So frustrated. Started as acne, now skin infection?

I'm just wondering if anyone has any experience with this kind of problem.

This is Smudge:



When we adopted him in April, he had acne. We washed his chin with benzoyl peroxide and put muciprocin on it (per our vet).

The comedones are pretty much gone but his chin is still swollen, he's lost hair and his lymph nodes are swollen as well. Our vet was concerned that perhaps it was the shampoo that caused a reaction so we haven't used it in about a month. He's also been on Baytril for the infection for about 3-1/2 weeks. It seemed to get better for awhile but it feels like we've hit a wall and aren't making any more progress.

Here are a couple of pics:





We put out clean glass bowls for him every day and change out his water. He's on dry, grain-free food with a little bit of wet. He is very energetic, playful, etc., so the infection doesn't seem to be bothering him at all.

Does anyone have ANY ideas about this? We've been battling this issue for almost 3 months and I just feel so bad for the little guy that we can't get it cleared up.

I would try eliminating the dry food altogether and going with a novel protein wet food diet. Raw would be ideal - if you're interested in more info just ask, or check out the raw forum here: http://www.thecatsite.com/f/65/raw-feeding-for-cats
 

Thank you! We're in the process of trying to transition him over to wet but it's slow-going. He likes it but hasn't quite gotten the hang of exactly HOW to eat it yet. (Does that make sense?) Raw is probably far down the road.

Can you explain what you mean by "novel protein"?

A novel protein is one he hasn't had before. . .rabbit, lamb, venison, etc.

Originally Posted by ColoradoKitty  

When we adopted him in April, he had acne....

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I'm wondering how that diagnosis was made....the only way to confirm the condition is to do a biopsy or take skin scrapings.

"Acne" can be acne, but, its appearance can also mimic some other conditions.

White Shadow said:

I'm wondering how that diagnosis was made....the only way to confirm the condition is to do a biopsy or take skin scrapings.

"Acne" can be acne, but, its appearance can also mimic some other conditions.

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Well, it was pretty straightforward at first with the black, dirty-looking comedones. His chin was a bit swollen but not too bad. But once we started treating it, his chin and lymph nodes swelled up. We discontinued the benzoyl peroxide because our vet was worried it was irritating Smudge's skin.

Our vet did do a skin scraping and that didn't show anything unusual. We've talked about doing a biopsy but I'd rather take a wait and see stance on the antibiotic before we take that step.

Well, if it were acne, the treatment you've provided is almost straight from the textbook - the 'almost' is because no steroids were used.

But, here's a snippet that speaks to a definitive diagnosis:Quote:

Skin scrapings may be performed to rule out other causes of similar lesions such as demodicosis, Malassezia (yeast) infections, allergies, ringworm, and a condition called eosinophilic granuloma complex. A skin biopsy may also be performed to rule out these conditions. A culture and sensitivity may be performed if a secondary bacterial infection is suspected.  http://www.peteducation.com/article.cfm?c=1+2141&aid=2517

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Now, here's an excellent coverage of one of the conditions mentioned in there - EGC: http://www.marvistavet.com/html/eosinophilic_granuloma.html

I've dealt with EGC - a bioposy was taken (under anesthesia) and the area was "cleaned up" and the cat received one steroid shot (Depomedrol, I believe), an antibiotic and, I think, a skin ointment. When the bioposy report came in, EGC was confirmed. There was no recurrence.

When you read that last article, pay particular attention to the explanation about the transient allergens that do cause this...yes, food allergies can spark an outbreak....but remember, this condition predated your acquiring Smudge. One more point about that article - notice how this can be an endless cycle increasing in intensity until the cat's immune response is quieted by the steroid.

Hope that helps. It can be beyond frustrating.

Well, I had a long reply typed up here, but TCS was being updated, so I lost it.

Short version :

Try small glass or ceramic or stainless steel plates to feed off of. Might be that the bowls are accumulating bacteria around the sides and therefore exacerbate the acne when he eats. One of my kitties had this problem, and the plates did the trick.

I highly recommend you feed grain-free canned or a balanced raw diet instead of kibble. Not only is that better for kitties, but kibble actually has a lot of surface bacteria on it. Also, kitties don't have the thirst drive physiologically like humans and dog do, so they must get most of their water/moisture from the foods they eat or they will be in a state of dehydration because they just won't drink enough water to compensate.

He might have overactive sebaceous glands, so washing his chin with a mild (no scent) Castile soap (Google to find this if you can't get locally--it's actually called Castile soap) and water, then rinse with plain water, after every meal could help.

That's it in a nutshell!

What about his dental health? Often stubborn chin acne is caused by problems in the mouth.

And keep in mind that too much scrubbing can make things worse by cause excessive irritation.

I don't like the sound of the lymph nodes being swollen. I recommend another FeLV/FIV test, too.

A second opinion is always an option, perhaps starting with a dermatology specialist, or internal medicine specialist (the lymph nodes again)

Smudge is a beautiful boy, keep us posted!

