A Rare Skin Condition in Cats
Take extra precaution so cats with cutaneous asthenia don't get injured.
Q: I've had my 3-year-old male longhaired cat, Smokey, since he was 6 weeks old. Around 8 weeks of age, I noticed his skin seemed to shed a layer, for lack of a better term. Since then, I've spent approx $2500 in veterinary costs trying to find out why. It started with skin tears around his neck and head. Even though he wasn't bleeding, his skin looked like hamburger meat and stretched like a rubber band. After several trips to the vet, multiple stitches, and several weeks with an Elizabethan collar around his head, we decided to remove his back claws because he was apparently wounding himself when he scratched. This worked for the most part. The initial biopsy gave a diagnosis of allergic dermatitis with severe ulceration and inflammation. I was told that there was nothing I could do for him. The vet wanted me to take him to a nearby veterinary university for further studies, but I couldn't bring myself to put my poor cat through any further tests without some sort of diagnosis. Everyone I've asked has never heard of this before. Have you? Would it benefit Smokey if I do take him to the university for treatment? (One of his littermates was euthanized at less than 1 year old for the same skin issues.) Smokey seems very healthy otherwise, and lives a very spoiled life. The skin disorder does not prevent him from any normal cat activities.
A: It sounds to me like your cat has a condition called cutaneous asthenia, an inherited disorder of collagen metabolism characterized by excessive skin fragility. This condition resembles the Ehlers-Danlos syndrome in humans. It causes decreased tensile strength of the skin. I am familiar with this condition because in 1992 I published a case report of a cat with this condition in the journal Feline Practice. Cats with this condition may have a normal lifespan, providing that the cat is in an environment where the possibility of skin trauma is minimized. Affected cats should not be allowed to go outdoors. Declawing of the rear paws, or all four paws, has been recommended to reduce the likelihood of self-inflicted trauma. Ideally, no other cats should be kept in the household, to minimize inter-cat interactions that can lead to trauma. Of course, it is impossible to eliminate every source of trauma from the cats environment, and when a laceration occurs, it should be addressed immediately. Small lacerations often heal quickly, but larger ones require sutures. Owners of such cats should be advised against breeding, not only because of the heritable nature of the defect, but because mating and birthing may result in serious trauma to the affected animal. If this is indeed what your cat has, I'm surprised the biopsy didn't reveal it. The disease is uncommon, and it is possible that the pathologist misread the specimen. Rather than take the cat to the university, have your veterinarian instruct the laboratory to forward the original slides to a pathologist at the university for a second opinion, along with a detailed history. Ask them to specifically evaluate for cutaneous asthenia.
Arnold Plotnick, DVM
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A Rare Skin Condition in Cats