Licky Granuloma - change to Hill's z/d, d/d or IVD Limited?

As many of you know (and some have similar problems), my cat and I have
been battling her "licky granuloma" on her right hind leg for several years
now. I've gone from several depo medrol shot at the beginning to treating
her with 2.5 - 5 mg/day of Prednisolone with Tresaderm or Gentaved applied
topically when there's an outbreak. Her latest outbreak lasted two months
and I now have it under control (she's now taking 2.5 mg of Prednisolone
every other day).

I've decided to try to take her off her Purina Pro Plan Chicken and
Rice/Beef and Rice hard food diet (getting her off of Fancy Feast canned
food will be alot harder! At least the Fancy Feast doesn't have wheat and
corn).

I've been reading alot about the Hill's z/d and d/d diets. The z/d is the
more "allergy friendly" diet. D/D is good too, as it avoids the beef,
dairy, fish, corn and wheat that seem to affect cats with skin problems.

I've also read good stuff about the Innovative Veterinary Diet (IVD)
Limited Ingredients line.

Has anyone had any luck with any of these foods, and just as important, did
your cat eat the food (dry or canned) and not snub his/her nose at it (as
my cat did with the IVD canned Venison and green peas).

Rene S....

I had a friend who used the z/d for a cat who had an allergy problem.
She used it for several months but didn't see any improvement.

femcat...

I reada similar responses to z/d on this board in a post from several years
ago.

Might I suggest that you try a high-quality food that doesn't contain
corn/fillers instead of a prescrption food? Wellness canned is a good
food that I used on my Tucker for several years. Now I feed Nature's
Variety raw, another excellent food that contains 95% meat and 5%

femcat...

Thanks for the advice. Nature's Variety looks like a good food except that
the dry food contains some dairy. The canned food looks interesting and
very healthy. The raw food sort of frightens me (although I know that some
vets recommend it, especially holistic ones). I just worry about cats with
sensitive skin and stomachs (mine is prone to diarrhea when changing foods
too fast) trying a raw food diet. Some cats can adjust to anything (like
some people) while others just can't.

As far as Wellness goes, everyone knows the quality of the product. My cat
just wasn't too keen on its taste (for the canned food). Once again, the
dry food looks promising, although there are alot of ingredients in it,
whereas the Hills z/d, and d/d are just a few main ingredients with vitamin
and mineral additives.

Rene S....

I was frightened too with the raw diet but I see the results now and
won't go back. It's meant to replicate what a cat's diet would be in
the wild, and contains more digestive enzymes than even canned (which
are cooked out). The key is to switch over slowly, over a period of 1-2
weeks, so the system can adapt to it.

I'm not affiliated with either company. I'm a consumer who has used
their products with great results. :)
Rene

Cheryl...

-L....

My feeling has always been that the granuloma complexes are auto-immune
related diseases. As such, they're very complex and not easily solved.

cybercat...

Yes, after four years of successful treatment, Gracie now has the itchy kind
(I guess that is what people are calling "licky") and it comes back a single
month after the Depo shot. There is no way I am giving her shots more than
four times a year, so I am not sure what to do. But she has little red marks
and some small scabs in front of her ears, and her ears look "patchy," kind
of moth-eaten. I have not changed her food, or any of my household cleaners,
nothing. I might try bottled water and see if that helps.

-L....

I think Depo gets a bad rep more than it should. Quality of life *is*
an issue, afterall. True "lick graulomas" usually develop *after*
licking - dogs get them after licking themselves when nervous, for
example. I'm not sure why in this case the vet called the lesions

cybercat...

Well this makes sense because when she is upset she does overgroom.
I posted in the past about how she would groom herself bald--not pulling
the fur out but licking--when she was upset. I know that is what is was
because as soon as I figured out what was bothering her and corrected
it she stopped. But this time it is her ears and it seems much worse. But
WAIT a minute ... she sure can't lick there. Could it be something else?

-L....

Could be systemic ECG and she's just getting lesions on her ears. No
un-heard-of, but nit common, I'd say.

The vet saw it but said nothing last time I took her in. Her ears look
motheaten, like there are little see-through spots, and then there are
raw spots from her scratching the balding areas in front of her ears.
Have you seen this before?

-L....

Hum...that almost sounds like ringworm. I would take her in again for
a consult. Have them sample the lesion and check for ringworm just in
case - the test should be under $25.

C.J....

I thought about that, but she's never out in the dirt and I keep both the
boxes
and the house clean enough. I just searched the web for it, and I see it is related to
Athlete's
foot fungus--nobody in the house has ever had that or signs of ringworm.
(And
if she has it I should too, I am always in her face and she sleeps snuggled
with
me.) It sure can't hurt to have it checked out. Thanks. I will take her in
this week.

-L....

They can get ringworm from the air or tracked in from your shoes - the
spores are everywhere. Peewee gets it ocassionally because he's just
suceptible. Nobody else ever gets it (except Mimi and I did once, when
Pee was a tiny kitten.)

cybercat...

I had no idea. I looked at her more closely tonight, and I just don't know,
I've never seen ringworm and hers does not look like the pictures I found
on the web. One thing is for sure: I would rather it be ringworm and easily
curable than a new manifestation of EGC.

"licky" except that the cat was licking them. "Systemic eosinophlic
granuloma" is a better description, IMO.

Not with my allergy cat. We tried a diet trial of Hill's ZD but he
didn't eat it, was losing weight, and we tried the IVD. He wouldn't
eat the canned, and snubbed the dry, too.

