Hermione, a 3yo female spayed orange domestic shorthair cat, presented for evaluation of swollen, painful paws.
Brittany Lancellotti, DVM DACVD
Veterinary Skin and Ear, Los Angeles, California
History
The owners had noticed waxing and waning problems with her paws for about a year prior to initial presentation, and as the disease progressed, the discomfort began to affect her quality of life. She was primarily an indoor only cat but was allowed some unsupervised time in the owner’s fenced in yard and there were several other cats in the household. She had otherwise been healthy with no major medical concerns. She was FIV/FeLV negative.
Physical exam
On initial presentation, she was bright, alert, responsive and hydrated with a BCS of 5/9. All paws had varying degrees of edema, purple discoloration and white scaling to the paws and digital pads. The pelvic limb paws had multifocal crusts with adhered litter and underlying hemopurulent exudate (Figure 1) with erosions to ulcerations. The remainder of the body was unaffected, including the oral cavity.
Diagnostics
Cytology of the exudate showed severe suppurative inflammation with plasma cells and rare small lymphocytes, hemorrhage, and 20-30 coccoid bacteria per oil immersion field. Complete blood count and serum chemistry had been recently submitted by the primary care veterinarian and, apart from a mild hyperglobulinemia, was unremarkable.
Assessment
Based on the clinical appearance and distribution to multiple paws, she was diagnosed with plasma cell pododermatitis. Doxycycline 5mg/kg twice daily was recommended for immunomodulatory and antimicrobial properties, in addition to gabapentin 10mg/kg twice daily for pain, parasite prevention with selamectin and sarolaner topical solution monthly, daily antimicrobial wipes and an elimination diet trial with a prescription hydrolyzed soy protein diet. IF YOU ARE VET : To read the full text, please register at the upper right of the website. Thanks
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