Allergies, self harming.

Hi everyone,
I've posted before about my recently diagnosed cat also struggling with an awful mite allergy.
Poor Murphy has been in an e-collar for a month. I'm so upset for him and he's understandably at the end of his tether.
Every time the collar is removed, he attempts to self harm. So I give him at least an hours time, collar free, supervising him whilst he grooms. He's learnt to hold my hand and press it to his temples to relieve some of the itch, bless him.
We've tried different topical steroids, antibacterial and antifungal creams, all to no significant effect.
We started 5mg prednilane two days ago (he's had two tablets), and his itching certainly isn't better and possibly worse. He also wriggled out of his collar twice in as many days, both times I've found him not long later with his head covered in blood
I just don't know what to do. Atopica has been suggested, but that can take 6-8 weeks to work.
Does anyone have a diabetic cat on depo medrol? Though I know this just masks the root cause...so....
Does anyone have any tried, tested miracle mite cures?
It's a nightmare for him. He's currently hiding under a bed and I've placed a fan facing him to cool him down, which he seems to like.
He's eating normally.
Would love any advice and help. Thank you.

 

Have you checked out Apoquel. It is FDA approved for dogs; it is off label use for cats. I don't know if it is available in the UK.

Omega 3 fatty acids supplement in the diet may help a little.

Allergy shots, maybe?

 

Hello! Have you tried a bit of Diatomaceous Earth (food grade)? Gently, so as not to cause powder flying around the two of you, rubbing it into his fur? I would start with a very limited area, perhaps part of his head. Sorry, I have used DE only against kitty fleas so I do not know its effect on allergies or mites. Perhaps, others could comment.
Best wishes,
Sophie & Pudge (GA)

 

I'd ask your vet about anti-seizure medications for short term to see if they would benefit. Many cats can start with an actual allergy or reaction, but then the behavior of biting/scratching continues long after the allergy or cause is gone (lick granulomas). Until the behavioral/compulsive component is take care if, the vicious cycle continues. Eventually it can progress into hyperestesia or a seizure disorder (like my cat has).

Also, if it is mites, you need salamectin or ivermectin to get rid of them. Other anti-flea medications don't work.

 

Hello, you may wish to work to make his skin healthier (& quicker to heal) by rubbing some Vetericyn into it. In the US it's available without a prescription and can be purchased via Amazon. Also, I forgot to add that anti mite/ anti allergy bedding covers cut down on mites. I use zippered Enviracare pillow cases. Find them helpful. Washing his bedding frequently in hot water might help.

I did not know that anything could get rid of mites! They seem omni-present. Above e-mail contains great news!
Best wishes,
Sophie & Pudge (GA)

 

Hi everyone, thank you for your replies.

BJM, my vet had mentioned Apoquel, but isn't willing to prescribe it as he feels there isn't enough of an evidence base to indicate its safe use for cats. I've just started supplementing his food with a little evening primrose and he's on a wet food that has fish oil in it. Will be interesting to see how it goes, although I'm not sure how long after starting omega 3 oils I'd expect to see on his skin. I'm not sure what allergy shots are, but ill ask my vet. Feeling very desperate for Murphy, especially as he's worked so hard on getting better after his DKA episode. The good news in all this is that his BG is definitely heading in the right direction.
Sophie (and Pudge!) I've tried DE - both around his neck line and in his food. It doesn't seem to be having any effect. I've found the Vetericyn however, so have ordered that.
Meya, that's definitely one to watch out for and I'll definitely be asking my vet. I'm pretty certain it's not at a behavioural level yet. I can tell the mites are back as there's the coffee grinds in his ears and sticky black wax. I gave him Advocate spot on two weeks ago, but I presume it would be safe to give him Frontline (which is Revolution in the U.S) on top of that. Would that be the spot on treatment you'd recommend? Thank you.

 

Allergy testing is taking a blood sample and evaluating it at a lab which does the test.
@Meya14 mentioned ivermectin as one of the treatments to use.

 

Advocate is midacloprid and moxidectin. Frontline is fipronil and (S)-methoprene. Neither of these works well for mites.

Revolution is Selamectin which is effective. The best treatment is ivermectin which is not available for spot on for cats, but is in hartgard oral chews for cats. The oral will work for mites too. Ivermectin will kill pretty much any parasite that she might have so it's really the way to go unless there are liver concerns.

Mites can't live off of the body and don't lay eggs that drop off the body like fleas do, so you don't have to go wild cleaning. Just wash her bedding for good measure after you dose, and that's about it for cleaning.

