Why Does My Cat Have Scabs All Over the Nose?

Fly Bites on a Cat’s Nose

Scabs All Over a Cat’s Nose

“Doc, Shadow’s nose just looked this way one day,” said Maria as she held the scared black cat’s head pointed toward the veterinarian. “What is it?”

Bumps and crusted scabs covered the top of Shadow’s nose.  She did not itch it very much and it did not look ulcerated or raw (see the exact picture at the right.)

“It looks just like fly-bite hypersensitivity, but we must do a few tests to rule out some other problems that can look similar to this,” said Doc Truli.

“Is it contagious?” asked Shadow’s worried mom.

“We’ll know when I can run a few tests and diagnosis what it is,” said Doc Truli. (By the way- a doctor cannot honestly answer a question of contagion or survivability without a diagnosis – unless they are psychic or lying to make you feel better. So save your worried questions for later if you have anywhere to be in a hurry; you will just slow down the doctor’s thought process!)

Appropriate Tests for a Crusted, Scabby Cat Nose

Because the skin reacts to attack, there is a limited look to the patterns of reaction.  For example, the skin gets red and sore and bumpy from infection, allergy, parasites, injury, autoimmune disease and cancer.  After all, it is skin, it can only react in certain ways.  Sometimes the pattern of reaction can sway a veterinarian to form an opinion as to what caused the problem.  It is always an educated guess.

If you have a good account of the history of your cat’s activities, you can help the veterinarian narrow down the likely possibilities.  By knowing your cat’s whereabouts and habits, you could save time and money on tests that are unlikely to show the problem.  For example, if your cat is always indoors and never around other animals, then a cat bite injury is highly unlikely and parasites are less likely!

Tests for a Scabby Crusty Cat Nose

• Skin cytology – pressing a sample from the skin against a microscope slide, preparing it with fixative and special stains, especially useful to find cryptococcidiosis (a fungus)
• Skin scrape cytology – scraping a sample from the capillary beds under the skin – especially good for finding mites
• Dermatophyte culture “ringworm test”
• Skin Biopsy – certain tumors and autoimmune diseases will only reveal themselves after a small surgical biopsy sample is analyzed
• Empirical guesswork – this means trying different medicines and if they work, guessing the what the diagnosis must have been.  For example, if you use insecticide cream and it works, probably the problem was an insect! (You can see the obvious uncertainty and potential loss of valuable time in this approach, not to mention the chance of making the nose worse. Why do I mention this approach?  It saves money or costs nothing.)

When Skin Tests Find Nothing

Shadow’s tests showed no parasites, no cancer, no bacteria, no yeast, a few immune cells called eosinophils, and very much scabby stuff that was non-diagnostic of anything. Based on knowledge and guesswork, Doc Truli treated Shadow with an anti-inflammatory medication designed to treat fly-bite hypersensitivity.  Shadow was better in a few days and cured in a week.

When a Skin Problem is Confusing

Here’s the glitch to this story: Shadow’s mom Maria reported her to be a 100% indoor-only cat.  How on Earth did the little girl get so many fly bites on her nose? Well- it turns out mom’s definition of indoor and Doc Truli’s were not a match.  And this happens every day.  Here’s how it goes:

Nurse asks: does your cat go outside?

Mom replies: no.

Nurse: does your cat ever escape and get outside, even for a few hours?

Mom: no, never.

Nurse: do you have a screened-in porch your cat has access to?

Mom: of course, she really likes it in there.

Bingo!  A screened-in porch (here in Florida, they are called lanai – pronounced lah, nigh) is almost the identical health risk environment as actually being an outdoor cat.  How?  Fleas, ticks, feline leukemia through hissing, fecal parasites through dirt particles, tapeworms through lizard hunting, and in this case, flies.  The screened porch precludes car accidents and falling out of trees, probably prevents unwanted kittens (although Doc Truli met a big orange cat that used a claw to surgically cut a round hole in the screen and then go in and out as he pleased), and prevents dog attacks.  Otherwise, the disease list is similar to an outdoor cat.

Moral of the story?  If you are a pet parent, tell your veterinary team about the screens.  If you are a veterinary team member, remember to ask!

 

P.S. No fly bite hypersensitivity is not contagious.