Weird Paw Condition - Vet Can't Diagnose

My two-year-old, Mendel, has a Weird Paw Thing. I can't be more specific because the vets he's seen don't know what it is. Last May, I noticed that one of his paws was swollen and purple and generally unhappy looking. Obviously I took him to the vet immediately and she basically said "Wow. That's definitely a medical condition." and she gave him some antibiotics.

We went back weekly for about a month, during which time we concluded that the antibiotics weren't really stopping it. She gave him some steroids and it cleared up. "It's probably autoimmune," she said.

It reoccurred several times last summer and we treated with steroids and never got any closer to figuring out what it was. It was slightly different every time. Less/more swollen, different discoloration, different location on his paws, etc. The vet said she might be able to diagnose it specifically  if we opted for a $500+ biopsy, but since it cleared up with steroids she told me I didn't really need to spend that money.

When I went back to college, I took my cats with me. In September, I noticed a little spot of purple on one of his paws and took him to a vet near my school. "He's probably allergic to his litter," she said. We switched to Precious Cat Respiratory Relief and she gave him some steroids to help him along and it cleared up. And it hasn't reoccurred since September. Until now.

It's not purple this time, but one of his toe-beans has swollen again. It's the top/left-most one in this picture. Sorry that it's not very good. He really didn't want to lie still. 


We haven't switched brands of litter. I did recently add canned food to his diet, but I also changed kibble brands in October and he was fine, so I don't think it's a dietary thing. I can  think of potentially stressful things near-ish in time to his outbreaks, but he's also had stressful things happen and not broken out.

Throughout all of this, he has never acted like his paws hurt. He walks and jumps like normal. The vets and I can touch his paws with no reaction. He DOES lick his paws, but he doesn't chew on them or anything. I put bitter apple on his paw today because he looks so sad in his cone of shame and he basically went: *lick lick*   *lick lick*   *lick lick* 

Both of his vets have been cat-specific practices and they haven't really diagnosed him. Do you guys have any ideas what this could be or how I can treat it over the counter?

Is he declawed? I can't tell in the photo if he still has his claws.

Draco said:

 
Is he declawed? I can't tell in the photo if he still has his claws.

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No, he's not declawed. 

lemondrop said:

 
No, he's not declawed. 

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that eliminates my concerns. Glad he's not declawed!

I am not sure how to help. if the vet thinks he's allergic to the litter, then maybe he's allergic to the food? You can't feel any hard bumps or anything, right?

So right now it looks like there is a big scoop taken out of that one pad on his paw.  (at least that's  what it looks like to me).  But you said it moves around even to different paws?  So all 4 paws are affected?  But at different times?   Ddo they ever open up and bleed or anything like that?  If your Vet suspects an autoimmune issue, has she run blood tests to check for it? 

Maybe someone here will recognize it has something they have seen before, but I don't recall seeing anything like this in any posts. 

At least the good thing is that it doesn't seem to bother him, although it sure would be good to figure out what it is. 

I don't feel any hard bumps.

It kind of looks like a scoop's been taken out because the swollen part (partly concealed by fur) is pushing his toe pad off to the side.

It's been on all of his paws at various times. The first time (also the worst time) it started on one front foot and spread to the other front footfoot before we got it cleared up.

It doesn't bleed, but his skin gets cracked and scabby. Like, you can peel off scabs, but he doesn't bleed.

Vet has not run blood tests. She said to diagnose, she'd have to do a biopsy. Is there a blood test for autoimmune disorders?

Hello! I just happened to breeze by and saw this post - I had to reply because my little girl has a very similar condition. The vets will never be able to figure it out - trust me. (In fact, from what you had mentioned about the first vet, to be honest, she doesn't sound all that swift - sorry, just my opinion).

My girl is already compromised with CH or Cerebellar Hypoplasia - damage to the cerebellum that happened in utero. (She was/is feral and chances are that the momcat developed distemper when she was pregnant. Anyway, being feral, mom's usual ditch the kittens at the point when they start to walk and they can see that they are moving/walking differently then the "normal" way. They will abandon them and leave them to die. It's just instinct - survival of the fittest and all. But mine fought on somehow for a couple weeks until someone spotted her and did a rescue - pretty amazing)!

