Is it really psychogenic alopecia?

In cats, psychogenic alopecia is a common diagnosis when medial regions of limbs, caudal abdomen and the inguinal area affected by hair loss – but it’s important to rule out many other conditions before confirming this diagnosis.

In this article, the authors stress the importance of obtaining a full clinical history and of performing a rigorous physical examination. They also recommend additional tests, including skin scrapings, cytology, fungal culture, trichoscopy, parasitic treatment and an elimination diet. Should these prove negative, glucocorticoids, lime sulfur dips, urinalysis and evaluation of blood samples are recommended as next steps.

Their study considered 21 adult cats referred with a presumptive diagnosis of psychogenic alopecia and with a minimum six-month period of continual hair loss. Each cat underwent an exhaustive diagnostic protocol in order to determine the existence of underlying medical conditions.

In 76% of the cats, psychogenic alopecia was not the cause. In fact, it was confirmed as the cause of hair loss in only 10% of the animals. Diet was the key factor with 57% of the cats showing adverse food reactions.

In addition to the conclusion that psychogenic alopecia is over-diagnosed in cats, the authors’ findings support previous studies that show that the presence of even a few eosinophils in the dermis mean that other conditions should be considered.

Waisglass S., Landsberg G., Yager J., Hall J. Underlying medical conditions in cats with presumptive psychogenic alopecia. J Am Vet Med Assoc. 2006 Jun 1;228(11):1705-9. DOI: 10.2460/javma.228.11.1705