Feline Acne

Feline acne or chin acne is a common skin disease in cats. Unlike humans, feline acne occurs in cats of all ages. It is a disorder of the hair follicles that leads to secondary infections. Although many ideas have been proposed including allergies, poor grooming, increased sebum production and viral infections, none have been proven.

Chin acne starts with blackheads that form on the chin and below the lips. The blackheads or comedones do not seem to bother the cat. As the condition progresses, the comedones become infected causing pustules. The pustules rupture releasing pus. Eventually, the entire chin can become inflamed with chronic draining wounds. These cats will rub their chins on anything they can find. They are uncomfortable and painful.

This cat was under anesthesia, note the trach tube, for a dental cleaning and the extraction of two infected teeth. See the small black dots along his lips? These are comedones. There is one in the center of the picture that has become a pustule. The pustule was expressed releasing an amazing amount of pus in the second picture.


To confirm the diagnosis of feline acne, other common skin problems need to be ruled out including mites, fungal and bacterial infections. First, the skin is scraped with a scalpel blade and checked under the microscope for mites. Second, a few strands of hair are placed on a dermatophyte culture tube for fungus. Third, a slide is pressed against the chin, stained and then examined with the microscope for bacteria. If the infection is severe, a culture is performed to determine the antibiotic sensitivity of the bacteria.

Treatment of feline acne depends upon the severity of the disease and if there is a secondary infection present. In the early stages, topical therapy alone will usually control the disease. The chins are cleaned with wipes or shampoos that target seborrhea. Clipping the chin makes it a lot easier to treat the skin. If the condition is more severe, the cat may need something for the pain and inflammation as well as antibiotics.


-Shell, Linda G. Original author, Short, Jeanmarie Revision author. ‘Chin Acne’ Associate Database – VIN, last updated 3/19/2018.


You Make The Diagnosis: Name This Dog Parasite Found On Skin

Last week I examined a dog for itching and wound up with a surprising diagnosis. This beautiful dog has a history of allergies which require constant treatment to keep her comfortable. I though she had another breakthrough of her allergies or maybe developed a secondary bacterial or fungal infection. This wasn’t the case at all. During her examination, I found little black specks all over her body that moved. She also had thick tan colored crusts on the edges of her ears, excoriations on her abdomen and generalized inflammation. This dog itched constantly. She was miserable. Examine the microscopic image of the black specks below and then answer the following questions: What parasite is this? How did this dog become infected? Is it transmissible to people?

Diagnosis: Lice

Unfortunately, my patient was suffering from pediculosis which means an infestation of lice. Lice are small parasites that are divided into two groups: 1) Chewing lice that feed on the skin (secretions, hair, fur) 2) Biting lice that pierce the skin to obtain blood. Pictured above is a biting lice.

Lice spend their entire life on their victim. The adults lay eggs (nits) on the shafts of hair. Nymphs hatch from the eggs and then begin feeding on the host. They molt three times before they become an adult capable of reproducing.

Lice are spread through close contact with an infested dog or contaminated objects like bedding. My patient started itching after going to the groomer. Most likely, the groomer transferred lice from an infected dog to my patient through their tools.

Unlike fleas, ticks and mites, lice are fairly easy to treat because they spend their entire life cycle on the dog. There are many topical treatments that work well killing the lice within a week. I recommend treating all the dogs in the household when lice are involved. I also recommend cleaning the environment including dog beds, blankets and brushes to prevent reinfection. Since most lice are species specific, the varieties found on dogs don’t infest humans and vice versa. That means that cats don’t have to be treated either unless the lice infestation is caused by a variety called Heterodoxus spriniger. I treated my patient with Vectra 3D and she is feeling much better now.

Source: Shell, Linda original author, Rothrock, Kari revision author, ‘Pediculosis’ Associate Database, VIN, last updated 6/8/2017.