She is 10 now but out of nowhere when she was about 5, she developed "puffy paws" (as we call them) - similar with purple blood bruises. Paws would switch off, take turns over a few weeks, never seemed to bother her (same biting them) or disable her. Cat Vet hadn't a clue - did bloodwork, did biopsy, found not an absolute but was able to diagnose her as having Eosinophillic Granulomas.

About this time I was starting to feed my cats a raw diet and also looking for a holistic vet - basically, wanting to stop feeding them the toxic, mass-produced dry foods that are so bad for them (and some big name wet foods too) and get them back to a more natural state and use less invasive, non-drug methods when they got ill. I also was experimenting with homeopathy and flower essences with the cats in the house. (Condition wasn't related to any of these foods or changes).

I found a holistic vet that wasn't a huge distance away and off we went. She did a thorough exam and we talked a lot - she asked a ton of questions about my cat & her lifestyle. She said it was definitely a stress issue / auto immune issue and the granulomas made sense but steroid treatment wasn't the answer. She started me on a homeopathic remedy and over time ( a year or so) I kept working on fine tuning that (just because I had the remedies and lots of books & had started using them on other animals by this time). I finally found a particular remedy that worked for her and was able to get her breakouts back to normal within 10 days or so after they started, so I kept using that. No drugs, steroids or anything else needed.

She also did get a Rodent Ulcer on her lip once or twice and I used the same remedy with the same result (but it took a little longer to heal for some reason).

A huge follow up to this is that during the time she started breaking out, we had taken in some feral cats & kittens. We ended up having them for a lot longer then I had planned on. Looking back over my cat calendar and their journal, she started having the breakouts when they moved in and continued while they were living with us. When they moved out after a couple of years, she only had 1 more breakout. We ended up moving and she had one breakout at first but then it settled down. I'm pretty sure in her case, it is a bodily reaction to extreme stress. You may want to think about the environment to see if there have been any changes that would make him stressed?

I would definitely also consider a change in diet - switch to a quality wet food & get away from dry. The body can't heal and have proper immunity if it isn't healthy. Here is a great link on nutrition - http://www.catinfo.org/

It sounds like your guy has this - Feline Plasmacytic Pododermatitis  - go here to read about it - picture looks just like what you described     http://www.2ndchance.info/egc-Bettenay2003.pdf

Very similar to eosiniphilic granulomas which you can read about on this page - http://www.2ndchance.info/egc.htm    (scroll down under miliary dermatitis)

Hope this helps......?

9happycats said:

It sounds like your guy has this - Feline Plasmacytic Pododermatitis  - go here to read about it - picture looks just like what you described     http://www.2ndchance.info/egc-Bettenay2003.pdf

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That looks exactly like what he has! Thank you so much!

I've considered switching to an all-wet or raw diet, but honestly, I'm doing the best I can afford right now as I'm still in school. Hopefully in the future I'll be able to get my boys on something better. For now I'm just happy to have a decent answer to this paw problem! I'm gonna go read every article I can find.

Interesting!  Before I saw 9happycats post, I looked up "pillowfoot", and wondered if that was what it was.  I think it's the same thing, known by yet another name.  Here's another article on it, and it CAN be diagnosed via a blood test.  http://www.veterinarypartner.com/Content.plx?A=1720

I got him to the vet this morning for possibly the most frustrating vet visit of my life. We saw a different vet than usual at the same practice as the first vet. I'm pretty sure she had already decided how to treat him before I had even walked in the door. I tried to tell her that I thought it could be this and that it could be easily treated, but I blanked on the name of the condition (I get nervous easily) and she was like "While you look that up, I'm going to go get the injections." And she was adamant that there was no way to diagnose it besides a biopsy, when it seems like she could have done a blood test or just tried treating with doxycycline! She even offered to sell me a hypoallergenic prescription diet when it is CLEARLY not a dietary thing because I've switched his food a couple of times with no correlation to his outbreaks.

So it probably WILL clear up because steroid injections have worked in the past, but it cost me about $200 and was diagnostically useless. I don't want to just shrug and keep giving him a massive dose of steroids every time this happens! Definitely going to find a new vet.   

