Infected nailbeds and infected areas on back

goholistic

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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.
You're welcome.  
  I really hope Loki gets some relief soon. It's so heartbreaking to see our babies not well.
 
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violet976

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Bumping this thread back up. Since Loki's initial diagnosis of severe allergies (highly suspected of them being to chicken), Loki has been on a 30 day course of prednisone:

30 days of 10mg's per day - divided into two 5mg doses morning and night with meals

5 days of 5mg's once per day (to wean)

5 days of 5mg's every other day (to wean)

We also switched her to Nature's Variety Limited Ingredient Lamb, since we've never known her diet to include lamb. Since she had infected nailbeds and back lesions, she has remained in a cone this entire time, bringing her total time of living in a cone up to around 2 months now - which is heartbreaking for us. We do allow her to go outside supervised to try and make her days more enjoyable, but with a cone we have to be very careful about that. Luckily, since she is disabled and missing her back feet, she mostly just likes to lay outside and sleep.

We are now at the weaning phase for the pred - we are currently giving her 5mg's once per day for just a few more days. We've decided to try and take the cone off for short periods of time to see how she reacts, to see if she seems itchy or her skin begins to revert. During the 30 days a good cone (one big enough that it didn't scratch any part of her when she moved her head around), ALL of her lesions and infected areas have finally healed.

Unfortunately, we've only taken the cone off for short periods today and yesterday, maybe 10 minutes at a time, and she does still seem quite itchy, She is scratching compulsively and doing *a lot* of gnawing with her teeth when cleaning. In just a minute of cleaning her butt, there is already some tissue there that is getting red/slightly bloody, and she already has one irritated area on her arm. She is doing a lot of gnawing on her dewclaws, which were the first claws to get the bad nailbed infection a few months ago. Because of this, we have only been removing the cone for very short periods to try and gauge the current status of her allergic reaction.

I'm at a loss for what the best way to proceed from here is? July 8th will be the 2 month mark for her being only on Nature's Variety Limited Ingredient Lamb, and at least the two month mark for her living with that blasted cone. Is this really what life is like for a cat when trying to get to the root of food allergies? Are they normally kept in a cone the entire time, or is there some other medication normally given to hinder the inflammatory reaction so she can live cone-free while we try to figure out her triggers? Do most people simply let the reactions occur so as to see when a medication is truly the root of the progress, or do they keep the cones on instead to keep the reactions from getting too bad?

Quite honestly, I believe the cone has done the bulk of healing up these lesions, as even with the pred we haven't seemed able to remove the cone without her inflicting more damage. Shouldn't the pred have given her the ability to live cone-free? I'm just so baffled on what we should be doing. Is there is some other course of action we are missing to get her back to a normal lifestyle? Do all cats with severe allergies live in a cone like this, or am I completely missing some crucial aspect to this treatment?

I'm also wondering if we should, indeed, be weaning off the Pred? Given that we were trying to give her short term pred doses before the 30 day course she's on now, this is probably nearing 2 months of her being on pred - but I do not feel we have actually resolved her allergy issues.
 

goholistic

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@violet976, I'm so sorry you're still struggling with Loki. This seems like a pretty severe situation. I agree that her living in a cone is not a great way to spend her days. 


So the back lesions only get bad again when she starts licking and chewing? Have you tried putting a baby onesie on her to prevent her from getting to her skin directly? You would have to wait until they heal up fully again before you put the onesie on.

What are the chances of revisiting her diet? Just kind of going off the beaten path here, I wonder if it's something in the can itself that is causing the issues, such as BPA. 
  I wonder if you're at a point to try a raw or home-cooked diet, which has very little processing and ingredients. Is she a fussy eater?

