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Itching in a cat: why my cat is scratching and how to help him?

Itching in the cat

Did you know that the skin is the largest organ in the body? Fascinating, isn't it? It is the only organ whose appearance and functions are clearly visible on the proverbial hand.

It does not take much to assess the condition of the skin, but it can provide a lot of information not only about itself, but also about the functioning of the entire body. It is a mine of knowledge about the quality of our animals' health, because as long as nothing disturbing happens, the skin is also flawless. However, when it begins to fall ill, it is necessary to consider whether the observed symptoms should be attributed solely to the skin, or whether their causes should be looked for deeper - in disturbed functions of other organs and systems. One of the most common and eye-catching and - unfortunately - the most "annoying" symptoms of skin disease is itching. In this article, I will introduce you to the issue itching in cats, I will briefly describe the possible causes of its occurrence and outline how you can help your scratching cat. However, before we delve into serious diseases accompanied by itching, let's take a closer look at what is the phenomenon and what factors are responsible for its formation.

  • What is itching?
  • Why is the cat scratching?
  • Itching symptoms in the cat
  • The cause of itching in the cat
    • Bacterial infections
    • Fungal infections
    • Dermatomyositis (especially Malassezia pachydermatis)
    • Feline scabies and ear mites
    • Demodex
    • Chelyletelosis
    • Thrombiculosis
    • Allergic flea dermatitis (FAD)
    • Food alergy
    • Atopy
    • Hypersensitivity to insect bites
    • Psychogenic diseases
    • Autoimmune diseases: pemphigus deciduous
  • Follow the thread to the spool: diagnosis of cat pruritus
  • Diagnostics: clinical examination
    • Diagnosing the cause of itching
  • Types of skin reactions associated with itching
    • Feline eosinophilica granuloma complex
    • Bilateral, symmetrical alopecia
    • Itching of the head and neck
    • Piglet dermatitis (dermatitis miliaris)
  • Treatment of cat pruritus
  • Ways of influencing pruritus
  • External antipruritic treatment: topical medications
    • Indications for the introduction of local treatment
    • Moisturizing and cleansing treatment
    • Anti-inflammatory and anti-itching treatment
    • Keratomodulating and anti-seborrheic treatment
    • Restorative and nourishing treatment
    • Substances included in the antipruritic preparations and their intended use
    • Forms of external preprarts
    • General therapy for pruritus
  • Itching in a cat with medications

What is itching?

Itching is a medical term for an unpleasant sensation in the skin leading to scratching or rubbing.  This definition of pruritus was proposed in 1660 by Hafenreffer and is still valid today. Itching is undoubtedly a symptom of skin diseases, but it can also accompany other systemic diseases.

Due to the duration, the following can be distinguished:

  • acute pruritus (lasting less than 6 weeks),
  • chronic pruritus (lasting more than 6 weeks).

Short-term itching is a defense mechanism (similar to acute pain) that informs that there is "something going on" in a given area of ​​the skin. For example, an insect bite causes a scratching reaction that removes the parasite from the surface of the skin. Another issue is chronic pruritus, which accompanies many dermatoses as well as systemic diseases and is often a serious medical problem. The pruritus may be limited, specific to one area of ​​the body, or generalized. Finally, itching is an indicator of ongoing inflammation of the skin.

Why is the cat scratching?

Why is the cat scratching?

Various types of stimuli, coming from both the external and internal environment, are perceived by the body through receptors and then processed into nerve impulses. Thus, the receptors are designed to provide the central nervous system with information about the environmental conditions.

There are many types of receptors in the skin:

  • mechanoreceptors,
  • thermoreceptors,
  • harmful stimulus receptors (pain, itching).

The itching sensation can be triggered by all sorts of impulses. They can be mechanical, thermal, electrical, but most of all chemical stimuli. In the past, people wondered if pruritus was a certain form of pain sensation or a completely different type of sensation. It is now known that it is a type of superficial sensation, different from pain, which is transmitted to the central nervous system through separate nerve pathways. It is also known that both pain and itching can be triggered by the same stimuli but of different intensity. Pruritus receptors are specific, free nerve endings located in the epidermis where the dermis transitions into the epidermis and in the dermis. After acting on the pruritus receptors of the appropriate mediators, the stimuli are transferred via special nerve fibers to the dorsal horn of the spinal cord. The impulse initially reaches the subcortical centers, where it is extinguished or sent to the cortex of the brain, and then consciously felt as itching, it triggers a scratching sensation. In the case of receptors that conduct noxious stimuli, there is constant inhibition (ie, inhibition) by the sensory receptors; therefore, scratching by stimulating tactile receptors suppresses the sensation of itching.

In other words, when a cat scratches itself, it stimulates other receptors, thus inhibiting the itching sensation. It is a kind of cheating the nervous system. Stimulation of nerve endings depends on numerous mediators. Knowledge of the mechanisms underlying pruritus is essential in subsequent antipruritic therapy. I will briefly list the main pruritus mediators that directly or indirectly affect the skin nerve receptors.


  • substance P,
  • neurokinin A,
  • the gene-released peptide calcitonin (calcitonin gene related peptid - CGRP),
  • Vasoactive Intestinal Peptid (VIP),
  • neurotensin,
  • bradykinin.

Substance P and VIP are the most pruritic neuropeptides.


  • Histamine - its main source in the skin are mast cells (mast cells). Histamine acts on itching through its H1 receptors. It dilates blood vessels, causes smooth muscles to contract and increases the permeability of blood vessels.
  • Serotonin - its source in the skin are mast cells, basophils, neutrophils, and thrombocytes. It acts on the central nervous system by lowering the itch tolerance threshold. By itself, serotonin is a weak pruritic factor, but when combined with prostaglandins, pruritic synergism is noticeable.
  • Eicosanoids: leukotrienes and prostaglandins - these are not typical mediators, but as a result they increase the influence of other mediators (e.g. histamine).
  • Platelet activating factor (PAF).
  • Proteases: kallikrein, cathepsins, trypsin, chymotrypsin, plasmin, bacterial proteases - affect the release of histamine.
  • Hormonal or nervous opioids also contribute to pruritus.

Before introducing the therapy, it is necessary to consider and analyze which levels of the itch ladder we want to influence, and in the case of no effect of treatment, the therapy should be modified accordingly. It is worth noting that a cat's perception of itching may change depending on the time of day, skin condition, body temperature, and even nervousness or severe stress.

The itch threshold is lowered (and thus the pet becomes more sensitive to itching stimuli) in the following situations:

  1. In the night. Various stimuli (e.g. pain, touch, cold, heat) compete with stimuli causing itching, which can weaken or intensify it. Thus, at night, when the effects of other factors on the body are less, the urgent need to scratch may increase.
  2. With elevated skin temperature.
  3. With reduced skin hydration - dry skin itches more.
  4. In situations of mental agitation, in states of stress. Then, opioid peptides are released, which may increase the itching sensation.

