Psychogenic alopecia of cats. Health and care. Patchy symmetrical baldness in a cat. Endocrine etiology of symmetrical baldness. Treatment of symmetrical baldness in cats

Cat owners quite often face the problem when their pet's hair falls out in clumps behind the ear, on the neck, paw or back, and a bald spot forms. Bald spots in cats (especially short-haired cats) are a common occurrence. It's called alopecia or baldness in cats. What kind of disease is this, what are its causes and methods of treatment?

Alopecia, or feline hair loss: what is it?

All cats shed twice a year, and this is the norm. How to distinguish: is it molting (the process when the fur is renewed) or pathology (baldness of the animal)? To do this, you need to know how the disease manifests itself, what its prerequisites are and in what cases the owner needs to sound the alarm.

Alopecia is the name given to abnormal hair loss in cats, as a result of which bald spots are formed on the animal's body - areas with absolutely no hair. The fur may fall out in clumps, forming bald areas on the animal's head, ears, and paws. Having noticed such areas, the owner should immediately take the pet to an appointment with a veterinarian. Baldness can be a signal of serious problems in the animal’s body.

But this should not be confused with hair loss, which normally occurs in all healthy felines. Cats lose their fur during:

• molting (a seasonal change of “coat” occurs twice a year; cats usually shed more than males);
• stress (the animal may shed some hair due to excitement);
• age-related changes (old animals lose hair and whiskers);
• frequent bathing (this is why it is recommended to bathe an animal only if necessary; twice a year is quite enough).

At the same time, the wool does not come out in clumps, without forming bald spots. But the disease has slightly different symptoms.

Alopecia symptoms

You can recognize alopecia in a pet by the following signs:

• The fur falls out excessively, in clumps. Bald spots in cats appear mainly behind the ear, in the neck, back, and on the tail.
• The skin in these places may have a familiar pink color or turn red, sores or scabs may appear there.
• Check your pet's reaction to touching the bald spot: perhaps the spot hurts or itches.
• Check if the animal has symmetrical bald spots.

If you notice these symptoms, you should urgently seek professional help from a veterinarian. Otherwise the disease will progress.

Causes of this disease

If an animal has bald spots on its body and head, this may be a sign of a food allergy. Allergies should be looked for in your pet's diet. They can be:

• Proteins of animal and plant origin;
• Various cereals;
• Meat - in particular lamb.

In addition, it may be an allergic reaction to flea bites, cigarette smoke or other odors (inhalation allergy).

The causes of baldness may lie in the psychological state of the pet, that is, hair may fall out due to stress. If the veterinarian diagnoses this reason, then the first thing the owner needs to do is find out what kind of stress or experience the pet has had recently, eliminate it, and only after that give sedatives, which only in this case will be effective. Symptoms of alopecia of a psychogenic nature are bald patches that are located on the thighs, abdomen or paws.

The causes belonging to the third group are infectious. If a cat's hair is falling out, the culprit may be scabies, lichen, fungus, or mites. If a cat has a bald spot behind its ear, it could be ringworm. There are several varieties: fungal (another name is ringworm; contagious to humans), psoriasis or eczema, viral.

Hair mites can also cause hair loss. They are very small and impossible to notice with the naked eye. Lice eaters do not live long, but they reproduce very quickly.

Hair loss can be a consequence of seborrhea, a disease in which the functioning of the sebaceous glands is disrupted. This is usually indicated by baldness in a cat near the tail. That is why this disease is sometimes called “greasy tail”.

Another group of problems causing baldness- disruptions of the hormonal system:

• thyroid problems, manifested by both increased and insufficient levels of hormone production;
• diabetes;
• malfunctions of the adrenal glands, in particular their hyperfunction.

Other reasons include the presence of tumors in the animal, genetic predisposition and reactions to medications. Thus, a kitten’s bald spot may appear due to the fact that during pregnancy its mother did not receive various essential minerals and vitamins.

Diagnosis of the disease

If a cat's hair falls out in clumps before bald spots form, it should definitely be seen by a specialist. Only a veterinarian can accurately determine the diagnosis. To determine the disease and prescribe the correct treatment, the doctor must:

• Find out how and when the disease manifested itself. The owner will have to tell in great detail the animal’s lifestyle, what the pet ate and drank, what it came into contact with, and whether it walked outside.
• Examine the patient.
• Examine hair roots under a microscope.
• You may need blood and hormone test data, and a scraping is a must.
• Sometimes an ultrasound or x-ray is done to confirm or rule out the presence of tumors.

Treatment of hair loss in cats

Hair loss in cats is a serious but completely treatable disease. Treatment must be selected individually. What medications the doctor will prescribe depends on the causes of the disease. If bald spots on the ears or other places appear due to allergies, the animal must first be isolated from the allergen. The doctor also prescribes drugs that stimulate the immune system and antiallergic medications. If there is a food allergy, you should review the animal’s diet and switch it to hypoallergenic foods.

If the bald spots were caused by an abscess, the animal must undergo a course of treatment with antibiotics and antiseptics. If a cat has been diagnosed with endocrine problems, she is prescribed hormonal medications.

Preventive measures

To prevent ear baldness in cats and hair loss on other parts of the body, it is recommended to take preventive measures. Namely:

• regularly independently examine the animal, take it for professional examinations, and, if necessary, for treatment at the veterinarian;
• vaccinate your pet on time;
• don't forget about the right thing hygiene care for the cat;
• Provide your pet with proper nutrition.

