Page 21 - Winter 19-20

My Journey with Boris by Wendy Dixon, NZ
Boris, a 9yr old Russian Blue male neutered cat presented with a 5month history of ulceration of the metacarpal foot pads affecting both fore legs. Histology had been inconclusive however the lesions looked typical of the condition labelled plasmacytic pododermatitis. This is thought to be a rare auto-immune condition of cats, however its pathogenesis is not clear. Some cats will spontaneously recover from this, others benefit from surgical intervention with the majority being treated with immunomodulatory drugs. In 35-50% of cases Doxycycline also seems to help.
Antibiotics had been used initially prior to referral (not doxycycline) with only minor improvement (reduced sign of infection), but with the use of prednisolone some healing did take place. Boris had also suffered a bout of ataxia with crossing of the forelegs and tendency to fall to the right 3 weeks after his starting the initial antibiotic treatment. This was treated with steroid injections.
Lesions one centimetre in diameter were present in the centre of each metacarpal pad with friable granulomatous tissue protruding from within. The pads themselves were overly ’squishy’ and ’spongy’. The ulcers were painful and bled easily especially upon licking, resulting in Boris having to wear an Elizabethan Collar constantly. In addition to this he had recently been diagnosed as having a non- regenerative anaemia (PCV 12.8% (24-45), another recognised but less common symptom of this autoimmune disease. This prompted his owner to seek homeopathic help as she was now faced with the prospect of a heavy course of steroid treatment.
My first impression of Boris was of how gangly and unattractive he looked. His head was over big for his thin
neck and he was tall and angular. He lacked the usual cat grace and came across ungainly and awkward. He sat in the box for most of the consult and only came out to explore after one hour. He tentatively explored the room but displayed very little engagement with his owner or myself other than to sniff my hand and rub his cheek against me once, before returning to the box. He went several times to the water bowl to drink. Examination was tolerated but he was very tense and attempted to shrink away. He had a grade 2/6 heart murmur and also a luxating patella. His scrotum was also a little puffy on the left side. His feet left small wet marks on the table – possibly serum ooze from the ulcers or sweat.
He lived in a house as an indoor cat with his brother and two people – his human ‘Mother and Father’. His ‘Mother’ was far too worried about his safely to let him out but he seemed un-phased by this (she has nightmares about the cats getting out of the house). She treated them like her children complete with their own bedroom and bedtime routine. Boris despite the attention he received from his ‘Mum’ traditionally had preferred his ‘Dad’ for company. His father had recently been more occupied than usual studying and had shut himself in a room behind closed doors.
During the consultation the following information was collected:
• He is gentle good natured and well behaved and has never growled or bitten.
• He likes some attention but can be shy and bashful.
• If you look at him and talk to him he will look away with
‘Mum’ saying “he doesn’t believe he is lovely”.
• Like a child of 3-4 yrs old. If the owner looks after him
and takes on this responsibility then he is happy.
• If there is a loud noise he will look to the owners and if they reassure him he is fine. Similarly he reflects the emotions of his owners (if they are excited he is also) and therefore reacts to them rather than other external
things.
• When he has needed his paws bathed he seems to like
the attention and has grown closer to ‘Mum’ due to this. Also although he didn’t like the buster collar he tolerates it and now purrs when it is put on.
• If you cuddle him like a baby on his back he’ll snuggle in. • He thinks he is a person and not a cat.
• Can behave sulky at times and not generally a lap cat.
• He used to sleep with his nose against the wall. Likes to
sleep in cool places.
• Used to be quite chatty and liked to show off to
strangers and be around children even if they were
noisy, but didn’t like noisy adults.
• Not interested in other cats or birds.
• “Obsessed with routine and order” according to the
owner, and ‘Mum’ has given both cats a bedtime routine since the onset. He doesn’t like anything different.
• Clumsy and knocks things off easily.
• Likes to be clean and grooms a lot.
• Likes fish.
• Thirst is high and he prefers warm water.
• He has always tended to be constipated with hard ball
like stools and a lot of effort made before passing a
small amount.
• He will urinate next to the litter tray but will use the tray
properly if praised and watched. I prescribed Nat mur 1M split dose
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