Some questions for those who have dealt with rodent ulcers

A little over a month ago (maybe 2 months by this point) my cat had a lump on her chin. I took her to the vet, the lump was biopsied and it was found that the lump was a granuloma. I'm a little unclear about this, but from my own research it looks like granulomas are also called rodent ulcers (if I'm wrong please correct me).

The lump wasn't bothering her then, so the vet wanted to wait before doing any treatment, though she did give me the option of a steroid injection. However, my cat is just over a year old and also has a heart murmur (though no heart disease according to a cardiologist visit a few months ago), so she didn't want to start her on steroids because of her age (she didn't want her to be on steroids for the rest of her life if it could be avoided) and the fact that steroid injections can be rough on the body in general.

So we set out to attempt to figure out what was causing it. Originally I had Samantha eating out a plastic bowl, but several months before the lump appeared she was switched to stainless steel. I have 11 cats and various different bowls (they are surprisingly good at eating from their own bowls), so after this was found to be a granuloma I switched her to a glass bowl. That seemed to work, because the lump went away on its own.

But now about a month later, its back and it seems to be bigger than it was the first time around. It doesn't seem to bother her at all. I can rub her chin like I normally do and she doesn't seem phased in the least.

So since I'm assuming this is the exact same thing it was a month ago, here are my questions for those who have dealt with this:

Is it necessary to take her back to the vet at this point? Or should I wait to see if it goes away on its own again?

She's been eating from a glass bowl, so my only other option is ceramic at this point, which I can do, but do you think the problem is the glass or the oils left from the food? I wash the bowls every other day, but starting today I'm going to wash them every single day to see if that helps.

At what point does this warrant a vet visit? What size lump is too big to leave untouched?

If the bowl isn't causing the reaction, do you have any suggestions on what is? My next guess would be her food, and in that case, is there any suggestions on what to switch her to?

I think those are all the questions for the moment, but I may come back with more as I try to figure this all out!

A quick and easy thing you can add to the daily routine is to wash your cats faces after each meal. All it takes is a couple swipes of a damp wash cloth. For cats with more sensitive skin or in a active breakout (sore/acne) you may have to do more thorough washing.

But if this more more immune related than acne is you may have some other factors to rule out wish the vet.

This is common with many of the people in the feline herpes group on yahoo. The "outbreaks" can be caused by stress or any type of change in the kitty's environment. Many have found that reducing the stress level for their kitty and in their home helps keep the outbreaks down. You might want to add some L-Lysine (human supplement) to her diet to strengthen her iimmune system, introduce grain-free food, and run a feliway diffuser 24/7 to help reduce stress.

Is grain free food whats typically recommended? I already have 4 feliway diffusers in the house and have had them consistently for a long time now. I also have L-lysine in all of their drinking water because I have several with the herpes virus, so she's been exposed to Feliway and has been getting Lysine for the entire time I've had her. She's not eating a grain free food though. I know that with typical diet switches, discussing it with the vet is a good option, but is grain free something I can do without a vet's supervision? I know that cats need certain things in their diet, so I don't want to switch her unless I know she's getting everything that she needs, and I don't know much about grain free foods at all.

I do think its more immune related than acne. I have 2 others with acne and I've been cleaning their chins each night. When I first started cleaning them, I was getting what looked like dirt on the washcloth. Thats never happened with Samantha. The vet never said anything about it being related to acne. All she said was that it was probably an allergy. But as far as knowing if she actually has acne or not, I really can't tell because she's solid black and its impossible to see if she has any blackheads or dirt on her chin. But since the washcloth has never looked the way it looks with my other acne cats, I'm assuming its not acne, but I could be wrong. I haven't washed her chin as much as I've washed the others, so maybe I'll start doing that after every meal she has.

ETA: As far as stress, absolutely nothing has changed in her environment. I do have 11 cats, but she was my 9th cat so she's always been around my crew, and she gets along with the others really well. So if its stress related, I can't imagine whats stressing her out right now...

My Cinnie gets these periodically. Hers started with an allergic reaction to fleas, she's highly allergic. When she does have it I try to put warm compresses on it. Sometimes they are small, sometimes they can be pretty large. They do shrink and go away. I think it bothers me more than it does her.

I recently had Sophie back to the vet for an anti inflammatory shot because she had another tiny one under her chin.

I asked my vet what more could i do because their bowls are stainless steel, their cleaned every day with fresh water/food, their groomed every other day and i swiff their hairs up everyday. I asked about washing her chin, but he said theres nothing i'm doing wrong and said washing wouldn't really help either.

He's told me to squirt an Oil of Evening Primrose capsule in her food as that can help keep them at bay or salmon oil, but he said there was no need to keep taking her back for an injection everytime she gets one which could be 3-4 times a year unless it got really bad.

I also asked if she could be stressed, but Sophie was rolling her head on my hand then slowly strolled back into the carrier and he said there's no way she's stressed!!

He confirmed they won't turn into anything sinister, and that the small ones she has won't be giving her any pain, so that was enough for me

Oh, and i've just recently put them on Royal Canin kibbles for skin and fur as Sophie has a little dandruff, so i'll see how that works on her