Bald spots in cats on the head, ears, belly or paws are a fairly common phenomenon. Why a cat has bald spots on its back or other parts of its body - only a doctor can say for sure after conducting the appropriate diagnosis. Depending on this, treatment is prescribed, which can consist only of diet, or contain a course of hormonal drugs or antibiotics. But it is highly not recommended to self-medicate your pet: you can only torture the animal with unnecessary drugs, and in the meantime the cat will lose most of its fur coat.

Bald spots at first glance seem harmless, although they spoil the aesthetic appearance of the animal. But it should be understood that they can be provoked by quite serious diseases that develop in a pet. Therefore, you should not hesitate to visit the doctor.

The beautiful, soft and silky fur of our pets is a clear sign of their good health. Loss of hair, therefore, may indicate some serious pathologies in the animal’s body. One of the most complex disorders in cats is alopecia. It is divided into two types:

• Symptomatic when the pathology is only a visible effect of another cat disease.

• Idiopathic. It occurs “on its own”; more often it is impossible to identify visible causes.

In addition, the pathology can be focal, when hair falls out only in a limited area, and generalized (mass baldness over a large area). In addition, symmetrical alopecia occurs in cats, in which hair falls out symmetrically on all sides (hormones, chemotherapy) and asymmetrically, when hair loss is observed in only one area of ​​the body.

The term “alopecia” in this case refers to hair loss, and it can be either local or massive, systemic. Simply put, this is baldness. In cats, this “disease” is quite common, and the causes of this disorder cannot be identified in all cases... However, such a pathology, which is psychogenic alopecia in cats, has already been fully studied and confirmed. It occurs in the most “finely organized” animals.

Most often, chronic or very severe stress (even short-term) leads to this outcome. Cats are very sensitive animals to changes in their environment, so many things can cause it. Hair loss often begins suddenly, and within a couple of days your pet becomes a “Sphynx”, regardless of its original breed.

Read also: Stress in cats: causes and methods of combating

Here are the main reasons for what is happening:

• The appearance of a new cat in the house.
• Moving to another house or city.
• Large-scale renovation.
• The birth of a child, to whom all the attention of the cat’s owners is now directed.
• Death or divorce.
• “Chronic” chaos in the apartment.
• Boredom and a depressed, apathetic state.
• Restriction in movement (after injury, when a cast is applied).
• "Toilet problems."

What to do with a “mentally unstable” cat?

Carefully evaluate your pet's living conditions, paying attention to the slightest changes that could cause baldness. Even a new diet or litter tray are “good” causes of alopecia in cats. If your work schedule has changed, as a result of which your cat spends days and nights in splendid isolation, sitting in the apartment, then you should not be surprised at the massive hair loss.

There is no need to immediately start feeding your pet sedatives. It may be possible to find an alternative solution. So, if the changes in the cat’s environment are not so critical and “monumental” (a new litter box, for example), you just need to be patient: soon everything will return to normal, and your pet’s fur will grow back.

It’s unlikely that anyone doesn’t know that baldness in a cat, just like in humans, is nothing more than hair loss, in this context hair loss. Hair loss depends on pathological trophic processes in the skin, which cause disruption correct height and hair structure.
Baldness, or, as it is fashionable to say now, alopecia, can be congenital or acquired.

Causes of baldness in cats

Acquired baldness can be a consequence of various diseases.

Congenital baldness has an unclear etiology, that is, its cause is not known for certain.

• Most scientists are inclined to think that congenital alopecia is a consequence of a lack of minerals in the diet of a pregnant cat, as well as endocrine disorders in the fetus itself.
• In addition, the birth of hairless kittens may be associated with a functional pathology of the mother's body, a hereditary anomaly or incest (inbreeding of a cat and a female cat).

Congenital baldness can also include breed characteristics of some cats, such as, bambino, elf, Ukrainian Levkoy, Cojona. Naturally, in this case, physiological alopecia is quite difficult to call a pathology, but such cats are still, to put it mildly, an acquired taste.

Acquired baldness in its origin can be:

1. Symptomatic: of various nature, dysfunction of the endocrine system, etc.
2. Idiopathic, that is, directly related to an infectious disease, toxic effects on the animal’s body of plant or mineral toxic substances, radiological exposure, etc.

Among other things, alopecia areata is quite rare, characterized by the appearance of round small hairless spots that can merge into large areas of baldness. The skin in this area is absolutely smooth and has a bright pink coloring, which is clearly visible in light-colored cats.

Alopecia areata is associated with hormonal disorders, vitamin A deficiency, resulting in deterioration of blood supply hair follicles and, as a result, hair loss. The disease may initially resemble normal shedding, but hair does not grow back on hairless areas.

Often the cause of baldness in cats can be:

• use of low-quality cat shampoos;
• frequent washing of your four-legged friend;
• allergic reactions to certain medications.

Signs of baldness in cats

It is logical that the appearance of hairless areas in cats largely depends on the underlying disease that led to baldness:

• When the hair is damaged by microscopic fungi (trichophytosis, microsporia), the hairless areas of the skin are reddened and may have scales and crusts, scabs and wounds.
• With scabies, there is redness, itching, and especially advanced cases and pyogenic inflammation of the skin.
• Dermatitis is accompanied by erythema, increased local body temperature, scratching, the appearance of pimples, etc.
• In diseases of the endocrine system, areas of alopecia appear in the area of ​​the bridge of the nose, croup, base of the tail, hips, and chest; the skin loses its elasticity.

How to treat hair loss in cats?

Treatment of any type of baldness primarily depends on a correct diagnosis and a reliably found cause that led to hair loss.

The use of local and general medications aimed at eliminating external signs, but not combating the main etiological factor, provides only temporary relief, but does not cure the cat completely. After a while, the hair will begin to fall out again, and the intensity and speed of baldness will increase catastrophically.

