Original Question: "Hello Dr., I am Rajesh from India. I have 5 cats. One of my cats started licking his tummy and that general area and he is almost bald. He is a 3 ½ year old male and is neutered. He has been doing this for a very long time. Please help me. All my 5 cats are indoor cats and I am feeding them Royal Canin Fit 32. Hair is falling out as well (a lot for all my 5 cats.) Please suggest medicine for the above-mentioned disease for my cats. Lots of love." - Rajesh
Thanks for your question and I appreciate you reaching out from so far away.
There is limited information in your question but it certainly describes a common condition of cats called 'psychogenic alopecia'. It means the loss of hair for a psychological/behavioural reason. It's very common for cats to become anxious and especially ones that are in a multi-cat household. Cats are territorial so they are often having sometimes unseen, or obvious, power struggles to form the hierarchy in the group. You may find that it's the less dominant cats that are affected or the ones that are overweight as this tends to cause stress as well.
Before we assume this diagnosis, it's important that we rule out other causes of hair loss in cats. I would recommend you first have your veterinarian perform a 'skin scraping'. This is a quick and inexpensive 'in clinic' test that looks for entities such as parasites, bacteria and yeast on the skin. A fungal culture for ringworm would be ideal as well as this is known to cause semi-circular areas of hair loss. To gain an actual diagnosis, you would have to them move to a skin biopsy to determine the exact cause but if the aforementioned tests are negative, I often offer a treatment trial for psychogenic alopecia because it is the most likely diagnosis given the negative test results. If you determine that the hair is 'barbered', it furthers supports the diagnosis of psychogenic alopecia. Barbered hair is present if you find individual hairs of different lengths. This means that the hair was licked off or broken. If the hair falls out due to disease, then the individual hairs are often the same length because they fall out at the same time. If it's an allergy or immune condition, which does occur in cats, it would likely take a skin biopsy to be certain.
Psychogenic alopecia is behavioural but still has causes and influences. A change in a cat's environment can be very stressful for them and they can start licking the hair out. They can do it so significantly that they can even open up the skin and create lesions. The most common pattern of hair loss is on the belly.
The first item of treatment is to try and identify and remove the source of stress. It could be a change in the environment such as noise, a family member visiting, new furniture, to name a few. Cats are very in tune with their environment and when it changes, it can really bother them. Overweight cats are prone to stress just due to their size. If your cat is overweight, I recommend you work with your veterinarian on creating a diet for weight loss. If lack of stimulation is a contributing factor, you could try engaging your cat more with active play, using a laser light, adding toys, and hiding treats around the house among other things. These things can stimulate them and reduce anxiety. If that is not working you can try natural anti-anxiety supplements that you could find in a local pet supply store or your veterinary office. If the condition is serious enough then you can consider medication that is very effective with this condition. I've used a medication called clomipramine or fluoxetine which helps tremendously in most cases and is very safe. I try not to recommend drugs for behavioural modification because most people have a natural unease with this plan, but in cases where the anxiety is really impacting your cat's quality of life in a negative way, I think it is very important to consider.
I hope this helps. Good luck!
Dr. Clayton Greenway
Disclaimer: healthcareforpets.com and its team of veterinarians does not endorse any products or services mentioned. Advice presented by our veterinarians is not meant to replace a regular physical exam and consultation with your primary veterinarian. We always encourage you to seek medical advice from your regular veterinarian.
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