Just from my own experience with my cats with food allergies and what I have learned from others on this site, what you are currently doing for Loki should have provided her with some, if not complete, relief by now. So the fact that this continues has me baffled as well. 
I would think that 10 mg of pred daily for 30 days plus the LID diet would have done the trick. But the fact that it did not seem to work, and you say that you think the cone did the majority of the work, makes me wonder IF it's really allergies. I also find it odd that the skin gets so red and bloody even after just a moment of licking. Does she have thin, fragile skin as determined by the vet?  If you're not sure, or if they're not sure, it might be worth getting a better look.

And just checking again...did she have a full CBC done to check for metabolic disorders? Have you considered going to a veterinary dermatologist or an internal medicine specialist? Perhaps another avenue to explore with your vet is a medication to help with oversensitive nerves. Perhaps something like this will help decrease the itchy / tingly feeling or whatever it is that Loki is experiencing. 


I'm really rooting for Loki and hoping she can get out of that cone soon. Poor girl.
 
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violet976

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Right now I think we are at that perfect point to try different approaches to getting her out of the cone, as every one of her lesions healed up completely once we got the right cone (one that was large enough that the rim wasn't scratching anything when she attempted to groom). Her back lesions, infected nailbeds and butt are all healed at the moment (her butt eventually got swollen from the cone rubbing, which is when we made the connection that the cone needed to be larger).

The concern comes in now that we attempt to take the cone off again - as her grooming and gnawing look pretty intense, and her butt tissue is the first indication that we may not have kicked this through medication or diet alone. Within a minute of grooming, the tissue on her butt turns red and a little bit of blood can be seen, and she's already made one tiny spot on her arm a bit bloody. We are hoping perhaps she was just so thrilled to be out of the cone after two months that she was going to town with the grooming, but we are also trying to prepare ourselves and plan in case taking the cone off results in all lesions/infections returning.

The shirt is a great idea, and I had forgotten about the pink one we got for her. It doesn't protect her lower back but will still give us some coverage while we attempt taking this cone off. Her nailbeds there is really no way of protecting and I just check them multiple times per day for regression. Even bitter apply spray did nothing to deter her in the past. Her butt as well - no real way to stop her from grooming that area but a cone.

As for diet, we actually thought we were making the best move for her in the past by switching her to a homemade diet this year - unfortunately, the recipe online (Dr. Pierson) was a chicken diet, quite possibly the highest amount of chicken Loki would have gotten in her lifetime - and that was when her allergic reactions reached this horrible level. We had briefly wondered in the past if she might have chicken allergies and totally forgot about that when we put her on the homemade diet. So now all the other cats eat the homemade chicken diet but she eats Natures Variety. Given the fact that she's only had mild scabbing issues in the past that quickly resolved, and that all of these severe reactions occurred when we switched her to homemade chicken, we were very hopeful that this was a simple case of a chicken allergy that could be resolved through diet.

Since we have the equipment, there is definitely a possibility of making her a different recipe, but we had no idea what recipe to try. If you have links to recipes other than chicken that would be good for allergies, we'd love to see them.

As for the reactions not clearing up by now, I was disappointed as well. She was tested for bacterial, fungal, urine, bloodwork and finally the skin culture. The skin culture revealed severe dermatitis, but did not specify a source. As the vet explained it to me, he told me that basically the skin becomes extremely sensitive and reactive, so that it just doesn't take much to irritate it and cause lesions. Beyond that, that vet didn't have much more of a plan of attack and even said that after 30 days he wanted to take her off for at least 30 days, even if she began regressing again - which I really wasn't sure I agreed with. We've now had some other concerns with that vet on treatments and have switched to one we like better, so if Loki can't hold her own without the cone we'll be taking her for a second opinion before she regresses much. I don't know if they specialize in skin issues or not, but they seem pretty up to date there and at least it will be a second set of eyes evaluating her.

As for how fragile her skin is, I can only *assume* it's quite fragile given how quickly it bloodies and irritates. Really though, she does *a lot* of licking and gnawing, so I don't know if it's really overly fragile or if most cats skin would react that way with that much attention.