Well, try not to beat yourself up.  What's done is done THIS time, and next time just write down the name of what you think it is and take it with you, and either make sure you schedule the appointment with a  specific Vet (the first one) or maybe even a vet that specializes in cats only.  I know when we call to make an appointment, we make it with Dr. Christina, and if she's not available, then we wait until she is.....IF we can wait.  Sometimes it's just not possible

But don't let them push you around anymore.  If you don't want steroids, by golly, don't let them give them to him.  (although sometimes if the Doxy doesn't work, low dose pred may be the answer, at least for Pillowfoot, as I recall)   Remember, they serve YOU, not the other way around.

Amen! Vets get away with SO much because most pet parents don't research things or take the time to understand meds, foods, etc. You are paying them for their service to YOUR baby. YOU tell them what you want - not the other way around. Stand firm on that! If they will "work with you" on issues or take you seriously, then it's time to leave. 

I do not believe in repeat vaccinations for cats & dogs - the more I read over the years, the more horrified I got. I also will not allow rabies or other "required" shots. My vet knows this and I know the laws of my state but I choose not to put my cats in physical danger to accommodate the law. You can take titers and work around things.

When trying to find a new vet, I ask for an appt to do a meet & greet with the vet. I meet them & ask every question I can think of & how they handle different situations, etc. I look over the practice at the same time & if things just don't feel "right" to me, I move on. And....I write things down all the time also! LOL...

Hang in there...go find someone that you get a warm & fuzzy feeling from & isn't burned out, crabby & rushed.

Good luck!!!  >^..^<

9happycats said:

 
Amen! Vets get away with SO much because most pet parents don't research things or take the time to understand meds, foods, etc. You are paying them for their service to YOUR baby. YOU tell them what you want - not the other way around. Stand firm on that! If they will "work with you" on issues or take you seriously, then it's time to leave. 

I do not believe in repeat vaccinations for cats & dogs - the more I read over the years, the more horrified I got. I also will not allow rabies or other "required" shots. My vet knows this and I know the laws of my state but I choose not to put my cats in physical danger to accommodate the law. You can take titers and work around things.

When trying to find a new vet, I ask for an appt to do a meet & greet with the vet. I meet them & ask every question I can think of & how they handle different situations, etc. I look over the practice at the same time & if things just don't feel "right" to me, I move on. And....I write things down all the time also! LOL...

Hang in there...go find someone that you get a warm & fuzzy feeling from & isn't burned out, crabby & rushed.

Good luck!!!  >^..^<

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I agree with the above post.  Time to look for another vet.

UPDATE: Mendel's paw is back to normal. If this summer is anything like last year, however, I can expect it to swell up again in a few weeks. 

What questions do you ask when you visit prospective new vets?

Hi Lemondrop....I just wrote you a huge reply about vets and then somehow lost it as I was wrapping up....ugh! I'll Reply again tonight or tomorrow when I can get more spare time.....

Hi Lemondrop - 

So glad Mendel's paw is back to normal! My girl's paw clears up anywhere from 2 weeks to a month but she really doesn't get them anymore since I started her on the homeopathic remedies -it's been 3 years now I think? Pretty amazing.

As far as the vets go...I look online at  the sites of vets in my area. I always looks for Holistic vets first because they treat less invasively then "regular" vets. They use a combination of both regular medicine and alternative medicines - acupuncture, homeopathy, chinese herbs, cold laser therapy, nutrition planning, etc. They are much harder to find and just because a vet does one thing, i.e., acupuncture or chinese herbs, doesn't make them holistic. They need to know a number of modalities (practices) and have extensive knowledge of the best way to treat a condition. They usually do a consult with you and your cat or dog first - they ask a ton of questions about the animal & behaviour because they believe (as I do) that with any issue or condition that the cat may have, the vets are treating the body as a "whole" not just for the reason they were brought in.

Be forewarned, most  vet-diet approving, vaccine-pushing, steroid-using, vets totally don't understand anything about alternative care and will say it's bunk, which is a real shame. If they would open up their minds and the two could work together, a lot more animals would be healed and saved.

If you can find a holistic vet, go see if they are for you - they are usually a bit more pricey but you'll be there less because they usually can Heal rather then just managing symptoms.