Misdirected Play Aggression in Cats

Scratching and biting are common kitten behaviors. Their predatory nature motivates them to explore the world looking for prey. They stalk, pounce and bite anything that moves during play. Unfortunately, this natural behavior can become a serious problem in some cats as they grow and the strength of their bite increases. Beside the physical trauma from their large canine teeth (fangs), cats carry several bacteria in their mouths that can cause serious infections. People can also develop cat scratch fever from the bacteria Bartonella henselae that is found on some cat’s nails.

Misdirected play aggression is usually seen in cats under two years of age.  They are often the only cat in the household or live with other cats and/or dogs that do not play. The worst cases are seen with orphans who were raised alone. These little ones didn’t learn to inhibit their bites during play because their was no queen(mom) or siblings around to let them know when they bit too hard. The other common history findings are rough play with humans as young kittens and being left alone for long periods of time. One of the biggest mistakes people make in raising kittens is allowing them to bite hands and scratch during play. Rough play teaches kittens to surprise attack without the normal warning signs. What was once a cute little nip turns into a deep wound.

Diagnosis of misdirected play aggression is made by observing the cat or kitten in their environment before, during and after the bite. Most often, movement is the trigger. In my experience, feet moving under the covers, making the bed and walking down the hall are the most common triggers. It is also reported that walking up and down stairs as well as  coming out of a closet will trigger play aggression. Most kittens assume a crouched position with an intent look on their faces before striking. Usually their ears are forward in anticipation of doing something fun i.e., biting. They do not growl or vocalize during play. This is a very important point to remember to differentiate misdirected play aggression from other forms of aggression. If the kitten hisses, growls or screams, the behavior is not play related.

Treatment is based on giving the kitten or cat a different outlet for their energy. As I was taught in veterinary college, ‘A tired cat is a good cat.’ If the home can accommodate another feline, adding another slightly older kitten or cat that likes to play is a great solution. Beside giving the troublemaker an outlet for their energy, another animal will get a home which is a win for everybody. Consult with your veterinarian about the proper methods for introducing cats and go slow. Dumping a new cat into an environment and letting them ‘work it out’ is not recommended. Make sure the new addition is free of disease before the introduction. A two week quarantine is recommended just in case the kitten was exposed to a virus during the re-homing.

If a new feline roommate isn’t an option, then play is the key. A variety of toys should be placed in the environment to stimulate the kitten. Remember that cats and kittens will habituate which means become bored with toys quickly. Change the toys frequently to keep them engaged. Create several play stations in their environment to keep them moving. Here are some examples:

  1. Cat nip infused scratching post tucked in the corner of the room. Provide a horizontal as well as a vertical scratch pad. Cardboard scratch pads work well for the horizontal surface.
  2. Hang a toy from door nobs in multiple areas. Make sure the toy is secured well to prevent swallowing a string.
  3. Boxes and/or bags left out to explore. After grocery shopping, leave a few paper bags on the floor to give the kitten something new to explore. When the kitten becomes bored, put them away until the next day or place some cat nip inside.
  4. Perches placed by windows provide ‘natural T.V.’
  5. Outdoor fully enclosed ‘catio’ will keep the cat safe while allowing them to experience the great outdoors. The screened in area should have multiple perches placed at different heights to help the cat exercise. Some cats may also enjoy munching on container grass.
  6. Fabric tunnels placed along walls or behind sofas give the cat a ground level space to explore.
  7. Ping pong balls in the bath tub work well for curious cats.

Beside the play stations, cats also need interactive play. Four to six fifteen minute active play sessions per day are recommended. Cat fishing rods, wads of paper to retrieve or bat around, balls and feather dusters work well. Stimulate the actions of a mouse or bird with the toy by pulling it under and around furniture. Make the motions unpredictable, slow then fast, smooth along the ground with pops up into the air. Many cats can’t resist the whirling noise made when a feather toy is spun over head. Many people make the mistake of throwing the toys directly at the cat which frightens them. Remember, cats are used to chasing prey. The toy mouse jumping into their face is illogical to them.

