Infected nailbeds and infected areas on back

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
We've been working with out vet to try and figure out what's going wrong with our cat Loki, who is a spayed Siamese/tabby around 11 years old. We began noticing signs of what we thought were food allergies within the last year - small crusty scabs that would form on her neck to mid back that usually came on and resolved with food changes. We were hoping that the latest issues listed below were again signs of food allergies but are second guessing that assumption now.

About a month or two ago Loki got a larger, infected looking area on her lower back, about the size of maybe 4-5 quarters pushed together. We waited for it to resolve like the others had, but it got worse and we then noticed that she had an infected dewclaw (the sheath around the claw was red, bloody and very swollen). We took her to the vet who said he suspected she had a "hot spot" on her back, but also said we might be looking at auto-immune issues. He shaved and cleaned the hotspot and sent us home with clavamox and instructions to soak her paw in epsom salt water twice a day. She also had a bacterial culture done, which later revealed a staph infection. Her bloodwork was said to be "pristine" with no signs of any major issues occurring beyond a slight infection.

A few weeks later and the hot spot had resolved but the nailbed infection was now in multiple front nails, both paws being affected. Loki has been missing half a back leg and the other back foot since birth, so there would be no nail issues anywhere but the front paws.

About a week after that we noticed more scabs/lesions forming on her back and the nailbeds still looking worse. We also noticed what definitely looked like ringworm on one person in the house, though no other people/pets showed any symptoms (it's been almost two weeks and still no one else has any sign of ringworm). We took her back to the vet to try ringworm medication and have a fungal culture done and are still awaiting the results - but it's now been 10 days since the start of the Diflucan and Loki's symptoms are still just worsening.

We also recently attempted soaking the paws and back lesions in 4% hibiclens (chlorhexidine), diluted 20:1 per the vets advice, but after three days we noticed that she was trembling in pain on her front arms. We moved back to ebsom salt soaks only and the shaking has toned down again.

We'll be taking her back to see how we proceed from here, but I really wanted to see if this rings a bell for anyone else or how others think we should proceed. Does this sound like autoimmune at this point? I've been reading and the closest thing seems like pemphigus, but it doesn't quite fit the symptoms and she has no lesions at all on her face, ears, neck, etc. Just her nailbeds and back.

and if it matters, we've moved all cats to a homemade diet as we were simply having too many issues with throwing up/sick kitties on dry kibble, and even brands like Wellness were not showing any improvement. We are currently feeding the chicken version of homemade food by Lisa Pierson.

I'm attaching the best photos I can get of her symptoms in case it helps:






 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,860
Purraise
13,175
Location
Columbus OH
I don't have a clue.  I am wondering if it could be auto-immune when there is a positive culture for a staph infection.  I know chicken allergies are common in kitties, I have one that developed an allergy to chicken, but that seems extreme for a food allergy.  Food allergies usually show up in the ears or somewhere on the face and there is still the positive for staph.  I hope you and your vet can get it figured out.
 
  • Thread Starter Thread Starter
  • #3

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
My vet thought it might not be uncommon for there to be a staph infection if there was an autoimmune disorder. His explanation to me was that the autoimmune disorder could open the door for a lot of different infections to occur, simply because the immune system was not up to fighting them off. He said staph infections were a type of bacteria that is always present but is opportunistic, and as such it tends to present itself in animals who do not have a strong enough immune system to keep the bacteria under control. The explanation sounded correct to me based upon what I've read online and also because I've dealt with mycoplasma infections with many of my rats - which is another type of bacteria that most all pet rats have but which many times does not cause an issue until their immune system can't fight it off.

If the explanation I've been provided for regarding staph infections in cats sounds incorrect though I hope people will chime in and correct that.
 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,860
Purraise
13,175
Location
Columbus OH
I know that for people staph is something that is usually on the skin, an opening in the skin can give it an entry point to start an infection.  Autoimmune disease is caused when the immune system goes haywire and begins attacking the body.  If this causes an opening in the skin that would give a staph infection the opening to get started.  That would create a catch-22.  Autoimmune disease is usually treated with a steroid which brings down the immune reaction but that isn't something I would think you would want to do with an infection present.
 
  • Thread Starter Thread Starter
  • #5

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
@ Denise: So how would one go about dealing with this sort of issue. Obviously the clavamox and the diflucan haven't made a dent in any of Loki's symptoms. It almost seems like she would need to be on a combination of steroid to treat the the possible autoimmune and antibiotics to keep the infected skin areas from becoming worse.

