Rescue cat with acne (?), getting worse despite treatment

[Sees1804]

At a small rescue where I volunteer, there is a young cat (female, spayed) with this terrible “dirty chin”: black crust and a few bald spots on it.
The vet first diagnosed as cat acne, then as yeast infection, supposedly not contagious to other cats. Despite treatment, it’s not getting better but rather worse. She does not scratch her chin, but she hates it if you touch it, she starts hissing and wants to hide.
She is a beautiful, affectionate cat with zero chances of being adopted with this condition. This is going on for 1.5 months now.

Treatment she recieved: Convenia, Dexamethasone injection, Prednisolone 5 mg (1/2 pill for 1 week, ¼ for two more weeks), Intrafungal, Mupirocin, acne wipes.
She’s a picky eater and won’t eat hypoallergenic food (Hills or Royal Canin were recommended). She loves Fancy Feast Tuna&Salmon Savory Puree. Her food and water bowls are stainless steel.
I am wondering why the treatment does not seem to work? What else should we look into? If hypoallergenic food is needed, are there any brands on the market that are good for picky eaters? Could we use Microcyn on her chin?
Any advice is much appreciated.

 

[Kris107]

Do you have her wearing a cone? It can't be too comfortable to have her chin in that condition, so it'd be good to help rule out her scratching at it or rubbing it. Have you tried washing the area? I know you tried wipes, but sometimes that's hard to get at the black stuff. You said you're using stainless bowls - I assume they're getting cleaned after each meal? When she eats her wet food does she eat it "nicely" or does she get her whole face in there? I have seen some cats who eat their wet food in some odd looking ways. Will she eat dry at all?

 

[mrsgreenjeens]

It's possible she needs more than the Convenia shot. Sometimes daily antibiotics are needed, either in pill form or liquid. I have not heard of using steroid for feline acne, but since we're not Vets here, perhaps that's why.

Even though her dishes are stainless steel, are the being thoroughly washed daily? That's still very important with feline acne. Wht are the acne wipes? Does she actually allow them to be used since she hisses and hides. My own cat had a slight case of feline acne and I purchased chlorahexidine wipes and it cleared up with just a couple days of using them, but it was very difficult to wipe his chin with them. I always wondered if perhaps it hurt him .

Are you aware that the food she is eating is NOT 100% nutritionally complete? I wonder if that could be part of the problem too? Is she eating anything else as well.

 

[Sees1804]

Thanks Kris 107 and mrsgreenjeens for your replies!
I usually volunteer at a different location so I'm missing quite a few pieces of information about this cat. I've only seen her twice but I read her file, this is how I know it's going on for so long now.
I just came back from visiting her, and it looks like she started scratching her chin because there are some bloody spots now. I brought Microcyn spray (this is something I used succesfully for my own cat's chin issues in the past) but unfortunately, the timing was bad because two new cats arrived at the rescue and she got totally mad at them so I couldn't handle her. Will try coordinating with someone else to hold her for treatments.
She is eating dry food (not just tuna treats) but I have to ask which one is currently in use.
She is eating her wet food nicely, she's not a messy cat.
Yes, cleaning her bowls with hot water and soap after each meal will be a new rountine from now on.
I was also thinking if more consistent antibiotic like liquid clindamycin could help.
I'll talk with people who are in charge of this location in the next couple of days and see what we could do. Thank you.

 

[silent meowlook]

Have you tried not topically treating it and only treating systemic. Can you send out a culture? Maybe a biopsy? That doesn’t look like normal
feline acne. I am sure there must be another component. Perhaps something auto immune?
Not a vet, just speculating.
If that was my cat with that condition, I would:
Be sure to only use stainless steel bowls for water and flat ceramic dishes for food.
I would wash those twice a day in hot soapy water, rinsing well.
Stop all topical treatments and not clean it at all.
Submit a sample for culture to the lab
Check with a black light for any fluorescence
Run a CBC and Chem panel along with virals.
I wouldn’t be inclined to use a cone if it is made of plastic. There are fabric ones you can buy, but he will be able to scratch his chin on other things.
If possible, seek out advice from a dermatologist.

 

[silent meowlook]

Also, make sure there are no parasites.

 

[Sees1804]

silent meowlook, thank you for replying.
Yeast infection is her main diagnosis now (vet found lots of yeast on her skin).
She was given Pyrantel and Bravecto 5 weeks ago, and tested FelV and FIV negative.
Why do you think that topical treatments are bad/not necessary?
I was actually thinking the opposite because I suspect there has been no consistency in cleaning her skin or applying treatment. This is a small volunteer run rescue with different people taking shifts every day.

 

[silent meowlook]

Some cats skin react badly to topical medications. Not all, but some. Sometimes cleaning can irritate the skin and cause damage to healthy tissue. Sometimes when cleaning it can also cause tiny breaks in the skin and allow more bacteria, fungus to enter.

Yeast on a cat is not often seen. May have to be handled systemically.

Cold Laser may help the area if you make sure his eyes are protected, and if your vet has one.

 

[silent meowlook]

Can you

silent meowlook, thank you for replying.
Yeast infection is her main diagnosis now (vet found lots of yeast on her skin).
She was given Pyrantel and Bravecto 5 weeks ago, and tested FelV and FIV negative.
Why do you think that topical treatments are bad/not necessary?
I was actually thinking the opposite because I suspect there has been no consistency in cleaning her skin or applying treatment. This is a small volunteer run rescue with different people taking shifts every day.

make up a treatment sheet for her and keep it with her, that everyone checks off when they give any meds or preform any treatments.

 

[Sees1804]

Just wanted to share with you guys that this cat went to a foster for two months and she completely recovered (treatment remained the same: steroids, antifungal, antiseptic). More relaxed environment and a dedicated foster worked wonders. She's now ready for adoption (fingers crossed she'll get adopted before the kitten season starts!)

 

[fionasmom]

Thank you for the update! I hope that she finds a good home.