Question Details
Psychogenic Lick Alopecia In A Cat
by ninamalik - January 23, 2020    View Case Report
Hi Steve,
I am so grateful to you for the time, energy, and wisdom you put into answering our questions on this forum. My question is about a cat named Mocha, 11 year old, FS, DSH. She began licking herself to alopecia 4 years ago. The rDVM ruled out allergies. She particularly licks her ventrum, medial legs, underside of base of tail, and scratches pinnae. Fleas and ectoparasites have been ruled out. The only effective therapy has been shots of Depomedrol by the rDVM which last for 6 weeks. Her tongue is pink but the tip mildly red. Her pulse is wiry. When I initially saw her 11/19/19, I performed acupuncture every 1-2 weeks for four treatments and tried Qing Ying Tang. I surmised that since the licking was responsive to steroids maybe this herb would work along with relieving some liver blood stagnation. It did not help. On 1/7/2020 I was able to get more details from the owner that within the 3 cats in the household there were dominance issues with Mocha being second in line to a male 8 year old cat who had just started marking indoors and a newish 8 month old kitten (third in line but a pest no less). I advised her to use Feliway, Nurture calm collars, add litter pans, give Mocha separate time away from the other cats, and added Shen calmer. However she continues to lick. The male cat in the household is now being treated with Clompiramine which has helped him and the owner is considering it for Mocha as well. Other than this she has a III/VI Heart murmur and a slightly elevated ALT. I was thinking of XYS of an option but for some reason just haven't had great results with this herb in cats. I would be open to any thoughts or ideas on other herbs I can try with her.

Thanks so much,
Sincerely,
Nina Malik, DVM
Replies
by naturevet
January 24, 2020
Hi Nina,

If the problem is steroid-responsive, that would suggest hypersensitivity, wouldn't it? If the cat is on a real food diet, I would try a Shao Yang approach first, if the pulse responded to sedating of GB points like BL 19 or GB 25. In that case, I'd combine Xiao Chai Hu Tang and Si Wu Tang in a 2:1 ratio. You may be able to source Si Wu Tang from Kan as Four Substances, and XCHT as Harmonize the Qi from them. Alternatively you can use granules such as from Natural Path

If the pulse responds instead to Liver points like BL 18 you can look at a Liver Qi moving formula. If SP 4/LV 3 helps, you can consider Bu Zhong Yi QI Tang for that, as it is a Liver Qi mover that relieves stress through its content of the adaptogen, Ginseng. Otherwise, you can look at Xiao Yao San, as you said.

A shortcut to diagnosis would be for her to just try the clomipramine. If it doesn't work, you're no further ahead, but if it does, then you know to look at BZYQT or XYS

Hopefully that helps you out! Please let us know how it goes!

Steve
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