Another thing I'd like to know for the food. If she is still reacting when the cone comes off, is 2 months the cutoff for the new food we gave her? Is that how long you give and then you try another food, or do we still need to give the food more time? Nature's Variety Limited Ingredient only has turkey or duck as their other options, and we thought both might be too close to chicken, allergy wise. Are there other good limited ingredient canned foods for allergy testing?

(please mind any typing errors. things are crazy over here lately and I've no time to proofread)
 

goholistic

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My vet told me that 6-8 weeks is a typical time frame for a food trial, so I would think that two months would be sufficient. It's possible, though, after reading your explanation that this all started after feeding Dr. Pierson's chicken recipe, that it needs more time to clear her system. 
  Or, is there some other component during that same time that would have attributed to this allergy / skin condition? Rhetorical question.

I know there are novel protein raw recipes out there, but someone more versed in raw feeding would have to chime in on that. Of course, you could always browse the raw feeding resources on TCS. There are links at the top of this page: http://www.thecatsite.com/f/65/raw-home-cooked-cat-food

I'm currently feeding Sebastian a home-cooked and canned diet. I use Balance It Carnivore Blend supplement for the home-cooked. It was developed to be used with home-cooked diets and is fairly "hypoallergenic" as it doesn't contain any meat proteins or plant materials that may cause reactions, which was part of my draw towards it for Sebastian. Here are the ingredients: https://secure.balanceit.com/marketplace2.2/details.php?i=23&cc=. Go to their free recipe generator (https://secure.balanceit.com/tools/recipegenerator/) and type in the information. You'll have to leave body condition as "Ideal" and make sure the only condition checked is "Healthy adult pet." Otherwise, it'll say you have to pay for a custom recipe to meet any special conditions. On the next page, select "Balance IT Original Blends - Carnivore Blend" from the drop-down list. You'll then get an drop-down to pick a protein. There are several novel protein options. Some of them are ground meats, which I don't prefer, but it might only be temporary anyway to see if it helps. Here's the TCS home-cooked resources thread: http://www.thecatsite.com/t/264153/home-cooked-cat-food-resources

Again, given where you are with everything, I would probably start exploring some options that address behavior and/or pain and oversensitive nerves. Other options might include a holistic / TCM vet and acupuncture.

For the record, I think you're doing a great job trying to get to the bottom of this. I know it's frustrating. 
 
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violet976

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Thanks for the advice. We ended up taking another kitty to the vet today, Bagerra, as suddenly this week both him and our cat Jinx began getting scabs on their ears. I don't think it's related to Loki, as Loki has been eating different food than the other cats for over 2 months now. Loki also never got scabs on her ears, just her back and paws, so I think Loki's troubles are separate than these current ones with the other cats. For the other cats, since we use homemade food, I'm suspecting we may have a bad batch on our hands. I've considered household allergens, cleaning products, outdoor contaminants, etc and have come up with no common bonds beyond the food. We don't use household cleaning products other than water really, use fragrance free/dye free/etc detergent, and can't recall anything we've done out of the ordinary in the past few months. We also use no chemicals outside.

Anyways - since we were bringing Bagerra in to have his ears checked, I also brought in Loki's medical folder to get a take from our new vet on how we should proceed. The new vet agreed that he'd prefer to keep weaning Loki off the pred. and leave her off for now, as it doesn't appear to really have helped Loki - we do honestly feel that the cone is responsible for the majority of Loki's healing. The new vet also wanted to move Loki to ZD wet food, as he stated that even though it begins chicken based, the way they process it is supposed to remove the allergen factor (or something to that degree, I didn't fully understand it myself). I'd love opinions on ZD food in terms of allergy resolution, and also in terms of if it seems like a healthy enough food. I suppose the vet is mainly trying to use it to arrive at a conclusion of whether or not food is responsible for the itchiness/self mutilation we are seeing with Loki, and I do fully agree that her scratching/gnawing appear to be responsible for the lesions, as they will go away when she remains in a cone.

