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What is Feline Miliary Dermatitis?

Cats are known for licking, grooming, and scratching themselves on the regular. But what about extreme itchiness and rashes? If your cat has been recently diagnosed with feline miliary dermatitis, you should read on to understand what is going on with your pet and what treatment options you and your feline friend have.

Dr. Jess explains the details below:

What Does ‘Feline” Mean?

A feline is just a fancy way of saying cat.

You know – purr purr, meow meow.

Cats come in all shapes, sizes, colors, and personalities.

In many medical and veterinary circles – you may hear doctors and veterinary staff referring to cat and kitten issues and illnesses as “feline something-or-other this” or “feline something-or-other that

What Does ‘Miliary’ Mean?

Miliary is a descriptive term to describe the size and shape of the condition involved.

In this case, miliary describes a skin lesion that is just a few millimeters in length and is shaped like a grain of millet, a cereal-grain crop.

What is Dermatitis?

Dermatitis is the inflammation of the skin. Inflammation is when the issue involved in swollen, reddened, sometimes with increased heat, and many times is either itchy or painful.

Feline Skin Problems:

Many cats come into the veterinary clinic with the issue of itchy skin, scratching, licking excessively, or recently found scratches, bumps, or wounds on their skin.

It is very easy to overlook a cat’s skin problems, so it is best to closely look at your cat’s skin on a regular basis.

It is likely easiest to do this during regular grooming sessions or during a daily petting session.

What is Feline Miliary Dermatitis?

Feline miliary dermatitis is not a diagnosis.

Instead it is a description of one of the most common cutaneous (skin) reaction patterns seen in cats presented to veterinary clinics.

Miliary dermatitis is also referred to as miliary eczema, papulo or papular crusting dermatitis, and scabby cat disease.

This isn’t a specific disease.

Instead, it is referred to as a disease condition or complex.

It is characterized by a rash around the head, neck and/or back, often with some intense itching.

It most commonly results from an allergic reaction, where at times, the lesions being felt rather than observing the rash.

It is called FELINE miliary dermatitis because it affects cats.

The name ‘miliary’ dermatitis comes from the skin lesions which have a millet seed-type appearance found on the top of the skin.

Symptoms:

Cats who develop the conditions that manifest as feline miliary dermatitis can show a wide array of differing symptoms.

Most cats with this condition will develop a rash with small crusty bumps and be extremely itchy.

There are many different symptoms that cats may present to the veterinary clinic with that will eventually be diagnosed as miliary dermatitis.

Some of these symptoms include:

  • Rash with red, crusty bumps, especially around the head, neck, and down the back to the tail. Sometimes, the rash can be seen under the chin and down the bottom side of the neck, flanks, belly, and in extreme cases, the rash can include the entire body. Bumps can have scabs on the top or be oozing with pus (grouping of white blood cells; resembles a pimple), and can be just a few small raised bumps, to many.
  • Intense itching (pruritis) in the areas of the rash
  • Hair loss (alopecia)
  • Licking of the rash area
  • Scratches along the rash area (due to increased scratching and licking of the area)
  • Hair pulling
  • Thickened, darkened skin of the affected area

What Causes it?

Because feline miliary dermatitis is a group of conditions involved in itchy skin and rashes of kitties, there are going to be many different causes that result this condition.

Some of the more common causes of feline miliary dermatitis are:

  • Flea bite hypersensitivity (flea allergy) this is the most common cause of feline miliary dermatitis. One flea bite is all that it takes in some cat cases to cause a flare-up of dermatitis!
  • Environmental allergies
  • Food allergies and food intolerances
  • Bacterial infections
  • Drug hypersensitivity and medication reactions
  • Mites (harvest mites, ear mites, etc.) and lice
  • Mange
  • Ringworm
  • Improper diet
  • Immune-mediated diseases (decreases the cat’s immune system and lowers the impact of the animal to fight of disease and infection)
  • Hormonal or endocrine disorders

How is it Diagnosed?

Once you have brought your feline friend in to your local veterinarian’s clinic, they will likely want to perform a few diagnostic tests on your pet to help determine what exactly is going on.

Diagnosis is based primarily on medical history that you will give the doctor about your pet’s condition, and clinical signs that the veterinarian observes on exam.