Acquired baldness is quite difficult to treat and requires a lot of strength and patience.
In addition to special medications prescribed for a particular disease, the symptom of which is alopecia, it is recommended:

• strengthen the pet’s body with the help of auxiliary products aimed at improving immunity and general resistance of the body;
• provide adequate nutrition, the diet should include increased content vitamins, and the amount of minerals is balanced according to cat standards.

Alopecia areata is treated by rubbing camphor alcohol, the use of an alkaline soap solution, thermal water compresses, physiotherapy (electrophoresis, darsonvalization, etc.) and restorative therapy.

The condition of a cat's hair is a reflection of the work of the whole organism. Normally, a cat loses a large number of hairs daily or during seasonal molting. Excessive hair loss is called alopecia or alopecia, and indicates serious health problems for your pet.

Hair is a modified part of the skin, and only part of it comes to the surface (Fig. 1). The root is attached to the hair follicle, which is surrounded by blood vessels and nerve endings. Therefore, hair loss is the result of various causes.

Rice. 1. The structure of a cat's skin.

Causes of baldness in cats

The causes of baldness in cats can be congenital or acquired.

Congenital ones include those that affect the body of a pregnant cat:

• lack of vitamins and minerals in the animal’s diet;
• stress;
• diseases of various nature;
• unbalanced diet;
• starvation and, as a result, exhaustion.

Exposure to these same causes even before pregnancy can serve as a prerequisite for the occurrence of alopecia in the future generation, resulting in glandular dysfunction in the fetus internal secretion and impaired formation of hair follicles.

This should also include hereditary anomalies that arise, among other things, from inbreeding. However, it is important to clarify: if hereditary anomalies are accompanied only by the absence of hair (partially or completely), and not changes in anatomical location organs or disruption of their functioning, then we can talk about individual, and in some cases breed, affiliation. It is these anomalies that underlie the creation of cat breeds: Sphynx, Bambino, Elf, Ukrainian Levkoy, Cojona.

Acquired baldness in cats can be a symptom of a disease of the skin itself:

This also includes alopecia, as a result of aging hair follicles, or from constant injury to certain areas of the hairline.

Another large group of factors that cause alopecia in cats are disturbances in the functioning of the body itself:

• stress: the cat itself intensively licks and plucks areas of the skin;
• allergies to food, medications, flea bites, odors, low-quality pet cosmetics, etc.;
• hormonal status disorders: diabetes mellitus, insufficient or excessive levels of thyroid hormones, adrenal glands, etc.;
• intoxication (acute or long-term infectious disease);
• inflammatory processes;
• blood diseases;
• condition after difficult childbirth;
• lack of vitamins, especially groups A, C, B;
• malignant tumors of internal organs.

In some cases, the cause of hair loss in a cat remains unknown, then we are talking about the unknown nature of baldness.

Symptoms

A healthy cat's fur is smooth, shiny, firmly held in the skin, and the coat itself is not ruffled.

With the development of alopecia, areas of baldness can be complete or partial, located symmetrically or not. In some cases, the animal may scratch these areas, and the skin here may be hot and red.

Rice. 2. Partial alopecia on the back of a cat.

In skin diseases or behavioral disorders, alopecia is symmetrical on the trunk, forelimbs, thighs, sides or abdomen. The age and gender of the animal do not matter.

When stress occurs, hairs broken and torn out by the cat itself are found in the back, on the limbs, stomach and inner thighs, near the genitals and anus. Cats of “nervous” breeds are especially susceptible: Siamese, Burmesse, Himalayan and Abyssinian. These breeds will have darker hair color after restoration.

In case of hormonal imbalances, alopecia is observed in the area of ​​the bridge of the nose, croup, base of the tail, hips, and chest. The skin loses its elasticity.

And if there is a lack of thyroid hormones in a cat, hair in the area of ​​the pelvic bones is easily pulled out by the roots. Such alopecia, including asymmetrical ones, are recorded on the abdomen, chest and neck. The cover is restored with difficulty.

In case of malignant tumors, there is a complete absence of hair shafts on the abdomen, alopecia quickly progresses to chest and limbs, and then can affect the entire surface of the skin. At the same time, the skin on the affected areas shines.

With vitamin deficiency A, alopecia areata develops: spots without hair, round in shape, form on the skin, which merge to form large alopecias. The skin has a bright pink color.

With microscopic fungi (trichopytosis, microsporia), hairless areas of the skin are reddened and may have scales and crusts, scabs and wounds.

With scabies, redness, itching, and in particularly advanced cases, purulent inflammation of the skin are observed. Dermatitis is accompanied by an increase in local body temperature, scratching, the appearance of pimples, etc.

If the course of alopecia is unfavorable, an infection may occur, and then an inflammatory process develops on the skin.

Diagnosis of alopecia in cats

Due to the varied nature of alopecia in cats, only a veterinarian can determine the true cause of the lesion. Typically, the doctor will suggest approximately next algorithm making a diagnosis:

• collecting information about the cat’s life history and illness;
• clinical examination of the animal;
• general clinical blood test, biochemical if necessary;
• microscopic examination of hair;
• scraping from affected areas of the skin, which helps to identify diseases caused by microscopic fungi;
• Sometimes X-rays and ultrasound may be required to determine the cause of baldness.

Treatment of hair loss in cats

Treatment for alopecia in cats depends on the cause and can only be prescribed by a veterinarian. Treatment boils down to the following activities:

The doctor will advise strengthening the immune system and increasing the resistance (stability) of the body with auxiliary means. In addition, balance the diet according to the main nutrients taking into account the norms for cats of different ages, breeds, physiological conditions (pregnancy, feeding, castration, etc.).

