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Diagnostic challenge in veterinary pathology: Chronic ulcerative pododermatitis in a cat

A 6-year-old, castrated, male domestic shorthaired cat presented to the Ohio State University College of Veterinary Medicine Dermatology Service in March 2021 for evaluation of chronic pododermatitis. The owner first noted the lesions in February 2018. Clinical signs included licking of his right forepaw with crusts noted on his paw pads. The licking continued and the lesions progressed and became ulcerated and hemorrhagic. Similar lesions developed on the right hind paw. Various medical therapies were attempted by the referring veterinarian including antibiotics (cevofecin, orbifloxacin, zithromycin), glucocorticoids (prednisolone), and cyclosporine. The cat tested negative for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). A biopsy from the right front paw pad in January 2019 revealed chronic pyogranulomatous pododermatitis with ulceration. Special stains (Gram and FiteFaraco acid-fast) were performed, and no etiologic agents were apparent. The lesions waxed and waned for 3 years, sometimes with several months between recurrences. The lesions recurred in January 2021 with associated lameness, prompting referral to our dermatology service.