PRACTICE: If they take their time with the appts. or how long the average appt. is, Do they have a separate waiting area for cats? If not, can you wait in car & someone come to get you to go straight into exam room? What is fee structure?  If they will let you, ask to see the holding area for after surgeries. What are their hours/ Are they open 24 hrs? If not, is someone there with the sick animals during off hours? Is someone available to take calls 24/7? Do they have financing available? Is it clean inside?? Is the staff nice or rude?? Is there a BBB sign anywhere? Do they accept walk-ins?

VET: If it's a "regular" vet, check their credentials - where they went to school/what schools. I ask how strict they are about vaccines and if they take titers in place of boosters (because I personally don't believe in repeat vaccinations). Will they do house calls in extreme circumstances? How many vets are in the practice? How many are on staff each day? Can you request a certain one or do you just get the one that's available? Find out what type of Emergencies they handle and where they usually refer other types. What equipment is on site that you use - xray? Do you do in-house blood work? Do you fill prescriptions here? What types of diets do you recommend? Do you know any acupuncture or other alternative treatments? Do you have any experience with feral cats? Do you offer any discounts for TNR spays/neuters? (That's because I usually work with rescues, ferals and TNR groups).

And, anything like that you can think of that relates to you and your cats or interests. Bring a pad with your questions so you don't forget them. I think you'll probably get a feel for who you like & who you don't by doing it. Don't go by price even though I know your budget is tight. If you like a vet - look online for reviews of the practice - see what others say about them. 

It takes time to find a good "fit" but pays off in the long run when you need care - you'll know where to go and won't waste $$ on bad care with a stranger.

Good Luck!

lemondrop said:

 
UPDATE: Mendel's paw is back to normal. If this summer is anything like last year, however, I can expect it to swell up again in a few weeks. 

What questions do you ask when you visit prospective new vets?

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I think it's pretty awesome that @9happycats  helped you find a possible diagnosis!  I definitely think you should print out that article and just take it along with you. Unfortunately, according to that article, no one knows the actual cause but at least there's some information about possible treatments. 

Could flare-ups be related to stress? Have you tried seeing what's changed during flare-ups? Weather, maybe, or something else. Anything that's immune related, whether autoimmune or an immune response to a pathogen, could be aggravated by stress. Here's a list we've compiled about possible causes of stress, see if anything rings a bell with these - 

 [article="30274"]Potential Stressors In Cats The Ultimate Checklist​[/article]  

9happycats - Thank you so much for that list of questions. I'll definitely write some down and shop around for a while. 

His outbreaks are only very loosely correlated with any big stressors like his adoption or moving to college with me; he's also dealt with similar situations and not had a flare-up. I switched brands of dry food and added wet food to his diet and he had no issues, so it isn't dietary. The flare-ups HAVE been concentrated in the summer; his first one was last May and his previous one was in September, then nothing until this flareup in June. I read that this condition can be seasonal, so I guess that's part of it, but I don't know if there's any other factors at play.

  I need your help again, TCS. 

My problem child has developed a lovely new symptom. I'm pretty paranoid about Mendel's health (well, the health of ALL of my cats), so I noticed a small pink/raw patch on his upper lip when I checked him today. I'll attach an image when I can, but it's nighttime here right now and I don't have enough light to get a good, clear picture. 

His foot sores PLUS the beginnings of a lip bump would point towards the eosinophilic granulomas that 9happycats mentioned, right? Is there a way to diagnose that aside from a biopsy? The link mentions bloodwork, but I can't tell if that would actually diagnose it for sure or just indicate it as a possibility. 

I'm planning to get him to a vet soon, but I don't know when I'll be able to get an appointment. I haven't even had time to properly look for a new vet yet. Why couldn't you wait a little longer to get sick again, buddy?

Does this condition have a tendency to be seasonal? So far (knock on wood!) he's only had problems like this during the summer months.

Gosh, so sorry to read that Mendel has had another setback. Definitely sounds like it could be some kind of allergy or autoimmune thing.

Hmm...between the lip and the paws, any chance he could be allergic to some kind of material that is making contact with both? What kind of food/water bowls are you using? Are you using a feeding mat, as well? A plastic allergy is not too uncommon nowadays. Just a thought! I hope you can get Mendel into the vet soon.