Cat with bald spot on back & chin and bump?

Question
Dear Dr.Schiavone-Brensinger (again),

Thank you very much for all of the information.  I understand you cannot truly know what Shadow has without seeing him, but I do appreciate your expertise.  The bump in his mouth is actually on his lip, not on his gums or above a tooth.  Infact, the vet I saw said Shadow had beautiful teeth and to bring him in for a cleaning next year.  And the bald spot before his tail, on his back, looks like a small, bald circle and is smooth and pink. About the size of a quarter.  As far as I can tell, he has no other bald spots on his body.  Under his chin there was a bump but now it looks more like a scab or dried blood.  I don't know how she diagnosed him so easily, like you said, but she seemed to see this all the time in long- haired cats, or so she said.  She did take his temperature and he was fine and so was his heartrate.  She said she didn't usually prescribe antibiotics so early but that it was a precautionary thing.  I'm not sure why she didn't do any blood tests or scrapings ... this particualar vet is at a big Animal Clinic in our area they also do animal emergencys 24 hours a day so I figured they have seen a lot of different cases of things, but I still wished she had taken more time with Shadow.  For now, I am just waiting to see if Shadows wounds heal on their own like she said because emotionally, Shadow is his happy self.  Do you have any other suggestions?  From the things I've told you, without seeing and testing Shadow of course, what would your diagnosis be on just those things alone (the small bald spot, the bump on his lip, the bump on his chin)?  Thanks so much!  I really appreciate your insight.  Happy Holidays to you and all of your animals!


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Followup To
Question -
Dear Dr.Schiavone-Brensinger,

I am so happy to find this site of caring, pet-loving vet volunteers to answer my question!  My cat, Shadow, is a long haired cat.  I recently took Shadow to the vet because of a bump under his chin and a bald spot near his tail, on his back.  He also has a lump inside his mouth.  The vet looked at him quickly and diagnosed him without problem.  She said something about him having a reaction to himself?  She prescribed antibiotics which I have already given him all of and anti-inflammatory liquid medicine.  It's been two weeks and not only have I not seen a change, I fear it's gotten worse.  The bald spot on his back seems larger (a little bigger than  the size of a quarter) and is pink.  Under his chin, I believe the bump is gone but it looks all red and like its not healing.  The lump/bump is on the side of the inside of his mouth on his gums.  My vet said all those things were related and they all were a reaction to himself.  She said that it would take time but they would go away on their own.  My question is first, do you think this diagnosis is correct?  Have you seen other cats with this problem?  If her diagnosis was correct, can you explain it to me in detail?  How long should I wait before taking Shadow back to the vet again?  I really appreciate your guidence as I am worried about my cat.  Thank you very much and happy holidays.
Answer -
Hi Allison!  Without seeing Shadow, it is hard for me to determine whether or not the diagnosis was correct or not, but I can tell you what I would have done, had I seen Shadow.
Hairloss is a very, very common symptom of Hyperthyroidism in cats.  Hyperthyroidism is also a very common ailment in cats and is treated by giving medication for the rest of the cat's life.  Hyperthyroidism is diagnosed through a blood sample.
Had the test results come back negative for Hyperthyroidism, I would have then suggested doing a skin scraping to find if the hairloss in that area was due to a parasite, an allergy, or a bacteria and treated accordingly.
As for the bump under the chin and in Shadow's mouth...to me, this is absolutely, positively an abcessed tooth.  Anytime there is a bump in the facial area or inside the mouth, this is due to an abcessed tooth.  I would have definitely suggested a dental cleaning and extraction of the tooth be done.  If the abcess was questionable as to which tooth was causing the infection, a dental x-ray would have to be done.  An abcess is something that definitely needs to be treated promptly.  The reason that the lump has decreased in size is because of the antibiotic.  The antibiotic has helped for now, but in order to ensure that the infection is not going to be continuous, the tooth definitely needs to be extracted.  An abcessed tooth that is left untreated will cause kidney damage, anorexia, and severe infection that will eventually reach the blood stream.  
I would definitely suggest taking Shadow to a different veterinarian for a 2nd opinion.  I have never heard of a cat having a reaction to itself, so with the symptoms you described and the diagnosis you were given...I would have to say, it doesn't sound right to me either.  I definitely agree with you and your concern for Shadow.  Definitely get another opinion.
I hope this helps, and give Shadow tons of kisses for me!
Let me know how he does,
Hilary

Answer
Hi Allison! How old is Shadow?  There is something called Feline Eosinophelic Granuloma Complex, which is a skin problem seen in cats.  The granuloma cells group together and cause irritations to the skin.  This is treated with a steroid injection called Depo Medrol. This ailment is a lifelong disease and is usually maintained by a Depo Medrol injection every month to every three months.  It usually shows up between the ages of 1 and 3.
This is the only kind of "reaction to himself" so to speak, ailment that I can think of that your veterinarian may have been referring to.  This can only be diagnosed through a small skin biopsy.
I will talk to some colleagues of mine to see if anyone has any other suggestions for you and I will let you know what I hear.  The only other form of treatment besides antibiotics at this point, would be a steroid, whether in form of an oral pill or injection.  Steroids are used to reduce inflammation, which Shadow may benefit from.
I will let you know what I find out!  Thanks for bearing with me.
Have a wonderful holiday and I will be in contact with you soon!
Sending Shadow tons of get well chin rubs,
Hilary