Itching symptoms in the cat

Itching in the cat, symptoms: excessive licking

Some of the more common symptoms of pruritus in cats:

  • scratches,
  • licking the skin and hair,
  • bites,
  • chewing various parts of the body (e.g. paws, tail),
  • complete or partial hair loss,
  • baldness,
  • self-damage,
  • skin infection.

Cats are very discreet and not always catch the moment of obvious scratching.

Therefore, it is worth paying attention to other unusual behaviors of your pet, such as:

  • rolling, turning from side to side,
  • rubbing against objects more than usual,
  • shaking your head,
  • tobogganing,
  • stronger than usual demand for caressing and "putting on " itchy parts of the body.

The cause of itching in the cat

The list of causes of cat itching is huge. They can affect the skin as such, and can be a sign of more serious systemic diseases. The condition of the skin and coat brings a lot of valuable information, not only about the animal's maintenance condition and possible temporary parasitic problems.

To paraphrase a well-known saying, one could say that:

What is outside is also inside.

In many cases, the condition of the hair coat, the appearance of the skin and its diseases are only the visible tip of the problems hidden deep in the body. It is often very difficult to get to the root cause of itching, but the most important and common are:

Bacterial infections

Superficial pyoderma in cats is rare. They usually develop secondary to pruritic conditions (FAD, food allergy, atopy, ear mites), systemic diseases (feline immunodeficiency virus) or immunosuppressive therapy (cancer therapy, corticosteroids, etc.).

The most commonly isolated bacteria are:

  • Staphylococcus intermedius,
  • Staphylococcsu simulans,
  • Staphylococcus aureus.

The changes that accompany the infection include:

  • local hair loss (with or without erythema),
  • lumps,
  • pustules,
  • erosions,
  • ulcers,
  • scabs.

A characteristic purulent exudate that sticks together the hair and covers the skin in the affected areas is possible.

Fungal infections

The most common cause of mycosis in cats is Microsporum canis (you can learn more about mycosis in cats in the article: "Ringworm in cats ").  Ringworm in a cat is an infectious disease and infection occurs through direct contact with a sick animal or its surroundings (cage, bed, brush, etc.). Pruritus is not a permanent symptom and may be mild. The clinical symptoms are varied and multiform, alopecia of varying severity, erythema and the formation of scales predominate. The lesions are usually located on the face, head, neck and limbs, but sometimes they are also present on the trunk. In every cat with skin lesions, dermatophytosis should be ruled out first. In felids, mycosis can mimic many skin diseases, both with and without pruritus. Therefore, it is recommended to perform a breeding test in any case. The Wood's lamp test performed in the office gives diagnostic results only in 50% of cases, therefore it cannot be used to rule out mycosis.

Dermatomyositis (especially Malassezia pachydermatis)

This is a yeast disease where itching can vary in severity. It may be limited in nature - yeast organisms then develop within the ear canals, and a typical symptom is a characteristic, dark brown, smelly discharge in the ear canals. Sometimes the skin on the chin, tail and between the toes becomes inflamed. In the case of generalization of the process, changes appear on the skin in various parts of the body, and redness and skin unpleasant smell and itching are classic symptoms of the form of generalized malasiosiosis.

Feline scabies and ear mites

Contagious, parasitic diseases that cause intense itching. Caused by Notoedres cati, which mainly affects cats, and ear mite (Otodectes cynotis). You can learn more about them in the article: "Scabies in the cat ".


Demodicosis in cats can be caused by Demodex cati or Demodex gatoi. The former is constantly present in the hair follicles and sebaceous glands. Dermatological changes (such as hair loss, erythema, peeling epidermis and pustules) usually appear on the face of the mouth, especially around the base of the ears, around the eyes, on the chin and on the neck. Demodex gatoi, living on the surface of the skin, produces similar symptoms, with the location being head, neck and elbows. Sometimes there are also symmetrical alopecia. Demodicosis also occurs in dogs - you can learn more about this disease in the article: "Demodicosis ".


Cheyletiella blakei - mites, the most common cause of chelletelosis in cats. These mites live in the callous layer of the epidermis and do not penetrate the hair follicles. The disease is very itchy, leading to alopecia and severe exfoliation of the epidermis (dandruff is visible on the skin).


Neotrombicula autumnalis - adults of this parasite live in the soil, while the six-legged larvae periodically live on mammals, remaining on the host for several days.

They are located in parts of the body covered with delicate skin, especially in the area of:

  • eyes,
  • lips,
  • belly,
  • external genitalia,
  • catch,
  • Stop,
  • head and ears.

The skin is red, covered with very itchy lesions in the form of lumps, lumps, pustules and crusts.

Allergic flea dermatitis (FAD)

An unpleasant, bothersome and itchy hypersensitivity reaction caused by the antigens found in the saliva of the flea Ctenocephalides felis. It occurs regardless of the age, sex or breed of the cat. The itching varies in severity, from mild to severe. FAD should be ruled out in any cat out, even if no fleas or flea faeces are found in the coat, and even though fleas are regularly applied. During the daily care of cats, cats clean their fur so thoroughly that during the examination it is possible to not find any traces of parasites. The process of excluding flea allergy dermatitis can take up to several months, and the use of flea killers every month while allowing people to go outside does not rule out the disease. In such a situation, it is possible to use an anti-flea preparation at least 3 times every 2 weeks and only on the basis of the response to such treatment exclude (or confirm) the disease.

Food alergy

Food allergy in a cat

A food allergy is caused by an immune response to certain proteins in your food. It appears regardless of age and sex, although there is a certain racial tendency in Siamese and Burmese cats.  The main symptom is itching of variable intensity, which may be accompanied by dermatological and gastrointestinal symptoms (diarrhea in a cat, vomiting in a cat).

Occasionally there are changes typical of feline eosinophilic lesions, such as:

  • itching of the face, head and neck,
  • symmetrical alopecia due to licking,
  • miliary dermatitis.

Scratching causes damage to the skin, but unlike dogs, it is rarely superinfected by yeasts or bacteria. About 1/3 of cases of food allergy are associated with atopy and / or flea allergy. In diagnosing the disease, it should be determined whether the pruritus is seasonal. If not - the pruritus remains similar regardless of the season - it is necessary to perform an elimination dietary test. Some doctors are skeptical about the serological tests used in cats, considering them to be unreliable. The gold standard in the diagnosis of food hypersensitivity is the use of a 12-week elimination diet. It consists in feeding the kitten only with hypoallergenic veterinary food. Only veterinary diets are suitable for this purpose.


Congenital disease in which a hypersensitivity reaction develops after the action of an environmental allergen. The main inhalation allergens in cats are house dust mites (especially Dermatophagoides farinae).

To a lesser extent:

  • pollen of flowers,
  • exfoliated epidermis,
  • mould.

The disease can occur in cats from 6 months to 3 years of age, with mild to severe pruritus. It can cause self-harm as well as swelling of the lips and chin.

