Q: The rash and lump above my cat’s eye have shown little improvement after being on antibiotics and medication. What should our next steps be?

Original Question: "My cat developed lumps above one eye and a rash above the other. We’ve tried antibiotics with no effect and Prednisone now for 3 weeks with only moderate improvement (not worsening, however). Our vet suspected a food allergy to chicken so we have gone to a non-chicken based diet. This is taking way too long I feel to get better (a month now). What should be my next step? The lumps, which have shrunk marginally, are NOT causing any irritation for my cat Blue. Thanks" - Bob

Vet Certified Answer | Answered: October 11, 2017

Hi Bob,

Thanks for your question.

When you find a growth or lesion like this, no one can know what it actually is by looking at it. My concern with your question is that you make no reference to any testing and you've also said that you've started using Prednisone which is a pretty serious medication when you don't have a diagnosis. So I would suggest that you consider tests to determine what this is so that you can start a proper treatment.

I would recommend you perform a biopsy on the lumps above the eye unless your veterinarian feels confident enough to simply aspirate them with a needle. Directing a needle into such a small lesion so close to the eye of an awake animal would be quite dangerous. Aspirating it with a needle is called cytology whereas using sedation or general anesthesia and cutting a sample of the tissue off would be called an incisional or excision biopsy depending on how much tissue is removed. The biopsy has a high probability of delivering an accurate diagnosis that will allow you to initiate the proper treatment and understand its suspected course of resolution. With the rash, I would begin with a 'skin scraping'. This is a quick and inexpensive in-clinic test to look for parasites, bacteria or yeast. This would allow you to determine if an infection is playing a role either as the cause or as a concurrent complicating condition. If this lesion is an allergy or an immune system based hypersensitivity reaction, a biopsy is likely needed to confirm that diagnosis.

The problem with simply selecting a treatment and implementing it, such as the Prednisone, you really don't gain any knowledge from it. If it works, you don't know why and for how long will it stay in remission and if it doesn't work, you don't know if you have the treatment wrong or maybe just the dosage of the drug. It's an inexpensive option but not one that has the ability to confirm a diagnosis and allow you to understand the prognosis of the disease going forward. It's great that your veterinarian provided treatment as an option to expensive testing, but now the condition has remained and it's probably time to figure it out.

I hope this helps,

Dr. Clayton Greenway

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