What are some strategies on how to soothe flea allergy dermatitis in cats?

Original Question: I have been told my cat Cyrus has skin allergies by the vet. They didn't run any tests to confirm but that is what was said. She tells me he is allergic to fleas because he over grooms - licking and pulling out his hair and he also tends to get a fat bottom lip sometimes. So far she has given him Cortisone shots and sent me home. I have heard this can be dangerous for him when frequently done. I have been getting topical flea medicine but he must be licking it off because I still see him over grooming. I wish I knew what to do to help him. He is like my child. I have another cat but he doesn’t have the same problems. Both are indoor cats and they get the same flea medicine. Both cats are very picky eaters and I feel like a pill would help better but I'm scared he will just throw it up. I can’t handle him being so miserable. What should I do? I have an appointment Monday at a different vet. I was thinking prescription of oral prescription flea medicine and I tried to order it online but I don’t have a prescription. - Jessica

Jun 26, 2018

Hi Jessica,

Thanks for sending in your question.

You bring up a few separate issues here, so I’ll address each. If there is a flea problem, it is indeed important to deal with that first. If you are not happy with the current treatment plan, then you can certainly ask your vet for an alternative. When it comes to how to treat fleas on cats there are a wide variety of options available and they come in many forms (topical or oral, given at different intervals, etc.). It is also important to consider the home environment if you are dealing with a flea problem. Most of the flea life cycle happens in the environment, not on the pet. You must follow your vet’s recommendations for cleaning the environment and ensure all pets in the house have been treated for fleas. As a side note, please be cautious with over-the-counter treatments and home sprays, as some of these are not safe to use around cats.

The next issue to address once you have the flea situation under control would be to address your cat’s discomfort and itching. In theory, if this is a true flea allergy, then eliminating the fleas should resolve the itching. If this doesn’t happen, there may be other things triggering her allergies, or another disease process altogether. There are many skin disorders aside from flea allergies in cats that can cause itching and over-grooming. Sometimes there is also a behavioural component. You may want to consider a referral to a veterinary dermatologist as a further step to determine how to help your cat with this issue.

Finally, you are correct in that steroid injections for cats or any steroid medication can come with some significant side effects, especially if they are used long-term. However, some pets are so uncomfortable that this is the only way to get the inflammation under control. There are alternatives to steroids that can be used in treating cats with allergies, but I would encourage you to discuss this with your vet to know if they are the right choice for your cat.