Plasma cell pododermatitis

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Swelling of the footpads of a DSH cat with plasma cell pododermatitis and FIV infection
Feline plasma cell pododermatitis of unknown etiology

Plasma cell pododermatitis ('Spongy pad') is a rare skin disease of cats.

There appears to be no breed, age or sex predilection for this diseases. A number of incriminating causes have been implicated, of which FIV, Mycobacterium spp and FHV have been mentioned[1], as well as Anatrichosoma spp nematode infection.

Seasonal occurrence has been suggested but not confirmed[2]. An immune-mediated relationship has been hypothesized since hypergammaglobulinaemia appears to be a consistent finding[3]. Additional features such as glomerulonephritis, leucoclastic vasculitis and plasma cell stomatitis may also occur[4].

The disease usually starts with marked pain in one or more metacarpal or metatarsal footpads. These swollen footpads are soft and painful in the center, causing lameness. With time, swellings, which ulcerate and bleed at the slightest touch, develop on one or more metacarpal or metatarsal footpads and/or digits[5]. The lesions often look purple and crosshatched with pale striae and feel spongy[6]. The older the lesions are, the more likely they are to develop secondary infection. Cats are sometimes affected systemically with pyrexia, listlessness, anorexia, anemia and peripheral lymphadenopathy. In a minority of cases, there may be concurrent plasma cell stomatitis, immune-mediated glomerulonephritis or renal amyloidosis[7].

Histopathologically, there are dense infiltrates of plasma cells with smaller numbers of lymphocytes and macrophages. Mycobacteria have also been reported in a small number of cases, but is not the norm[8]. That there is a variable histopathological appearance to pododermatitis in cats, suggests that the clinical signs may well be the result of any number of etiological agents, with infections (bacteria and viruses) and hypersensitivity as possible primary factors.

A differential diagnosis would include Sporothrix spp fungal infection, which is common in tropical regions of the world.

Spontaneous recovery is common in some cases after 2-3 months, and this appears to reflect the multiple etiology. A few cases have been treated surgically, but the majority are treated with immunomodulatory drugs such as Interferon-Ω.

Azithromycin and Doxycycline appear to have some success in 35-50% of cases[9]. Recovery reflects the ability to determine the causative agent and/or treat with appropriate antimicrobial/immunomodulatory medication.

References

  1. Simon, M et al (1993) Vet Pathol 30:477
  2. Gruffydd-Jones, TJ, Orr, CM & Lucke, VM (1980) Foot pad swelling and ulceration in cats: a report of five cases. J Small Anim Pract 21:381-389
  3. Guaguere, E (1992) Feline pododermatitis. Vet Dermatol 3:1-12
  4. Scott DW (1987) Feline dermatology 1983-1985: 'The secret sits'. J Am Anim Hosp Assoc 23:255
  5. Guaguere, E & Prelaud, P (2000) A practical guide to feline dermatology. Merial, France
  6. Taylor, JE & Schmeitzel, LP (1990) Plasma cell pododermatitis with chronic footpad haemorrhage in two cats. J Am Vet Med Assoc 197:375-377
  7. Scott, DW, Miller, WH & Griffin, CE (2001) Muller and Kirk's Small animal dermatology. 6th Edn. Saunders, Philadelphia
  8. Rest, JR (2006) Controversial and emerging diseases. In: August, JR (Ed): Consultations in feline internal medicine. Vol 5. Elsevier Saunders, Philadelphia. pp:267-278
  9. Bettanay, SV et al (2003) Treatment of plasmacytic pododermatitis with doxycycline - a prospective study. Vet Rec 152:564-566
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