Be extremely careful with laser light pens. Direct eye contact may result in blindness. Also, some cats develop ‘frenzy play syndrome’ because they can never catch, touch and kill the dot. If using a laser, stop every few minutes and give the cat an actual toy they can bite and scratch. When the cat feels the toy has been ‘killed’, go back to the laser.

Food dispensing toys or feeder toys are great for burning off energy. Instead of regular meals placed in a dish, make the kitten work for their food. Place small amounts inside and then let them roll it around until something good falls out. Treats may be hidden around the house to stimulate exploration. A few kibbles placed in a water bowl can provide entertainment as the kitten works to get the floaters. Remember to vary the flavors of food often (every 2 or 3 days) for added interest.

Battery operated toys that simulate prey can be a nice addition to a cat’s toy box especially when the humans need a break. Although some cats like the battery operated vacuum cleaners and robots, most seem frightened by these machines. Stick with ‘Panic Mouse’ and similar toys.

Now that the cat has an outlet for their play drive, it is time to teach them not to attack humans. First, evaluate the environment where the attacks occur. If possible remove furniture or other items that are the launch point. Second, obtain a noise maker to startle the cat. Compressed air or pennies in a soda can work well. When the cat shows signs of stalking behavior such as raised hair, twitching tail or slinking on the ground, startle them with the noise. Third, re-direct their attention to an appropriate toy. This is the most important step as they must have an outlet for the behavior. Negative punishment does not work because the cat associates the bad thing with the human, not their behavior of biting the human. Cats subjected to punishment often become more aggressive as they adopt a ‘I’m going to bite you before you can spank me’ approach. Some cats may become fearful and start urinating outside the litter box. As veterinary behaviorist, Dr. Debra Horwitz states, “It is important to redirect the behavior, not punish it.”


-‘Cat Scratch Fever’ www.cdc.gov/healthypets/diseases/cat-scratch.html.

-Horwitz, Debra F. ‘Feline Aggression Toward People’ Australian Veterinary Association Proceedings 2012, VIN.com.

-Thomas, Nicole & Brook, Itzhak. ‘Animal Bite-Associated Infections’ Expert Rev Ant Infect Thor. 2011;9(2):215-226.

Holiday Dangers for Pets

Winter holidays are fun but can present dangers for pets. Here are some of the common hazards for dogs and cats:

  1. Chocolate – Chocolate contains caffeine and theobromine which are toxic to animals.  This fact surprises a lot of people because humans are fairly resistant to this class of drugs. We can drink a lot of coffee and eat chocolate without too many problems. But dogs are much more sensitive to the effects of these chemicals. The half life of caffeine in dogs is 4.5 hours while the half life of theobromine is 17.5 hours!                                                                                             The amount of these two chemicals varies with the type of chocolate. Milk chocolate contains the least amount of caffeine and theobromine while the bitter chocolate used in cooking contains the most. Dark chocolate falls in between. The general rule that I was taught in veterinary college is the more bitter the chocolate, the more of these chemicals and the greater the danger of poisoning.
  2. Lilies – Lilies cause severe kidney problems (renal tubular necrosis) within two to three days of ingestion.   All parts of the plant are poisonous including the pollen.  In my experience, cats are more attracted to these plants than dogs. If your pet is exposed, bring them in for veterinary care immediately!  This is not something you can treat at home.
  3. Poinsettias – These plants irritate the mouth and stomach leading to vomiting and gastrointestinal upset. Despite the hype, I have never seen any serious toxicity from poinsettias ingestion.
  4. Mistletoe – At high doses, this plant can cause cardiovascular disease.
  5. Christmas Tree Water – Bacterial overgrowth often develops in the stagnant Christmas tree water. The water may also contain fertilizers. To be safe, use water free of additives and change it out at regular intervals.
  6. Batteries – batteries are extremely toxic to animals. Most batteries contain a strong acid or alkaline material that will burn any tissue it contacts. Some batteries emit an electrical current that causes severe electrical burns. Batteries may also contain heavy metals such as zinc, mercury and lead which are poisonous.
  7. Escape – During parties, open doors and gate provide opportunity for escape. In my practice, we see the most lost pets during holiday parties.
  8. Antifreeze – Antifreeze causes serious kidney damage and often death. If there is even a remote chance that your pet has ingested antifreeze, seek immediate medical care. Treatment will only help if given early to prevent kidney destruction.
  9. Electric cords – Electrocution is a big problem when the decorations go up. Keep pets away from electrical cords at all times.
  10. Tinsel and Ribbon – Tinsel and ribbon can cause serious damage to the intestines when eaten.
  11. Potpourris –  Dry potpourris may contain toxic plants or cause obstruction when eaten. The simmer pots can also be dangerous if the pet drinks it or gets it on their fur.
  12. Candles – Thermal burns are common during the holidays. I see a lot of cats with singed whiskers.
  13. Xylitol – Xylitol is an artificial sweetener used in many products including gum, mints, candy and even baked goods.  When dogs ingest this compound, it causes insulin release from the islet cells of the pancreas.  The insulin causes a drop in blood sugar.  The drop is dose dependent which means the bigger the dose the more severe the drop in blood sugar.  Dogs who ingest toxic doses of xylitol may be depressed, shaky on their feet, tremor and even seizure if blood sugar drops low enough.  This effect lasts about twelve hours.
    In addition to causing excessive insulin release, xylitol also harms the liver by causing necrosis. In my experience, the liver enzymes begin to rise about 12 hours after ingestion and peak about two days later.  The full extent of liver damage may not be known for several days.  Unfortunately, there are no antidotes for this poison in dogs.  Victims of xylitol toxicity are treated symptomatically.
  14. Ornament Dough – Ornament dough contains high levels of salt that is dangerous to dogs and cats. Ingestion of a large amount can cause severe neurological disease including seizures.


