Successful Treatment with Dexamethasone of a Cat with Suspected Feline Atopic Skin Syndrome Not Responding to Prednisolone

Abstract

A 6-year-old client-owned indoor, female neutered Persian-exotic shorthair cat was presented for further investigation of severe itchy lesions on the head and neck to our polyclinic. The patient had previously been applied selamectin and a cleansing, soothing, and protecting shampoo, but did not respond positively to the treatment. After the exclusion of ectoparasite infestation, retroviral infection, neoplastic and psychogenic causes, and food allergy, a suspect diagnosis of FASS in the cat was made. Although skin lesions clearly improved, the intensity of pruritus did not reduce during the 4-week prednisolone therapy. Based on these results, the case was considered to be resistant to prednisolone. Treatment with dexamethasone provided a fast and complete recovery of clinical signs and the cat has been clinically healthy maintained for over 2-years. This study suggests that oral dexamethasone can be a good alternative for treating cats with suspected FASS that has not responded positively to prednisolone therapy.

Keywords

• fass
• therapy
• dexamethasone
• prednisolone
• resistance

References

1. de Mello, L. S., Ribeiro, P. R., de Almeida, B. A., Bandinelli, M. B., Sonne, L., Driemeier, D., & Pavarini, S. P. (2023). Diseases associated with feline leukemia virus and feline immunodeficiency virus infection: A retrospective study of 1470 necropsied cats (2010–2020). Com parative Immunology, Microbiology and Infectious Diseases, 95, 101963. https://doi.org/10.1016/j.cimid.2023.101963
2. Favrot, C. (2013). Feline non-flea induced hypersensitivity der matitis: clinical features, diagnosis and treatment. Journal of Feline Medicine and Surgery, 15(9), 778–784. https://doi.or g/10.1177/1098612x13500427
3. Favrot, C., Steffan, J., Seewald, W., Hobi, S., Linek, M., Marignac, G., Olivry, T., Beco, L., Nett, C., Fontaine, J., Roosje, P., Bergvall, K., Be lova, S., Koebrich, S., Pin, D., Kovalik, M., Meury, S., & Wilhelm, S. (2012). Establishment of diagnostic criteria for feline nonflea-indu ced hypersensitivity dermatitis. Veterinary Dermatology, 23(1), 45 50, e11. https://doi.org/10.1111/j.1365-3164.2011.01006.x
4. Halliwell, R., Banovic, F., Mueller, R.S., & Olivry, T. (2021a). Immunopat hogenesis of the feline atopic syndrome. Veterinary Dermatology, 32(1),13-e4. https://doi.org/10.1111/vde.12928
5. Halliwell, R., Pucheu-Haston, C. M., Olivry, T., Prost, C., Jackson, H., Ba novic, F., Nuttall, T., Santoro, D., Bizikova, P., & Mueller, R.S. (2021b). Feline allergic diseases: introduction and proposed nomenclature. Veterinary Dermatology, 32(1), 8-e2. https://doi.org/10.1111/ vde.12899
6. Hobi, S., Linek, M., Marignac, G., Olivry, T., Beco, L., Nett, C., Fontaine, J., Roosje, P., Bergvall, K., Belova, S., Koebrich, S., Pin, D., Kovalik, M., Meury, S., Wilhelm, S., & Favrot, C. (2011). Clinical characte ristics and causes of pruritus in cats: a multicentre study on feline hypersensitivity-associated dermatoses. Veterinary Dermatology, 22(5), 406-413. https://doi.org/10.1111/j.1365-3164.2011.00962.x
7. Lowe, A. D., Campbell, K. L., & Graves, T. (2008). Glucocorticoids in the cat. Veterinary dermatology, 19(6), 340-347. https://doi.or g/10.1111/j.1365-3164.2008.00717.x
8. Lowe, A. D., Graves, T. K., Campbell, K. L., & Schaeffer, D. J. (2009). A pilot study comparing the diabetogenic effects of dexamethasone and prednisolone in cats. Journal of the American Animal Hospital Association, 45(5), 215–224. https://doi.org/10.5326/0450215

9. Miller, W. H., Griffin, C. E., & Campbell, K. (2013). Muller and Kirk’s Small Animal Dermatology (7th ed.). St Louis, MO: Elsevier Mosby.
10. Mueller, R. S., Nuttall, T., Prost, C., Schulz, B., & Bizikova, P. (2021). Tre atment of the feline atopic syndrome – a systematic review. Vete rinary Dermatology, 32(1), 43. https://doi.org/10.1111/vde.12933
11. Pascal-Tenorio, A., Olivry, T., Gross, T. L., Atlee, B. A., & Ihrke, P. J. (1997). Paraneoplastic alopecia associated with internal malignan cies in the cat. Veterinary Dermatology, 8(1), 47-52. https://doi. org/10.1111/j.1365-3164.1997.tb00263.x
12. Rottenberg, S., von Tscharner, C., & Roosje, P. J. (2004). Thymomaas sociated exfoliative dermatitis in cats. Veterinary Pathology, 41, 429–433. https://doi.org/10.1354/vp.41-4-429
13. Rzeszutek, U. (2020). Successful treatment of a multi-drug-resistant se verely pruritic hypersensitivity dermatitis in a cat. Case Reports in Veterinary Medicine, 14. https://doi.org/10.1155/2020/88973659
14. Santoro, D., Pucheu-Haston, C.M., Prost, C., Mueller, R.S., & Jackson, H. (2021). Clinical signs and diagnosis of feline atopic syndrome: detailed guidelines for a correct diagnosis. Veterinary Dermatology, 32(1), 26-e6. https://doi.org/10.1111/vde.12935
15. Scott, D. W., Miller, W.H., & Griffin, C.E. (2001). Skin immune system and allergic skin diseases. In D.W. Scott, W.H. Miller & C.E. Griffin (Eds), Muller and Kirk’s Small Animal Dermatology (pp 543–666). 6th ed. Philadelphia, PA: WB Saunders. http://dx.doi.org/10.1016/ B978-0-7216-7618-0.50012-2
16. Turek, M. M. (2003). Cutaneous paraneoplastic syndromes in dogs and cats: a review of the literature. Veterinary Dermatology, 14 (6), 279–296. https://doi.org/10.1111/j.1365-3164.2003.00346.x