Do you post on YouTube ?

Why Is My Cat Licking Itself Raw ?

What Is Making My Cat Lick Its Paws And Body Too Much ?

Hair Loss And Scratching Problems In Cats

>
 

How Do I Know When My Cat's Licking Is Excessive ?

What Are Some Common Causes Of Excessive Licking ?

How Will My Veterinarian Diagnose My Cat's Problem ?

What Are My Cat's Treatment Options ?

Ron Hines DVM PhD..........Nothing seems to be helping ? Consider a home cooked diet..

..................

 

Lots of my articles are plagiarized and altered on the web to market products and services. There are never ads running or anything for sale with my real articles. Try to stay with the ones with http://www.2ndchance.info/ in the URL box or find all my articles at ACC.htm.

The treatment and causes of hair loss, itching and dermatitis in cats and dogs are not identical. I do not write my articles simultaneously; so you might find information in the dog article that I have neglected to put in this one. You can read that one here.

Licking and self-grooming are so basic to your cat’s nature that it can be hard to decide when it crosses the line from normal to abnormal behavior. Happy normal indoor house cats spend up to a third of their day grooming themselves. So most cat owners only realize they have a problem when their cat’s hair begins to thin.

When a dog licks excessively, the behavior generally remains an idiosyncrasy, a quirky behavior without physical damage. But when a cat’s self-licking passes from a normal grooming behavior to an obsession, their unique raspy feline tongue rapidly causes hair loss, skin abrasion (damage) and secondary infections. That’s because the sharp hair-like growths (lingual papilla) that you see on the tip of your cat’s tongue act just like a wire brush. You can read more about your cat's tongue here.

How Do I Know When My Cat’s Licking Is Excessive ?

Your cat has a licking problem when:

1) Cats are creatures of habit. Be suspicious if your cat’s licking behavior varies from day to day, week to week or month to month when nothing else in its life has changed.

2) Normal indoor cats do not experience heavy seasonal sheds as some dogs do. Their hair is often a bit thinker in the winter than in summer months; but there should never be times when the hair on its belly, rear thighs or, for that matter, anywhere else on its body becomes thin. When dogs loose hair in a symmetrical pattern on both sides of their bodies, the problem is often hormonal. That is not the case in cats. When they show similar hair loss, they are generally licking the hair off. You may not see them doing the licking because cats are often more secretive about licking and scratching than dogs are. (It is normal for the hair on the temples of cats to thin as they age. That thinning should be the same on both temples. If it is accompanied by scratches or scabs, the cat’s ears need to be checked for mites or infection.)

3) Your cat’s paws should be dry to the touch. If they remain damp when the home environment is dry, suspect a problem. If your cat’s paws are puffy, have a distinct odor, show areas of discoloration, ulceration or are sensitive to the touch, there is a problem. Blisters, growths or burns are always abnormal.

4) Paw infections can also cause cats to limp or be reluctant to move about, jump or climb stairs.

5) Toenails that are broken, cracked or bleeding occur in many skin problems in which excessive licking/scratching is present.

6) An increased frequency of gagging, hairballs or constipation often occurs in cats that are licking themselves too much.

7) Increased dandruff and scruffiness are common in cats that lick too much.

What Are Some Common Causes Of Excessive Licking ?

I have listed them, more-or-less, in the order of how frequently I find them to be the source of the problem.

Fleas

Fleas, seen or unseen are the most common cause of excessive licking and scratching. Cats with a flea bite problem often have scabs surrounding their neck as well as on their back near the base of their tail. When the problem is long-term, their coats are often thin and ragged. It is unclear why some cats are more annoyed by fleas than others. It is common for one cat in a multi cat household to suffer more than the rest. Perhaps this is due to that cat’s unique sensitivity (“allergy”) to flea saliva and antigen or that in combination with its individual temperament.

Just because you never find a flea on your cat is not proof enough that fleas are not all or part of its problem. The presence of pepper-sized grains of blackish material (flea feces) on your pet is evidence enough, but cats often lick that evidence off rapidly. That is why most veterinarians and veterinary dermatologists incorporate a systemic monthly flea-control product in their treatment plan no mater what their probably diagnosis.

