Ask a vet: how can i stop my cat’s obsessive licking?

I am wondering whether I can put an anti-itch cream like calamine lotion on my cat. For several years, she’s had a persistent rash on her tummy that will not go away. The rash is caused by her excessive licking. She’ll lick herself until she bleeds. She’s had steroid shots and liquid oral steroids, and has been tested for fungal infections, pemphigus, and every other condition on the planet. She is currently on a veterinary-specific hypoallergenic diet.

She has seen more than four vets and each has been stumped. She has had Tresaderm, and sometimes we use hydrocortisone. However, we were led to believe that neither is a long-term solution. I worry that my cat will lick through her skin to the soft tissue.

Laura, I am strongly suspicious that your cat is suffering from a severe form of psychogenic alopecia, which occurs when cats obsessively groom or bite their hair off. Usually cats will groom to the point of baldness without skin injury, but some severely affected cats will groom bare skin until it becomes inflamed. It’s unlikely that they’ll groom through the skin into the tissues beneath, but it can cause serious-looking skin lesions called granulomas. The granulomas most frequently occur on the abdomen between the belly button and the rear legs.

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Allergies to fleas, food, or environmental substances may exacerbate the condition. And inflamed skin can be itchy, which can trigger licking and further inflammation and itching. However, the underlying condition is not usually linked to itching, but is considered to be similar to obsessive-compulsive disorder in humans.

The main treatments are enrichment, exercise, and stress avoidance. Cats can be fed using balls that slowly release food as they are played with. This sort of activity, combined with lots of stimulation with a feather toy or laser pointer, may help your cat to expend energy that would normally be spent on overgrooming. Removing sources of stress often helps as well. A leading stressor for cats is the presence of other cats, so if you have several cats, you may want to work out a way to separate them, especially if they don’t seem to get along.

Drugs such as selegeline (Prozac) and amitryptiline (Elavil) may help with the problem, but they shouldn’t be used as stand-alone therapies. Enrichment, exercise, and stress avoidance should come first and be used in conjunction with the medications.

An Elizabethan collar is the last resort — and I mean dead last. E-collars themselves cause stress, which might exacerbate the underlying condition in the long run. I recommend E-collars only for cats who are at risk of seriously injuring themselves.

I recommend that you talk to your vet about a behavior modification program for your cat. I think she also might benefit from one of the medications mentioned above. Since topical therapy has seemed to help in the past, ask your vet about using hydrocortisone or Tresaderm (which contains a steroid similar to hydrocortisone) to help the lesions heal. If this works, then it’s not likely that you’ll need to use a topical product continuously. At that point there should be no itching, and the true challenge for the long term will be to address the underlying psychological issue.

I do not recommend calamine lotion, simply because I don’t think it will work.