Local medications and physiotherapy are used as an addition to the main treatment.

Treatment of alopecia is a long process that must be monitored by a veterinarian; his prescriptions must be followed exactly, since the first signs of hair restoration do not indicate a complete cure, and in advanced cases, hair may not be restored.

Authors): A.N. Gerke, Ph.D., veterinary dermatologist, member European Society veterinary dermatologists (ESVD) / A. Gerke, DVM, PhD
Organization(s): CJSC "Network" veterinary clinics", St. Petersburg / "Network of veterinary clinics", St. Petersburg
Magazine: №5-6 - 2013

Keywords: cat, alopecia, allergic dermatitis, fleas, atopy, food hypersensitivity, dermatophytosis

Key words: cat, alopecia, allergic dermatitis, fleas, atopy, food sensitivity, dermatophytosis

UDC 619:616.5:636.7

annotation

Alopecia is a feline cutaneous reaction pattern that may have various causes. Most cats with non-inflammatory alopecia are pruritic as a result of allergies and may be closet groomers. The diagnostic approach to alopecia must be methodical, and should involve certain fundamental steps: a detailed history, thorough clinical examination, and carefully chosen diagnostic tests, selected according to the differential diagnosis. An initial range of tests (e.g. skin scrapings and mycological investigations) should he perform routinely, given the incidence of ectoparasitic infestation and dermatophytosis in the cat. Differential allergy diagnosis is based on avoidance measures (e.g. flea control and restricted diet) as allergy testing remains unreliable in this species. Hormonal alopecia is extremely rare in thefeline and typically affected cats show other severe signs. Psychogenic alopecia in the cat is greatly overdiagnosed. Skin biopsies are indicated when the history and clinical examination suggest a dermatosis that requires histological diagnosis.

Alopecia is the partial or complete loss of hair. Alopecia is a symptom that can be associated with a variety of disorders in the cat's body, manifesting itself as symmetrical, focal or total loss/thinning of the coat. Based on their origin, alopecia is divided into acquired and hereditary/congenital.

Etiology of alopecia in cats

The most common causes of alopecia in cats may be "self-induced alopecia", damage to the hair and hair follicles, inflammatory and/or infectious processes, less often - impaired hair growth associated with hormonal disorders and hereditary diseases. The latter are associated with genetic reasons leading to disruption of the formation of follicles or structural proteins, and therefore hair growth becomes impossible. Such alopecias include ectodermal dysplasia and follicular dystrophy. Hereditary hypotrichosis occurs in Cornish and Devon Rex, Burmese, British and Siamese cats. These alopecias can be focal or generalized. Histopathological examination of biopsy specimens reveals small, underdeveloped primary hair follicles and a small number of secondary hair follicles. Alopecia of “weakened” (cream or blue) color is associated with the destruction of the hair shaft under the influence of abnormal melanin granules. At Pili torti And Trichorrhexis nodosa pathological changes occur in the hair shaft.

Endocrine pathologies in cats rarely lead to alopecia, unlike in dogs. Such alopecia, unrelated to follicular pathology, is caused by cycle disorders hair follicle(for example, with systemic diseases - hyperadrenocorticism, hyperthyroidism, diabetes, rarely, unlike dogs, with hyperestrogenism). The syndrome accompanied by polyuria-polydipsia, weight loss with polyphagia in older cats may be associated with hyperthyroidism, which can also develop symmetrical alopecia. Iatrogenic or spontaneous hyperadrenocorticism is rare in cats. It can lead to dermatological disorders such as non-inflammatory alopecia, atrophy, increased skin fragility, hemorrhage and curling of the ear tips. In most cases, Cushing's syndrome is accompanied by diabetes mellitus.

Changes in general condition with signs of impairment digestive system, caused by neoplasia of the pancreas and biliary tract, can lead to paraneoplastic syndrome accompanied by alopecia. In this case, progressive telogenization and miniaturization of the follicles are observed, followed by atrophy, accompanied by mild hair removal over the entire surface of the skin and alopecia, mainly in the abdomen and limbs. The skin of the affected areas acquires a glossy shine. Paraneoplastic alopecia occurs primarily in older cats with a history of progressive weight loss and lethargy. In this case, the appearance of alopecia is preceded by signs of gastrointestinal disorders (anorexia, vomiting, etc.).

Differential diagnosis

Flea allergy dermatitis (FAD) is the most common cause of dermatoses accompanied by itching in cats. The absence of fleas and their feces on the skin of a cat does not exclude the presence of hypersensitivity to flea bites, since cats with dietary supplements intensively lick and remove them from the skin. A characteristic feature of BAD is self-induced alopecia, mainly in the back and lumbar region. In addition, many cats with BAD may show signs of miliary dermatitis, and sometimes eosinophilic plaques and linear granulomas.

In all cases of alopecia in cats, the first recommended test is trichoscopy to assess the structural changes of the hair, including the root, shaft and ends. To do this, using a surgical clamp, 20–30 hairs are plucked out, which are placed on a glass slide with a pre-applied drop of liquid paraffin or glycerin, covered with a covering material, and microscopy is performed using x4 and x20 objectives. This study allows you to evaluate the predominant stages of the hair follicle cycle (anagen, telogen), identify damage to the ends (with self-induced alopecia) and hair shafts (dermatophytosis, various changes in the cuticle, for example, Pili torti, follicular dysplasia and Trichorrhexis nodosa).

Telogen effluvium develops 4-12 weeks after stress, such as severe illness, fever, shock, surgical intervention and so on. in these cases, premature termination of the anagen stage leads to synchronization of follicles in catagen and then in telogen. In this case, fur growth will resume with the next molt.