You can read an article of mine on fleas and what to do about them here, and two by the most knowledgeable people on the subject here and here.

Mange mites are considerably less of a problem in cats than dogs. But cats are susceptible to several forms of mange. When it is the root of their skin problems, many of the products used on dogs are unsuitable for use on cats.

Cats occasionally have other skin parasites, mange mites, ticks and even lice, but they are not common causes of licking, scratching or hair loss in cats. When they are, the products used to treat them must say clearly on the label that they are safe to use in cats of your cat’s age.

Injuries

Cats will lick an injury incessantly, particularly if the skin has been broken or if some object such as a thorn is imbedded in its skin. Paw injuries from hot objects (thermal necrosis), a pad cut, burrs and splinters between the toes or a broken toenail are not uncommon.

Just as common as paw injuries are abscesses that occur subsequent to fighting.

Putting topical ointments or sprays on this type of wound without some form of physical restraint or topical bandage is a waste of time. Cats lick these products off as fast as they are applied. Without those additional measures, medications need to be given orally or by injection.

Eosinophilic Granuloma Complex

Eosinophilic granuloma complex or EGC might be listed by some vets as more common than injuries as a cause of excessive licking. The term groups a number of disease that cause similar body reactions – all associated with an abnormally high number of blood cells called eosinophils being present in the itchy area and often present in abnormally high numbers in the cats blood circulation as well.

In some cases, a hypersensitivity to fleas appears to be the cause, in others, perhaps a host of other hypersensitivities or “allergies”. No matter what the underlying cause, all respond favorably to medications that suppress the cat’s immune system with all the dangers doing so entails. So saying your cat has an EGC problem is like saying it has a vomiting problem. The real question is why ?

When large areas of the cat are affected by EGC in its crusty rash or red bump form, it is often called miliary dermatitis.

Allergies And Sensitivities

The relationship between Eosinophilic complex disease, simple allergies and sensitivities is unclear. Allergies are true immune system phenomena in which the cat’s immune system attacks specific substances it has mistaken for invaders. In Eosinophilic complex disease a similar process is occurring. In substance sensitivity, the cat simply cannot tolerate exposure to a certain substance or chemical. There could even be cats in which all three processes are involved.

When veterinarians think of allergic skin disease or atopy, they tend to think about dogs. But cats can have allergies too and like dogs, they can express those allergies through itchy skin. The skin appears to be the primary target organ for these allergies in pets, in humans; the primary target is our respiratory system. The inhaled pollens of trees, grasses and mold spores appear to be the most common allergens in dogs and cats. Certain breeds like Siamese and Bengalis seem more prone to having the problem.

Inhaled chemicals are not the only root of sensitivities. Perfuming agents added to cat litter, household cleaning products, sanitizers, deodorants and industrial chemicals incorporated into common household goods and carpeting have also been implicated. Occasionally (but not commonly) food ingredients are thought to be the trigger.

Anxiety And Stress-related Obsessions (psychogenic alopecia)

Animals (and people) faced with stress often react with exaggeration of common activities they find pleasurable and comforting. Psychogenic or stress hair loss is a way that cats deal with stress and worry of one form or another. (professorial folk would call this a “displacement behavior”)

When grooming becomes obsessive in this way, the result is a cat with thin or bald areas of hair. These areas are usually similar on both sides of its body. Any area can be affected but the cat’s flanks and thighs tend to show the most hair loss damage. As the problem persists, only areas of the head and in between its shoulder blades remain normal because the cat cannot reach them when it grooms.

Skittish and nervous cats, as well as cats that live in group homes seem more prone to this problem but it only becomes the likely diagnosis when test have ruled out all organic causes. The loss of a companion pet, a caregiver or major changes in the home environment often trigger this problem.

