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How I Approach... Overgrooming in Cats
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Key Points
- Alopecia from overgrooming should be distinguished from spontaneous hair loss and requires a systematic approach to establish the underlying cause.
- Most cases of overgrooming are caused by pruritus, particularly due to ectoparasites and hypersensitivities.
- Pruritic causes should be eliminated before a diagnosis of psychogenic alopecia is made.
What is overgrooming?
Grooming is a normal cat behavior, involving licking and nibbling of the hair and skin, and facial rubbing with the forepaws. Its purpose is for cleaning, removal of parasites, and thermoregulation (1). However, overgrooming is a common, acquired problem of cats in which excessive licking and grooming results in hair loss. It usually presents as bilaterally symmetrical alopecia, affecting the ventral abdomen, caudal and medial aspects of the hind legs and perineum (Figure 1), although the lateral abdomen and other areas may also become alopecic (2) (Figure 2).
Overgrooming is the most common cause of feline symmetrical alopecia (FSA), one of the four major cutaneous reaction patterns expressed by cats. The other reaction patterns are head and neck pruritus, lesions of the eosinophilic granuloma complex and miliary dermatitis, and all four patterns occur in response to a wide variety of underlying diseases (3) (Table 1). Although previously named “feline endocrine alopecia”, it is now known that the majority of FSA cases are caused by overgrooming in response to pruritus (4).
Is overgrooming present?
When presented with a case of feline symmetrical alopecia, it is essential to employ a thorough and systematic approach in order firstly to establish whether it is due to overgrooming or, more rarely, spontaneous hair loss. This requires a detailed history, a thorough dermatological and general clinical examination, and some basic diagnostic tests.
This article will consider in detail the author’s approach to cases of overgrooming, but the reader is referred to the standard dermatology texts for further details on the conditions causing spontaneous hair loss, which often require histopathology and appropriate laboratory tests for diagnosis. [...]
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