Ask the Cat Doc: Skin Conditions, Upper Respiratory Infections, Gabapentin, and More

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Welcome to our regular “Ask the Cat Doc With Dr. Lynn Bahr” segment! Once a month, Dr. Bahr answers as many of your questions as she can, and you can leave new questions for her in a comment.

Dr. Bahr is a 1991 graduate of the University of Georgia’s College of Veterinary Medicine and founder of Dezi & Roo, a company that designs, manufactures, and sells solution-based products that enhance the lives of cats and their owners. She volunteers at numerous animal-related charities and causes and serves on the Fear Free Advisory Board, the Parliamentarian of the Society of Veterinary Medical Ethics, the Cat Committee of the Pet Professional Guild, and the Alley Cat Allies’ Feline Forward Task Force.

Dr. Bahr is co-author of the upcoming book Indoor Cat: How to Enrich Their Lives and Expand Their World, due out in April of 2022 and available for pre-order now.

For more information about Dezi & Roo and their unique and innovative cat toys, please visit Dezi and Roo on Etsy.

Do you have a question for Dr. Bahr?
Leave it in a comment and she’ll answer it in next month’s column!

Itchy skin and hot spots

Dr. Bahr,

Thank you for sharing the news about Coco. You may have given me a clue to Rosie’s skin problems. She is 10 and has been with me since she was 2. (She started life feral and was brought in to the shelter as a TNR when a volunteer was feeding her colony.) She has always had itchy itchy skin. She’s seen 3 vets in the local clinic where we go. The first was sure it was a food allergy. We tried single protein food for cats with allergies. Was not helpful. Vet #2, who is really good and considerate and gave Rosie plenty of time, was convinced it’s a flea bite allergy. I put a Rx topical anti-flea treatment on Rosie monthly. And have also given Captstar if she’s scratching a lot anyway. This summer nothing stopped her scratching. She has a large hotspot from under her chin down her neck front and side. Friday she went to the newest vet in the practice who is especially interested in skin problems.

She got an injection of antibiotic and Rx’s of prednisolone, chews and liquid (because I can’t be sure which she will accept I need choices). Every night I put a mixture of ResQ cream with manuka honey and a liquid prednisolone onto the hotspot. The hotspot is looking better, tho it’s not cleared.

I was given a liquid Atopica, p.o., for her once, but it tastes terrible and she will NOT take it. Does it come in injectable form?

The hardest part of treating and caring for her is that she wants to be outdoors. She sits at the cat flap (locked closed now) and begs me to open it, calling and calling for hours. I don’t expect this to change. I will have to let her out again when the hotspot has healed. I hope and pray she will decide it’s OK again to come in to sleep and eat, as she used to do. But it would be so useful to have an injection I could give her when I do get hold of her. If not Atopica, what else? – Cheri Collins

Hi Cheri,

You have certainly been trying your hardest to help Coco with her skin problem and I commend you for your efforts. Coco is lucky to have you advocating for her.

While I cannot give out medical advice without seeing her, I can make the following suggestions:

If Coco has a flea allergy, then preventing even one flea bite is the best way to control it. That may include applying a prescription flea preventative more frequently (some are safe to apply every 2-3 weeks) than the labeled direction of every 30 days. Ask your veterinarian for the proper recommendation. Treating your yard for fleas will also help. There are beneficial nematodes that you can use as a safe and effective alternative to harsh pesticides.

If fleas are not the root cause of Coco’s scratching, then I would make sure that she has had a full skin workup that would include some basic diagnostics like skin scrapes to look for mites and tests to rule out ringworm. Have any of these diagnostics been performed on Coco? If not, I would recommend they be done.

A veterinary dermatologist can perform allergy testing, and this is something you may want to purse if all else fails. Knowing what she is specifically allergic to will help with a proper treatment plan and will go a long way in successfully reducing her itchiness.

Unfortunately, Atopica does not come in an injectable form. However, steroids do, and I was wondering how Coco is responding to the ones you are currently giving her. How would you rate her response to therapy? I am a bit confused about the liquid prednisolone she was prescribed. Are you applying it topically or giving it orally?