Out of curiosity, does anyone know how autoimmune disorders are typically diagnosed? Her bloodwork didn't indicate any issue of that sort, and the only other test I myself know of to try is a skin biopsy, though I'm not sure if that would shed any light on an autoimmune disorder either.
 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,860
Purraise
13,175
Location
Columbus OH
The only experience I have with auto-immune disorders is probable IBD.  The only way that can possible be diagnosed is with biopsy, that's why most of us have kitties with probable IBD.

I know its very common to use a steroid like a diagnostic tool, if the condition improves with a steroid that it probably is auto-immune in nature.  You wouldn't want to use a steroid with an infection because the steroid ratchets down the immune response.

I did really give you any answers but by posting this will get bumped back up and maybe someone who wasn't on the site over the weekend and knows something about this will see it.
 

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
I'm so sorry you're going through this with Loki. Does she go outside?

ETA: Also, where are you located?
 
Last edited:

ldg

TCS Member
Veteran
Joined
Jun 25, 2002
Messages
41,310
Purraise
842
Location
Fighting for ferals in NW NJ!
I would try 500ppm colloidal silver (used externally).

Please read this thread: http://www.thecatsite.com/t/240011/colloidal-silver-usage-for-cats-health-in-some-occasions

This member, as you will see, had a cat with an abscess that had not responded to surgeries, numerous antibiotics, etc. Within 2 weeks, the wound, almost the size of her entire thigh, was reduced to the size of a quarter.

I began using colloidal silver for any wounds on ourselves and the cats. It has treated abscesses in the ferals, and heals bite wounds on us basically overnight. It cleared up acne my Flowerbelle got from shoving her face in a plastic bag 90% in one night and 100% in two.

One thing is for sure? It cannot hurt to try. It will only cost you the colloidal silver and cotton balls.

I use the brand Amino Acid & Botanical supply, and I purchase it on amazon. Many health food stores sell colloidal silver, but it is meant for internal use and only sold at 20 - 30ppm, not the 500ppm you'd need for external wound healing.
 
Last edited:

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
I found this, which is eerily fitting to Loki's condition, and the reason for me asking if she's goes outside and your location.

SPOROTRICHOSIS

A fungus caused by the organism, Sporothrix schenckii, which is found in soil, vegetation, and timber. In the US, it is most commonly found in coastal regions and river valleys.
When bacterial cultures have been performed, the ulcerative and exudative lesions of sporotrichosis are often secondarily infected with bacterial organisms, especially Staphylococcus intermedius.
Source: http://www.vet.unicen.edu.ar/html/A... the Dog and Cat 3rd Ed/63 Sporotrichosis.pdf

Photos and detailed description are included in the document.

Also see last entry on this page: http://www.merckmanuals.com/petheal...ystems_of_cats/fungal_infections_in_cats.html
 

ldg

TCS Member
Veteran
Joined
Jun 25, 2002
Messages
41,310
Purraise
842
Location
Fighting for ferals in NW NJ!
Whether it is a fungus or bacteria, I personally would use the colloidal silver to treat it.

I would additionally consider putting kitty on a large dose of human quality antibiotics. And if you're not feeding a grain-free food, consider switching to one. :)
 
Last edited:
  • Thread Starter Thread Starter
  • #11

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
Thank you everyone for your responses and ideas. We have scheduled Loki an appointment tomorrow for an injection of depo medrol and prednisone to see if those provide any relief. She has been on Diflucan since the 17th and so far her symptoms are just worsening, and we don't want to take any chances with her losing any nails on her front paws as she is already missing both back feet and half a back leg and really needs all her defenses. The vet stated that he'd prefer to see how she responds to the steroids before the biopsy, but if there is no medical reason for that I will be requesting we do the biopsy as soon as possible.

@ LDG: Thank you for linking that other thread. It definitely looks like CS is something worth trying for Loki alongside the treatment we are seeking from the vet. Since we were unable to provide her with the diluted chlorhexidine soaks without it causing her visible pain, I'm hoping the CS might be an alternative form of relief while we try to figure out what's wrong with her. She is also being fed a homemade food, the chicken recipe listed by Lisa Pierson, and she was treated with the antibiotic Orbax initially when we brought her in for treatment.

@ GoHolistic: Thanks for providing that link. I'm not sure if it fits the bill with Loki or not as much of the article was greek to me, but I did look the condition up and it stated fluconozole (Diflucan) is one of the possible treatments, and that is what Loki has been on since the 17th with only worsening symptoms. She is indeed an outdoor cat though, so we're not ruling anything out. She did have a bacterial culture done though which I was only told showed a Staph infection, along with a fungal test which is still showing negative but wont be complete until Wednesday.
 