Boredom

The individual temperament of cats vary as much as they do in humans. So cats do quite well when left alone in a boring environment. Others spend their time munching and plumping up. Still others spend their time licking and grooming. When owners suspect that boredom is the cause of their cat’s excessive licking, they sometimes alleviate the problem by adding another pet, turning on radios and TVs, making window ledge perches to observe the out-of-doors, and other forms of environmental enrichment . Save the thought of adding another pet for last. The effects of additional pets are unpredictable and once they become family members, you are pretty much committed to keep them. Adding a kitten often works – temporarily - but that kitten will mature and when it does, it will assert itself in ways that might add stress to the original pet. I have never done well in predicting which cats will enjoy living in groups and which prefer their solitude the exclusivity of their owner’s attention.

Compulsiveness

Some cats have more compulsive temperaments than others. Some breeds, like Siamese, Bengals, Burmese, Balinese and Tonkinese appear to me to be more emotionally sensitive and apt to develop stress-related hair loss. I see more cats with this problem that share the thin, “pink panther” physique than plumper felines, and more often in female than male cats. They are also the cats most likely to be “wool suckers”. They also appear to be over-represented in all forms of skin ailments.

The best treatment for compulsive cats is to divert their attention to activities that are not self-destructive.

Obesity

One cannot prove that fat cats are any more likely to over-groom than thin ones. In fact, I see more thin cats with hair loss than overweight ones. But very fat cats might be inclined to spend more time performing low-energy activities like grooming. Such is the case in dogs.

Feline hyperesthesia

Feline hyperethesia syndrome or “ghost pains” is a condition of cats that is very poorly understood. The same cats at risk of compulsive behavioral problems appear more at risk of this condition as well. It is believed to be a neurological problem, which causes the perception of itching or pain in areas where no cause exists.

Cats with feline hyperethesia syndrome lick or bite themselves excessively for no apparent reason. During these episodes, they may vocalize as well. The skin on their back often ripples or spasms and they appear out of touch with their owners and environment during the episodes. Some describe it as “pouting”, others as being “distant” still others as having a “tantrum”. In many ways, I find it similar to the frontal lobe epilepsy I have seen in children. These cats have been known to attack their owners during episodes and it has also gone under the name of “cat schizophrenia”. During these periodic bouts, many become hyperactive, overly alert and wide eyed – as if they were on some form of methamphetamine medication.

Some of these cats are sensitive along their backs when touched. Some chase or swish their tails. A few progress to seizures.

Before you jump to conclusions, be sure that fleas are not the cause of your cats bizarre behavior. I also check these cats to be sure they do not have the dry form of FIP, hyperthyroidism, FLV or FIV.

Again, cat breeds known for their compulsiveness are over represented with this problem too.

It is hard for veterinarians to treat a disease for which the symptoms are apparent but the cause remains obscure (unknown). But most vets attempt to control the problems with mixtures of human antidepressant and anti-compulsive mediations and/or drugs know to control epilepsy. (Prozac, Amitriptyline, clomipramine, Phenobarbital) The cure rate is low.

Skin Infections

Whenever a cat’s skin is abraded, inflamed, or its outer protective coating (stratum corneum) is destroyed by licking, bacteria and fungi (Malassezia) take advantage of the situation. These are called opportunistic infections. They are never the root or underlying cause of the cat’s skin problem. That does not mean they do not need to be treated to allow the cat’s skin to heal and itching to subside. It just means that if the underlying issue is not solved, the problem will return. All cats with skin infections that can not be readily explained or that relapse after antibiotic therapy ceases need to be tested for FLV and FIV.

Ringworm is a special case. It is capable of causing hair loss and dermatitis when no underlying cause is present. Luckily it can be easily diagnosed and cured.

Certain virus can, on rare occasion, also affect your cat’s skin. One of these is the cat herpes-1 virus. You can read about it here. Another is the feline calicivirus. You can read about skin problems linked to that virus here.

Stitch Abscess

If your female cat has one or multiple pustules, lumps or open sores just ahead of its belly button (umbilicus), have your vet probe that area for a protruding suture ruminant from the time it was spayed. They are easily removed. If your cat was declawed and a paw is incessantly licked, check that paw for a retained suture from the time of the declaw surgery. Old braided suture frizzles into wispy filaments – it can be hard to distinguish from fur.