A quick and simple tape test can be used to identify mites living on the surface of the skin. For example, using this method you can detect adult individuals Cheyletiella blakei, as well as their eggs attached to the hair shaft. However, the sensitivity of the tape test is quite low, so for a better result it is advisable to study the material obtained by combing with a brush.

Silbermayr K. et al (2013) also suggests using coproscopy to diagnose invasion Demodex gatoi. For flotation, a saturated solution of sugar and zinc sulfate was used. In this study, mites Demodex were found in the feces of both a Cornish Rex cat with alopecia and a contact Thai cat with no signs of skin lesions. Tick ​​detection Demodex in feces is due to the fact that cats ingest ticks when licking. Thanks to their chitinous cover, ticks are not exposed to digestive enzymes and are excreted in feces.

In the presence of areas of inflamed skin, miliary dermatitis, a cytological examination is recommended; it can be useful in diagnosing allergic dermatitis, and also allows identifying dermatophytes and Malassezia.

Since dermatomycosis can cause both focal and total or diffuse alopecia Fungal infections should be ruled out in all cats with alopecia .

Methods for direct visualization of mycoses include: assessment of clinical signs, including examination under a Wood's lamp, trichoscopy, and cytological examination. The undoubted advantages of these methods are simplicity, speed, and low cost. However, their negative qualities are low sensitivity, lack of specific identification, difficulty of interpretation in cases of opportunistic mycoses. Therefore, to establish and identify fungal infections in cats, it is recommended to combine several methods.

The routine approach to all cases of alopecia in cats includes a Wood's lamp examination. The principle of the method is to detect green fluorescence in ultraviolet light, characteristic of pteridine, a pigment contained in hyphae Microsporum canis. The inspection is carried out in a darkened room, after preheating the lamp for 3-5 minutes. This procedure allows you to identify up to 50% of cases of microsporia. False glow (bluish, yellowish, etc.) can be caused medicines, bacteria, etc.

A new method of express diagnostics is dermatoscopy using a dermatoscope, which has been used for some time in humane dermatology. Thus, during a dermoscopic examination, using 10x magnification, for an infection caused by Microsporum canis Damaged hairs were found, covered with pointed scales of the same thickness, white-yellow color, and “greasy” appearance. When performing microscopy of these hairs, hyphae and spores were discovered along the hair shaft .

For trichoscopy and obtaining a culture of dermatophytes, it is preferable to choose hairs that fluoresce in the rays of a Wood's lamp (if any are identified). Direct microscopy of hair and scales makes it possible to detect hyphae and spores of dermatophytes (3-12 µm in diameter), but their species can only be established by obtaining a culture on nutrient media.

For cultivation, both selective media (Sabouraud with an additive for dermatophytes, Dermatophyte Test Medium (DTM)) and non-selective media, such as Sabouraud agar, are used. Before taking the material, the skin is treated with a swab moistened with alcohol for 30 seconds to eliminate contamination of the sample with non-pathogenic flora. For crops, wool and scales from the affected areas are used (in case of focal lesions, the material is taken from the center and from the edges); to confirm mycological recovery, the material is combed out with a brush. Obtaining a culture of dermatophytes involves macroscopic and microscopic examination of colonies. When dermatophytes grow on selective DTM medium containing a color indicator, the medium acquires a red color associated with the influence of alkaline metabolites by the growing colonies of dermatophytes. This usually takes 3-10 days (at a temperature of 25-27 0 C). A later change in the color of the medium (after 2-4 weeks) is observed under the influence of the growth of saprophytic fungi (for example, Aspergillus spp. and Mucor spp.) and bacteria, which could be the cause false positive result. The exception is the form Microsporum persicolor, does not give a color change (false negative result). In this regard, the author recommends mandatory microscopy of the obtained colonies to obtain an accurate diagnosis, regardless of the type of nutrient medium used.

Obtaining a culture makes it possible to establish an accurate diagnosis and is the only method that confirms mycological recovery after a course of treatment. With the help of cultural studies, it is possible to diagnose various mycoses - these are highly specific methods that, in some cases, allow one to determine sensitivity to antimycotics. However, working with fungal cultures requires skill, poses a risk of contamination and can be hazardous to health. These methods are quite expensive and time-consuming (it can take up to two to three weeks to obtain a mature culture), and there are also certain difficulties with opportunistic fungi .

A highly sensitive and specific method for confirming mycoses is the detection of fungal antigens in tissues using immunohistochemistry, which allows for quantitative assessment, but requires significant financial costs and special equipment. Another group of precise studies consists of methods that allow assessing the host response (specific antibodies, the use of biomarkers, analysis of the cellular response in histo-preparations) - highly sensitive and specific, with the possibility of quantitative assessment, but requiring a special laboratory; some methods are species-specific and are not applicable in acute forms of the disease. Therefore, this group of studies is used only in specialized research laboratories .

Another fungus found on the skin of cats with alopecia is Malassezia. Mushrooms of the genus Malassezia is a lipophilic yeast (2-8 microns in size), present in some quantities on the skin of all warm-blooded animals, and is an opportunistic pathogen. M. pachydermatis, M. sympodialis, M. globosa are found both on the skin of healthy cats and in skin lesions(moreover, the last 2, mainly for otitis in cats). M. pachydermatis is not lipid-dependent, i.e., grows well on Sabouraud’s medium even without the addition of lipids, for cultivating other species Malassezia, which are lipid dependent, use modified Dixon's medium and other lipid-containing media (0.05% chloramphenicol and 0.05% cycloheximide are used to inhibit bacterial growth).

