I have a mystery condition that causes cat to violently scratch at his face constantly…

I have a mystery condition that causes cat to violently scratch at his face constantly. He lives in a cone because once removed he scratches violently. He only scratches at two spots. has been treated for fleas/ticks/mites. Skin was UV light tested. X-rays done when a mass popped up behind his ear. Not ear mites. No infections. Eyes were tested. Awaiting biopsy of a mass (removed)behind his ear & lesion under his tongue. Constant head shaking in that Cone has caused an aural hematoma. Vet is mystified!

A few questions. Can I give my cat metacam and trazodone together ? They were prescribed separate times to treat his destructive scratching at his head and face. We’ve since removed a mass behind his ear and taken biopsy of 3 other lesions. One under his tongue. He has been treated for mites and fleas etc. X-rays and UV testing. He has lived in the cone of shame for about 5 months now. He scratches like mad within seconds of removing it. A bloody mess everytime it heals. It is very localized which makes it hard to be (food)allergies?
He just had surgery to fix the aural hematoma caused by his violent head shaking and cone scratching. (No ear mites either)

So he is in an extreme amount of discomfort. He was given a 2 week injection of antibiotic and sent home with metacam. However. The ear now seems very inflamed. It is stitched down to a piece of surgical ‘plastic’ to keep from refilling I think? He is trying to scratch at it so much. He had caused a severe infection in his back toe from scratching at that cone so intensely. It will need amputation.

It is like taking apart an engine. We are awaiting the biopsy results but until then his poor surgery site seems so uncomfortable.
I’m not sure if I should clean it? His head shaking still causes the ears to tap at the cone edges causing such tenderness the poor guy needs to be so sedated to get rest.
Any advice is great advice! Thanking you in advance.

Symptoms started after he started going outside for the first time, one small wound turned into his face being scratched off. so I got him his first set of shots and an antibiotic injection. Medications tried include: numerous antibiotic injections, metacam, trazodone/tramadol for sedating effects to stop scratching. Cyproheptedine. Advantix/flea tick and mite treatment. His X-rays revealed nothing other than an elongated heart. I had his brother who died suddenly at 15 weeks (heart attack?)

*** update ~vet visit for biopsy results **^

Hello and Thanks so much for your advice! I saw my vet today for the results. Also because My cat has continued to shake his post surgery ear which split the tip open. Healing post-hematoma has been botched. So they will be removing the ear flap and cauterizing the edges.
As for the biopsies I’ll summarize point form the microscopic interpretations.

Skin: ulcerative dermatitis, pleocellular with eosinophils, low grade to moderate with granulation tissue proliferation with superficial bacteria.

Tongue : ulcerative glossitis, eosinophilic rich with collagenolysis.

Mass from behind bottom of ear: hyperplastic/reactive, draining lymph node.

So basically what he said was its food allergy or an external (who knows what) allergy.
However in the report it noted that these types of allergies usually respond to corticosteroids. He was given about 3 cortisone injections which did nothing.
So at this point we try the vet diet like you recommended.
He will be sent home with prednisone for the recovery of his ear once again.
So basically what we face is should we try the blood test 300$ to narrow allergens down?? Or do we try vet diet first. (I’ve gone into debt with these bills )
The most pressing issue is how to calm the scratching at his cone, head and ear shaking. It is constant. To the point where he doesn’t stop unless we snugly bandage his ear/head. And heavily medicated him. (Trazadone) The pressure helps.
I just want him to be able to get some rest. And not have us constantly bombarding him to clean his wounds. Wrap his head. Clean his cone. Ouff. My poor boy. He’s starting to get real annoyed with all of the fussing over him. However he is actually gaining weight!
I also asked about feline herpetic just in case and he said there are no upper respiratory signs present. And X-rays for the chest and head were all clear.
I pray we find something that works for the itch.

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Krista Magnifico
4 years ago

Hello I am sorry to hear about your cat. I think it sounds like you and you vet have done a very good job with the basic diagnostics. I also think that the most likely place for the answer at this point is the biopsy. Your vet should be the only person to advise you on the medications for your pet. Please call them and ask for assistance today with keeping your cat comfortable and further self-traumatization. Here are a few hints based on the description and photos that I would talk to your vet about; 1. Herpetic dermatitis and… Read more »

Krista Magnifico
4 years ago

hello again,
I should also add a note about dietary allergy.. it might help to try a prescription diet like z/d.. please also ask your vet about this.

Krista Magnifico
4 years ago

thank you for the follow up. I would probably talk to the vet about trying to manage the current infections and itching while minimizing environmental allergens (fleas, household products) and attempting a food trial. I dont usually do the derm allergen trials until everything else fails. Just my opinion. Get your cat comfortable and see if this was just a one time occurrence.. (fingers crossed).