I love the fact that the Internet allows me to interact with people from around the world. Here's a question from Nagwa in Egypt.
I am writing to you from Cairo, Egypt. My beloved friend is Lucy a female cat. I found her when she was a few-days-old kitten. She is now about seven years old. Although she is so cute; she aggressively refuses to go the veterinarian because of previous painful experiences. As she was treated from tooth decay and the doctors took off many teeth, in addition to being treated by painful injections from Pus on the uterus.
Now, her top complaint is in her scalp and hair. I don't know how to describe it, please refer to the attached pictures. Knowing that these pictures were taken about two months ago, it is spreading allover her body now. It was treated before as allergy with no use. I hope that you would be able to help us by these pictures.
Moreover, she is very aggressive against the other three females I have (I found them on different occasions), and I was forced to keep her in a separate room as she beats them badly. At first, I was able to get her out of the room for several hours daily while keeping the others in another room, but ten months ago I couldn't do this anymore because she sprays everywhere (like males) when she gets out of her room. I know that she is sad for being kept in the room while seeing the other three cats going around, but I can't help it. I try to play with her several times during the day in addition to spending the night with her in the room but she is not happy.
Would you please advise me what to do?
I'm not posting the pictures, but Nagwa did include some photos in the email. One of the big things to consider in this case is that there are often geographic and regional differences in what parasites and diseases are common. I'll be honest in saying that I have absolutely no idea what may be found in the Middle East, so my answers are going to be limited to my knowledge of feline medicine and diseases in the US.
I hate to say it, but Lucy really does need to be seen by a vet. The pictures show some shortened hair and what appears to be hair loss on the legs and tail. While I can speculate on some possibilities, nothing is going to take the place of a vet looking at her and doing some diagnostics.
The first possibility is something simple....fleas. Here in the US that would be my number one possibility, even for an indoor cat. However, fleas do better in warm, humid environments and are rarely found in desert areas of America. So I would imagine that they wouldn't be extremely common in Egypt.
Itching and chewing can also be due to other ectoparasites, such as skin mites and lice. These can be easily diagnosed by vet and are normally easy to treat. Lice can be seen with a close exam, but skin mites require a microscopic exam of skin scraping samples.
The other big possibility would be allergies. This isn't as simple to diagnose and treat as would be imagined. Allergies can be caused by numerous things, including dust mites, pollen, mold, fleas, and food ingredients. Nagwa, you said that she was treated for allergies, but there is not one treatment. For contact allergens treatment may include antihistamines, steroids (injectable or oral), and medicated shampoos. Food allergies won't typically respond to such medications, and the only real way of handling that situation is a diet trial of two to three months of a specific hypoallergenic diets. These foods must be fed exclusively with no variation at all. If all of these possibilities weren't considered or attempted, there are still options to try.
The behavioral issue is another situation entirely. A possible treatment that doesn't require veterinary prescriptions would be Feliway, a duplication of a pheromone in cats' cheek glands, and a chemical that has been shown to reduce anxiety and stress in the majority of cats. I have no idea whether or not this would be available in Egypt, but it's easy to find on the Internet so perhaps you could order some internationally, depending on the shopping sites you have access to. Other than something like Feliway you may have to look at prescription antianxiety drugs such as amitriptyline, fluoxetine, or clomipramine. These all require a veterinary prescription and will require the vet visit.
I'm not sure if any of this helps, Nagwa, but I appreciate you asking me. I hope a local vet can give you more answers.