Malassezia overgrowth is much less common in cats than in dogs. The literature contains data on Malassezia overgrowth of cats, confirmed by cytological and cultural studies (M. pachydermatis). Clinical signs included alopecia and itching, as well as the appearance of erythema and crusts . Devon Rex and Cornish Rex cats have a breed predisposition to Malassezia-I will outgrow. Generalized lesions (excluding the ear canal, interdigital folds and muzzle) caused by overgrowth Malassezia in cats, as a rule, they are a complication of primary systemic diseases that have a poor prognosis, for example, follicular atrophy against the background of paraneoplastic syndrome (carcinoma of the pancreas or hepatobiliary system, etc.). Thus, detection of fungal overgrowth Malassezia at cytological examination in cats implies the need to search primary cause. In most cases, control of Malassezia overgrowth in cats involves lifelong therapy of the diseases that led to it, otherwise a relapse is likely. skin tests lem .

HYPERSENSITIVITY REACTIONS

Hypersensitivity reactions are the most common cause of skin diseases in cats, including hypersensitivity to flea bites (less commonly than other insects), food hypersensitivity reactions, urticaria, contact dermatitis and atopic dermatitis .

According to studies conducted in different geographical areas, the ratio of different diagnoses varies significantly, but flea bites occupy the leading place in the list of causes of hypersensitivity in cats. A large number of studies have been devoted to the immunopathogenesis of hypersensitivity to flea bites. In general, flea saliva Ctenocephalides felis felis contains many high molecular weight proteins that cause both type I allergic reactions and mast cell degranulation, as well as delayed type allergic reactions. Apparently due to immediate type reactions, cytological/histological examination of skin areas susceptible to self-induced alopecia due to dietary supplements revealed an increase in the number of mast cells compared to intact skin areas. Diagnosis of dietary supplements by performing intradermal tests with various types of extracts Ctenocephalides felis felis has not brought the expected results to many researchers, since unstable antigenicity poses problems with reproducibility of studies. The same failure befell serological tests, as many healthy cats without signs of pruritus showed results similar to cats with dietary supplements. . Criteria for the diagnosis of hypersensitivity reactions to flea bites in cats, described in the study by Favrot C. et al (2012), include the disappearance of signs of itching in cats against the background of strict flea infestation control and the resumption of itching when treatments are stopped. In this study, 137 of 238 cats with signs of alopecia suffered from hypersensitivity to flea bites. A recent study to identify the areas most susceptible to itching and alopecia due to flea hypersensitivity found that signs of itching were observed in 95.9% of these cats, including only increased licking in 42.3%. Most often, alopecia appeared on the back (43.6%), lower back and tail (26.2%), abdomen (26.8%), less often on other parts of the body . According to C. Favrot, the manifestation of alopecia on the dorsal and lateral surfaces of the body is characteristic of hypersensitivity to flea bites, while alopecia accompanied by lesions in the head and neck area is more often associated with food reactions and aeroallergens . When flea hypersensitivity and food allergies have been ruled out by regular treatments and a trial feeding of elimination diets for 8 to 12 weeks, and signs of itching still persist, allergy tests may be performed to detect reactions to aeroallergens.

Cats with hypersensitivity symptoms may have associated non-dermatological symptoms. In one study, 6% of cats with skin allergies also had respiratory symptoms (sneezing, coughing), 14% had signs of digestive problems (diarrhea, vomiting), 7% had conjunctivitis, and 16% had external or otitis media .

Research by Rossi M.A. (2013) showed higher efficiency of skin tests compared to intradermal injections for hypersensitivity reactions in cats .

In addition, additional diagnostic procedures necessary to make a diagnosis and assess the prognosis may include blood tests (hematology, biochemistry, endocrinological studies) to identify systemic disorders. Eosinophilia in the blood can be observed in many diseases of cats, and is often associated with hypersensitivity to flea bites and other allergies. However, in case of an acute reaction, eosinophilic infiltration of the skin due to the migration of eosinophils as effector cells of the allergic reaction may not be accompanied by eosinophilia in blood tests. On the contrary, the presence of eosinophilia in the blood during antiallergic therapy indicates the ineffectiveness of this treatment tactic.

Rare cases where only histological examination allows for an accurate diagnosis include alopecia areata, atrophic alopecia (pseudopelada), etc. To obtain biopsy samples, excisional biopsy (surgical excision of a skin sample) or punch biopsy (punches with a diameter of 6 and 8 mm are usually used). The biopsy specimen is fixed with 10% formalin. Skin biopsies should be examined by a histopathologist experienced in veterinary dermatology.

Visual diagnostic methods (X-ray, ultrasound, CT and others) can be used if pancreatic paraneoplastic alopecia is suspected .

Differential diagnosis of non-inflammatory alopecia in cats is presented in

TREATMENT

Most itchy cats require strict flea infestation control (either as a primary or aid therapy and/or diagnosis). One objective study of spinosad (Comfortis®, Elanco Companion Animal Health, UK), which included 46 cats with alopecia (of which only 27% were found to have fleas and their feces), confirmed that reliable protection against flea bites provided fast and long-term action. The drug was used monthly in a dose of 1 (270 mg) or UU tablet (depending on the size of the cat) for 7 months. All animals tolerated the drug well (cats ate the tablets voluntarily or crushed with food), however, some animals experienced single vomiting (three animals only when receiving the drug for the first time). All cats participating in the experiment had full recovery coat without additional therapy .

- Suspicion of hypersensitivity to flea bites: Aggressive flea infestation control is necessary for 4 to 6 weeks. Elimination of signs of disease after treatment confirms the diagnosis; in these cases, it is recommended to use adulticides together with insect growth regulators for neutralization environment.