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
@ GoHolistic: Thanks for providing that link. I'm not sure if it fits the bill with Loki or not as much of the article was greek to me, but I did look the condition up and it stated fluconozole (Diflucan) is one of the possible treatments, and that is what Loki has been on since the 17th with only worsening symptoms. She is indeed an outdoor cat though, so we're not ruling anything out. She did have a bacterial culture done though which I was only told showed a Staph infection, along with a fungal test which is still showing negative but wont be complete until Wednesday.
I understand. It is a long shot, and just something to consider with the vet. The photos in the first link/document just looked a lot like what Loki has, and says it can be secondarily infected with Staph. It does not, however, list fluconozole as a treatment for Sporotrichosis (see page 7 of the document) .  


I looked into Pemphigus, which is the most common autoimmune skin disease in cats, but that is usually associated with crusty scabs, not the raw, red lesions I see on Loki.

Does she have any other symptoms? I know Hyperadrenocorticism (Cushing's Syndrome) can cause thin, fragile skin that can start to break, but this condition has other symptoms that I'm sure you wouldn't have missed. Here's some info and a pic: http://www.icatcare.org/advice/cat-health/hyperadrenocorticism-cushings-disease

I hope she's not in too much pain and that you and your vet can figure it out soon. Sending lots of vibes...
 
  • Thread Starter Thread Starter
  • #13

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
Sorry for the delay in updating. It's been a long few months and the past week has been no exception. Loki had a biopsy done last Tuesday on her nailbed and back, of which we are awaiting results - should be less than a week now for those. While we had her in a cone the first day, we opted to keep bandaging her paw so she could go outside and because she was biting and licking at it constantly. Unfortunately, we weren't told that we needed to stop her epsom salt soaks and that preferably the paw bandage was only for the first day - a forgivable oversight since so many things were going on during her appointment and the biopsy was actually squeezed in for us - so we ended up taking her back about four days after because the incision site looked a bit iffy and her pain spasms were getting worse. We were told it didn't look infected but to discontinue the soaks/bandaging and go back to the cone. It's been three days since then, but Loki is still showing worsening shivers/spasms that appear to be pain related and I'm just hoping nothing went wrong during her biopsy that might result in chronic pain. In fairness, she was showing mild spasms before the biopsy so I hope it's just the nail bed infections. We got the vet's approval to give her tramadol, which I think has helped her pain some but appears to be making her act funny - very agitated and overly alert.

With the cone, however, Loki's back lesions are finally showing quite a bit of improvement - her nailbeds as well though those still look very bad. The vet said he'd wanted to wait at least 5 days after the biopsy before giving her depo medrol and possibly prednisone since she wouldn't heal as well once administered.

Still looking into the colloidal silver. I had hoped to find it locally but I'm going to have to order it online.
 

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
I'm so sorry that Loki is in pain.  
  Trembling and spasms can definitely be signs of pain. My Boo was having these, and I couldn't figure out what it was. I thought he was having a mild seizure or something. It was like a shiver, like when someone is cold, accompanied by random twitches. When I explained what he was doing to my vet in detail, she said it sounded like it was from pain. I felt horrible! We still don't know exactly what is causing his discomfort, although he does have arthritis and IVDD, but he was put on Gabapentin, which helps tremendously.

I bet you're anxious to get those results back.

Personally, Depo-Medrol is not something I would want my cats to have if there are other options available. I am not a fan of any drug that meant to last an extended amount of time in the body.

Please keep us posted. Sending lots of vibes for Loki! 
 
 
 
  • Thread Starter Thread Starter
  • #15

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
We got the results of the biopsy today. Not sure I'm spelling it all correctly, but we're told Loki has "severe subacute ulcerative eosinophilic dermatitis". Basically, as far as my research tells me, allergies. I'm most suspicious of food allergies as we've wondered about her having slight food allergies in the past.

As far as food allergies go, is there a standard place to start food wise? I keep reading to feed a single protein, single carb food with as few ingredients as possible, but most of what I see available still has very long ingredient lists. I'm suspecting that she has a chicken allergy now, which just so happens to be the food we used when moving her to a homemade diet. All the other cats are now on a homemade chicken diet and just getting used to it, so I'll need to pick up something canned just for Loki.

GoHolistic: Yes, what you described is exactly how Loki behaves. I kept saying that it felt like she just came in from the cold, and while I was sure it was pain from her paws I still took her temperature just to be sure. We are working on getting her some sort of pain med, as the pills I had on hand for her are a no go. She will absolutely not take a pill - she just spits them right back out. No tricking her with food either, but she's easy as pie with liquid.