-Lee, Justine A. ‘Holiday Dangers Poisonous to Dogs and Cats’ Midwestvet.net/resources/articles. Dec. 2016, pp 11-12.                           -Wisner, Tina, ‘Winter Holiday Hazards for Pets’ VIN Veterinary Partner, Published Dec. 11, 2001 and revised June 7, 2010.

This Is Why Your Dog Needs A Dental With Anesthesia

Dental disease is the most common problem I see in dogs and cats. During physical examination, I look for large accumulations of tartar, inflammation of the gums, masses, fractured teeth and other problems. Pictured below is the mouth of a dog before having a complete oral examination including dental X-rays and treatment.


See the severe accumulation of tartar on the upper premolar and molar?  The tip of the large canine tooth as well as the back surface is worn creating a large defect in the enamel.  Now look on the inside of the teeth on the other side of the jaw. The premolars and molars located on the right side of the picture are stained and covered with tartar.

After dental X-rays were taken to look for problems below the gum line, the treatment could finally begin. The first step was to remove the large chunks of tartar or calculus from the surface of the teeth. (Calculus is pictured below.)

Tartar Snip

Then an ultrasonic scaler was used to remove smaller pieces of tarter. The tip must be kept moving at all times to prevent damage to the enamel surface of each tooth. After the crowns (exposed surface of each tooth) is cleaned, the area below the gums are scaled by hand to remove calculus and infection. In my opinion, if this step is not performed, the dental is worthless. The last step in the dental  is polishing all the surfaces and treating all problems that were found. This dog has periodontal pockets of infection that were cleaned, polished and packed with an antibiotic gel.


In this ‘after’ picture, note the bleeding along the gum line of the premolar and molar. The tartar extended under the gums causing severe inflammation and infection. The damage gums bleeds after treatment but will heal if kept clean. If the area under the gums had not been cleaned, the infection would have spread up the root. The dog would have been in extreme pain until the tooth was removed. That is why I consider anesthesia-free dentals malpractice. Cleaning the crowns make the teeth look good but does nothing for the areas under the gums – the roots. Also, without anesthesia it is very difficult to clean the inside surfaces of the crowns and polish. I have seen an image of a cat who had their tongue almost ripped-off during an anesthesia-free dental. The damage was so severe that the cat couldn’t eat and was euthanized.