History

Topaz, a 12-year-old Domestic Medium hair cat, presented for facial itching. Topaz initially came to see us for an ear infection in both ears. Topaz was treated and the otitis was resolved. One month later, Topaz returned with facial itching on the right ear and chin. The areas were raw in appearance. There was no ear infection this time. We started Topaz on a food trial to test for  allergies. Prednisone was also given to stop the itching, since she was damaging her face. Two weeks later, she returned with little improvement.

Differential Diagnosis

Atopy, mites, ringworm, and food allergy:

• Prednisone was given without improvement. This rules out Atopy (inhalant allergy).
• Skin scrape - rules out scabies, Demodex, and cheyletilla (all skin mites).
• DTM - fungal culture - rules out ringworm.
• Bloodwork to test for food allergies - soybean, venison, oat, wheat, egg, corn, chicken, duck, milk, and turkey.

Diagnosis

All of the above differential diagnoses can cause facial pruritis (itching). We have ruled out all except food allergy.

Plan

Continue food trial for up to  10 weeks and treat with antibiotics for bacterial infection.

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