Underlying medical conditions in cats with presumptive psychogenic alopecia

To identify underlying medical conditions in cats with a presumptive diagnosis of psychogenic alopecia.

Case series.

21 adult cats referred with a presumptive diagnosis of psychogenic alopecia.

A detailed behavior and dermatologic questionnaire was completed by the primary caregiver, and complete behavioral and dermatologic examinations were performed. A standard diagnostic testing protocol that included cytologic examination of skin scrapings, fungal culture of hairs, evaluation of responses to parasiticides and an exclusion diet, assessment for atopy and endocrinopathies, and histologic examination of skin biopsy specimens was used to establish a definitive diagnosis in all cats. Cats that did not respond to an elimination diet were treated with methylprednisolone acetate to determine whether pruritus was a factor.

Medical causes of pruritus were identified in 16 (76%) cats. Only 2 (10%) cats were found to have only psychogenic alopecia, and an additional 3 (14%) cats had a combination of psychogenic alopecia and a medical cause of pruritus. An adverse food reaction was diagnosed in 12 (57%) cats and was suspected in an additional 2. All cats with histologic evidence of inflammation in skin biopsy specimens were determined to have a medical condition, but of 6 cats without histologic abnormalities, 4 had an adverse food reaction, atopy, or a combination of the 2, and only 2 had psychogenic alopecia.

Results suggest that psychogenic alopecia is overdiagnosed in cats. Thorough diagnostic testing should be done before ascribing a behavioral cause to hair loss in cats.