Improperly Performed Declawing Operation

Occasionally, a inexperienced veterinarian or their assistant will miss a portion of the nail root when a cat is declawed. These surgeries usually heal normally at first. But the error eventually leads to a painful foot, limping, licking and a persistently draining lesion on the affected toe.

Plasma Cell Pododermatitis (Foot Pad Disease)

Cat owners occasionally bring pets that are reluctant to walk or limping to their veterinarian with another poorly understood problem. When the vets examine the paws of these pets, they notice that the food pads of all four legs are inflamed but not necessarily to the same extent. They may be puffy, the skin may be cracked and painful they may be darker in color (bluish) than normal and, when severe, the pads may bleed. These cats did not jump onto stoves or track through harsh chemicals.

Plasma Cell Pododermatitis often improve temporarily when given corticosteroids, but the problem comes back. Doxycycline antibiotic and medications that aid in blood flow (pentoxifylline) will occasionally give temporary relief as well.

When tissue from the affected footpads is examined by pathologists, the most remarkable finding is the presence of abnormally high numbers of plasma cells. These cells are a component of your cat’s immune system. They generally rush to an area of the body that is perceived to have been invaded by some foreign agent. When this problem occurs and no foreign agent is present, we call it an autoimmune phenomenon and assume that the cat’s body mistakenly perceives some portion of its normal tissue as being a foreign agent.

Many cats go on years with intermittent, mild foot pad inflammation that requires no treatment. In others, it can become debilitating. Veterinarians rely on medications that suppress the cat’s immune system to keep these difficult cases under control. However, the use of any of these medications, other than for brief periods, bring problems of their own. Cyclosporine (Atopica) is one of those agents.

Some of these cats are found to be positive for feline aids virus. In others, blood gamma globulin levels and lymphocyte numbers are persistently above normal.

You can read scientific articles on plasma cell Pododermatitis here , here and here

Hormonal Imbalances

Although hormonal imbalances are a common cause of non-itchy, symmetrical (same on both sides of the body) hair loss in dogs, they are an uncommon cause in cats that have hair loss that look quite similar. However, the thyroid gland function of older cats and those on fish-based diets ought to be part of the initial blood scans on licking and hair loss cats unless another cause is readily apparent.

Foot Tumor In Old Cats

Elderly cats occasionally develop tumors on their paws and elsewhere that can lead to licking and hair loss. There are many tumor types (squamous cell carcinomas, mastocytomas, exocrine sweat gland tumors, lymphomas, liposarcomas, etc.)

Autoimmune Diseases

I mentioned that veterinarians suspect that several of the skin conditions I previously mentioned have an element of autoimmune disease in them. But a classic form, pemphigus foliaceus, is also known to occur in cats.

By the time your general veterinarian becomes frustrated with the problem and refers it to veterinary dermatologist for diagnosis, about 6 in 100 cat skin problems end up being cases of pemphigus foliaceus. These cats usually have dermatitis of one degree or another on the front of their head, which is unusual in most of the conditions I previously mentioned. You can read a thorough review of the signs and treatment for this disease here.

Other Health Issues

Cats with health problems that are not primarily skin problems often look bedraggled and ill kept. In their poor health, they may not replace lost hair at the rate they once did nor are they motivated to do much else than lie around, groom and lick. These cats tend to loose hair on their bellies. They can lick that area due to pain-related health problems such as cystitis as well. Cats with inflammatory bowel disease or triad disease tend to dry, flaky skin because they do not absorb fats and proteins adequately. They can benefit from highly digestible diets. You can read about such diets here.

How Will My Veterinarian Diagnose My Cat’s Problem ?

When you take your pet to the vet for licking, scratching and hair loss, your veterinarian’s examination will include some of the following:

Simple as it may sound in the 21st century with so many sophisticated tests available, the two most important diagnostic aids your vet has are listening you talk about your cat’s home life and how its skin problem developed followed by a careful physical examination of your cat.