- Proven hypersensitivity to flea bites: Ideally, the constant use of insect growth inhibitors, environmental disinfestation and the use of adulticides (systemic, topical) are recommended. An alternative is to use adulticides only, changing the drug at the first sign of resistance, or reducing the interval between treatments. Often, the ineffectiveness of flea infestation control is associated with a violation of the treatment regimen, and not with the development of resistance in fleas.

- Lack of hypersensitivity to flea bites: Müller does not recommend regular treatments for such animals, unless the owner himself desires it. If a client wants to get started with flea control, insect growth regulators are an option.

For the treatment of demodicosis caused by Demodex gatoi, Silbermayr K. et al used an orally injectable form of ivermectin at a dose of 250 mg/kg every other day for three months (until negative results of scrapings or coproscopy were obtained). No side effects were identified. However, there is a report that after four months, ivermectin treatment had to be stopped in one cat due to ataxia and food refusal. .

ANTIFUNGAL THERAPY

Antifungal therapy should be prescribed only after confirmation of the diagnosis. It is optimal if antifungal therapy is continued 2 weeks after receiving a negative culture and 4 weeks after the absence of fungi in cytology. For systemic therapy, you can use ketoconazole in doses of 2.5-10 mg/kg 1-2 times a day, itraconazole 5-10 mg/kg 1-2 times a day, terbinafine 10-30 mg/kg 1 time a day . Side effects of these drugs may include anorexia, vomiting, diarrhea, and cases of cholangiohepatitis have been reported.

Some dermatologists do not recommend the use of ketoconazole in cats due to hepatotoxicity, preferring itraconazole . However, there is evidence that with long-term use of itraconazole, especially in high doses, hepatotoxicity may develop in some cats. According to Moriello K. (2013), the use of itraconazole at a dose of 5 mg/kg week - every other week is safe for most cats, however, the authors recommend monitoring the activity of transaminases and bilirubin in the blood serum of cats undergoing treatment every 14 days itraconazole .

Fluconazole is inferior in effectiveness to ketoconazole and itraconazole in-vitro, however, its administration in doses of 2.5-5 mg/kg daily for a course of 21-28 days was effective for seborrheic dermatitis caused by Malassezia spp. It should be taken into account that due to the renal excretion of fluconazole, its use should be avoided in case of renal failure.

There is data on high efficiency lufenuron (Lufenuron, Program® Novartis Animal Health) for dermatophytosis in cats. It is known that this drug, previously used to control insects (causes disruption of chitin synthesis in insects), can also affect cell wall synthesis in some fungi.

DIET

One of the criteria characteristic of food hypersensitivity reactions is the all-season nature skin pathologies, not eliminated after flea treatments. To confirm or exclude food allergies, a provocative test is performed after an elimination diet for 6-8 weeks. Only in cases where signs of itching disappear when using a new/hydrolyzed food and reappear when returning to the previous food can a conclusion be made about a food allergy. If there is no improvement clinical condition on a new diet, or the itching does not recur when returning to the previous food, then we can indicate the absence of adverse food reactions.

Such animals are treated with medication, including glucocorticoids, cyclosporine, histamine receptor antagonists, and possibly allergen-specific immunotherapy.

GLUCOCORTICOIDS

Glucocorticoids are often used in dermatology; in anti-inflammatory doses, they reduce the activity and migration of inflammatory cells. Corticosteroids are very effective in cases of atopy, they quickly relieve symptoms, sometimes even in small doses. Traditionally, oral and injectable glucocorticoids have been used to treat allergic skin diseases in cats, but some cats require long-term use, which increases the risk of side effects. Cats that are hypersensitive to flea bites also respond favorably to glucocorticoids. However, such animals may require larger doses. If necessary quick fix itching during dietary supplement therapy, corticosteroids can only be used in conjunction with strict control over flea infestation . Glucocorticoids may be an option in animals with seasonal pruritus for 1-2 months a year at anti-inflammatory doses (prednisolone up to 1 mg/kg, dexamethasone 0.1-0.25 mg/kg) every other day. For atopy, it is recommended to use glucocorticoids in the minimum effective dose, focusing on the presence/absence of itching. Thus, the dose is selected individually, and it may vary in different seasons of the year.

For local lesions, it may be advisable local use glucocorticoids. In the study V.Schmidt et al (2012), assessed the effectiveness of topical hydrocortisone aceponate spray (Cortavance®, VirbacSA) in cats with atopic dermatitis. The spray was applied once a day at a dose of 2 pumps per 10 cm 2 of body surface and itching was assessed using the FeDESI scale. There were no side effects or changes in hematology, biochemistry, or urine tests. Some cats have possible use spray every other day, and some still required daily use .

The likelihood of complications (in particular diabetes mellitus) possible with prolonged systemic use corticosteroids, maintains interest in the development alternative methods treatment.

CYCLOSPORINE

Data on the effectiveness of cyclosporine for the treatment of hypersensitivity reactions in cats were first reported in an open-label study published by Noli et al. .

Cyclosporine A is an immunomodulator from the group of calcineurin inhibitors.

At the cellular level, cyclosporine a inhibits the activation of T lymphocytes, eosinophils, antigen-presenting cells, reduces the secretion of proinflammatory cytokines by keratinocytes and IgE-mediated mast cell degranulation. Following oral administration, peak concentrations and half-life in cats are highly variable. However, there has been no correlation between cyclosporine serum concentrations and clinical response in cats, so this test is not necessary in most cases.

