Hello there, this is Dr Linda, a small animal vet with 10 years of clinical experience.
I'm sorry to hear of your cats ongoing skin issues, I know this must be a source of stress for you.
While his bloodwork was normal, in this instance it would be important to assess his skin health with e.g. a skin swab and scrape, to rule out e.g. a yeast overgrowth or bacterial infection.
The location of the itching can give us a clue as to the cause. If he is irritated mainly on his rump, fleas could be the culprit. I appreciate you say fleas have been ruled out but even a dermatologist can struggle to diagnose a flea allergy in some cases as irritated cats groom off all of the evidence.
Over grooming his abdomen may indicate cystitis, and this would especially be a concern if his urine habits have changed. Discuss with your vet if he may benefit from e.g. a urinary diet and urinary supplements.
Over grooming a certain joint can be a sign of underlying joint disease or arthritis, particularly in the older cat.
Another consideration would be allergies, which can develop at any time between the ages of 6 months and 5 years. Cats can react to many things including food, pollens, dust mites and mold. It can be hard to rule this in or out but allergy testing may be appropriate in some cases.
If your cat's signs improve with steroids, we'd consider an allergy more likely.
For behavioural issues, the key is in identifying the source of stress. Common sources including other pets in the home, young children, a lack of outdoor access, a lack of mental or physical stimulation, loud noises etc.
It is great you already play with him frequently and I'd try to keep things varied with e.g.
- Laser pointers and wind up mice
- Cat trees
- Treat hiding around the home
- Cat nip toys
- Etc.
If he is an anxious cat, you may also find he benefits from calming products such as a Feliway plug in and natural calming supplements that can be added to his diet.
