Over-Grooming in Cats
Written by Shula Berg BVSc CertAVP(GSAS) GPAdvCert(SASTS) MRCVS
Clinically reviewed by Elizabeth McLennan-Green BVM&S CertAVP(SAM) MRCVS
Table of Contents
Alopecia, meaning loss of hair, is very common in cats. Although primary skin conditions can cause alopecia directly, the most common cause is over-grooming, when the cat licks excessively causing hair loss. Sometimes, cats will also chew the skin, pluck the hair with their teeth, or scratch, though this is seen less often. It is not uncommon for cats to do this in secret, and many owners don’t realise it is happening until hair loss is significant, or other symptoms become apparent.
There are several reasons that a cat may over-groom, with the three primary reasons being pruritus (the medical term for itching), pain, or a behavioural problem. It is essential to distinguish between these, and identify any underlying causes, to succeed in treating over-grooming.
A clinical history is the first step in identifying the cause of over-grooming, and will usually include questions about your cat’s lifestyle, diet, outdoor access and parasite control. If flea control is considered inadequate, a comprehensive regime may be recommended before spending time and money on additional diagnostic tests. Some cats are allergic to fleas and can have a pronounced reaction from a single bite, even if there is no obvious flea burden, so it is always sensible to rule this out first. Bypassing this step can mean other test results aren’t reliable.
Your cat will also be examined for skin lesions, and confirmation of over-grooming (seen as fractured hair shafts – this often involves a sample of hair being taken and examined under the microscope). The vet will look for signs of primary skin disease, or underlying causes such as pain.
Your vet may then advise any or all the following investigations:
- Skin scrapes, hair plucks, tape strips and swabs
These samples are examined under the microscope and can be used to identify parasites (such as mites or lice), bacteria or fungal infection.
- Fungal culture
Fungal disease, known as dermatophytosis, can cause hair loss without itching. Sometimes fungal spores will fluoresce under a special light known as a Wood’s lamp, but sending a sample to the lab is always required to confirm infection.
- Diet trial
This is the only way to definitively diagnose food allergy (known as food-responsive dermatosis). A prescription diet with a novel protein source must be fed for 8 weeks with no other food, including treats and titbits. A “rechallenge” with the original diet is then performed to confirm the improvement is due to diet and no other factors.
- Blood tests
Bloods tests can be used to check organ function as well as red and white blood cell counts. Specific tests may be recommended to check the thyroid, or for viruses such as feline immunodeficiency virus (FIV) or feline leukaemia virus (FeLV).
Some less common conditions can only be diagnosed on a biopsy sample, such as autoimmune diseases and skin cancers.
If no primary skin disease is identified further investigations will be required. Allergic skin disease is most commonly a reaction to food, fleas, or environmental factors such as pollen. Feline atopic skin syndrome (FASS) is a predisposition to develop allergic symptoms to otherwise harmless "allergens." Dysfunction of the skin barrier may also contribute. Atopic skin syndrome is a diagnosis of exclusion, as there is no specific test for it.
If your cat is over-grooming a specific area, such as over the bladder, specific tests may be required to look for causes of pain or discomfort. This could include blood tests or imaging, such as ultrasound and/or x-rays. Common sources of pain-related over-grooming include urinary tract disease and arthritis.
In a small number of cats, over-grooming is purely a behavioural problem and is known as psychogenic alopecia. This is often a response to stress but can become obsessive or compulsive. There is no test to specifically diagnose this condition, though the history can increase suspicion. In these cases, a thorough work-up is particularly important to rule out other easily treatable causes, and to increase the suspicion of psychogenic alopecia as a diagnosis. More often, an allergic component is exacerbated by stress and both components must be addressed.
Treatment for feline over-grooming will depend largely on the cause.
Bacterial, parasitic and fungal infections are easily treatable with the right medication. Occasionally long courses of treatment are needed, and tests must be repeated to ensure the problem has resolved. Similarly, food responsive dermatosis can be very successfully managed by feeding a diet that the cat is not allergic to.
Cats with feline atopic skin syndrome may be harder to control and require long-term medication to reduce itching. In milder cases, treatment can include supplementation of essential fatty acids to improve skin barrier function. Administration of antihistamines can be trialled but often has limited effect. In amenable cats, topical medications can be very effective at soothing itching. More severe cases may require medication that supresses the immune-system’s response, such as steroids or a drug called ciclosporin. Allergen-specific immunotherapy is a treatment tailored to the cat’s individual requirements. Monthly injections are created based on blood tests that identify the allergens the cat is most reactive to. Up to 75% of cats can see a good response, however, treatment can take 9-12 months to be effective so is not an immediate fix.
Cats that are over-grooming due to pain or discomfort will need treatment of the underlying condition. This will most commonly involve administration of pain relief but may require other treatment in addition. Successfully managing the pain will often lead to resolution of the over-grooming.
The prognosis for cats who are over-grooming is mostly good, however, not all causes are curable. While bacterial and fungal infections can be completely resolved, conditions such as allergies or underlying arthritis are permanent and long-term treatment may be required.
Cats suffering from psychogenic alopecia can be very challenging to treat, especially if there is no obvious trigger. Changes at home can help reduce stress, and include the provision of places to hide, ensuring litter trays and food are kept separate, and making sure resources (such as litter trays) outnumber the number of cats in the household. Cats who do not respond to simple changes often benefit from a veterinary behavioural referral.
It is important to understand that these cases can often be frustrating and can take a while to reach a diagnosis and find a successful treatment protocol. Working alongside your vet and keeping a symptom diary can be very beneficial.
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Page last reviewed: 16th January 2024
Next review due: 16th January 2026