Treatment options for cats with feline atopic skin syndrome
Sandra Koch, DVM, MS, DACVD, offers a comprehensive overview of available therapies for feline patients with this allergic skin condition
Treating feline atopic skin syndrome (FASS) can be challenging, as treatment options for cats with this condition are limited, according to Sandra Koch, DVM, MS, DACVD, professor at the University of Minnesota College of Veterinary Medicine and director of the school’s Veterinary Medical Center Dermatology Service.
In this interview discussing her lecture on FASS at the 2025 WVC Annual Conference, Koch goes into detail about treatment options available for FASS. As Koch explained, although there are a wide range of treatment options for dogs with allergies, research on the pathogenesis of this condition in cats is lagging. Available treatment options
The majority of patients with FASS will need systemic medication, explained Koch. In severe cases, Koch recommends beginning with a higher dose of steroids, as it will increase the chances of the treatment being effective. Moreover, it is important for veterinarians to ensure that they are using prednisolone and not prednisone, as prednisone is not metabolized well in cats.
Another treatment option available for cats is cyclosporine. However, as Koch explained, veterinarians should keep in mind that this medication is slow acting. In patients with severe pruritus, this medication may not be ideal as an initial treatment. Instead, veterinarians can begin with steroids and transition to cyclosporine or combine both.
Below is a partial interview transcript which has been lightly edited for clarity:
Sandra Koch, DVM, MS, DACVD: I think [managing FASS is] a combination of strategies and creativity, because unfortunately, cats with FASS don't have as many treatment options available to them as there are for dogs with allergies. Research is moving very slowly in the understanding of the pathogenesis of this condition in cats compared [to] dogs. And if we don't understand the disease very well, it becomes more of a challenge to treat, right? ...For example, in dogs, you have many labeled medications, from Apoquel, cyclosporine, Atopica, you know, many other generics. You have Cytopoint, you have a multitude of options. While cats, we are limited to steroids, cyclosporine—which have been shown to have good efficacy, there's evidence based on good studies.
For everything else, there's not good evidence yet that [the treatment] works.... we’re very limited in options.