Peak concentrations are observed one hour after oral administration of cyclosporine at a dose of 5 mg/kg and range from 100 to 1600 ng/ml when measured by liquid chromatography under high pressure. It is worth noting that depending on the research method, the concentration of cyclosporine in the blood of cats varies. As a rule, higher values ​​are obtained using immunological methods. The bioavailability of cyclosporine in cats is quite low (29%) and its accumulation, as a rule, is not observed. Cyclosporine is lipophilic, which ensures a higher concentration in the skin (4 times higher than in serum). Feeding before administration of cyclosporine leads to a decrease in bioavailability, however, this does not affect the clinical effect. There are a number of studies devoted to drug interactions cyclosporine. It is known that cyclosporine interacts with cytochrome P 450, therefore, with concomitant treatment with ketoconazole, itraconazole, clarithromycin, the dose of cyclosporine should be reduced. Interactions with ranitidine, omeprazole, cimetidine, erythromycin, digoxin, furosemide, ciprofloxacin, tri-metaprim-sulfanilamide and a number of other drugs are also possible. Side effects of cyclosporine include gastrointestinal symptoms, anorexia, weight loss, and gingivitis. There have also been cases of the development of otitis media and cystitis due to the use of cyclosporine in cats, but the cause-and-effect relationship has not been fully studied. .

Immunosuppression caused by cyclosporine can lead to severe toxoplasmosis, 2 viral infections or neoplasia. However, this risk is small (when used at recommended doses for the treatment of atopy in cats) .

There are recommendations that outdoor cats should be tested for IgG cotxoplasmosis, since infection with toxoplasmosis during treatment with cyclosporine can have negative consequences. At the very least, seronegative animals should be prevented from going outside and feeding raw meat throughout the entire course of treatment. In contrast, sero-positive cats can be started on cyclosporine. Cats with chronic infectious diseases such as FIV, FeLV, and dermatophytosis should also not receive cyclosporine. Cats with chronic renal failure and diabetes mellitus can receive cyclosporine, but must be monitored regularly .

In the Novartis cyclosporine vaccination trial, cats were first vaccinated and then received cyclosporine A 24 mg/kg for 8 weeks. After this treatment period, they were re-vaccinated. As a result, lower serum titers were obtained in cats of the experimental group than in control animals, but they remained within the reference limits for vaccinated animals. The results of these studies suggest that vaccination may be given during treatment with cyclosporine .

The results of the first controlled study by Wisselink et al showed that clinical improvements in the treatment of cats with allergies were seen in both groups using cyclosporine a at a dose of 5 mg/kg and in the group of cats receiving prednisolone at a dose of 0.5 mg/kg. kg. Another study since then has provided evidence that a more effective dose for allergic cats is 7 mg/kg. . In addition, it has been shown that after an initial treatment phase of 6 to 8 weeks, about 70% of allergic cats can be switched to cyclosporine A every other day. After 4 additional weeks, 55% were receiving the drug only twice a week, while 20% were still on alternate days and 15% daily. Only 10% of cats did not respond to treatment.

Overall, research shows that cyclosporine A is a good treatment option for allergic cats and is, in most cases, well tolerated.

ANTIHISTAMINES

Antihistamines are often used in the treatment of patients with itching. Moreover, a positive response is observed more often in cats than in dogs. However oral administration Taking antihistamines for a long time, sometimes several times a day, is difficult for owners. However, if possible and visible clinical improvements, the use of antihistamines is preferable to glucocorticoids. Even in cases where it is not possible to stop corticosteroids, often the additional use of antihistamines can significantly reduce the dose of hormones. The most commonly used are cetirizine (an inhibitor of eosinophil exocytosis) at a dose of 5 mg/cat every 12-24 hours, loratidine at a dose of 5 mg/cat every 12-24 hours .

Various antihistamines have been used to treat cats with pruritus with conflicting results. Therefore, Wildermuth K. et al (2013) conducted a randomized, double-blind, placebo-controlled clinical trial on the use of this class of drugs in cats. In this study, cats with atopic dermatitis were divided into treatment and control groups and received oral cetirizine hydrochloride at a dose of 1 mg/kg orally once daily for 28 days or placebo, respectively. Cats were examined weekly and the severity of pruritus was assessed. The study showed that there were no statistically significant differences between both groups, and therefore the authors of this study do not recommend cetirizine hydrochloride for the treatment of cats with atopic dermatitis .

FATTY ACID

Essential fatty acids are essential for skin barrier functions and are a component of the cell membrane. Some nutritional supplements fatty acids, such as linoleic (from sunflower seeds), gamma-linoleic (from evening primrose oil), eicosapentanoic (from marine fish fat) can have an anti-inflammatory effect, which is associated with a decrease in the production of prostaglandins and leukotrienes. Also, the use of fatty acids in combination with glucocorticoids can reduce the dose of the latter. The ideal dose and ratio of omega 6/omega 3 fatty acids is the subject of scientific research and is not fully understood. Mueller Ralf S. (2000) recommends the use of 20 mg/kg per day of eicosapentanoic acid and 20-50 mg/kg of linoleic acid .

ALLERGEN-SPECIFIC IMMUNOTHERAPY (ASIT)

There is much less evidence for the effectiveness and safety of ASIT in cats than in dogs. In cats, immunotherapy is being developed based on positive results intradermal tests. However, traditionally, assessing the results of intradermal tests in cats is considered more difficult than in dogs. To facilitate the assessment of skin tests in cats, intravenous administration of a 10% fluorescein solution has been recommended by some authors. . In a double-blind study, immunotherapy with flea antigens was unsuccessful in treating cats with FAD, with more than half of the patients experiencing a recurrence of clinical signs. However, the likelihood of relapse was inversely proportional to the duration of immunotherapy, which is an opportunity for further research .

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