The Cat’s History

In obtaining that history, your vet will keep you on track with a few critical questions that guide him to the most likely causes for the symptoms you describe. All vets sore these mental flow charts in their brains that help lead them through maize of possible causes for what they see. “when did you first notice the itching or hairloss ? ” “How did it progress ?” “Have there been any other changes in its behavior? ” “What medications does it receive? ” “have any other family members developed similar signs? ” etc.

Physical Exam

Often, your vet will be conducting his physical examination at the same time this conversation is occurring. He/she will be observing the small characteristics and distribution of the hair loss, rashes, bald areas, scratches, etc. and making mental notes of similar cases he has seen in the past or read about.

Your cat’s age is also an important clue. Kittens and adolescent cats are more likely to have fungal or skin parasites at the root of their problem, while cats in their twos and threes are most likely to experience allergies and food sensitivities. As I mentioned earlier, breed can also be an important clue.

Ultraviolet Light Examination

Most vets follow their physical exam with an examination of the affected areas using an ultraviolet light source (a woods lamp) in a darkened room. Individual hairs of cats with fungal infections (ringworm) often glow under this light source. You can see how its done here. They well then probably go on to a microscopic examination of a skin scraping from an affected area. They will be looking for parasites or evidence of fungi. If the hair loss is characteristic of fungi but none were found, they may pluck out some likely hairs and submit them for fungal culture.

Cytology

Some vets will make glass slide impression smears from affected areas, process them with special staining solutions and examine them under a microscope (cytology). I have rarely found that to be diagnostic when the test is interpreted by other than a trained pathologist but a few astute vets excel in detecting tell tale clues from the procedure.

Skin Biopsies

Much more helpful are small snippets of affected skin (biopsy specimens) that are sent to a central pathology laboratory. Many skin diseases can be ruled in or ruled out through biopsy results. Biopsies are often reserved for cases that fail to resolve with treatment.

Skin Culture and Antibiotic Sensitivity

In some more severe cases, bacterial skin cultures with subsequent antibiotic sensitivity tests on the bacteria found are desirable to determine which antibiotics are liable to be the most helpful. Again, it is uncommon to do skin cultures unless initial treatments fail.

Allergy Testing

Allergy testing , both through intradermal testing or analysis of the cat’s blood, rarely adds treatment options or confirms a diagnosis. When it is performed, at least 4 months need to have passed since a course of corticosteroids have been given.
Read more about the limitations of that testing here.

You can read more about how diagnoses are made for itching (pruritic) cats here.

Treatments

Treatment options are harder to carry out in cats than dogs because cats are considerably harder to medicate. Owners need frequent encouragement and support from their veterinarians or many of them are likely to give up rather than face a constantly struggle to get medications into their cats. Some cats are more obstinate about taking meds than others. Unfortunately, it seems like the obstinate, high-strung ones are the ones most likely to have the problem.

Topical Ointments

I am not a fan of topical ointments applied to cats. Cats quickly lick these products off when they are left uncovered or when the cat is left without some form of physical restraint (Elizabethan collars, neck cones etc.) Both bandages and restraint collars just add to the underlying stress the cat is experiencing.

Systemic Antibiotics

A much more effective way than ointments or sprays to deliver antibiotics is by giving them orally or by injection. Antibiotics need to be given for about three weeks to gain the most assurance that the problem will not return. Commonly prescribed antibiotics for skin problems in cats include clindamycin, and amoxicillin/clavulanate (Clavamox). Cephalexin and cefadroxil are OK, but they sometimes cause digestive upsets.
In obstinate cats, an injectable form of Cefovecin is available that lasts for a full week. (ref).

Doxycycline antibiotic seems to aid in certain cat skin problems through an unknown mechanism that does not have to do with bacteria. But when it is given orally, it must be followed by food or water to prevent esophageal damage. (ref)

Shampoos And Rinses

These products can be very helpful in the long term controlling of many skin conditions. In some cases, medications they contain suppress itching and inflammation directly. In others washing toxic or inflammatory substances from the cat’s skin surface are their primary mode of action. They are rarely a cure in themselves, but they are often part of a successful treatment plan. They include products that contain colloidal oatmeal, topical steroids, antiseptics, petroleum distillates or parasite-killing sulfur. Not all dog or human medicated shampoos are safe to use on cats. Be sure the product states somewhere on its label that it is approved for use in cats.

