Pillow Foot in Cats

Pillow foot is rare in cats, but it can cause significant discomfort and pain. While the condition is generally mild and non-painful in early stages, if left untreated, it can quickly progress in severity. Read on to learn more about pillow foot in cats, including why it develops, symptoms pet parents may notice, and available treatment options. 

What Is Pillow Foot in Cats?

Pillow foot (also known as plasma cell pododermatitis) refers to inflammation of the paw pads due the presence of high numbers of plasma cells. These inflammatory cells respond to various stimuli, such as allergens or bacteria, that a cat may come into contact with. Sometimes this response can be excessive and lead to swelling. Typically, more than one paw pad is affected, but in rare cases, pet parents may notice just one swollen pad. In the early stages, this swelling is non-painful, but the condition worsens over time, causing significant pain and discomfort. 

Pillow foot affects cats of all ages and breeds. Cats with underlying viral diseases, such as feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV), are thought to be at a higher risk of developing the condition. 

Causes of Pillow Foot in Cats

The exact cause of cat pillow foot is unknown. The most commonly accepted reason this condition develops is due to an immune-mediated reaction. This means that the cat’s immune system overreacts and high numbers of plasma cells collect in the paw pads, which leads to swelling.  

The immune system can be stimulated by the following: 

• Environmental allergens
• Food sensitivities 
• Severe inflammation
• Infections

Signs of Pillow Foot in Cats

Pillow foot causes a wide range of signs, with the most distinctive being red, swollen paw pads. It’s also important to note that there are many other conditions that cause swelling of the paw pads, so pet parents should always bring affected cats to a veterinarian to determine the underlying cause.

Other characteristic symptoms include the following: 

• Ulcerated and/or bleeding paw pads
• Thickened skin on paw pads
• Pain
• Limping
• Lethargy
• Weight loss
• Enlarged lymph nodes

Cats with pillow foot may also have signs of concurrent illnesses, such as kidney disease, which could include increased thirst and urination, vomiting, and decreased appetite. Mouth sores may also be present. 

Diagnosing Pillow Foot in Cats

Pillow foot in cats is diagnosed using a combination of tests. First, a veterinarian performs a physical exam to identify abnormalities of the foot pad and collects information from the pet parent about their cat’s behaviors and when symptoms began. Blood is collected to check for high levels of inflammatory cells or evidence of underlying infection, such as FIV or FeLV. 

A sample of cells is taken from the affected paw pad(s) using a small needle and examined under the microscope. This procedure may cause mild discomfort for cats, but it is helpful for identifying high numbers of plasma cells to diagnose pillow foot. It is also useful to rule out other conditions that can look similar. A more accurate diagnosis can be made by taking a biopsy, which consists of surgically removing a small piece of paw pad. This generally requires sedation to ensure the cat remains still and free from discomfort. The sample is sent to a specialized laboratory for identification. 

Pillow Foot in Cats Treatment

Some cats with pillow foot improve on their own, particularly if they have only mild symptoms. However, in most cases, treatment is necessary and may include medication, surgery, or a combination of both. 

Medications for Pillow Foot in Cats

Your veterinarian may prescribe a medication called doxycycline to treat pillow foot in your cat. Doxycycline is a type of antibiotic that treats infection and reduces inflammation associated with plasma cell pododermatitis. It is usually given by mouth twice daily. However, because this medication has been linked with esophageal strictures (narrowing of the esophagus) in cats, pet parents should ensure their cats drink water after receiving it. Other medications that suppress the immune system, such as cyclosporine, can also be given orally to treat this condition. Injectable or oral steroids may also be helpful.

Your veterinarian can determine the best type of medication to meet your cat’s specific needs. Treatment may continue for several months. Always be sure to give the prescribed medications exactly as directed for the best treatment outcomes. 

It is important to follow up with your veterinarian while your cat is receiving treatment to identify any side effects of the medications and to determine when treatment can be stopped. In rare cases, some cats may have relapses throughout their lives, which require additional medications.  

Home Remedies for Pillow Foot in Cats

It is not recommended to try any home remedies for pillow foot in cats. Since this condition is likely due to an overactive immune system, specific prescription medications are needed for resolution. Trying home remedies before seeking veterinary guidance can delay appropriate treatment and cause worsening of symptoms.

Cost to Treat

Pet parents can expect to pay $20 to $40 per month for steroid treatment, while cyclosporine can range from $30 to $200 per month, depending on the brand. (Generic medications cost much less than brand name products.)

If your cat requires surgery and hospitalization, costs can range between $300 and $600 or more, depending on how many paw pads are affected and how your cat does during recovery. Most cats are sent home on medications, such as antibiotics and anti-inflammatories, to reduce swelling and prevent infection. 

How to Prevent Pillow Foot in Cats

Because the exact cause of pillow foot in cats is unknown, it is difficult to determine what to do to prevent this condition. If it is truly immune-mediated, there is nothing pet parents can do to prevent it from developing in their cats. However, ensuring you are bringing your cat to the veterinarian for regular preventative care can help detect any problems early and keep them as healthy as possible. 

Related Conditions

Pillow foot is a unique disease, but other conditions may cause similar changes to the paw pads. These include the following: 

• Mast cell tumors
• Eosinophilic granuloma complex 
• Paw pad injuries