss around the tail area. Upon examination, I found that Mimi also had tiny red pimples all over her body. She was suffering from feline miliary dermatitis.
Feline miliary dermatitis, also known as feline eczema or, colloquially, scabby cat disease, is an inflammation of the skin in cats. The term miliary originates from the Latin term milium, which means millet. The type of inflammation is specifically referred to as miliary because the inflammation manifests in the form of tiny pimples, two to three millimetres in diameter that feel like millet seeds.
In the initial stages, miliary dermatitis looks very much like a rash. It largely goes unnoticed because it is hidden beneath the cat’s fur. As the condition worsens, cats will typically develop patches of red crusty lesions on the skin that may be localised to certain areas of the body. Areas prone to miliary typically include the head, ears, neck, base of the tail and the dorsal area of the back. Less common areas include the belly, flanks and hindlegs, but some cats have been known to suffer this condition throughout their body. Cats suffering from miliary eczema may also have lifeless greasy fur characterised by heavy dandruff.
The condition is usually accompanied by intense itching that drives the cat mad. The itching, referred to as pruritus, makes the cat twitch its skin, lick the affected areas that it can reach, rub its head or body against furniture and scratch uncontrollably. With bad cases, the cat becomes so sensitised that even touching or patting it causes the itchiness to flare up, prompting yet another cycle of uncontrollable licking and scratching. Since many cats prefer to soothe their itchy skin by grooming and scratching ‘in private’, their owners may not even be aware that their cat is suffering until the symptoms become all too visible. Areas that the cat can lick will gradually experience a loss of fur that becomes increasingly noticeable, while those areas that the cat is able to scratch will soon end up as raw red wounds that become scabby.
The condition is not always straightforward to solve
Since miliary dermatitis is a condition brought on by a whole complex of possible diseases, the difficult part is in identifying the underlying cause. Most cases are found to be a direct result of an allergy, the most common of which is allergy to flea bites. Other allergies include food, environmental or contact allergies. Ear mites and other less common mites may be the cause of the problem as well as, for example, a hypersensitivity to intestinal parasites. The condition is not always straightforward to solve and other issues may additionally contribute to the clinical picture.
These include nutritional factors, fungal, yeast infections and/or bacterial infections. More serious cases may include certain cancers, autoimmune diseases and, more rarely, hormonal abnormalities.
Sometimes, the underlying cause is so obscure that it remains unknown and the only way forward is to treat the symptoms so that the condition is contained and the cat’s quality of life improves. The important thing in such cases is that the cat is not left to suffer needlessly. So, if you are a cat owner and you notice that your cat has been licking and scratching a lot more than usual, do visit your veterinarian as soon as possible.
Your vet will start by asking you for a history of your cat’s condition. How long you have been aware of the condition? Whether it is more pronounced at certain times of year and if there are other pets living in the same household. Your vet will then carry out a thorough physical examination of your cat and conduct baseline tests that typically include blood tests and urinalysis – these tests provide an overall picture of the state of health of your cat.
You will also be likely be asked about your cat’s medical history, its lifestyle and your domestic situation. Sometimes, the location of the miliary dermatitis will signal the source of the problem. For example, if the problem is localised around the ears, then chances are that ear mites are present and your vet will take a skin scraping to examine under a microscope.
Depending on the nature of the case, your vet may additionally opt to run lab cultures specific to the diagnosis, faecal examinations, food elimination trials, skin allergy tests, blood serum analysis, skin biopsies and so on.
Treatment will usually depend upon what your vet has found to be the specific underlying cause of the miliary dermatitis. However, the initial treatment is likely to include medication that suppresses the misery of constant itchiness so that your cat will start to feel better and far more comfortable.
In most cases, the prognosis for cats with miliary dermatitis is a positive one. Despite being the only cat at home, and happy to spend her days indoors with her human companions, Mimi was found to have fleas, with an allergy to flea bites. She was treated for fleas and her scabs are healing over nicely. In time, the fur she lost through overgrooming will grow back.
Dr Martin Debattista is a veterinary surgeon.
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