I really feel for you with your kitty problems. All treatments for
Shamrock have failed (cleaned up environment, diet change, allergy
shots, omega 3 & 6 with chlortrimaton (SP), and finally cyclosporin
(Atopica - made him sick sick sick). We're back to just Depo
shots, and he had one close to two months ago (after one that
failed to give him relief the month before, then a round of
antibotics) and he's already starting to get little bumps again.
I'm thinking about starting him back on the allergy shots. While
they didn't eliminate the need for Depo shots, they did reduce the

Inge Grotjahn...

Our Tientje is suffering from Eosinophile Granuloma and used to have
those Cortisone depot shots for many years. The problem with the depot
is, that it works fine for the first days but the effect will be less
after that. The time between two shots was shorter the longer he got
the depot. Finally the depot didn't work at all.

In addition Tientje developed a diabetes mellitus, coming from the
depot shots.

What we do now: Tientje doesn't get any depots anymore and when his
granuloma breaks out, we treat him with Prednisolone tablets as long
as it takes. Between two outbreaks he stays untreated.

The diabetes disappeared when we stopped the depot shots.

femcat...

That's great to hear Inge. Some cats show no effect from the Depo shots
while others are more sensitive. How do you give the Prednisolone?

Inge Grotjahn...

That's right. The first 5 years there was nothing wrong with the depot
shots for Tientje. Then we found out, that his skin became thin like
vellum and his wounds (he bit his paws until they were open and
bleeding) didn't heal anymore. That was, when we had Tientje checked
for diabetes.

I crunch the pill into a powder and pour it into small piece of low sodium
turkey breast (about 1/4 - 1/3 slice). She loves it so much that she licks
the plate clean and actually waits after I apply her a topical med (like
Tresaderm).

Inge Grotjahn...

This is not neccessary with Tientje. He is such a good boy. I take the
pill, open his mouth, pop the pill in, close his mouth - et voila:-)

In case someone is interested in Tientjes story and some ugly pics:

Purrs to you
Inge and the catgang

Purrs to you
Inge and the catgang

Cheryl...

Thanks for sharing this, Inge. I'm sorry that Tientje's treatment
caused the start of another disease. I've read about that quite a
bit, and Shamrock's first vet wouldn't give him Depo shots after
the first year because she kept telling me it could bring on
diabetes. But what else is there to do when nothing else helps the

Inge Grotjahn...

You can be lucky to have such a responsible vet.

evil itching that makes him make himself bleed? I'm so disturbed
to hear that the Depo may someday stop working for him. He's had
oral prednisone (which when metabolized by the liver turns into
Prednisolone) and it did nothing to relieve his itch and
discomfort. What would we do when Depo stops working? I have no

Inge Grotjahn...

There are several options of applying the cortisone to the cat orally.
Now that you know that Prednisone isn't working for Shamrock properly,
you could talk to your vet about another product or raising the dosis.

idea and don't want to think about that right now. :(

Inge Grotjahn...

Please keep in mind that having him under Cortisone permanently, will
not stop the granuloma from outbreak. For Tientje the main trigger for
an outbreak is stress. So you should think about finding Shamrocks
'trigger'.

We have a very good forum about eosinophilic granuloma here in
Germany. Our surveys brought out that there are different kinds of
reasons, why it comes to an outbreak.

1. it's a hormonal thing. In this case you can solve the problem
permanently by giving 5mg Megestrolacetat (the 'pill' for the cat)
once in 14 days.

2. it's an allergy. Quite common is an allergy to food-mites. In this

femcat...

Thanks for the advice. You've at least helped me make my mind as to what
flavor to get (although I don't like the thought of her eating those poor
rabbits!). I don't think she liked the venison, and I know she won't eat
Iams Lamb and Rice dry food.

I'm going to have to try the Hills D/D first, as my vet doesn't carry IVD
in the hard food. From a search of the ingredients on their websites, the
main difference is that Hills has fish oil in the d/d dry food line, while
IVD uses canola oil, and if a cat has a skin allergy, I believe I'm correct
in assuming fish s/b removed from their diet. If not, please respond.

case you can reduce the trigger by freezing the dry food in
meal-portions and take it out of the freezer 1 hour before feeding.

3. it's an autoimmune thing. In this case the cat is allergic to
itsself and stress is the trigger most of the time.

And please keep in mind, that eosinophilic granuloma is NOT cureable.
It's a chronic thing. The only thing you can do is treating the
symptoms when there is an outbreak.

When there are open wounds our vet takes a sample of the ichor and
makes cultures to find out, which bacterium is active in the wound.
Then he takes a blood sample for an antibiogram, where is tested,
which antibiotic is working best for the bacterium found. Then he
chooses the right antibiotic (not a broadband) for treatment. In
addition his wounds are treated with an ointment containing some
cortisone.

In my answer to femcat I posted a link to Tientjes story and some
pics.

Purrs to you and Shamrock
Inge and the catgang

Cheryl...

Thank you Inge. I have made a shortcut to Tientjes story to read
later. I will also remember about your vets strategy for fighting
the bacterial infection that results sometimes, because our vet
gives him a broad-spectrum antibiotic, clavamox, and he just can't
handle it. It makes him really sick. I think he can handle Baytril

Inge Grotjahn...

in the case, that he gets really sick from the antibotic, it is
useless and you should immediately stop to apply it. Getting diarrhoe
or throwing up from an antibiotic leeds to no effect, because both
'wash' the agents out of the body :-(

(also broad-spectrum).

Both you and Femcat have been very helpful to me, even if it was
her looking for help. :))

Inge Grotjahn...

I don't post much, but this time I had something to say:-) It was my
pleasure to share my knowledge with you:-)

Purrs to you
Inge and the catgang

Purrs for Tientje to keep being helped by the oral steroid, and for
his continued good health.

frequency.