Dear Doctor September 2014

How to recognize feline acne; aggression in cats; vaccinations for indoor-outdoor cats


Treating feline acne

Q Lately, I’ve noticed that my cat Fred has small black dots on his chin and around his mouth. Is this something that I should be worried about? They don’t seem to bother him, but I want to make sure it’s nothing serious. Thanks for any advice.

Georgianne Newell

A Dear Georgianne: Quite simply, your cat is suffering from acne. The small black dots that you have noticed are dilated hair follicles, filled with sebaceous secretions and sometimes inflamed. The cause of feline acne is not completely understood — but it is believed that there is a hyperproduction of sebum, with secondary inflammation and bacterial or yeast infection.

In most cats this is a rather benign process, restricted to the chin. This sounds like the case with your cat, Fred. You can clean the area two or three times a week with chlorhexidine-based shampoo or chlorhexidine pads to prevent the condition from worsening. (We usually recommend Douxo Chlorhexidine shampoo or pads, which can be found online.)

In some cats, the acne is more severe and the skin of the chin becomes inflamed and develops small scabs (papules and pustules). This can be the consequence of an infection, and your cat may then require antibiotic or antifungal treatment. If that’s the case, you need to consult with your veterinarian.

Lluis Ferrer, DVM, PhD, DECVD

Professor of Veterinary


Cummings School

of Veterinary Medicine

at Tufts University

Why is my cat so aggressive?

Q I have a two-year-old, neutered male seal-point Siamese. Ever since we adopted him, he has been mean, often biting and scratching. In the past year, he has calmed down somewhat, but every now and then when he is sitting in my lap, he suddenly attacks and bites me really hard.


A couple of months ago, I had to make an appointment with my doctor because I developed cat scratch fever. Even with medication, my arm still bothers me. Why is my cat acting so aggressively? We got him when he was a kitten, and we have always been very kind to him. We made sure that no one engaged in any rough play with him, but he seems to have this “wild” nature. What can we do to calm him down and protect ourselves from injuries?

Nancy Tarnai

A Dear Nancy: Sorry to hear about the problem you are having with your seal-point Siamese cat. It sounds to me that he has the personality of what I call an “alpha cat” — one who is in charge, bossy and will lash out when he’s not getting his own way. In veterinary textbooks, this is often referred to as “petting-induced aggression” because the cat takes up residence in the owner’s lap, seemingly enjoying the company and then perhaps after willingly accepting some petting, becomes aggravated, agitated, irritable — and then bites or scratches.

Some behaviorists have recommended not petting cats with this problem, and not allowing any lap sitting at all, explaining that cats of this persuasion should be appreciated in different ways. I advise my clients somewhat differently, teaching them to carefully monitor the warning signs, such as shifty sideways glances, ears rotating sideways and a twitching tip of the tail.

At this point, I recommend they stand up suddenly, allowing the cat to fall to the floor. In addition to this specific situational treatment, I teach them how to become more respected by their cats by first clicker-training the cat to obey a cue, such as “sit,” and then requiring the cat to earn all valued assets by obeying that command before the assets (say food and/or treats) are supplied.

I’m sorry to hear that your cat is a carrier of “cat scratch fever.” This medical condition is caused by the Bartonella bacteria and responds to a number of antibiotics, including azithromycin, ciprofloxacin and doxycycline. Though everyone talks about treating cat scratch fever in people using these antibiotics, I’ve heard very little mention of treating carrier cats with this antibiotic to inactivate the bacteria in their system. You might want to speak with your veterinarian about this possibility.

You should avoid all biting instances as far as possible in the manner I have described, and you may want to make sure that your cat’s claws are kept short or perhaps fitted with plastic nail caps.

Nicholas Dodman, BVMS

Animal Behavior Clinic Director

Cummings School

of Veterinary Medicine

at Tufts University

A question about vaccinations

Q Recently, I’ve noticed that my four-year-old neutered male, Berny, has tremors when he is resting or sleeping, especially in his hind feet/legs. Concerned that he might be cold, I’ve checked his paws and lower legs, but they have felt comfortably warm. I know it is not from “dreaming” as he is at times awake.


Touching his feet nearly always gets his attention though the tremors do not always stop. Having outgrown a childhood seizure disorder myself, I worry that he might be experiencing mild localized seizure activity. Is this possible and, if so, what can I do to help him? He’s been with me since he was four weeks old and has been strictly indoors. He did spend time with my mom’s elderly cat, who died from renal failure recently at age 17.

Could Berny have gotten something from this other cat? West Nile Virus has been reported in our area. I’ve kept Berny current on all recommended shots and have been faithful in giving him the once-a-month Revolution dose, but my mom never vaccinated her cat.

Diane Davis

A Dear Diane: I’m not sure why Berny is experiencing these episodes. I don’t commonly recognize tremor syndromes in cats so I consulted Dominik Faissler, DVM, a specialist in veterinary neurology at Tufts University. He agreed that the description of Berny’s episodes is unusual. He recommended videotaping the event and sharing it with your veterinarian. The video could provide useful information to help diagnose Berny’s condition.

It may be beneficial for you to have your cat examined by a board-certified veterinary neurologist in your area. To find one, visit the website under “search for a specialist.” Dr. Faissler and I are uncertain from your description if this will be a life-long or progressive syndrome and an evaluation at this stage seems indicated. Hopefully all will work out and please let us know if a final diagnosis is reached.

Michael Stone, DVM

Clinical Assistant Professor

Cummings School

of Veterinary Medicine

at Tufts University


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