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Kitty with thin skin that spontaneously tears. Ideas?

post #1 of 16
Thread Starter 
Hello all,

I'm new to this forum, and joined so I could seek some help with one of my kitties that is quite a puzzle.

Celia is a 6 year old DLH who lives inside only with 6 other kitties who all get along. She eats Innova dry food and Merrick canned food. She does have asthma, which has been very well managed with 1 cc of depo-medrol every 3-5 months. She is FeLV and FIV negative.

In January of this year, she presented with a full thickness wound where the neck meets the back (the wither region.) I took her to the emergency vet to have it sutured, and the vet was very perplexed as the skin was very thin and friable and we had no reason for the tear. She said that if the skin tore again, we would need to do some testing to evaluate the cat. My regular vet agreed. The lesion healed well.

Approx 4 weeks ago, Celia presented with another tear in the same spot but larger. Again, it was the weekend, so we went back to the emergency vet. She felt the kitty probably had iatrogenic cushings and should be tested, and she also wanted biopsies. I requested that she suture the wound, and I would follow up with my regular vet, which I have done.

While my vet felt that the our limited use of steroids would not cause iatrogenic cushings, he did feel we needed to rule it out. The ACTH stimulation test was negative. All blood work (CBC and metabolic panel) came back absolutely normal. She was at the vet today for some skin biopsies, and results on those should be back next week. Even though my vet knows this kitty and her issues, he was still surprised at HOW THIN the skin was when he was doing the biopsies--his words were "there's just nothing there, the skin is like paper."

I have never seen how she is tearing her skin. I have never torn her skin by handling her. I also have her littermate, who does not have any of these issues. Momma was a barn cat that had no skin issues but did have asthma.

Does anyone have any ideas about this? My vet, who is very sharp, is really quite perplexed.
post #2 of 16
I keep thinking "it's got to be the depo shots". Depo can mess with the hormones, can that be somehow linked???

Can you find a feline only vet to get her to??
post #3 of 16
Thread Starter 
Both tears occured several months following depo. In fact, I think Celia's last depo shot was shortly after her first tear, which would make it more than 6 months ago. If the tearing was related to the depo, I would expect tears to follow depo much more closely. Iatrogenic cushings (or just regular cushings) could absolutely explain the skin friability, but we are really using very little steroid--only 1 cc 2-3 times a year--and Celia was negative for cushings, anyway. It would have very nicely explained everything though.

Actually, thinking out loud here, perhaps the timing is significant. I wonder if an auto-immune disorder could cause the skin problems. The depo wears off, the immune system goes into over drive and attacks the skin and the skin tears? I'd imagine we'd see something on the bloodwork if that was the case, though. We'd certainly see something on the biopsy.

I don't see what advantage I would have with a feline only vet. My vet is very smart, very sharp and very well-read. I am VERY picky about my vets and believe he is the best in the area.
post #4 of 16
You need to get off the Depo Medrol Shots.
My Cat has been getting bladder problems from them and other problems.
Can you switch to a Inhaler?
I did with Coco last May
My Vet also said never to give Depo Shots more then two times a year.
I think the shot is causing the problems in your cat.
My cat isnt aloud to get them anymore and so far the inhaler is working.
post #5 of 16
The advantage to a feline only vet is:

1) new vet/new ideas
2) more up to date on feline health, etc.

I wouldn't think of it as "my vet is bad, can't figure this out", but more as "my vet is stumped, something is very wrong with kitty, I need more ideas/thoughts". I took my dying kitty to a 2nd vet, then presented my vet with the 2nd vets ideas. Bought her a few more weeks with me.
post #6 of 16
Thread Starter 
Quote:
Originally Posted by white cat lover View Post
The advantage to a feline only vet is:

1) new vet/new ideas
2) more up to date on feline health, etc.

I wouldn't think of it as "my vet is bad, can't figure this out", but more as "my vet is stumped, something is very wrong with kitty, I need more ideas/thoughts". I took my dying kitty to a 2nd vet, then presented my vet with the 2nd vets ideas. Bought her a few more weeks with me.
Ah, I see.

I'm not there yet If the skin biopsies come back as normal, I may be. When my vet is out of ideas and says "I don't know" is when I'd start looking elsewhere.

My vet is up to date with the literature.

While weird, this is not as pressing as a dying cat--I would be far more likely to demand a second opinion NOW if it were. Celia is absolutely normal on bloodwork, is a happy kitty who is eating and drinking well and while this skin stuff is BIZARRE, it doesn't bother her. I feel need to balance getting her well with the stress of going to and staying at the vets.

I do have a relationship with an excellent diagnostician/internist. She is not feline only, but she is very, very sharp. If my vet runs out of ideas, I'll probably take Celia down to her.
post #7 of 16
And you could consider a Vet School for an opinion, if needed.

Consider that the skin is produced in cells several layers under the layer you see on top. As the top cells are shead (weekly in humans), the layer below becomes the top layer. If the depo-medrol is impacting the newly formed skin, it would take a bit of time for the skin to work its way up.... Just a thought anyway.

Cats seem to have more issues with injection sites than dogs do.

As for treating asthma, depo only lasts 2-3 weeks in the body. I am amazed that you are getting positive effects that last longer than a month. Five months is incredible.
Would you consider a trial period using inhalers to control the asthma? It would be interesting to see what happens to the skin when inhalers are used instead on injections.
I have had asthma my entire life (and I am old). Inhalers weren't invented until I was in my teens and home nebulizers came along a few years later. I prefer inhalers to oral or injectable meds because there are less systemic side effects.
post #8 of 16
Quote:
Originally Posted by Simkie View Post
"there's just nothing there, the skin is like paper."
Sounds like my human disease Ehlers Danlos Syndrome, which has also been found in Himalayan Cats.
post #9 of 16
This is what Cocos Aerokat looks like if you decide to try inhalers.