 

Hopefully they'll agree to sending a blood sample off .. had a quick look and that treatment method looks promising.
I can't find any ivermectin products licensed for cats in the UK, though I may well not be looking well enough. I've found an over the counter product for use with rabbits and hamsters.
Is ivermectin more effective than salamectin?

 

Ahh ok, thank you Meya.. Ill look up the hartgard chews. I thought frontline was the same as revolution, clearly not. So I'll ask if revolution is sold here.

 

My bad.. it's called Stronghold here, not Frontline. Addled sleep deprived brain! Thanks Meya.

 

I had good luck with selamectin when Jane had her mites. Didn't have to get the ivermectin. It resolved after the first dose. Scratching took about a week to resolve. I was bitten up as well (they can bite people but not reproduce on people) and my rash went away after a week as well after she was treated.

 

If you have other animals, treat them all at the same time.

 

Meya..
Unbelievable... was querying whether to give Murphy his evening shot, due to it being low for him... and now I'm certain he's had a seizure, as is Rob (my partner). I've called the emergency vet, but am now in floods of tears.. I don't understand it. Did your cat get seizures from what started as ear mites? Thank you.

 

Oh no, (((Amy)))....
How is Murphy now? What did the vet say?

Huge hugs to you,

Eliz

 

It was actually my other cat (the one without seizures) that had the bad case of mites. Max has had seizures since I got him at age 2, he probably had them all his life. He is a manx with probable spina bifida. We we first got him he was having 10-20 two to ten second seizures a day. He has a lot of triggers, including touching, jumping, and scratching that can set them off. I am very careful with when he is itchy cause this is a trigger for him. He also has hyperesthesia.

Try to relax a little bit, short seizures aren't immediately dangerous. They are only dangerous if they continue for >1 minute or happen repeatedly. First, be sure it wasn't hypoglycemia that triggered.

Flea bite/mite bite is a common cause of hyperesthesia which is though to be a seizure disorder. Something about scratching and itching triggers a feedback loop in their brain and spinal cord. Hyperesthesia symptoms can become worse if they aren't prevented or treated.

Symptoms can be stereotypical, ie. the same behavors happens with each seizure. With max it's scooting himself and biting the floor and his back. He also flybites sometimes. Hyperesthesia looks kinda like this:

Treatment is good in the short term until you can manage the triggers. We were able to reduce triggers for max, and not have to treat. He only has a few a week now, and if we interrupt them by picking him up and providing stimulation to his back, they are shorter.

 

The vet has said to observe him overnight and bring him in tomorrow.
I just watched the clip.. He's not wide eyed with dilated pupils.. He was just looking distant.. eyebrow flinching, head twitching to the left and left ear twitching. He was lying down on his side. Tail swishing all the time. It lasted about ten minutes
It was after I cleaned his ears.
The same thing happened when I applied canaural last week, I realise now.
I'm not sure why the vet doesn't want him in yet.
He's currently lying under a table downstairs and trying to scratch his head like crazy.
The Stronghold arrives at the vets tomorrow - they've ordered it in.

 

Try not to worry too much, hyperesthesia is benign by most vet's standards. I don't agree that it's 100% benign (it does tend to get worse if untreated, and it looks like it distresses the cat). However, it's not an emergency.

I tend to notice with max that he has episodes of the twitching and fur rolling, and sometimes he tries to bite his back where the fur is rolling. When he does this, he usually has a very "faraway" look and doesn't pay attention to things around him. I try to provide other stimulation when this is happening, sometimes it's enough to snap him out of it.

My biggest concern for max is safety, because in addition to the partial seizures of the hyperestesia, he has generalized seizures as well. He's fallen down the stairs a couple times when this happened. He's fallen off a 7ft ledge once too when it happened. I'm always scared taking him to the vet and putting him on the table too cause it's high up. Sometimes he's bitten me and himself hard during a seizure, so that's a concern as well.

Treatment is a short course of phenobarbital until the mite problem/itching is gone. Electrolyte imbalance can trigger twitching too, so it's always good to have these checked as diabetes makes these problems more common.

