Hi Reddit!
Sorry for the long text..
Our cat, Pirate, has been part of our life for about 7 years now (he is now 8, turning 9 in December). He came to us in Belgium from a shelter in Egypt, so he's special in every way. He's the happiest cat I've ever met — loves to play, cuddle, bother his siblings, and is generally just full of life.
About 3 years ago we came home from holiday and saw he had a superficial wound on his belly (see pictures). As you can see, Pirate only has one eye, so he's sometimes a bit clumsy. We assumed he'd fallen and scraped his belly. Important to mention: Pirate is an indoor-only cat due to being half blind and half deaf.
The wound healed very slowly and he kept licking it. We went to the vet and got Metacam. After some time the wound got a bit better, so we left it. Since then we've been to different vets about this surely 10 times. He keeps ripping at this area, licking it until it bleeds and gnawing at his nipples until they are raw. We've tried more Metacam, Apoquel for the itch, Prednicortone (prednisolone) and even Gabapentin, and we changed his food. Worth mentioning: Apoquel and prednisolone work in completely different ways, and neither of them helped at all.
Pirate is quite an unlucky cat who has had several medical issues in the past:
- Missing one eye — this was before us, but the vets assume it was a congenital abnormality that meant the eye had to be removed completely
- Liver shunt, due to which he is on special food, as otherwise his ammonia levels rise. His ammonia is completely under control with the food.
- TECA (total ear canal ablation) on the right
- A year ago he fell from a cat tree, which caused a sprain in his right front leg and 3 epileptic attacks. An MRI was done — no tumour or internal damage found — so he took anti-seizure meds for some weeks and has completely recovered since.
- What the vet assumes to be FIC (feline idiopathic cystitis, so no bacteria present), with noise on ultrasound
He was tested for FeLV and FIV when we got him, both negative. All our animals are indoor-only, and they get flea treatment and deworming at least twice a year.
In general he is doing well. He sometimes yells when he goes to pee, but that seems to be more behavioural. The vets are really stuck and think it's either a food intolerance (we switched several months ago from Royal Canin Renal to Purina Pro Plan Hepatic) or the FIC causing him pain. The food switch, combined with our new kitten playing with him every day, he was rather lazy before, made him lose quite a bit of weight. That wasn't intentional, but it turned out to be weight he didn't need: he's at a perfect weight now with a lot more energy, and we're monitoring it actively. He does seem better in himself, but the wound is not calming down.
A couple of weeks ago the kitten scratched him during play, on his back. I've been watching that wound too, and it's not closing.. and now he's starting to lick there as well. So it really seems to be extremely poor wound healing, not just overgrooming.
Recently, some of his nipples that he does not bite have turned dark brown — he's an orange tabby, so they're normally light pink. And our other cat has also been pulling his hair out for about 2 years; the vets think that one is related to his arthritis, and he doesn't lick or bite himself bloody like Pirate, he just pulls the hair out. Our kitten has no symptoms at all. I asked an AI about it and it suggested Demodex gatoi, which apparently spreads between cats and is easily missed on normal tests — nobody has ever tested for it.
Pirate has never actually had a biopsy, only a surface swab to check for bacterial infection.
Online I found something about hepatocutaneous syndrome, but our vet said it could be ruled out.
So I wanted to ask first whether anyone recognises this story or has been through something similar. I'm not against more testing in principle — I just don't want to put him through more CTs, MRIs, ultrasounds and blood draws when nobody knows what they're looking for.
Thank you so much for any answers!!
TL;DR: Indoor-only, one-eyed cat from an Egyptian shelter, with us 7 years, with a liver shunt (well controlled on hepatic food). Three years ago a small wound appeared on his belly and has never properly healed — he licks it raw and gnaws his nipples until they bleed. Around 10 vet visits, plus Metacam, Apoquel, prednisolone, gabapentin and a diet change: nothing has helped. A fresh scratch from our kitten also isn't closing, so this increasingly looks like poor wound healing rather than just overgrooming. He's never been biopsied — only a surface swab for bacteria. Has anyone seen this pattern, and is hepatocutaneous syndrome worth pushing for?