Some patients also have other symptoms, such as:

  • rhinitis,
  • cough,
  • dyspnoea.

Hypersensitivity to insect bites

It runs with the formation of papular and crusty lesions and with edema (of varying degrees of severity) on:

  • bridge of the nose,
  • nostrils,
  • the auricles and around the ears,
  • fingertips.

Itching varies in severity, ranging from mild to severe. The symptoms disappear once the mosquitoes are eliminated from the cat's environment. Unfortunately, hypersensitivity to mosquito bites is still underestimated even among veterinarians, and the key element in identifying this type of cause of itching is an accurate and reliable interview.

Psychogenic diseases

Psychogenic dermatoses constitute a disease syndrome that is difficult to diagnose. The diagnosis is based on the dermatological and behavioral history, clinical examination of the animal, response to treatment, and above all on the exclusion of other skin diseases with a similar clinical picture. In the course of psychogenic dermatoses, abnormal cat behavior comes to the fore.

Belong to them:

  • replacement activity (metastatic effects) - these are the animal's behaviors that lead to the reduction of emotional tension felt by the cat (e.g. claw-biting, scratching, excessive licking),
  • stereotype - a repetitive, overly expressed single activity or a set of activities in which it is impossible to discern any purposefulness in relation to the existing situation; such evident stereotypes are the behavior of animals in zoos or circuses (walking back and forth, nodding the head evenly, chewing a certain part of the body, etc.)
  • auto-aggression - e.g. biting, attacking own tail, paw biting.

This behavior is often caused by chronic anxiety caused by constant stress. They can be manifested by excessive appetite and constant licking, leading to local alopecia or - in chronic cases - to generalized hair loss. Most often, cats begin excessive licking on the abdomen, sides and dorsal surface of the pectoral limbs. Then the hair loss may extend to the pelvic limbs and the tail. Eventually, the lesions may involve the back, shoulder blades and chest.

Autoimmune diseases: pemphigus deciduous

Deciduous pemphigus is an immune disease that perfectly mimics the clinical picture of allergic diseases. Initially, symptoms (ranging from macules, pustules to miliary dermatitis) usually appear on the face - they often increase and decrease in severity. Then they can spread to the area around the nipples and the pads of the limbs. The nose is usually depigmented.

The less frequent, but possible causes of itching in cats are also:

  • cutaneous lymphoma,
  • paraneoplastic syndromes,
  • viral diseases of the upper respiratory tract,
  • drug-induced pruritus,
  • overactive thyroid gland,
  • cat kidney failure, uremia,
  • keratinization disorders - acne.

Follow the thread to the spool: diagnosis of cat pruritus

Diagnosis of cat pruritus

Due to the fact that feline hypersensitivity reactions are significantly different from dogs (despite often similar clinical symptoms), they require a slightly different diagnostic approach. The first, very important step is to conduct a thorough interview with the pet's guardian. The data contributed by the owner cannot be overestimated, and which in almost half of the cases (in conjunction with the patient's clinical picture) may already at this stage of the study suggest a potential cause of pruritus. In the event of itching, there is no meaningless information and even the smallest details should be taken into account. Cat age is important in diagnostics - as a rule, in young cats that are under six months of age, the most likely causes of pruritus are parasitic or fungal diseases. Atopic dermatitis in such young kittens is rare.

Below is a sample list of questions with which he can (and should!) contact the owner of the cat at the veterinary office:

  1. When clinical symptoms are noticed? Has it happened in the last 3 days, in the last 3 weeks, maybe the cat scratching for longer?
  2. What disturbing symptoms have you noticed in your client?
    • Rubbing against objects?
    • Scratching?
    • Licking?
    • Biting?
    • Hair loss? If so, have you noticed any hair thinning or baldness??
  3. Have you noticed any changes on your skin? What was that?
    • Erythema?
    • Scales?
    • Scabs?
    • Pustules?
    • Bubbles?
    • Lumps or lumps?
  4. Whether there is an unpleasant odor from the pet's skin or mouth?
  5. Have you noticed the parasites in the hair??
  6. Whether the skin changes color?
  7. Whether the coat has changed color?
  8. Where there are changes?
  9. Do skin problems appear seasonally? If yes then when?
    • Spring?
    • Summer?
    • Autumn?
    • Winter?
  10. Does the cat go out or stay only indoors (possible external parasites)?
  11. Which of the symptoms did you notice first? Was it itching or maybe the skin lesions appeared first and the itch joined later?
  12. Have your cat ever had other dermatological problems before? If so, what kind?
  13. Has the patient been treated dermatologically before?? If so, what for?
  14. Have any dermatological tests been performed before?? If so, what kind?
  15. What drugs, in what doses and for how long they were administered (antibiotics, steroids, antihistamines, unsaturated fatty acids, shampoos and others)?
  16. After which drug and when improvement is noticed?
  17. Are there other animals in the immediate vicinity of the cat? What?
  18. Are there any symptoms related to the integumentary system in these animals?? If so, what kind? When did they appear?
  19. Have you or people who have direct contact with your cat developed any skin changes?? What? Where? When did they appear?
  20. Has the cat a previous history of symptoms related to other systems (e.g. cardiovascular, respiratory, urinary, digestive, nervous, osteoarticular, reproductive, endocrine systems)?
  21. Have any laboratory tests been carried out? If so, what (blood count, serum chemistry, urine test, X-ray, ultrasound, etc.).)?
  22. Have any other diseases been diagnosed? If so, what kind?
  23. Whether the animal is taking medication for a disease related to another system? If so, what and in what doses?
  24. What is the course of preventive vaccinations?
    • regular,
    • irregular,
    • lack.
  25. When was the last time the cat vaccinated? Date, preparation?
  26. Whether the cat is dewormed? What how many:
    • 3 months,
    • 6 months,
    • year,
    • less often,
    • it has never been dewormed.
  27. When the patient was dewormed last time? Date by what preparation?
  28. Is there any anti-flea and anti-tick prophylaxis?? Whether it is regular, irregular? When was the last time (date, preparation).
  29. Is flea prophylaxis carried out in other animals staying at home??
  30. In what environment does the cat reside?
  31. Are his lairs washed regularly?? Is there any flea prevention in the cat's environment?? What preparation?
  32. What is the origin of the animal? shelter? Breeding? Street?
  33. How is the animal fed? Cooked food? Commercial karma? If so, what kind?
  34. Are dietary supplements served? If so, what kind?
  35. What is the severity of the itching?
    • Low: Cat shows little interest in scratching or scratching very briefly - a few seconds.
    • Moderate: Patient is very focused on scratching for a few seconds.
    • Itching is clearly noticeable: the kitten is very upset when he scratches himself or he scratches for a long time - from one to several minutes.
    • Very severe itching: the cat can be aggressive if it scratches or scratches for a very long time - a few minutes.
  36. What is the incidence of pruritus?
    • No itching.
    • Occasional pruritus: the cat scratches itself less than once a day.
    • Itching quite frequent - the patient scratches himself several times a day, but periodically shows no symptoms of itching.
    • Pruritus frequent: the animal scratches itself at least once while it is observed.
    • Almost continuous itching - scratching itself several times each time it is observed; he spends more time scratching than not scratching.
  37. The location of the itch. Could locating the most severe pruritus help in making a diagnosis??