Antihistamines

Antihistamines are not as effective in controlling the signs of allergy in cats or dogs as they are in humans. But they can be part of a good long term treatment plan and their side effects in cats tend to be mild at the proper dose. Two that I have found particularly effective are Hydroxyzine (Atarax) and Cyproheptadine (Periactin). They seem to have a calming and increased well-being effect in cats that is unrelated to their antihistamine properties.

When using antihistamines, begin at a low-end dose and gradually increase it under the guidance of your veterinarian. Lower the dose if anxiousness or hyperactivity occur. Some cats on these products need diet control to keep them from gaining too much weight.

Steroids (corticosteroids)

All veterinarians know that they can stop itching dead in its tracks with corticosteroid drugs. The most common one used in cats is prednisolone. However, veterinarians also know that there can be a large price to pay for giving these products for long periods of time. It is always a cost versus benefit decision when electing to administer corticosteroid products for more than a few weeks. When they are given for skin problems, there is no place for the long acting preparations such as depomedrol (“Depo”) unless the cat simply refuses be given oral steroid medications.

Distractions And Diversions

You know, in your own life, that annoyances, aches and pains are less of a problem when enjoyable or interesting things are going on at the same time and worse when negative events are occurring. The same system occurs in your cat. Every disease has a “psycogenic” component - an increase in severity when the brain focuses on a physical or mental problem. So the more you keep your cat occupied with happy, interesting distractions, the less severe the skin problem is likely to be. In some cats, the improvement can be profound, in others, less so. Only when stress, boredom, anxiety or compulsiveness are the root cause of the skin problem will distractions be sufficient in themselves. But they should always be part of the treatment plan.

Good active diverters are things like kongs, tennis balls, laser penlights, chasing Christmas lights, scratching posts, food mazes, puzzle feeders etc. The number of things you can add and do to divert your cat from licking and scratching is limited only by your imagination.

Mood Altering Drugs

When all else fails, some owners and veterinarians resort to mood altering medications. There is no harm in giving these medications at the proper dose, for limited periods of time (a month or two) – time enough to give lifestyle changes and other medications a chance to work. Itching can be self-perpetuating – itching causes scratching and licking and scratching a licking causes more itching. So there can be a place for mood altering drugs as an alternative to physical restraint.

One commonly used medication in this class is amitriptyline, an antidepressant which some veterinarians believe also functions as an antihistamine. It needs to be given under the close supervision of your veterinarian as it can have a number of worrisome side effects including lowered white blood cell counts, altered mental states, urinary retention, dry mouth and constipation. It must be given with great caution to cats receiving hyperthyroid medications or other psychoactive drugs.

Another commonly prescribed medication is clomipramine (Clomicalm, Anafranil) Your cats can receive one or the other of these two medications , but never both at the same time.

Some cats respond positively to cat facial pheromones such as the Comfort Zone system or catnip which mimics it. There is no known down side to using them. Only one third to one half of all cats respond at all to catnip (ref). That may apply to artificial cat pheromone-like products as well.

Tranquilizers

Like the mood altering medications, tranquilizers can have a place in your cat’s treatment plan when they are used for limited periods to open a window for other medications and life style medications to work. The two most common ones dispensed to cats are acepromazine (Promace) and diazepam (Valium).

Progestational Medications

Drugs associated with pregnancy, called progestationals also have a calming effect (depopovera, megesterol) . But they cause side effects similar to steroids and so, must be used just as cautiously.

Corticosteroid-containing Sprays

These products often have an antibiotic in them as well. But it is the steroid in them that works, if at all. The steroids used in topical sprays, (often betamethasone), is a type that is less absorbed when it is licked off than pill-form steroids. But don’t overuse it because some will be absorbed in that manner. Either it stings when applied or some cats find the odor of the product objectionable. But that effect only lasts a minute or two.

