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Dermatitis

Diabetes Mellitus


Dermatitis


The term dermatitis is used to refer to any inflammatory condition of the skin. As such it is not a single disease, but can be part of many disease processes.

What are the signs of dermatitis?

The most consistent signs of dermatitis are scratching and reddening of the skin. Apart from this the signs will depend somewhat on the severity and cause.

There may be scabs, sores, crusting, pustules, flaking, oily discharge, discharge, thickening, colour changes (usually darker or redder), hair loss and in extreme cases bleeding.

Causes of dermatitis

There are a great number of causes of dermatitis in cats. The general groups of causes and some specific causes are listed below.

  • Parasites - Mainly fleas – either by number of bites in bad infestation or flea allergy.
  • Flea Allergy – if an animal is allergic to fleas, it only requires very small number to cause a bad reaction as your cat is allergic to the saliva of the flea·
  • Food Allergy – also causes itching of the skin ·
  • Seasonal Allergies – the cat is sensitive to something that is only around at certain times of year – usually the summer months. Pollens are often responsible.
  • Infections - Pyoderma – bacterial infection of the skin. This is often a secondary part of skin disease rather than a primary cause. Scratching damages the barriers that normally prevent bacteria from invading the skin. ·
  • Juvenile Facial Pyoderma – a bacterial infection of the follicles of the face and chin in young cats of certain breeds – particularly Persians.
  • Malassezia – a yeast-like fungus that can infect warm, moist areas of skin.
  • Seborrhoea – an abnormal condition of the production of oils on the skin that can be very greasy or cause lots of dry flakiness. Either form can cause irritation and a tendency to skin infections.

Treatment

Treatment of dermatitis is a very large area and will vary greatly dependent on the cause of the problem.

Typical treatments will include antibiotic and anti-inflammatory drugs in tablets and/or creams and dietary management, accompanied by skin washes and shampoos.

Anti-parasitic treatments are used where parasites are involved. Good veterinary registered flea products are required for an animal suffering from a flea allergic dermatitis.

 

Diabetes Mellitus


Diabetes mellitus is a disease in which your cat ’s pancreas can no longer produce enough of the hormone insulin. Insulin acts like a key in the body that allows glucose (from the food you feed your cat) to enter the cells where it can be used for energy and growth.

A lack of insulin results in an abnormally high level of glucose in the blood which is why we take blood samples to measure these levels.

Your cat then relies on fat breakdown for its energy which may have toxic by-products that make your pet ill and lethargic.

Signs of diabetes

In diabetic cats, the glucose in the blood is so severe that glucose is excreted in the urine. Glucose takes water with it so an increased volume of urine is produced. To compensate for this, and so that dehydration is prevented, the cat develops an increased thirst .

Weight loss and a voracious appetite are also frequently seen and these may be the original reasons for presentation to a veterinary surgeon. Therefore the main clinical signs seen in a diabetic cat are:

• Weight loss
• Increase appetite
• Increased urinating and drinking

These signs are not always present or may pass unnoticed. For example, the increased thirst may not be recognised if the cat is drinking from water sources outdoors while not noted to be drinking more in the home.

Other clinical signs which may be seen in diabetic cats include:

• Straining to pass urine and/or passing bloody urine associated with a bacterial urinary tract infection (bacterial cystitis)
• Enlargement of the liver evident on examination by a veterinary surgeon
• Poor coat

In a small number of diabetics, the nerves supplying the legs, and in particular the hind legs, may be affected resulting in sunken hocks. Very rarely, the eyes may be affected by cataracts and retinal abnormalities which develop associated with the diabetes.

This can cause problems with vision, including blindness in most severely affected cats. High blood pressure is a recognised potential complication of diabetes in people and has also been reported in a small number of diabetic cats.