There are diseases in the course of which the localization of lesions is very important. An example would be ear scabies.

During the infestation with this parasite, the kitten scratches mainly around the ears and head. The veterinarian - even before a thorough examination of the patient - can make a list of differential diagnosis on this basis. In cats, however, it may be more difficult or even impossible to determine the cause of the itch based on its location, unlike dogs. In this respect, felids are troublesome dermatological patients.

Diagnostics: clinical examination

Diagnosis of pruritus in cats

One should pay attention to the location of changes and their nature, because on the basis of this data, it is possible to exclude items from the differential diagnosis list previously created in the head. The cat should also be checked for abrasions that might suggest self-harm.

Location of skin lesions:

  • lesions around the lips and palate may suggest one form of eosinophilic granuloma,
  • the appearance of itching in a cat limited to the back and lumbar region - the presence of ectoparasites (fleas, Chejletiella mites, scabies and Demodex mites) should be taken into account in the differential diagnosis,
  • dermatological changes located on the auricles, near the claw bed and nipples may indicate pemphigus,
  • food allergy likes to show up around the cat's neck and head,
  • in the case of atopy, itching usually occurs in the facial area and (less frequently) on the paws.

Nature of skin lesions:

  • papules - these may indicate miliary dermatitis, which is a common manifestation of allergic diseases in cats,
  • hair thinning or baldness - these are common symptoms of itching and usually appear as a result of scratching or excessive licking,
  • pimples, crusts, ulcers - can be a symptom of dermatitis caused by bacteria or fungi.

Diagnosing the cause of itching

  1. Dermatological examination with Wood's lamp. It emits ultraviolet radiation with a wavelength of 320-400 nm. When illuminating the skin and hair in the presence of dermatophyte metabolites (tryptophan metabolites - pteridine), apple green fluorescence (sometimes, especially in long-haired cats, it is yellow-green or blue-green). Unfortunately, fluorescence is not visible in the early stages of infection, as it does not appear earlier than 5-7 days after infection (most often between 10 and 14 days). A useful method for confirming dermatophytosis, but the lack of fluorescence does not exclude the disease.
  2. Dermatoscopic examination. It is a non-invasive method of examining the skin and its products by viewing them under high magnification. A relatively young method in veterinary dermatology, applicable to feline dermatophytosis. A typical feature of a dermatoscopic examination in the case of mycosis infection is the presence of slightly curved hair, referred to as "comma-shaped hair ". The presence of this type of hair is characteristic of a dermatophyte infection and the technique is very sensitive.
  3. Direct microscopic examination of the hair: trichography. Easy, inexpensive, and very helpful in establishing a differential diagnosis of pruritus. Assessing the entire hair, determining the growth phase, brittleness, and other abnormalities can help your doctor identify the group of conditions that may be causing excessive scratching. It is one of the most important methods of diagnosing fungal infections. In the event of an infection, the fungal spores surrounding the hair are visible. Inside the hair, hyphae of dermatophytes may be visible.
  4. Brushing the hair. Brushing the coat allows you to find flea feces. By combing the fur with a fine comb or brush, the material is collected on a white, wet tissue paper and viewed through a magnifying glass. This method is helpful in identifying hair parasites.
  5. Adhesive tape test. The adhesive tape test is used to take material directly from the hair and skin. After parting the hair, a colorless tape is pressed against the skin and then viewed under a microscope (in a native state and after staining). The preparation prepared in this way allows you to examine the hair for mycoses, parasites, and it can also provide information about the condition of the epidermis (bacteria, fungi, cells of the stratum corneum).
  6. Impression preparations. In this method, the slide is pressed against the hairless skin and then - after staining - viewed under a microscope. In this way, the presence of bacteria, fungi and inflammatory cells in the skin is assessed.
  7. Scrapings. Scrapings are used in the case of suspected parasitic infestations, but it is also useful in the case of dermatophyte infection, especially in the case of their presence in the epidermis.
  8. Breeding study. A breeding test used to diagnose dermatophyte infection, although false-negative results are possible.
  9. Fine needle aspiration biopsy. Fine-needle aspiration biopsy involves taking sterile material from lumps, nodules, vesicles or pustules, or from organs lying under the skin (lymph nodes). It is used for the rapid recognition of fungal and bacterial infections, as well as for the identification of cells.
  10. Skin biopsy. The skin biopsy is used for the histopathological evaluation of the sample. It can provide valuable information, especially in the case of suspected autoimmune diseases, eosinophilic granuloma syndrome and neoplastic diseases.
  11. Intradermal tests. Intradermal tests are one of the most effective and convincing diagnostic methods in atopic skin diseases. Its essence is the local reproduction of the hypersensitivity phenomenon by intradermal injection of the antigen responsible for the allergy.
  12. Blood test. Blood test for antibodies against allergenic substances. The principle of these tests is to demonstrate specific IgE and / or IgG antibodies against specific antigens.
  13. Routine screening tests. Hematological and biochemical tests, determination of thyroid hormone levels, tests for infection with feline leukemia virus (FeLV), feline immunodeficiency virus (FIV).
  14. Dynamic functional tests. ACTH stimulation test, Dexamethasone low / high dose inhibition test, TSH / TRH stimulation test.
  15. Ultrasound. Imaging of the adrenal glands, pancreas and kidneys.
  16. X-ray examination. X-ray examination (especially of the chest) - may be helpful in suspecting metastatic bronchial cancer, thymoma.
  17. Electrocardiogram (EKG). Disturbances in the work of the heart with an overactive thyroid gland. In some cases, hormonal tests and bacterial cultures for fungi are also ordered.

Recognizing the cause of itching is of utmost importance as it allows us to introduce causal treatment in many cases, such as:

  • allergies,
  • food intolerance,
  • APZS,
  • scabies.

Another thing is to identify confusing factors (e.g. pyoderma, Malassezia, etc.) - often the very treatment of this type of complication, regardless of the cause of itching, leads to a significant clinical improvement and the reduction or even disappearance of itching.

Types of skin reactions associated with itching

There are 4 classic models of skin reactions in cats with pruritus.

Feline eosinophilica granuloma complex

By the name of feline eosinophilic syndrome we mean three skin lesions:

  1. Eosinophilic plaque.
  2. Acidophilic penetrating ulcer.
  3. Rope granuloma.

They were conventionally included in one clinical syndrome, commonly known as the eosinophilic syndrome. These changes can occur alone or in any combination in different cats. Eosinophilic syndrome can be a manifestation of various types of allergic diseases.