Thanks, everyone! Lots of good info and ideas here. Luckily, our vet is really great about being open to our ideas and working collaboratively; so if the antibiotics don't take care of it, I'm sure he'll be easy to approach when discussing next steps.

White Shadow - That's awesome info! I'll definitely discuss it with our vet if we get to that point. We haven't done the steroid shot because my vet said there's evidence that even one steroid shot can make some cats diabetic. Obviously, we'll go that route if needed but I think he'd like to try some other avenues first.

WhollyCat - We're transitioning him to wet food but it's slow-going. I will definitely try feeding him on plates. Thanks for the idea!

Otto - His dental health is good. Just some mild tartar. We got him from an animal blood bank and they do extensive blood testing on their donors because the cats can't have anything that could be passed on to another cat via blood. They also did another blood test before they put him up for adoption in February and his bloodwork was perfect so we feel pretty confident that it's just the "acne gone wild." :-) And everything I've read says that advanced cases of acne can cause swollen lymph nodes. However, I'm definitely considering the idea of seeing a specialist and I know our vet would be supportive of that. And thank you - we think he's a beautiful boy, too...with an awesome purr-sonality to match. 

I'm wondering if some of it is stress-induced.  Sometimes we don't think a situation is stressful, but it is for our kitty.  Do you have a feliway diffuser?  If not, using one might help with future flare ups and break outs.  You can also use hibiclens to clean the area.  I'm also wondering if anyone's considered it might be a rodent ulcer??
 

WhollyCat said:

Well, I had a long reply typed up here, but TCS was being updated, so I lost it.

Short version

:

Try small glass or ceramic or stainless steel plates to feed off of. Might be that the bowls are accumulating bacteria around the sides and therefore exacerbate the acne when he eats.

...

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Can't see that plates or bowls matter from a cleanliness if they are stainless and used once only and then get properly washed - the cat bowls here go in the dishwasher.  But maybe with a plate the cat dips it's chin in the food less?

OrientalSlave said:

Can't see that plates or bowls matter from a cleanliness if they are stainless and used once only and then get properly washed - the cat bowls here go in the dishwasher.  But maybe with a plate the cat dips it's chin in the food less?

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That's what I meant. With a bowl their chins are in contact with the sides of the bowl. With a plate, they're not.

My Mario had a chin that looked like that...maybe worse. The antibiotics helped but my vet also had me wash his chin everyday with antibacterial soap.

It cleared up very nicely and i went to stainless steel bowls.

Good luck
 

I'd stay away from the stainless steel. My cat has acne when I feed her from a strainless steel bowl. Glass or ceramic are safer bets.

Do you have a plastic water fountain by any chance? This can also be the source. 

burretje said:

I'd stay away from the stainless steel. My cat has acne when I feed her from a strainless steel bowl. Glass or ceramic are safer bets.

Do you have a plastic water fountain by any chance? This can also be the source. 

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I too dislike stainless steel. Glass or ceramic (make sure it is "Made in USA" because of lead laws) Wash them in scalding water between meals, air dry. Soap is not needed unless you are feeding raw. If you use soap when washing cat dishes after washing in hot water, rinse them repeatedly in cold water to remove soap residue.

If you use a dishwasher, also, rinse afterward in cold water and air dry. Dishwashers leave soap residue.

Why would glass and ceramic be better than Stainless steel? Is there a difference in bacteria build up? Just curious..
 

I don't know why. I guess a cat can be allergic to the material.

Levi68 said:

Why would glass and ceramic be better than Stainless steel? Is there a difference in bacteria build up? Just curious..

 

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I think a lot of the stainless steel pet dishes are of a very poor quality. "made in china", most of them. If you could find pet dishes of the same quality as good stainless steel cooking pots, maybe. But I used stainless steel dishes for a while and was very unhappy with them.

I use these little glass shallow saucers made by Corelle. They are sold as individual pieces in Walmart. "Corelle Vitrelle" 10 oz bowl is what it says on the back. They don't show them on the Walmart website, but these are the ones:

http://www.shopworldkitchen.com/corelle/winter-frost-white-bowl-6003899

FWIW, when it comes to kitties it is recommended that they be fed from a plate rather than a bowl because of their whiskers. A cat's whiskers are extremely sensitive, and using a bowl exposes them to "whisker stress" because it is quite uncomfortable for their whiskers to be rubbing on the sides of the bowl when eating. Some kitties will not eat as much, or refuse to eat, if fed from a bowl.

As far as stainless steel, whatever floats one's boat. (Just teasing here, so please don't take offense!) I've used glass, ceramic, stainless steel, and disposable paper plates all with success.

I will say that when I use the dishwasher, I run it through another HOT cycle (re-wash) to remove traces of detergent. When not using the dishwasher I use antibacterial detergent, and hot, hot water. I also rinse with the hot, hot water. I'm curious as to why those that rinse with cold water do so?