Q. I am at my wit's end. My 3-year-old cat appears quite healthy; however, for the past year she started steadily losing hair on her underside, which is now pink and smooth. My vet is scratching his head over this. I need answers now.

I see no scaling or lesions it simply looks as though she is molting. The hair is coming off her legs now and another little tiny bare spot is starting on the other side of her little chest.   

A. It sounds as though your kitty may be experiencing feline psychogenic alopecia (overgrooming behavior). Alopecia is simply the medical term for hair loss, and of course, psychogenic implies that it has a psychological basis. I've spoken with and referred many of these cases to behaviorists, and there are several important points you need to know.

First, in order to make a diagnosis of FPA, it is important to rule out all other causes of dermatological problems in your kitty. Even if the skin itself looks very normal, there can be a host of underlying organic or physiologic problems that are causing this behavior. This problem will often include, but is not limited to: allergy, parasites, dermatophytosis (fungal infections in the hair or skin), cystitis, gastroenteritis and anal sacculitis. It will be necessary for your veterinarian to do blood work, a urinalysis, a fecal exam, check the anal glands and test hair for dermatophytes (DTM), as a minimum database. In addition, skin  biopsies often help with this diagnosis. I have performed these procedures myself on many cats, much like your feline companion. Once all of these possibilities have been ruled out, then the possibility of FPA is considered.

Because this is generally thought to be a compulsive disorder, which arises out of anxiety, frustration or conflict, it will be important for you to try and identify your cat's at-home behavior and what might cause stress. After running a battery of tests, as a final diagnostic tool, I'd try an Elizabethan collar for six to eight weeks, and watch for hair regrowth. If the hair regrows normally by simply keeping the cat from licking the area, then I am comfortable with the diagnosis of FPA.

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