Poor Bella had lost her good looks with crusty scabs all over her nose, ears and feet.  She was also very miserable was loosing weight and not playing any more with her family.  Her owners were very worried about her and wanted us to find out what was wrong with their beautiful girl. We had done skin scrapings (where you take a sample of the skin from the surface and look at it under a microscope) to check for mites.

We had also sent samples away for a ringworm check (Ringworm is a fungal skin infection and will often cause bald spots but not usually such severe signs) which were negative.

The owners had been diligently applying cream to her affected areas and giving her antibiotics but this was not helping in the least.

We decided to anaesthetise Bella as Jody, one of the Vets at Vetcare was suspicious she could have a rare auto- immune condition.  This can only be diagnosed from a skin biopsy and so we took very small pieces of skin from her nose, footpad and ears to send to Gribbles Laboratory for histopathology. (They look at very thin slices of the skin sample under a microscope after it has had special stains applied to it)

Within 2 days we finally had an answer - Bella had Pemphigus foliaceus. This is an auto immune disease.

Autoimmune diseases develop when the body's immune system recognizes something within itself as a threat and creates antibodies to eliminate the danger. In the case of pemphigus foliaceus, a glycoprotein within the skin, called

desmoglein 1, is labeled as a foreign substance and destroyed. Without desmoglein 1, the cat's skin cells within the epidermis begin to detach from each other, leaving splits in the skin. 

This leaves the skin prone to developing secondary bacterial infection.

Treatment of this usually involves administration of oral corticosteroids. Initially, high doses are used to get the autoimmune condition under control, and then the dose is gradually tapered, with the goal being the lowest possible alternate-day dosage that controls the clinical signs. Bella was treated with prednisone, a commonly prescribed corticosteroid but unfortunately she did not respond to the high immunosupressive doses of this drug.  we decided to try her on a stronger steroid of the same family - methylprednisone (commonly known as medrol)  

After a few days of being on this new drug Bella was a new cat!  She was eating well, much happier and playing with her owners.  After a few weeks her scabs had all healed and she had put on weight and was almost back to normal except for the bald spots!   Now she is on lower doses and we are slowly weaning her off the medrol.  Often animals with this condition will have to be on medication for life as it recurrs if they are taken off completely.