Poor Wound Healing in a Diabetic Cat

Uncontrolled Diabetes can cause Skin Infections but Cushing’s Syndrome is a Major Cause of Thin Fragile Skin

Question:

My 15 year diabetic cat got a scratch behind her ear. She continued to scratch at it making it go to a gaping wound. A vet gave us antibiotic ointment and got it healed. She opened it up again. We’re now dealing with an e-collar and after 3 tries at leaving it on for 4-6 weeks whenever we take it off she opens it again. Will her e-collar become a permanent part of her dress – or is it her diabetes that prevents this from healing?

 

Dr. Nichol:

Your kitty may have serious problems. Diabetes that is not well controlled can cause skin infections that lead to poor wound healing. Some diabetic cats also have a disease of the adrenal glands called Cushing’s syndrome. Cushing’s causes thin, fragile skin. It’s also possible that the antibiotic ointment may be entirely to blame.

 

Check the label. Many prescription ointments contain a corticosteroid (like triamcinolone, dexamethasone, or hydrocortisone) to reduce inflammation. Unfortunately these topical steroids can delay healing if used long term. Provided that your cat’s diabetes is well controlled and stable, and she is otherwise healthy, simply discontinuing the ointment could solve her problem.

 

Diabetic cats have special needs, especially if they also have the high levels of the hormone cortisol that is seen in Cushing’s syndrome. Not only do these kitties struggle with skin disease, they may drink and urinate excessively, and develop liver and joint disease. To be safe your cat needs a follow-up exam and current lab work. Sorry this is complicated. While most diabetic cats do OK with careful feeding and insulin dosing those with concurrent Cushing’s syndrome usually need surgery of the adrenal glands to get lasting relief.