It has three clinical forms:

  1. Eosinophilic ulcer (penetrating ulcer) - a painless, poorly healing lip ulcer usually seen on the upper lip, although it can occur anywhere on the body. The main underlying diseases associated with eosinophilic ulcers are food allergy and atopy - if the allergic reactions are stopped, the lesions on the lips regress.
  2. Tile (in. thyroid) eosinophilic. A common symptom is severe itching, and the disease is characterized by the formation of one or more granulomatous lesions that are round or oval, red, and often ulcerated. They appear on the skin of the abdomen, the inner surface of the thighs, armpits and in the interdigital spaces. Sick areas have a moist surface (due to intensive licking). Eosinophilic plaques accompany food allergy, APZS, or atopy. The diagnosis is made on the basis of the presence of neutrophilic granulocytes in the skin in a histopathological examination.
  3. Linear eosinophilic granuloma - tends to appear in the mouth or as a linear granuloma on the hind limbs. This form of the disease is associated with mosquito bites and appears as nodules (ulcerated or not) on the face, ears and feet. It is also observed in the chin area of ​​cats (feline chin edema) and on the paw pads. It is often accompanied by the APZS.

The following reasons can lead to the development of eosinophilic granuloma syndrome:

  • flea allergy dermatitis,
  • food alergy,
  • hypersensitivity to insect bites.

The clinical forms of granuloma mentioned above have been grouped together due to some common features, including a positive response to corticosteroid therapy and unknown etiology (although it is known that they may be associated with a hypersensitivity reaction). They are usually itchy.

Bilateral, symmetrical alopecia

They can be caused by:

  • flea allergic dermatitis,
  • food alergy,
  • atopy,
  • invasion of pathogenic fungi,
  • may have a psychogenic background.

The cat loses the hair on the sides of the body, usually symmetrically. The skin usually has no primary skin lesions and the main symptom is itching.

Itching of the head and neck

It varies in intensity, from slight alopecia and erythema to erosive, ulcerative or crusty lesions on the head, around the base of the ears, on the auricles and on the neck.

Possible causes of itching in the head and neck include:

  • parasites (feline mites, ear mites, mites),
  • allergy (FAD, food allergy, atopy, hypersensitivity to insect bites),
  • infections (mycosis of the skin, pyoderma - rare in cats),
  • autoimmune diseases (pemphigus deciduous),
  • psychogenic diseases.

Piglet dermatitis (dermatitis miliaris)

It runs with the formation of papular and crusty changes on the cat's back, in the lumbar region, on the back surface of the pelvic limbs and on the neck.

Depending on the severity of the itching, there may also be:

  • baldness,
  • scratches,
  • pustules.

The causes of miliary dermatitis can be very different, the most important being:

  • allergies (APZS, food allergy, atopy),
  • parasites (ear mites, feline mites, chellethosis),
  • infections (mycosis of the skin, pyoderma),
  • food causes (deficiency of unsaturated fatty acids),
  • idiopathic - for no apparent reason.

Treatment of cat pruritus

Cat pruritus treatment Pruritus is one of the worst sensations that can happen to our pupils. When it becomes chronic, it causes a significant deterioration in the pet's well-being and leads to the development of skin lesions. Due to the multitude of causes leading to itching, as well as their multi-factorial nature, there are different ways to deal with this persistent sensation. Before starting treatment for pruritus, however, it is first necessary to determine if the cat has a summing up pruritus effect and also to establish the threshold for skin excitability to pruritus. Each animal has its own individual itching threshold. This means that even a cat that is allergic, but has not exceeded this threshold, may not react with itching at all. Sick, dry skin has a lowered pruritic threshold - i.e. impulses that do not pruritize in a healthy animal, but trigger reactions in a cat with a lowered pruritic threshold, often excessive in relation to the triggering stimulus. This factor varies with each individual; Cats may react differently to pruritus in the face of seemingly the same stimuli.

In many cases, one specific pruritic factor is not enough to trigger the pruritus on its own. However, if it is joined by another stimulus (also with a fairly low pruritic potential), then the combination of these two stimuli causes the pruritus threshold to be exceeded and symptoms of scratching appear. This is the so-called summation of itching effects.  Simply put, it can be said that the clinical manifestations of pruritus depend on both allergic factors and factors not related to allergy. The pruritus does not appear until these factors are added together and the pruritus threshold is exceeded. Therefore, the importance of these phenomena: the pruritic threshold and the cumulative pruritic effects should never be overlooked. Sometimes simple treatment of complications can keep your cat below the scratch limit, and the underlying allergic dermatosis remains asymptomatic. E.g. a patient suffering from atopic dermatitis, in whom - at the same time - allergic symptoms with bacterial or fungal complications. The conclusion is that the use of antipruritic drugs is not always necessary. Causal treatment of pruritic dermatoses should always be introduced prior to treatment of complications. Some even think that acaricides, insecticides, antibiotics and antifungal drugs are the best "antipruritic drugs ".

Ways of influencing pruritus

The itching symptoms can be influenced on several levels:

  1. By affecting skin receptors - e.g. care agents with local protective effect, local anesthetics.
  2. By influencing mediators - antihistamines, unsaturated fatty acids (to reduce the production of pro-inflammatory eicosanoids), some topically acting agents (capsaicin can interrupt the transmission of itch by reducing the amount of substance P of peripheral sensory neurons).
  3. Glucocorticosteroids - they work on many levels:
    • stabilize the lysosomal membranes of mast cells,
    • they inhibit the formation of vasomotor substances,
    • inhibit the formation of eicosanoids.
  4. Affecting the spinal cord - interneuronic inhibition factor.
  5. Influencing the cerebral cortex - opioid antagonists, serotonin reuptake inhibitor (increases pruritic tolerance, at the same time induces peripheral effects).

External antipruritic treatment: topical medications

There is a wide variety of topical formulations available on the market.

The assortment is huge, for example:

  • shampoos,
  • ointments,
  • gels,
  • spot-on preparations,
  • foam,
  • powders,
  • rinses.

Manufacturers of veterinary drugs and cosmetics are simply outdoing each other in the production of newer and more sophisticated articles. However, in order for the local treatment to make sense and although it will only help to alleviate the itching to a small extent, the preparation should be selected carefully, taking into account the cause and nature of the itch.

Indications for the introduction of local treatment

What are the indications for the introduction of local treatment? Why not be treated immediately with pills or injections? The first and main advantage of topical treatment is the fact that the topically applied preparations do not burden the body as a whole. They are applied directly to the affected area (the entire skin is available, unlike other organs, so we have direct access to it), and the range of application determines the area of ​​lesions. This essentially reduces the side effects and also makes it gentler on the body. Topical treatment also reduces the risk of developing drug resistance.

For example:

commonly and frequently used systemic antibiotics often lead to the development of drug-resistant bacterial strains. In the case of antibiotic ointments, this problem is generally limited. Thanks to the direct application of an external drug to the affected lesion, we greatly reduce the total dose of the drug.

