Skin: atopic dermatitis
Synonym(s): Feline atopic syndrome
Introduction
- Cause: feline atopic skin syndrome is due to an allergic reaction to environmental allergens.
- Signs: pruritus and four feline reaction clinical presentations: symmetrical alopecia, miliary dermatitis, eosinophilic plaques and pruritus of head and neck.
- Diagnosis: elimination of other causes of pruritus; history and clinical signs. Allergy testing is used to identify individual offending allergens but not for diagnosis.
- Prognosis: long-term maintenance therapy required as this disease is lifelong. The type and extent of treatment burden will vary between patients.
Presenting signs
- Pruritus: excessive licking or grooming, although this may not be noticed by by the owner:
- Trichoscopy will show broken hair shafts.
- There may be an increase in hairballs.
- Hairs may be seen between the teeth or on the tongue.
- Four feline reaction clinical presentations:
- Head and neck excoriations/pruritus (HNEP).
- Symmetrical self-induced alopecia.
- Miliary dermatitis Dermatitis: miliary.
- Eosinophilic granuloma complex; eosinophilic/indolent ulcer Indolent ulcer, eosinophilic plaque, eosinophilic granuloma Eosinophilic granuloma.
- Presenting signs may be seasonal.
- Chronically relapsing dermatitis.
Geographic incidence
- Atopy is universally recognized and considered to be one of the most common dermatological hypersensitivities in the cat.
Breed/Species predisposition
- There is some evidence of breed predisposition for Abyssinian cats Abyssinian and their crosses and Somali Somali and Ocicats Ocicat.
Cost considerations
- Elimination diets, either commercial complete novel protein hydrolyzed or homecooked novel protein diets can be more expensive (and time consuming in the case of home cooked diets) than standard cat foods Dietetic diet: adverse reaction to food.
- Often requires life-long, sometimes multimodal, treatment plans which may be costly.
Pathogenesis
Predisposing factors
General
- Familial history of atopy is assumed from the condition in other species.
- In some cases, where familial history is known, this can be useful and could be discussed with regard to breeding colonies.
Pathophysiology
- Feline atopic skin syndrome is caused by an exaggerated or inappropriate immune response of the affected cat to allergens.
- Current literature supports the possible role of IgE in the pathogenesis of feline atopic skin syndrome.
- More work is required to assess the Th2 (T-helper 2 cells) weighting in cases of feline atopic syndrome.
Diagnosis
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Treatment
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Pucheu-Haston C M, Olivry T, Prost C, Jackson H et al (2021) Feline allergic diseases: introduction and proposed nomenclature. Vet Derm 32, 8-12 WileyOnline.
- Halliwell R, Banovic F, Mueller R S & Olivry T (2021) Immunopathogenesis of the feline atopic syndrome. Vet Dermatol 32, 13-17 UofE (pdf download).
- Mueller R S, Nuttall T, Prost C et al (2021) Treatment of the feline atopic syndrome – a systematic review. Vet Derm 32 (1), 43-52 PubMed.
- Santoro D, Pucheu-Haston C M, Prost C et al (2021) Clinical signs and diagnosis of feline atopic syndrome: detailed guidelines for a correct diagnosis. Vet Derm 32 (1), 26-32 PubMed.
- Maina E & Fontaine J (2019) Use of maropitant for the control of pruritus in non-flea, non-food-induced feline hypersensitivity dermatitis: an open-label, uncontrolled pilot study. J Feline Med Surg 21 (10), 967-972 PubMed.
- Ravens P A, Xu B J & Vogelnest L J (2014) Feline atopic dermatitis: a retrospective study of 45 cases (2001-2012). Vet Derm 25 (2), 95-102 PubMed.
- Schmidt V, Buckley L M, McEwan N A et al (2012) Efficacy of a 0.0584% hydrocortisone aceponate spray in presumed feline allergic dermatitis: an open label pilot study. Vet Derm 23 (1), 11-6 PubMed.
- Wildermuth B E, Griffin C E & Rosenkrantz W S (2012) Response of feline esoinophilic plaques and lip ulcers to amoxicillin trihydrate-clavulanate potassium therapy: a randomized, double-blind placebo-controlled prospective study. Vet Derm 23 (2), 110-8 PubMed.
- Yu H W & Vogelnest L J (2012) Feline superficial pyoderma: a retrospective study of 52 cases (2001-2011). Vet Derm 23 (5), 448-e86 PubMed.
- Favrot C, Steffan J, Seewald W et al (2011) Establishment of diagnostic criteria for feline nonflea-induced hypersensitivity dermatitis. Vet Derm 23 (1), 45-50 PubMed.
- Wisselink M A & Willemse T (2009) The efficacy of cyclosporine A in cats with presumed atopic dermatitis: A double blind, randomised prednisolone-controlled study. Vet J 180 (1), 55-59 PubMed.
- Last R D, Suzuki, Y, Manning T et al (2004) A case of fatal systemic toxoplasmosis in a cat being treated with cyclosporin A for feline atopy. Vet Dermatol 15 (3), 194-198 PubMed.
- Moriello K A (2001) Feline atopy in three littermates. Vet Derm 12 (3), 177-181 PubMed.
- Gilbert S & Halliwell R E (1998) Feline immunoglobin E - induction of antigen-specific antibody in normal cats and levels in spontaneously allergic cats. Vet Immunol Immunopathol 63 (3), 235-252 PubMed.
- Roosje P J, Whitaker-Menezes D, Goldschmidt M H et al (1997) Feline atopic dermatitis - a model for Langerhans cell participation in disease pathogenesis. Am J Pathol 151 (4), 927-932 PubMed.
- Scott D W & Miller W H Jr (1993) Medical management of allergic pruritus in the cat, with emphasis on feline atopy. J S Afr Vet Assoc 64 (2), 103-108 PubMed.
Other sources of information
- Miller W H, Griffin C E & Campbell K L (2013) Feline Atopic Dermatitis. In: Muller & Kirk's Small Animal Dermatology. 7th edn. Elsevier, Mosby, USA. pp 388-392.
- Trimmer A M & Newton H M (2010) Rush and Conventional Immunotherapy. In: Consultations in Feline Internal Medicine Volume 6. Saunders, Elsevier, USA, pp 358-367.
- Foster A P & Roosje P J (2006) Update on Feline Immunoglobulin E (IgE) and Diagnostic Recommendations for Atopy. In: Consultations in Feline Internal Medicine Volume 5. Ed: August J R. Elsevier Saunders, USA. pp 229-238.
- Fadok V A (1995) Three Feline Dermatologic Syndromes and their Relationship to Allergy. In: Proc 1995 North American Conference Orlando, Florida Jan 14-18.