Pododermatitis in Cats

It is thought that an underlying infection may cause this incorrect inflammatory response to occur. All ages and breeds of cats can be affected by this condition. Both males and females are susceptible to pododermatitis. If you suspect your cat has pillow foot, bring it to a veterinarian for treatment as soon as possible. If this problem is left untreated, secondary infections may develop. The issue can be very painful in advanced cases, leaving the cat with puffed-up paws that are tender to touch. The cat may eventually become quite lame if the paws become too damaged. Pododermatitis is often paired with renal amyloidosis (a kidney disease) or plasma cell stomatitis (a disease of the mouth).

Feline plasma cell pododermatitis, often called “pillow foot”, is a condition in which severe inflammation develops on the foot pads of a cat. All four pads may be affected at once, and it is rare for only one paw to be inflamed. Plasma cells are fully matured lymphocytes (white blood cells) that are produced by the immune system in the body. Pododermatitis occurs when the immune system is mistakenly triggered and it overproduces lymphocytes that then pool in the cat's foot pads. Antibodies then attack healthy paws and cause swelling and pain to develop. 

In very mild cases, the cat may not be experiencing any discomfort. Signs of pillow foot may manifest along with signs related to mouth sores or kidney problems. Signs to watch for include:

• A “mushy”, swollen foot pad
• Bruising or purplish coloring on the foot pad
• Ulcerations on the foot pad
• Lameness 
• Splitting of the foot pad
• Tenderness when touched
• Lethargy
• Anorexia 
• Excessive licking of the paws
• Bleeding from the paws

The exact reason that a cat may develop pododermatitis is largely unknown. While there is reason to believe that a malfunctioning immune system plays a part in the condition, more research is needed to confirm the exact cause of the reaction. All known causes are listed below.

• Immune disorders
• Reaction to certain litter materials
• Feline Immunodeficiency virus (over 50 percent of cats with pillow foot are FIV positive)
• Feline leukemia virus (FeLV)
• Calicivirus 
• Feline infectious peritonitis (FIP) 

Make an appointment with your veterinarian to have the cat's feet professionally assessed. Be sure to provide the veterinarian with the cat's full medical history to assist with diagnosis and provide possible reasons for the development of pododermatitis. The veterinarian will then perform a complete physical examination of the cat. Pillow foot can often be confirmed by visual observation from a trained animal health care provider. 

Full blood work will likely need to be run including a complete blood count to check for anemia, and a biochemical profile to assess all levels of substances in the blood. In cases of pododermatitis, both the number of lymphocytes and the levels of globulin antibodies will be increased. The veterinarian will have to differentiate pillow foot from other issues that involve the foot pads, such as insect bites and cancerous or benign tumors. For a total confirmation of pododermatitis, a biopsy of the inflamed foot pad may need to be taken and histopathologically examined to establish if increased plasma cells are present. Viruses such as FIV and FeLV should be tested for.

If the case of pododermatitis in the cat is very mild, less aggressive treatments may be sought first. There has been success in treating immune system reactions which may be causing the footpad inflammation. If any secondary health issues have developed, they may also need further treatment.

Antibiotics 

Oral administration of certain antibiotics has been found to be effective in treating some cats suffering from pododermatitis. Doxycycline is one antibiotic that has properties that seem to regulate the immune system. Approximately half of cats with pillow foot will experience improvement when going through a long term course of antibiotics. 

Steroids 

A prescription of steroids may be useful in treating underlying immune disorders. Oral administration of prednisone or glucocorticoid on a daily basis can be effective. Injections of methylprednisolone acetate can be a longer-lasting alternative.

Surgical Removal 

In advanced cases of pododermatitis where ulcerations have formed, surgical removal of the ulcerations may be necessary. General anesthesia is required for this procedure.

If your cat has undergone surgery, you will need to follow all at-home care instructions provided by the surgeon. Special attention may be needed to keep the affected feet clean throughout the healing process. Activity may need to be limited during this time. Monitor the incision daily to ensure no signs of infection have developed. Regardless of whether surgery has been performed, keep your cat's litter box extremely clean. You may need to switch the type of litter you have been using to a more natural alternative. 

Administer all medications as prescribed. Regular follow-up appointments will be needed to assess if the condition is healing, and to possibly adjust dosages if adverse side effects to medications have begun to manifest. Giving anti-inflammatory supplements can also help your cat by strengthening its immune system. Topical treatments such as moisturizer application and the soaking of cracked paws can help to soothe soreness while the underlying problem is addressed. Spontaneous recovery of pillow foot is possible in some instances. The issue is often manageable and affected cats may go on to live a normal life. If the cat has been diagnosed with a feline virus, the prognosis may worsen.