Of course, as with all medications, there are disadvantages to the use of topical medications:

  1. Compared to general therapy, topical treatment is laborious and requires commitment on the part of the owner. Here it is not enough to just give a pill and we are done. Medicines are often applied several times a day, additionally baths are very time-consuming.
  2. Many medications have an unpleasant odor, may be greasy, or soil your kitten's hands or objects. They can also change the color of the coat or even stain it permanently.
  3. Cats do not like unnecessary skin manipulation, so applying medications can be difficult (or even impossible) when the patient strongly refuses to cooperate.
  4. As a rule, shampoo therapy is also excluded, unless the cat tolerates bathing.
  5. You should make sure that an exceptionally clean cat does not lick the preparation off the hair, which in many cases is simply impossible.
  6. There are local reactions with some groups of drugs.
  7. If the skin lesions or itching affect the skin, the penetration of some drugs may be significantly impeded.

Local external treatments include moisturizing and cleansing treatments, anti-inflammatory and antipruritic treatments, keratomodulating and anti-seborrheic treatments, regenerating and nourishing treatments.

Moisturizing and cleansing treatment

Initial task aimed at preparing the skin and cleaning it of impurities, dead epithelial cells or exudates. For this purpose, as a rule, soaps or shampoos containing mild detergents, hypoallergenic surfactants or lipoaminoids are used. Some also contain various types of additives, pH buffering, fragrances and preservatives. They can be used in the form of cleansing and therapeutic baths, skin soaps or irrigation sprays.

They can include:

  • glycerol,
  • propylene glycol,
  • urea,
  • lactic acid,
  • collagen,
  • plant colloidal extracts (starch, allantoin).


Hydrotherapy is still an underestimated form of local treatment. Considering the fact that almost 20% of water present in the body is present in the skin, it is an extremely important factor in restoring the proper functioning of the integumentary system. In addition to its antipruritic and analgesic effect, water can also warm or cool the skin (depending on the need - in the case of burns or impaired circulation), remove dried exudate, scabs, clean fistulas, get rid of excess epidermis. Whirlpool baths in water only (no detergents added) can significantly reduce the level of itching in patients with atopic dermatitis.

Anti-inflammatory and anti-itching treatment

In practice, the fight against itching always boils down to a soothing and anti-infective effect.

Therefore, in the first place, the following should be used:

  • antibacterial agents,
  • antifungal preparations,
  • antiparasitic drugs.

In the second, it is the elimination of the secondary keratolytic state. Anti-infective treatment (skin antibiotics, topical antifungal drugs), use of drugs that reduce inflammation (topical skin steroids).

Keratomodulating and anti-seborrheic treatment

Keratolytic agents:

  • salicylic acid - very effective in increasing water binding by diseased skin, thanks to which the primary dehydrated cortical layer is hydrated, which is the starting point for the processes of keratinization disorders; affects the reduction of intercellular adhesion, facilitating exfoliation; in practice, it is often combined with other keratomodulators, e.g. sulfur, with which it gives a synergistic effect in concentrations from 2-6%. It is used to treat:
    • local keratosis disorders,
    • generalized kerato-seborrheic conditions with dominance of keratinization;
  • lactic acid - has mild keratolytic, antibacterial and moisturizing properties,
  • undecylenic acid,
  • transretinoid acid,
  • urea - is an effective keratolytic, and in higher concentrations it has proteolytic activity and accelerates the absorption of fibrin. Moreover, it has irrigating properties.

Keratoplastic agents:

  • sulfur has anti-seborrhoeic and keratolytic properties - by producing H2S hydrogen sulphide at the level of the stratum corneum, it has a simultaneous decongestant, anti-inflammatory, antipruritic, antiseptic and anti-parasitic effect; sulfur is used to treat:
    • keratoyorrhoeic states with a predominance of seborrhea,
    • seborrheic acne (usually in combination with a variety of keratomodulators).
  • salicylic acid;
  • tar (tar, coaltar) - recommended in the treatment of keratolytic conditions, and characterized by a variety of therapeutic effects:
    • keratomodulating,
    • antiseptic,
    • antipruritic,
    • painkillers (wood tar - tar),
    • astringent (coaltar),
    • anti-parasitic (coaltar),
    • antifungal (coaltar),
  • ichthyol - accelerates the resorption of infiltrates, has (weakly) anti-inflammatory and antipruritic, antiseptic and keratomodulating properties.

Restorative and nourishing treatment

The regenerative and nourishing treatment is primarily the use of vitamins and polyunsaturated fatty acids.


  • biotin - prevents hair loss, improves its structure and activates the synthesis of fatty acids,
  • tocopherol acetate - supports healing processes (by activating tissue respiration mechanisms), protects fatty acids against oxidation.

Polyunsaturated fatty acids have an antipruritic and anti-inflammatory effect, recreate the formation of a lipid-protein "skin film", covering the epidermis and its products.

Substances included in the antipruritic preparations and their intended use



  1. Paraffin oil - creates an occlusive film on the skin surface, which prevents excessive evaporation of water from the surface, thus indirectly moisturizing. It softens, smoothes and regenerates the skin and coat.
  2. Vaseline - has similar properties to paraffin oil.
  3. Lanolin - it does not dissolve in water, but can absorb 2 times more than it weighs - thus regulates the water balance of the skin, creating an occlusive film on its surface. It reduces the evaporation of water from the epidermis by 20%, thanks to which it is softened and smoothed.


  1. Urea - has strong moisturizing properties, attracts water molecules and retains them in the skin. It has antibacterial, antipruritic and anti-inflammatory properties, and in higher concentrations it has a slightly exfoliating effect.
  2. Lactic acid - moisturizes and helps exfoliate dead epidermis cells.
  3. Glycerin - glycerol has water-retaining properties, which slows down skin dryness and softens it, thus reducing the severity of itching and making the coat shiny.
  4. Propylene glycol - has a bacteriostatic, fungistatic and moisturizing effect, is easily mixed with substances and various solvents.
  5. Colloidal oat extract - oat starch soothes irritations, reduces the severity of itching, moisturizes and firms the skin.
  6. Hyaluronic acid - has very high hygroscopic properties. Creates a water protective film on the surface of the epidermis.
  7. Collagen - moisturizes and improves skin elasticity. It retains and absorbs water on the surface of the epidermis, similar to hyaluronic acid.
  8. Lecithin - has a lipotropic effect, improves skin elasticity.

Soothing and regenerating agents:

  1. Allantoin - stimulates the epithelialization process, promotes the regeneration of the epidermis, accelerates granulation. It causes self-cleaning of the skin (elimination of dead tissues), has antiseptic and keratolytic properties. Improves moisturizing.
  2. Chamomile extract - has antipruritic and anti-inflammatory properties, soothes irritations and supports the healing of micro-injuries.
  3. Menthol - soothes pain, itching and inflammatory skin irritations, suppresses unpleasant odors.
  4. Panthenol - soothes irritations, regenerates (through the growth and stimulation of epidermal metabolism), supports healing processes, has antihistaminic and anticholinergic properties, has anti-seborrheic activity.
  5. Aloe vera (aloe) - soothes irritations, stimulates regeneration, has a cooling and moisturizing effect.