What would be the alternative to the depo medrol? From what I read it appears to be the common approach for initial relief of this type of condition and I had not second guessed it, especially because her nailbed infection is one that I do not care to see worsen. I hadn't read of many alternatives approaches to get this issue under control.
 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,860
Purraise
13,175
Location
Columbus OH
A steroid, which the depo is, is a good place to start.  It's ratchets down the immune response which gives some relief and can help with getting things under control at least initially.  There are oral steroids.  My kitty is on dexamethasone for IBD.  I do give it daily, some vets have steroids given every other day.

As far as food goes there are some commercial limited ingredient foods.  Natures Variety LID comes in some novel proteins and is available in most pet stores.  It is on the pricey side though.  Hounds and Gatos is available in some novel proteins.  It has limited distribution though and you may need to order it online.  http://houndgatos.com/cat-products.aspx   It has more thickeners in it then the Nature's Variety but it is also cheaper.  Maybe you could also get this kitty switched to homemade.  Some of what you are seeing on ingredient lists are the necessary supplements to make the food complete.

I am sure that other people will have suggestions as far as commercial foods.
 

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
Yes, that does sound like a fancy name for allergies. 


Nature's Variety Instinct canned food has a Limited Ingredient line that come in Turkey, Duck, and Lamb (separate flavors). EVO makes a 95% Venison and a 95% Duck, but they contain carrageenan. Natural Balance makes a Limited Ingredient line, also, that comes in Duck & Green Pea and Venison & Green Pea. There are more potentially problematic ingredients in the Natural Balance, though. Prescription-wise, Royal Canin Selected Protein PR is rabbit and green pea. Ideally, it should be a novel protein that Loki has never had before. When you decide on a canned food, you could also offer matching home-cooked. I do this for Sebastian for his single protein rotations.

Obviously, if your vet feels that Depo is the best way to go for Loki and her situation, by all means, listen to your vet. Your other options would probably be in pill form (like prednisolone) and have to be given daily or every other day. I think pred may be able to be compounded into a liquid, but I'm not sure.
 
  • Thread Starter Thread Starter
  • #18

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
GoHolistic: I want to thank you for bringing the depo medrol length of activity to my attention. I went ahead and quickly researched it and was a bit concerned with some of the reactions others have had. I'm not sure it if will be in my comfort zone for an initial treatment as I hadn't realized how long acting it was - a scary thing to consider if Loki has any adverse reactions to the drug.

Would trying prednisone first, or possibly as the only course of treatment, be a better choice? I've dealt with dex and pred. with my rats and have always felt pretty comfortable. & with Loki I'm assuming this will just be a jump start to controlling her allergic reaction while we try to get her on a food that will hopefully resolve this. Definitely not looking for any longterm fix with the steroids.

GoHolistic & Denice: Thanks for mentioning some brands to look into. I'll look for them locally. We are saving so much money on the homemade food that price isn't much of a consideration to me if there is a canned food that makes her feel better. Unfortunately, we are making a homemade food for 8 cats, one of which has beginning kidney disease, so it's actually easier for us to feed just Loki canned than change the entire homemade recipe just for her.
 

goholistic

TCS Member
Top Cat
Joined
Feb 27, 2013
Messages
3,306
Purraise
370
Location
Northeast USA
Yes, that is the exact reason it is on my "do not administer" list with the vet, alongside Convenia and Metacam. If there are adverse effects, the solution is typically to give sub-q fluids and wait. 
  This isn't to say I wouldn't consider it if I had exhausted all my options and it meant that my kitty's quality of life would improve. There are situations in which Depo works when others don't, and vice versa. Do your research and weigh the pros and cons with your vet.
 
  • Thread Starter Thread Starter
  • #20

violet976

TCS Member
Thread starter
Young Cat
Joined
Mar 3, 2011
Messages
23
Purraise
1
Absolutely. I myself have used long term, "quality of life" steroids for two of my rats when we had nothing else to fall back on. There is definitely a place for the steroids and one rat had many months of good time with daily injections. But a food allergy of which we are just in the early phases now of trying to pinpoint... well a long acting steroid is past my comfort zone until I know she can handle prednisone without any major side effects. I truly appreciate you bringing the length of activity to my attention as I was on my way to the vet later today for that exact injection. Now we are going to opt for prednisone instead and see if we can get her on track with a minimal ingredient food.
 
Top