Why Not Give Itching Cat Steroids?

Our reader is frustrated that her veterinarian opted not to keep her feline friend on steroid shots

Q. We recently adopted a 6-year-old male domestic shorthaired cat that was receiving steroid shots every six months when we got him, but our veterinarian opted not to give him this shot when we first brought him in, and now he is scratching all the time and has licked all of the hair off of his belly. Can you give us some advice about how we can help this boy?

A. Thanks for getting in touch, and I understand that this must be distressing for both your kitty and for you. Many things can cause a cat to scratch, so perhaps a brief review of the most common causes would help. It is understandable that your veterinarian was hesitant to give the steroid injection to your kitty, as while steroids can be effective at stopping scratching in cats, they may predispose to and/or worsen other health problems.

The first thing to make sure of is that your cat does not have ectoparasites, and far and away the biggest problem in this regard is fleas. Cats can harbor fleas without their owners knowing it, and they can be allergic to flea saliva. If this is the case, when a cat is bitten by fleas, this can cause itchiness and scratching. Passing a flea comb through your kitty’s fur is a good way to see if any fleas or small white and/or black particles are found. The latter are most commonly flea eggs and feces, respectively, and these are tell-tale signs of flea infestation, even if you don’t find any actual fleas. I imagine that your veterinarian looked for fleas, but it couldn’t hurt to keep an eye out yourself. Of course, if fleas are found, please discuss how to eliminate/prevent infestation with your veterinarian.

Another cause of scratching in cats is food allergy. Cats may become allergic to components of their food, most commonly the protein source, and this may cause itchiness. The best way to rule this out is to feed only a food that has a protein source that the cat has not eaten before for four to six weeks and see if this eliminates the itchiness. It’s important to note that if such a food trial is attempted, the cat must receive ONLY that food, so no treats, food of other pets’ food, or human food, as it’s important to strictly control the protein source in the food. If a cat stops scratching on this novel-protein diet, that suggests that he was allergic to the protein source in the original food, and this protein source should be permanently eliminated from the cat’s diet. In rare cases, allergies to other, non-protein components of the food may be identified in a similar trial-based manner.

Finally, cats may become allergic to inhaled allergens, in a manner similar to people who suffer from hay fever or seasonal allergies. Pollen, mold, and dust/house mites are potential sources of inhalant allergies in cats. Limiting exposure to these allergens by using air purification, frequent vacuuming with a HEPA-filter vacuum, steam cleaning mattresses/carpets, and/or removing carpets can be helpful with inhalant allergies, depending upon their cause. Either skin testing or bloodwork can be used to diagnose inhalant allergies, and treatment may consist of small, increasing doses of the allergen under the skin over time (immunotherapy, or allergy shots) or medications to decrease itchiness (steroids are often effective, but again, they can have side effects). Consultation with your veterinarian or veterinary dermatologist is recommended if inhalant allergies are suspected.

I hope that this is helpful, and please discuss these possibilities with your veterinarian. (By the way, we will be taking a more in-depth look at steroids next month.)

All my best,