Flea bite hypersensitivity

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Cost considerations, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Epidemiology (population dynamics), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Standard treatment, Monitoring, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Rosanna Marsella DVM DipACVD
Dr Ian Mason BVetMed PhD CertSAD DipECVD MRCVS
Dr Richard Squires BVSc PhD DVR DipACVIM MRCVS
Mr David Scarff BVetMed CertSAD MRCVS
Synonyms Flea allergic dermatitis

Introduction

  • Most common cause of skin disease in cats.
  • Cause : sensitization to flea salivary allergens.
  • Signs : miliary dermatitis  Dermatitis: miliary  , symmetrical alopecia, eosinophilic skin disease or any combination.
  • Diagnosis : evidence of fleas + response to flea control +/- positive reaction to intradermal flea antigen.
  • Treatment : flea control.
  • Prognosis : excellent.
    Print off the Owner factsheet on flea control  All about fleas  to give to your client.

Diagnosis

Clinical signs

  • Miliary dermatitis (papulocrustous eruptions, alopecia, excoriations, crusts, scales, hyperpigmentation) most commonly head and neck  Flea bite hypersensitivity  .
  • Presence of fleas and/or flea feces within material brushed from the coat  Flea feces in coat   Cat flea 02   Flea   Flea feces   Flea and flea dirt combed from hair   Flea feces: test  .
  • Finding of fleas on in-contact animals.
  • Miliary dermatitis elsewhere (dorsal lumbosacral area, caudomedial thighs, ventral abdomen, flanks).
  • Self-induced alopecia: symmetric (usual dorsal, flanks or ventral) focal or multifocal  Ventral alopecia - hyperadrenocorticism  .
  • Eosinophilic granuloma complex (indolent ulcer, eosinophilic plaque, collagenolytic granuloma or some combination of these 3 patterns)  Skin: eosinophilic granuloma - mouth   Skin: eosinophilic ulcer on mouth - DSH   Skin: eosinophilic plaque on flank  .
  • Owner lesions.
  • Absence of fleas or their feces does not exclude diagnosis.
  • Erythematous papulopustular eruption (sterile eosinophilic folliculitis and furunculosis) .
  • Lymphadenopathy (especially popliteal lymph nodes).

Diagnosis

Differential diagnosis

  • Miliary dermatitis  Dermatitis: miliary  .
  • Symmetrical alopecia  Alopecia: overview  .
  • Eosinophilic skin disease  Eosinophilic granuloma complex  .

Sequelae

Prognosis

  • Excellent provided flea control remains in force.

Expected response to treatment

  • Hair regrowth over 4-6 weeks.

Reasons for treatment failure

  • Inability to eradicate fleas particularly in hot, humid weather or inadequate flea control of in-contact animals. Difficult if cat visiting other households.
  • Concurrent underlying disease, eg atopy  Atopy  , food hypersensitivity  Food hypersensitivity  .

Sources

Publications

Refereed papers

  • Kunkle G A, McCall C A, Stedman K E, Pilny A, Nicklin C & Logas D B (2003)Pilot study to assess the effects of early flea exposure on the development of flea hypersensitivity in cats.J Feline Med Surg.5(5), 287-294.PubMed DOI
  • Colombini S, Hodgin E C, Foil C S, Hosgood G & Foil L D (2001)Induction of feline flea allergy dermatitis and the incidence and histopathological characteristics of concurrent indolent lip ulcers.Vet Dermatol12(3), 155-161.
  • Boy M G, Six R H, Thomas C Aet al(2000)Efficacy and safety of selamectin against fleas and heartworms in dogs and cats presented as veterinary patients in North America.Vet Parasitol91(3-4), 233-250.
  • Lee S Eet al(1999)Putative salivary allergens of the cat flea, Ctenocephalides felis felis.Vet Immunol Immunopathol69(2-4), 229-237.
  • McKeon S E & Opdebeeck J P (1994)IgG and IgE antibodies against antigens of the cat flea, Ctenocephalides felis sera of allergic and non-allergic dogs.Int J Parasitol24(2), 259-263.
  • Blagburn B L, Vaughan J L, Lindsay D S & Tebbitt G L (1994)Efficacy of lufenuron against developmental stages of fleas (Ctenocephalides felis felis) in cats.Am J Vet Res55, 98-101.
  • Mason K V & Evans A G (1991)Mosquito bite-caused eosinophilic dermatitis in cats.JAVMA198, 2086-2088.
  • Moriello K A & McMurdy M A (1989)Feline flea allergy dermatitis - Practice tips on making a diagnosis.Comp An Pract19, 23-27.
  • Plant J D (1991)Recognizing the manifestations of flea allergy in cats.Vet Med86, 482-486.

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