If her skin condition recurs or fails to completely heal, then I would recommend you get her seen by a veterinary dermatologist. Skin problems are what they are best at solving.  Good luck!

Nasal congestion

I have a male cat who is 10 years old and generally healthy. However he gets congested with a lot of sneezing, snorting and blowing his nose in air conditioning and when it gets cold in the winter which it does occasionally here in Florida where I am. During good weather when I have the windows open he can sometimes still get congested. I have taken him to the vets and they gave him an antihistamine which only worked for a couple of days and he now refuses to take it. I administer it by mouth with a syringe.

Would steroids shots make Willow more comfortable? Is there anything you can recommend?

Thank you
BJ Beavin

Hi BJ,

Thank you for taking the time to write in about your congested kitty. Chronic upper respiratory conditions can be frustrating and sometimes difficult to resolve completely but we do have ways to manage this common problem.

Antihistamines are a good option to try initially since they are relatively safe and easy to obtain but, unfortunately, many cats do not respond to them as well as we would like. They are of value when a cat is experiencing seasonal allergy symptoms but are not as helpful when trying to control other causes of nasal congestion. Otherwise, it may take either antibiotics, antivirals, or anti-inflammatory medications (or a combination of medications) to successfully combat chronic congestion.

Does Willow have a visible nasal discharge? If so, is it clear and runny or colored and thick? Does it seem to come out of one nostril or both? Does it ever go away on its own or only when he takes an antihistamine?

A steroid injection will certainly help decrease inflammation but will do little else if there is a bacterial component to his congestion. In that case, he may benefit from having an antibiotic on board as well.

Have you tried applying any topical nasal medications? For mild cases, I recommend pediatric saline nose drops (apply one drop, once or twice a day to alternating nostrils). For more advanced cases, I use medicated drops that contain antibiotics and steroids. Since cats are unable to blow their noses like we can, the drops not only help lubricate their nasal passageway, but they may also cause a cat to sneeze which helps to expel the mucus and phlegm. Always check with your veterinarian before using any medications.

Hopefully, some of these recommendations will help Willow be more comfortable. Let me know if any work.

Kittens with URI and elderly cat begging for food

Hi Dr Bahr! I have a couple questions, I hope it is ok. First, I have a kitten and her brother I rescued when they were 5 weeks old, they are now 14 weeks old. Their eyes were matted shut, they had URI. The runt “Mini” has never been able to shake it completely. Her brother is sick again too. It is always in the nose and eyes, lungs remain clear. I’ve tried many homeopathic remedies, two different antibiotics and antivirals to no avail. The only thing that’s made a difference is human doses of Transfer Factor Plus (a natural super immune booster that has had amazing results with FeLV cats) but if I give them smaller doses they wake up not able to breathe out of their noses. We do steamy bathroom every few hours and Little Noses Saline nose drops. Is there anything I haven’t tried?

My other question is about my 11 year old girl Luna. Luna went from obese to skin and bones. She used to be 18 lbs now she is 8 lbs! She used to eat dry kibble but would vomit often and get bladder infections. After I switched her to wet food she stopped vomiting and has not got a one single bladder infection since! But she constantly begs for food now even if she just ate! And she’s Soo skinny!I took her to the vet and had them run every test possible on her. All tests came back negative and the vet said she is fine other than needing her teeth cleaned. She’s not fine being this skinny and begging for food. She’s bit my son and I on the hand thinking we are holding food. All my cats eat strictly wet food now. Any suggestions for dear Luna? – Misty

Hi Misty,

I am so sorry to hear that your kittens are having such a hard time shaking off their nasty upper respiratory infection and appreciate you being concerned about it.

Without the full history of which antibiotics and/or antivirals your babies were prescribed, at what dosages, and for how long, it is difficult for me to give you helpful advice. That is important information to assess before one can say that the treatment failed. Dosages, along with length of treatment of medications, often need to be adjusted or tailored to meet each patient’s specific needs and it is possible that your babies haven’t recovered because their medications were not given for long enough or the dosage was below optimal level to eliminate the problem. I would recommend you take them in for either a recheck with your veterinarian or seek a second opinion. Chronic infections can cause long term damage.