 

Thank you so much, that's actually very reassuring. I've been feeling so sad and researching all about this. Be interesting to see what the vet says in the morning.
He's not had the darting around and hallucinating. But he definitely has a degree of the skin rolling and has done for quite some time. If I lightly touch his back, it will often set off lots of twitches and then the skin kind of jumping/rolling.
All I want for him is to not have this nightmare cushion around his neck.. It's been a month and it feels like I'm torturing him, but without it he literally rips his head apart and slices his eyes. I'm desperate to see an end to it.. as is he, poor boy

 

Ok. I'm absoblinkinglutely exhausted. Roll on my kids heading to bed!
I do really like my vet - he absolutely listens to what I say and ask.
He was very sad for Murphy as he's clearly in great discomfort with a horrible corneal ulcer in each eye, which have unfortunately come back after escaping from his e collar and self harming.
He wishes he could give him depo medrol as it worked so well, but triggered his diabetes.
So he's upped the prednisone to 10mg a day, keep up the tramadol and apply eye drops eight times a day.
If this doesn't work, he wants to try amitriptyline.
He agreed he's probably developing an epileptic disorder, more due to stress that anything. He couldn't see any sign of mites in his ear. But I clear the huge amount of debris daily, so they're there. I've applied the stronghold (selamectin).
Desperately need to heal his eyes to get this constant cushion away from him. He's so fed up and growling at me now - he's never ever growled at me and he still hasn't bitten or scratched me (he's a gorgeous teddy bear of a boy - I'm very lucky).
I'm absolutely not to touch his head any more, vet said he's stuck in a loop and I'll just be contributing to it if I do so. No more feedback needed.
His evening caninsulin has been lowered.

 

Oh and he put anaesthetic drops in his eyes and ablated (abrased?) the epithelium off in each eye, right there and then at the appointment. Not a pleasant procedure either for Murphy to go through (though he clearly felt no pain) or for me to witness. But at least I could cuddle him and reassure him.

 

So in the long term, the tramadol is not a great medication if there is itching involved. Tramadol can trigger severe itching due to it being an opiate, and also because it increases serotonin and histamine. I've had patients on tramadol tell me that they feel like bugs are crawling all over them and they pick holes in their skin. A better opiate would be bupe for the eye pain until it's healed up, but all opiates will cause itch to some degree. Tramadol can also decrease seizure theshold.

Amytriptaline is a better drug for chronic pain/neuropathy (itching can be a type of neuropathy), but it does have a lot of side effects including dry eyes which may not be great with the ulcers. It doesn't do anything for the seizure behaviors.

Gabapenten is a great drug, however, for neuropathic pain, itching, and will also help to decrease the seizures. This in combination with phenobarbital would be what I would ask for, and get rid of the tramadol a couple days after you start it. The phenobarb will cause him to be pretty tired the first few days, so it does act as a calming medication at first and this can decrease pain. The gabapentin takes a couple days to reach full effectiveness. Both of these medications once you start would have to be tapered (don't stop suddenly) when the problems start to resolve.

 

Hi All,
Meya, apologies for not replying to your very helpful message sooner. Feeling exhausted and run down turned into viral tonsillitis - utterly wiped out.
But, just wanted to say thank you SO much for mentioning selamectin. IT WORKED! Over a month in neck cushions and finally at the end of last week I released him from them. The relief was UNREAL! He's my happy boy again. I cannot begin to say how tough it was.
The vet said the selamectin wouldn't do anything the Advocate hadn't already done and on the last visit he'd said there was no sign of mites. I tried to explain that was perhaps because I'd been fastidiously removing the coffee granule wax every day. How wrong was he? Selamectin works!
I got to the point where I thought I'm just going to taper off the pred, taper off the tramadol. So I did, cautiously removed the e collar and gently distracted him from any over enthusiastic scratching whilst he slowly got used to being free from it.
Anyway, I'm rambling. Next to tackle is the diabetes, but I'm pleased to say it's still heading in the right direction.
For now I'm happy, my boy is a my feet, but keeps jumping up on the sofa for cuddles and to ask for food. He's back! And so's his super loud, wonderful purr.
Thanks all - gratitude hugs to each of you and an extra one for Meya! Hooray for selamectin!
Amy.

 

When Jane's mites got to the point where they were biting -ME- I did some deep research and found the big guns. It took us a few tries as well to get them gone. Most bugs are becoming resistant to insecticides, unfortunately. I'm glad he's feeling better! If you have other cats/pets, make sure they get treated as well, or it might come back.

 

No other pets to treat, but fairly sure I was bitten. I never get big bites, but suddenly had one on my scalp and the most angry enormous one on my ankle.
Severe cases you can apply to Stronghold two weeks after the first spot on. That'll be this coming Tuesday... Will definitely apply!