Section: Diagnosis In-depth
Veterinary care includes diagnostic tests and subsequent treatment recommendations. Diagnostic tests are necessary to rule out other skin diseases as well as support the diagnosis of atopy.
Your veterinarian will take a complete medical history about your cat. Important aspects of the medical history include the age of onset, whether the problem is (or was at one time) seasonal and which areas of the body your cat chews and scratches. Bring a record of medications your cat has received previously and be prepared to answer questions about how effective they have been.
Your veterinarian will perform a thorough physical and dermatological examination of your cat. Included in the examination of the skin will be a careful examination of the feet, food pads and nails. Special attention will be paid to the ears.
A skin scraping will be performed to eliminate scabies. The sarcoptic mange mites are notoriously difficult to find, even with repeated skin scrapings. Your veterinarian may recommend a trial treatment for scabies to rule out this diagnostic possibility, especially if the ears are severely affected from scratching.
A fungal culture often is performed to rule out dermatophytosis (ringworm). Dermatophyte infections of the skin can mimic many other skin diseases, and a fungal culture frequently is part of the diagnostic process.
A food trial may be recommended to rule out food allergy. During a food trial, the animal is fed a food containing ingredients that it has never been exposed to before as its only source of food for 6 to 12 weeks. If the symptoms don't improve, food allergy is excluded as a diagnostic possibility.
Once the previously described diseases have been ruled out, a presumptive diagnosis of atopy is made. Allergy testing is then performed to identify allergens to which the animal is sensitive. Intradermal allergy testing (skin testing) is done to determine which allergens cause a skin reaction. The hair is clipped from one side of the chest and small amounts of many different allergens are injected into the skin. Light sedation may be necessary to allow proper restraint during the procedure.
This test usually requires referral to a veterinary dermatologist. Animals must be off all medications before testing so that the skin can react properly to the antigenic challenge of the allergen injections. Reactions to allergens in cat skin are subtle and therefore more difficult to interpret.
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