You are right to believe Luna is not fine. She is NOT! Any cat that goes from 18lb to 8lb (despite having a ravenous appetite) is in trouble.  Please get her seen by another veterinarian immediately.  And keep feeding her as much as she wants until your appointment.

Cat licking owner’s fingers

My cat licks my fingers non stop. Is that normal? – Kristina Young

Hi Kristina,

Licking is one of the most common ways cats show affection toward each other and you should feel honored and impressed by your cat’s PDA toward you.

It starts at birth with the queen licking and cleaning her newly born offspring. She also licks her kittens to stimulate them to urinate and defecate. As adults, cats lick themselves, and others, to keep cool, clean, and for pleasure.

So, yes, it is purrfectly normal for your cat to lick your fingers. Just make sure you do not have anything toxic or harmful on them. Enjoy the cat baths!

Gabapentin dose

Hello Dr Bahr,

My question is regarding my cat who can not travel in the car as she drools, vomits and poops in the cage when ever we go to the vet. They said gabapentin is the med of choice 100 mg the evening before and 1 hour prior to the car ride. I fear this is a hefty dose of medication as I had to take this same med for my back pain in the past. Your opinion? – Theresa Anspaugh

Hi Theresa.

Thank you for taking time to write in with your question.

Gabapentin is commonly used in cats as a pre-visit pharmaceutical to make the experience of a car ride and vet visit less traumatic. I am happy to hear that your veterinarian prescribed it for your kitty and I think it will make a big difference for your cat’s mental and physical well-being.

Felines (like humans) differ in their reaction to all drugs, as well as the dosages prescribed for them. While 100mg may be strong from one, it may barely affect another. I would suggest you test various dosages with your cat before you ever need to go to the vet. Why not give her 50mg one evening to see how she reacts? If there is no noticeable change then you can increase the dosage to 75mg and continue titrating upwards to 100mg. The right dosage is the one that makes her calm and relaxed yet still steady on her feet and alert. Having her feel a little groggy is okay but you don’t want her falling over or disoriented.

She will be a lot happier, less stressed, and hopefully even relaxed and content the next time she must go to the veterinary hospital. Giving her Gabapentin to achieve that is a good thing. Bravo to your vet for suggesting it.

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Vets keep saying cat is fine when he is most definitely not

Hi Doctor. I just read the questions by other cat parents and wanted to leave my own. My cat George is 6 years old, and hasn’t been feeling good for a few months. He looks glassy eyed, hunches over on the floor like hes in pain in the back or stomach, feels warm to the touch, and lays on me and around the house with his chin in the floor looking miserable. I’ve taken him to three different vets and the only thing they know for sure is that he has a heart murmur. Otherwise they all say he’s okay, that they can’t find anything. But whatever is going on is bothering him more lately, and now he’s getting some feces on his tail (hes a Maine Coon) and not able to clean back there very well. I’m worried about him and I don’t mean any disrespect toward vets in general, but I feel like the ones I’ve seen are brushing me off and I feel angry and disappointed because something IS wrong and if they or another vet don’t find it, he’s either going to continue to be miserable or worse. I’m at the end of my rope, and tired of watching my little guy feeling bad and being helpless to help him. Do you have any ideas of what could be wrong and what else I can do or say to the vets now? I don’t want something to happen to him because they think he’s “fine”.

Thanks for your help,

Tracy

Hi Tracy,

I have always been a big believer in “mother’s instincts” and if you are concerned about your cat, then I am too. The symptoms that you describe do not sound normal and George does not seem to be “fine”.

While I have no idea what is wrong with George, I can try to steer you in the right direction to making him feel better. Did any of the veterinarians that saw him pursue diagnostics like bloodwork, urinalysis, radiographs and/or ultrasound? If not, then I would encourage you to get those done. It is important to have this information to diagnose what is going on with your precious boy. Comprehensive bloodwork and a urinalysis are the minimum data base I would want to see. An ultrasound to evaluate the heart and abdomen would be extremely useful and radiographs would be icing on the cake.

Hopefully, after George has been fully evaluated, you will have a better idea as to his health. Let me know how it turns out.

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