Itching and Scratching (Pruritus) in Cats

Scratching, as well as biting, licking, and rubbing, is a response to the itchy sensation and can have unhealthy impacts, such as skin damage, open sores, and hair loss. In the absence of treatment, damaged skin is vulnerable to the development of secondary bacterial or fungal infections that add to the pruritus.

Rarely does a cat scratch, lick, or chew without a reason, so finding the source of the itch is important. The challenge for a pet owner or a vet is that the source of the irritant is often not obvious from looking at the irritated skin alone. For example, the absence of visible fleas does not rule out flea allergy dermatitis. Additionally, the wide variety of conditions that can cause itch create skin symptoms that look alike, so veterinarians typically use a combination of diagnostic testing and therapeutic trials to determine the best plan for keeping an itchy cat comfortable.

Treatment for an itchy cat is determined based on the underlying cause.

The outlook for itchy cats also depends on the underlying cause. Allergies cannot be cured, so allergic cats are expected to be itchy any time they are exposed to their allergens if they are not on allergy medications. Itch due to other causes like infections, wound healing, or parasites is expected to fully resolve once the trigger is removed.

In rare instances, excessive itch can be a manifestation of a behavioral problem or neurologic disorder. Feline hyperesthesia syndrome (FHS) is an example of this. FHS is characterized by twitching skin and hypersensitivity to touch.

Itchiness (pruritus) is the most common symptom of skin disease in almost all animals, including cats.

Itch can present along a spectrum of mild to severe. Some veterinarians have pet parents track their cats’ itch level on a scale of one to ten, where one is not itchy at all and ten is so itchy the cat interrupts itself from activities like eating or playing to scratch.

Itchiness itself isn’t cause for concern, but it is important to find out what is causing the itchiness, and treat it appropriately. Untreated pruritus can lead to severe skin damage, secondary bacterial and fungal infections, and lowered quality of life for the cat.

The veterinary approach to determining the underlying cause of itch starts with getting a thorough health and lifestyle history of the animal. Taking a history is helpful to not only better characterize the nature of the itch, but also to fully evaluate the cat’s overall health status.

The next step is thorough physical examination followed by standard diagnostic skin tests:

• Flea combing
• Skin scrape to look for mites
• Fungal culture to look for fungal skin pathogens
• Skin cytology to look for pathogens and inflammatory or abnormal cells in any skin lesions
• Bacterial culture to determine appropriate antibiotic for secondary infections

Pruritus may be mistaken for behavioral symptoms that are not actually related to itching sensation, such as overgrooming and feline hyperesthesia syndrome.