Your vet will likely first perform a physical examination on your cat, looking very closely at their skin, especially on their face, back, tail, and belly.

Your vet will want to identify what is causing feline miliary dermatitis so the correct treatment can be given. This may include;

  • The location of the lesions may provide a clue as to the cause. If fleas or flea dirt (flecks of flea poop) are observed, or if the cat is not on a flea preventive, the diagnosis may be presumed as a flea allergy. If they are close to the base of the tail then fleas are often the culprit.
  • If the lesions are around the head, mite allergies may be more likely the cause.
  • If the condition does not respond to symptomatic flea or mite treatment, other diagnostic testing will likely be performed before a referral to a veterinary dermatologist is recommended.
  • Coat or comb brushings to check for external parasites
  • Skin scrapings to check for external parasites
  • Cytology and/or culture to identify bacterial or fungal infections
  • Fur samples to check for parasitic or fungal infections
  • Fecal exam to detect the presence of intestinal parasites
  • Biochemical profile (bloodwork) to see if there is an underlying medical condition
  • Allergy testing to see if inhalant allergens are the cause.
  • Hypoallergenic food trial to see if your cat’s diet is causing the allergic reaction
  • Skin biopsy

Is it Contagious?

How contagious, or even if the condition IS contagious, will depend on the causative agent, creating the problem.

For instance, fleas causing feline miliary dermatitis in one of your house cats can transfer fleas to your other house cats.

If those other cats are also allergic to flea bites, they may come down with symptoms of miliary dermatitis as well.

In another example, of a food allergy, where the other cats in the household are not found to have the food allergy, the other cats will not come down with the dermatitis symptoms.

Is it Preventable?

Because feline miliary dermatitis is not diagnosed until symptoms arise, it is very hard to prevent.

It is much easier to monitor an already-diagnosed cat from further flare ups and episodes of this dermatitis than it is to prevent it all together.

Monitoring techniques are discussed in another section below.

How is it Treated?

Treatment of feline miliary dermatitis depends on the cause of the problem but is often fairly straightforward.

Remove the irritants and make the cat more comfortable until the miliary-shaped lesions heal.

Treat the cause and miliary dermatitis should dissipate!

Some of the more common treatments include:

  • If it is a parasite such as fleas, mites, or lice, then removal of the parasite from the cat and home/living environment should cure the problem. Strict parasite control will need to be performed routinely to ensure the miliary dermatitis doesn’t come back. Keep in mind that cats groom themselves daily, and therefore it is hard to find live fleas on many of them.
  • A hypoallergenic diet
  • Antibiotics for secondary skin infections (sometimes this antibiotic comes in a topical ointment applied to the cat’s affected skin)
  • Soothing shampoos to relieve inflammation and itching
  • Antihistamines and other anti-itch medications
  • Corticosteroids (anti-inflammatory drugs)
  • Fatty acids (skin oil replacements)
  • Turn outdoor or indoor-outdoor cats into strictly indoor-only cats.

Monitoring:

Cats with miliary dermatitis need to be monitored closely for any re-emergence of clinical symptoms of the disease.

Your cat may require additional diagnostic testing and/or medications to control clinical signs during any additional flare ups.

Allergies can change and they can worsen over time so the treatment plan is never set in stone and may need to be adjusted periodically according to how your cat is currently doing.

Prognosis:

For most cats with feline miliary dermatitis, the prognosis is great for controlling the condition.

The causative agent, also known as the ‘offending allergen’, must be removed for long-term resolution of your cat’s symptoms.

Depending your cat’s environment and lifestyle, year-round treatments may be recommended.

Many cats that have allergic reactions as the cause of their miliary dermatitis respond well to intermittent corticosteroid therapy, hypoallergenic diets, antihistamines and/or other allergy medications that your veterinarian can guide you and your cat with.

Your vet will best determine the course of treatment and monitoring protocol for your cat’s individual needs.

Summary:

Feline Miliary Dermatitis is a group of conditions that can cause a red, scabbed rash and severe itchiness in cats.

This type of dermatitis is caused by an allergic reaction which can be due to parasites, food, or other environmental allergens.

Once you take care of and treat the allergen culprit, the symptoms will dissipate.

Therefore, once you treat the underlying problem causing the allergic reaction, you will see a much more comfortable cat, with less itching and less of a rash or scratches.

Article References:

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