He also put Loki on an antibiotic, Orbax, I believe to relieve any secondary skin infections Loki might bring upon herself due to the itching.

So, for the moment, Loki is weaning off the pred, staying in the cone, beginning a ZD wet food diet and also a course of Orbax (antibiotic). If anything rings any bells or seems like we are off track, please let me know. We will be following up with the vet on Loki in a week or so.

For the two cats with the ear scabbing, they are being put on Orbax to keep the ears from becoming infected, and have received Betagen topical spray for us to put on the scabbed areas to provide some relief. The vet said he didn't think ear scabbing was as common with food allergies (his experience with food allergies showed the scabs mostly contained to the neck/back, like Loki), but he said he wouldn't rule it out. He also said sometimes there can be a certain type of small fly/gnat in the area that are attracted to ears and they could be responsible for this, and that if an ointment of some sticky variety was applied to the ears the gnats wouldn't prefer to land there (vaseline, for example - or some healthier alternative? - suggestions welcome). We also decided to switch the other cats to Natures Variety Limited Ingredient Lamb - the diet Loki has been eating for 2 months for food allergy testing - in case we do indeed have a batch batch of homemade food sitting in our freezer. Upon reviewing this past week, we do think two of our other cats may have seemed less inclined to eat the homemade food this week, but we feed them so often throughout the day we just chalked it up to them not being that hungry.

To be honest, it's been a bit of a nightmare over here this year. Onyx has been fighting a recurring/severe UTI since February (our main incentive to move them to a homemade wet food diet). We also took in a biter kitty Jinx who was on the 10 days euth list, who has a very large urine output, suspected UTI and suspected beginning renal troubles. Loki has been batting these suspected food allergies since around March. And now Bagerra and Jinx with the ear scabbing. We also have a kitty we took in with the worst ear cancer they had seen for a 3 year old cat, but luckily they were able to cut them down. Still though, I had hoped to run bloodwork for her to verify the cancer is gone, and with so many confusing issues this year, it's all been a mess really.

lol. I think I've hijacked my own thread... I wouldn't trade them for the world, it's just discouraging to not be able to get to the bottom of some of these issues.
 

goholistic

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Gee, you've really got your hands full! I'm so sorry you're having to deal with problems in all your cats right now. I can certainly relate.

Your new vet's recommendations for Loki are not unreasonable, IMO. Hill's z/d wet food uses hydrolyzed chicken liver. "A hydrolyzed protein diet consists of a single protein source that is specially processed to break the structure of the protein down into multiple, tiny particles that the immune system will not recognize as an allergen." (Source) The food is okay - not great, not terrible. I, personally, wouldn't prefer a hydrolyzed protein diet because in my mind it's no longer chicken. BUT I might be willing to give it a shot if I was in your situation and nothing else seemed to work. I have heard of pets doing well on these diets for severe allergies.

You said Loki's issues started in March. Was this around the same time you brought new kitties into the household? (It was so nice of you to take them in!)

Another thing to consider is your water source. I know it sounds farfetched, but if you are currently giving tap water, you may want to considering giving good purified or spring water.
 
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violet976

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Thanks for the reply. Yes, the Z/D food is definitely not my food of choice, but since my only concern right now is trying to finally get her out of that blasted cone, I'm willing to give it a try. I figure if it doesn't work, we move on. If it does, then we can perhaps use it as a stepping stone to keep trying healthier limited ingredient foods again.

One other thing I'm considering, and would appreciate advice on, is a shampoo, perhaps? Part of me wonders if, after 2 months of not being able to bathe herself, that her skin might be very dry and her fur very dirty - resulting in her need to obsessively gnaw and groom. I don't believe it's the root of her problem, but I wonder if a shampoo might provide some other form of relief since she is coming off the pred now and she is *so* very itchy now.

I'm wondering if I should look into a medicated shampoo that might be formulated for itchiness, or should I instead just be looking for a natural formulation (oatmeal, aloe, and the like)?
 
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