Most diabetic cats will remain well in themselves but ketoacidosis is a potential complication that can be seen in any uncontrolled diabetic. In this situation, the cat may become extremely depressed with signs such as vomiting, diarrhoea, complete loss of appetite, dehydration, collapse and coma.

If any of these signs are seen in a diabetic cat, it is cause for immediate concern and a veterinary surgeon should be contacted as soon as possible.

Diagnosis of Diabetes

Blood and urine tests are required to confirm a diagnosis of diabetes. Testing increased levels of glucose in the urine is needed.

The easiest way of collecting a urine sample at home is to replace normal cat litter with non-absorbent cat litter (supplied by a vet) or clean aquarium gravel so that a sample can be collected. The urine sample can be taken to a veterinary surgeon for testing or the hospital may give you some test strips to use at home.

Treatment

  • Managing predisposing factors -It is vital to control obesity or withdraw drug therapy if that is the cause such as corticosteroid use. If no predisposing causes of the diabetes can be identified, or if correction of these do not lead to resolution of the diabetes, then specific treatment is required.
  • Management with a change of diet - Underweight diabetic cats may need energy dense diets until their weight normalises. Obese diabetic cats should be put onto a weight loss regime, under the guidance of a veterinary surgeon, as obesity interferes with the way insulin works. In some of these cats, this may resolve the diabetes.
  • Oral medication - In a small number of cats, it is possible to stabilise their diabetes using oral hypoglycaemic agents. They have a number of actions which include stimulation of insulin secretion. This treatment appears to be most effective in mildly affected cats and obese cats where insulin resistance is present.
  • Insulin injection - In most diabetic cats, insulin therapy is the most effective treatment. Insulin is given by an injection under the skin of the scruff and most cats will be stabilised on a regime involving either once or twice daily injections.

This is the biggest concern that most owners have, but the needles are so tiny that some cats do not even notice when you are giving it. Veterinary surgeons often recommend that diabetic cats are offered food just before they receive their insulin so that the cat is distracted by eating and does not notice the injection.

Once stable, you will need to give the injections in the recommended amounts daily at the same time each day. You will have to feed a recommended amount of food and sometimes in 2 meals, but always at a specific time.

Fresh water must always be available. Should you forget to give the injection by less than 3 hours, it can still be given then. Give the next injection at the usual time. If your cat will not eat, just give half the usual dose of insulin, and it is recommended that you inject in a different spot each time.

Careful in long-haired cats to get the needle in the skin, not just in the fur. Only use each needle once as they become blunt and it is vital that needles are recycled in special containers that can be obtained from the practice.

Emergency situations

Hypoglycaemia or low blood glucose levels - Signs seen include:

• Weakness/lethargy
• Disorientation
• Drunken gait
• Strange behaviour e.g. aimless wandering, searching for food, licking lips
• Severe neurological signs e.g. collapse, convulsions, loss of consciousness and eventually death

If the signs are mild, then the cat should be offered food and encouraged to eat. If this is not successful or if the signs are more severe, then glucose powders or syrups should be given orally, applied directly to the gums.

An effect should be seen within five minutes of applying a tablespoon of glucose to the gums. If no glucose powder or syrup is available then honey or sugar should be used. Owners should then contact the surgery for further advice. Severely hypoglycaemic cats may need to be admitted for intravenous glucose administration and further stabilisation.

Ketoacidosis - Ketoacidosis is an uncommon complication of poorly controlled diabetes. It can be rapidly fatal if not treated so is a cause for immediate action where suspected. The clinical signs most frequently seen with ketoacidosis are:

• Loss of appetite
• Lethargy/weakness
• Vomiting/diarrhoea
• Dehydration/collapse

The breath may have a fruity odour. Owners of diabetic cats should be provided with urine glucose and ketone sticks by their veterinary surgeon to allow periodic monitoring of the urine as described above.

If a positive ketone result is seen on the urine dipstick, immediate veterinary advice should be sought and all ketoacidotic cats are treated as emergencies and will require hospitalisation.