I have had Asthma for over 26 years and when I used to take pred or get shots I would bruise very easy and bleed alot when I got cut.
post #10 of 16
Thread Starter 
I'll certainly speak with my vet again about the inhalers. We did discuss perhaps a year or more ago, but it's quite hard to justify the cost and need for daily dosing when Celia has been SO well managed on depo. A sub-q shot 3 times a year (or less) with a total cost of perhaps $3 for the year vs over a hundred a month and daily dosing. Has the price come down at all on the inhaled stuff?

kitytize, I did see some info on Ehlers Danlos Syndrome in kitties, but what I did read led me to believe I would be seeing a LOT more tearing. I wonder if it can vary in severity? I do believe this (or any other collagen disorder) will show up on the biopsy. I'm eager to get that back.

Mom of 4, I actually live in Fort Collins, CO--home to the Colorado State Veterinary Teaching Hospital. And I will never take a cat of mine back there (or a dog, or a horse) unless the animal requires diagnostics that can't be preformed anywhere else (just faced this with my horse--she needed a bone scan.) I have some stories that would stand your hair on end and, quite frankly, I am DONE with CSU. We do have an excellent private emergency/diagnostic hospital, and that's where I would take Celia next, if we don't find something with my regular vet.

It is quite curious about how long the depo suppresses Celia's asthma, isn't it? I think it's also very interesting that BOTH tears occurred *long* after the last depo injection. To me, that seems to point away from depo as the culprit here, but who knows.
post #11 of 16
Its hard to say if that is the cause of the tearing. Cocos bladder infections come 2 months after the shot. The inhaler was 245 which is way to high.
Coco is on her first inhaler. There are times when her Asthma is ok for a while so I do not use it. She did get lumps from the depo that would last 2 months. I wish you were near Uc Davis because they could help your cat.
post #12 of 16
A couple of things. I honestly question the depo lasting long enough to cover your cat for 5 months. So that would mean her asthma is possibly not as severe or frequest as you thought. And that could mean the inhaler would not be needed very often. Depending on the inhaler, there are some generics.

My experience with depo in my very allergic Golden was completely the opposite of yours with your cat. The 70 bucks for his injection (110 lb dog), which worked for less than 24 hours. His file is marked so they will never waste our time or money on it again.

And I am sorry that you had a bad experience with CSU. I have two friends who had life changing results for their pets at CSU.
post #13 of 16
Mom of 4,
My Vet told me depo last only 3 weeks at the most and he is a very good vet and top 16% in the Us.
post #14 of 16
Quote:
Originally Posted by Simkie View Post
kitytize, I did see some info on Ehlers Danlos Syndrome in kitties, but what I did read led me to believe I would be seeing a LOT more tearing. I wonder if it can vary in severity? I do believe this (or any other collagen disorder) will show up on the biopsy. I'm eager to get that back.
Simkie, EDS in humans is a genetic soft tissue disorder which becomes apparent from early in life (I have a related genetic collagen disorder, not quite so severe but leads to excessive scarring, bruising, and joint/ligament/tendon injury which was apparent in childhood) and I think you'd have been seeing skin tearing from an early age if that were the case. A DNA test specifically for the condition would either confirm or rule out.

I am not familiar with the medication that your cat has been on, but I do know that longterm steroid treatment for allergies and asthma is known to result in thinning of the skin, so my instinct is that the shots your cat has been getting are most likely to blame.

The difference between getting shots and an inhaler is that shots affect the whole body, whereas an inhaler reduces immune response ONLY in the trachea and bronchioles - it is a topical treatment with far less risk of systemic side effects, and for that reason is the favoured method of treatment both in humans and animals. I take a steroid inhaler daily with no side effects, but if I were on oral or injected meds I could expect to have side effects from longterm use including weak skin and weight gain.
post #15 of 16
Thread Starter 
The skin biopsy results came back today: moderate chronic lymphocytic fibrosing dermatitis.

My vet explained that there is chronic inflammation in the skin that is making it very thin and friable. There is no collagen disorder. This is an immune-mediated response, but not an auto-immune response.

This sort of inflammation is due to an allergic response, which we're going to treat with a food change to a novel protein diet, along with supplemented omega 3, vit e and vit a. Steroids would also treat the inflammation in the skin very effectively, but are not advised in this case (due to their skin-thinning effect )

The asthma is most likely also due to this allergy, so by treating the skin, we are also treating the lungs.

We're going to start with California Naturals Salmon and Sweet Potato and go from there. If that's ineffective, I'll be looking for more novel protein diets.

Right now, I'm feeding all 7 kitties the same thing and we'll see how they settle into no more dry food. Can anyone give me tips on whether or not I'll be able to feed Celia one diet and the other kitties something else? Right now they are not finishing their plates right away and are all eating together. Or should I just plan on keeping them all on the novel protein food?
post #16 of 16
My Cats eat differant foods.
Coco is Allergic to almost everything and has bladder problems.
She is stuck on Urinary food but I have caught her stealing their food.
Can you feed them in seperate rooms.
I take Coco out here to feed her and let them eat.
When i have to go somewhere I leave the Uriary food out because I do not want Coco sick again.
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