Cyclosporine (Neoral, Atopica)

This product is heavily marketed by the pet pharmaceutical industry because of its profit-earning potential (corticosteroids are off-patent). Its possible side effects are wart (papilloma) formation, gum disease (hyperplastic gingivitis), activation of silent (latent) toxoplasmosis and cancer. It will grow hair on women (hirsutism) so perhaps something similar might occur in cats.

Weigh the positives and negatives of this product carefully before deciding to use it in your cat. You can read more about cyclosporine here.

Bitters Sprays

You can run down to your local Petco or PetsMart and pick up a bottle of bitters spray.
It has a vile taste, but I have not found that it stops itching and excessive grooming. A side effect is that everything in your home will taste bitter as your cat moves about the house.

Diet Change

Unless your veterinarian is quite certain that he/she knows the cause and cure for your pet’s skin problem, a diet change is often a good inclusion in your cat’s treatment plan. Mealtime is always a delightful time for cats. Not only is what they eat important, but so is the presentation, frequency and portion size. So even if you cat has no food hypersensitivity, a new, savory diet, presented in novel ways is an excellent means of distraction from licking and scratching. For itching cats, I prefer diets that are high in a single meat ingredient, high in fresh animal fat, low in grains and other plant products, correctly vitamin and mineral balanced and prepared at home. You can read about them here.

Be cautious about including fish or other sea foods other than moderate amounts of human-quality fillets. It is possible that the high iodine content of fish byproducts increases your cats risk of hyperthyroidism. (ref).

It can take 2-3 months to see a positive change. Make all diet changes very gradually. If you purchase one of the many limited-ingredient commercial diets, a moist one is always better than one that is dry.

Flea Control Products

Even if you know that your cat’s problem is not flea-related, any exposure to fleas is going to make it worse. So use one of the newer monthly topical flea control products. Be sure the package says it is approved for use on cats. Many veterinarians increase the frequency of application to twice a month even though product instructions suggest a single monthly application. You can read some tips on flea control here. To be effective, you must treat every dog, cat or ferret in the household. If you have an in-and-out cat, consider making it and “in” cat only. If you have feeders outside, remove them, opossums and raccoons carry fleas.

Lifestyle Changes And Environmental Enrichment

It is hard to separate distractions and diversions from lifestyle changes and enrichment, but things like bird feeders outside the window, climbing platforms, hinging mobiles will keep your cat from becoming bored or focusing on its skin and fur.

Lifestyle changes, particularly for sensitive or shy cats, need to be made gradually. Spend more time with your cat if you can. Some cats feel threatened by the visual presence of outdoor cats. That, in itself can be enough stress to cause urine spraying and even compulsive behaviors such as over-grooming.

Punishment , Denial of Affection or Shouting

Never a good idea.

Elizabethan Cones

These collars or donuts are an increased stress on your cat. But there is no doubt they prevent the cat from licking and chewing. Consider them only as a short term fix – like duct tape on a broken car window until you can get to the autoshop.

No Baby Or Mineral Oil Topicals

Do not use baby oil or any other petroleum oils on your cat’s skin. It can lodge in their lungs when they lick it off.

Booties And Bandages

These work well to control compulsive paw licking in dogs. I have no experience using them on cats.

Bandages on your cat’s paws or other portions of its body tend to become damp with oozing liquids causing infection.

Humidifiers

Some cat owners seem to think they are helpful. If you live in a dry, arid climate or your winter furnace heat is dry, you might experiment with one.

A Litter Change and A Chemical And Volatile-Free Environment

Both are worth a try if your cat is not making progress.

Omega Fatty Acid Supplements

This again is a treatment with no apparent downside. However, many of these products contain seafood ingredients. Inquire as to the level of iodine in them. (ref)
High iodine intake has been associated with thyroid over-activity
(hyperthyroidism).
(ref)

Alpha-interferon

Interferons have the ability to activate the body’s immune system in multiple ways. It has been given to cats for numerous problems that include inflammation, virus infection or cancer. Its effects, if any, are hit-or-miss. Use it as a last resort since it does have the potential for unwanted side effects similar to those occasionally seen in humans. (ref)