If FAD is even remotely suspected, treatment should be started. Not all pruritic cats have only one disease, and if FAD is an accompanying disease, treatment to eliminate this differential first, allows you to pursue additional other differentials for pruritus. I prefer to use one of the prescription topical preparations for fleas that are applied to the dorsal cervical area. These preparations are known to kill the flea before it has a chance to bite the cat thereby eliminating the allergic reaction to the bite. I also advise the owners to use environmental control, usually a product that contains an insect growth regulator.
Some veterinarians prefer to use steroid injections along with the prescription flea treatment.
This will certainly give the cat some relief if FAD is the only problem, but it may give the owner a false sense of security in that the flea problem has been solved. I prefer to not use steroids if possible, since the owner will be better able to determine how they are doing in eliminating the flea problem on both the cat and in the environment. To be sure FAD does not accompany an additional skin problem, make sure the patient and environment are treated for fleas faithfully for at least one month, then reassess whether the cat is still pruritic. If so, additional differentials for pruritus need to be pursued. Inhalant allergy Inhalant allergy or atopy is a relatively newly recognized disease in the cat.