Topical antiseptics. An antiseptic is a chemical that has the ability to eliminate (kill) or inactivate microorganisms on living tissues.

Once used alcohols, iodophores, hydrogen peroxide, KmnO4, dyes (acridine, rivanol, violet). Currently, more and more are used:

  • Benzoyl peroxide, which is metabolized in the skin to benzoic acid, has a strong antibacterial effect by lowering the pH of the skin. It is characterized by a triple therapeutic effect (by reducing the activity of the sebaceous glands, it acts seborrheic; by dissolving the superficial epidermal-sebaceous plug of the comedone, it has a comedogenic effect; by lowering the pH of the skin, it acts as an antiseptic). The indications for use are:
    • the drug of choice in seborrhoeic conditions,
    • as an adjunctive treatment of purulent dermatitis,
    • in bacterial foot rot,
    • in generalized demodecosis.
  • Benzalkonium chloride.
  • Chlorhexidine - a synthetic antiseptic with high bactericidal activity against Stapylococcus intermedius, Pseudomonas sp., Malassezia yeasts and pathogenic fungi. It is safe for cats, rarely causes allergic reactions, has no toxic or irritating effects, and the residual organic material (e.g. pus) does not impair its operation. It has a number of therapeutic indications, the most important of which are:
    • topical treatment of purulent superficial and deep skin inflammations,
    • skin asepsis and post-itching lesions,
    • dermatitis caused by Malassezia.
  • Hexamidine.
  • Hexetidine.
  • Ethyl lactate - the antiseptic effect is achieved, among others, thanks to the use of bacterial lipases of the skin flora - decomposing ethyl lactate into lactic acid and ethanol. The local change of the skin's pH towards acid creates conditions that are not conducive to the multiplication of pathogenic bacteria, and alcohols - apart from the bactericidal effect, dissolving the excess, especially dried sebum, make it easier to saponify. In addition, the use of lactate-style dissolves the sebum obstructing the mouths of the hair follicles and thus facilitates the penetration of active substances into its interior. This type of action removes the most common purulent process, which is chronic, diffuse purulent folliculitis.
  • Chlorothymol.

Forms of external preprarts


Bathing the cat

Shampoo therapy plays a significant role in veterinary dermatology, and its main advantage is the possibility of using it on large areas of the skin.

The active substances in anti-itching and anti-inflammatory shampoos include:

  • 1% hydrocortisone,
  • 0.001% flucinolone,
  • 2% diphenhydramine,
  • 1% pramoxin.

Moisturizing shampoos contain:

  • fatty acids,
  • lipids,
  • phytosphingosine,
  • urea,
  • glycerin,
  • oat colloidal solution.

Unfortunately - in spite of the undoubted advantages of shampoo therapy, its use in cats is very limited or - in most cases excluded

However, it is worth considering the use of shampoos in the form of soaps, which are then rinsed with water.


Like shampoos, they allow the active ingredient to be spread over a large area of ​​the skin. Usually, they are soaked in the entire body of the animal. May contain moisturizing, antipruritic and antibacterial agents. As in the case of shampoo therapy, they are completely unsuitable for cats that do not like bathing.

Powders (powders)

These are finely powdered substances with highly hygroscopic (water absorption) properties. They work well in cases of purulent dermatitis, especially in places such as skin folds or interdigital spaces. The powder is used on dry, previously cleansed skin. Very limited use in cats (licking the hair of any foreign objects).


Lotions are suspensions of a powder (or other substance) in a liquid. They are easy to spread on the skin.

They can have properties:

  • cooling,
  • antipruritic,
  • antibacterial,
  • drying.

The active substances of lotions are usually:

  • hydrocortisone,
  • betamethasone,
  • oat colloidal extract,
  • pramoxin,
  • chlorhexidine,
  • miconazole,
  • sometimes sunscreens.

Spot-on preparations

The best known are those containing parasiticides. These products disperse from the application site into the natural lipid layer of the animal's skin. They accumulate in the hair follicles and sebaceous glands, from where they are gradually released, covering the entire surface of the skin and hair. Products containing fatty acids or phytosphingosine are used in the treatment of patients with atopic dermatitis and seborrheic disorders.


Designed for use on a large area of ​​the skin. Most often they contain emollients and moisturizing substances, but also anti-parasitic, antibacterial and antipruritic compounds (hydrocortisone, triamcinolone, phytosphingosine). They work very well in difficult locations (interdigital spaces, fingertips or outer surfaces of the auricles).

Creams and ointments

They are used in various ways (depending on the active substance).

They are perfect for locations such as:

  • the ear canals,
  • nose,
  • finger pads,
  • interdigital spaces,
  • elbows.


After rubbing into the skin, they do not leave any film on its surface. In veterinary medicine, gels containing benzoyl peroxide (for the treatment of acne, comedones and demodicosis) as well as salicylic acid and urea are used.

General therapy for pruritus

Antipruritic treatment should be directed to tackle the root cause of the pruritus. Unfortunately, it is often very difficult or impossible to determine it, and often itching is caused by several factors. It is extremely important in undertaking any skin therapy to take into account the concept of the pruritic threshold and the effects of summation. And even if the cause cannot be identified, simply combating other factors that aggravate scratching can significantly reduce or even stop itching. Many skin diseases are pruritic, but the most common are allergic diseases (such as atopic dermatitis or flea allergic dermatitis) and parasitic background diseases (e.g. scabies infestation). In the course of allergy, pruritus is also chronic, accompanying the disease throughout the patient's life. Therefore, in addition to the causal treatment, the key is to fight this troublesome symptom, which greatly reduces the comfort of life, which is pruritus.

Itching in a cat with medications

Cat antipruritic drugs


Glucocorticosteroids - one of the most commonly used drug groups in dermatology due to their anti-inflammatory and immunosuppressive properties. They can be used in the treatment of pruritus in cases of atopic dermatitis and flea allergic dermatitis, however, in the course of food allergy, they have limited antipruritic efficacy. In cases of acute itching, accompanying atopic dermatitis or flea allergic dermatitis, the main route of administration of glucocorticoids is the oral route.

However, you should remember about a few very important rules for steroid therapy:

  • steroids should be administered as little as possible,
  • the minimum effective dose should be sought,
  • if possible, use them every other day,
  • in the chronic form, the use of glucocorticosteroids is possible only when other, less harmful methods of treatment are ineffective,
  • glucocorticoid doses can be effectively lowered when used in combination with other antipruritic drugs, such as. polyunsaturated fatty acids or antihistamines,
  • possible side effects should be monitored.

In atopic cats, the recommended systemic corticosteroids are prednisolone or methylprednisolone at a dose of 1-2 mg / kg.c., triamcinolone can also be administered at a dose of 0.1 to 0.2 mg / kg m.c. In cats, a divided dose may be used twice a day. It is also recommended that cats be administered drugs later than dogs (in the afternoon, as opposed to dogs treated with drugs in the morning).  In the case of allergy to flea allergens in cats, prednisolone is recommended at a dose of 2.2 mg / kg m.c. Orally, for 5-7 days, then every other day. Other glucocorticosteroids that are useful in atopic dermatitis may also be administered. In cats, the administration of injectable glucocorticosteroids (in pruritic cases) is less controversial than in dogs as it leads to less side effects. Iatrogenic Cushing's syndrome is extremely rare in this species.

The steroids used in this way include:

  • methylprednisolone acetate (5.5 mg / kg m.c.),
  • dexamethasone (0.125-0.5 mg / cat),
  • flumethasone (0.03-0.125 mg / cat),
  • methylprednisolone (10-20 mg / cat),
  • triamcinolone (0.1-0.2 mg / kg m.c.),
  • prednisolone (0.5-2.2 mg / kg m.c.).

Glucocorticosteroids are used as the treatment of choice in the case of pruritic attacks and while waiting for the effect of the implemented causal therapy. Their short-term use in cats is very rarely problematic, however, due to their multiple action, one should strive to identify the cause as soon as possible and, if possible, to discontinue steroid drugs.


Cyclosporin is a polypeptide isolated from metabolites of the fungus Beauveria nivea. It shows strong immunosuppressive and immunomodulating properties. Initially, this drug was introduced into human medicine as a means of preventing and rejecting transplants. It has also proven effective in dermatology. A dozen or so years ago it was used by veterinarians. In cats, it is effective against itching in atopic inflammation. Its effectiveness (at a dose of 5 mg / kg m.c.) in the case of AD-related pruritus is comparable to the effect obtained with the administration of prednisolone. An important and used feature of cyclosporine is that it exhibits a number of interactions with other drugs. And so, e.g. azole antifungal drugs (ketoconazole, itraconazole, fluconazole), slow down its metabolism in the body, and therefore allow to reduce the dose of cyclosporine (from 38-75%), and thus significantly reduce treatment costs. It has also been shown that frozen grapefruit juice (as well as powdered juice) significantly increases the bioavailability of the drug, therefore there is a possibility of reducing cyclosporine. The drug is best absorbed when administered on an empty stomach (approx. 2 hours before or after a meal). Unfortunately, side effects in the form of vomiting often occur when administered on an empty stomach, so initially you can try to use cyclosporine with a small amount of food, and after 1-2 weeks try to administer it on an empty stomach. You can also reduce side effects by getting your body used to the drug - treatment is started with low doses and then gradually increased. To prevent vomiting, some people give cyclosporine chilled.

Like all drugs, cyclosporine has a number of side effects:

  • a common symptom of long-term administration of cyclosporine is gingival enlargement (especially in dogs),
  • ulcerations and growths on the skin,
  • increased susceptibility to bacterial, fungal, viral and parasitic infections,
  • increased risk of cancer formation (especially in cats),
  • nervous system symptoms (convulsions, hyperaesthesia, ataxia, blindness, muscle weakness, hallucinations).

Janus kinase inhibitors

Oclacitinib (a preparation Apoquel) is a drug that has been introduced relatively recently for the treatment of pruritus in animals. It has anti-itching and anti-inflammatory properties. It is used to combat very intense itching, and not for long-term treatment lasting many months. The drug has been studied so far mainly in the case of allergic diseases in dogs. About 2 years ago, studies on its use in cats were published. Oclacitinib was administered to cats with allergic dermatitis (not caused by flea or food allergy) at the same dose as for dogs. However, the drug was less effective than in dogs. A significant reduction in pruritus was seen in only 50% of the cats. It is therefore used in the treatment of pruritus in cats, but it should be borne in mind that the pruritus will not be significantly reduced in all cases.


The effectiveness of antihistamines in reducing pruritus in the course of allergic diseases in animals is not high, and they are completely ineffective in pruritus caused by parasitic invasions. They are not recommended in cases where there is intense, severe itching. Instead, they can be used to treat minor pruritus. In general, they should be administered rather as part of a combination therapy in combination with other groups of drugs, as they alone cannot quickly stop the intense itching.

In cats, you can use:

  • clemastine (0.67 mg / cat 2 times a day),
  • chlorpheniramine (2 mg / cat every 12 hours),
  • hydroxyzine (12.5 mg / cat 2 times a day),
  • cyproheptadine (2 mg / cat 2 times a day),
  • ranitidine (0.5 mg / cat),
  • cetrizine (5 mg / cat).

Polyunsaturated fatty acids

The addition of polyunsaturated fatty acids (omega-3, omega-6) to the diet has a beneficial effect in cases of allergic diseases. They have anti-inflammatory and anti-itching properties, they also allow to reduce the dose of glucocorticosteroids and act synergistically with antihistamines.

Megestrol acetate

Megestrol acetate is an analog of progesterone. Its antipruritic activity in cats is known, but due to the risk of side effects, and with long-term therapy, even with serious complications, it is not recommended for treating pruritus in cats.

Psychotropic tricyclic antidepressants

They are used because of their antihistamine effect.

Serotonin uptake inhibitors

Fluoxetine (Prozac) - reduces itching, it is not recommended in cats (drooling).

Morphine antagonists (naloxone, naltrexone)

In cats, excessive and persistent licking has been shown to secrete endorphins, reducing the animal's stress and anxiety. This can lead to psychogenic alopecia in cats. The use of morphine antagonists is expected to break this vicious circle: licking - endorphin release - analgesia / comfort.


Cat itching can be very troublesome

The itching does not hurt, but it can be very annoying. We know from people's reports that chronic severe itching is more difficult to bear, even than severe pain. Currently, we are able to reduce the symptoms of severe pain, but the fight against itching is still difficult. It is one of the most common reasons for consulting a vet, and when it occurs in a cat, it can be a real diagnostic challenge. These animals are hidden by nature, they tend to lick or scratch themselves, especially in those moments when they are not seen by their owners. Very often, caregivers only notice the effects of intense itching in the form of changes in the skin or in the structure and density of the hair. Additionally, in many cases it is very difficult to tell whether the cat is actually scratching or licking itself intensely. Cats are exceptional cleaners and it is not easy for us to notice the moment when intensive care becomes a disorder. The matter is complicated by the fact that in many cases of cat pruritus it is caused by stress factors. That is why determining the cause is sometimes difficult, the diagnostic path is tedious, and the owner and his ward are more and more dissatisfied. However, strong and overburdening drugs should not be used immediately. In all cases of cat pruritus, the first thing you need to do is find out if you can help your pet in a milder way and try this treatment while looking for the cause of the pruritus.

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