Understanding Pillow Foot (Feline Plasma Cell Pododermatitis) in Cats
Pillow foot, medically known as feline plasma cell pododermatitis, is an uncommon but notable skin disease that affects the paw pads of cats. This condition stands out because it transforms the normally firm, resilient pads into soft, swollen, and sometimes ulcerated surfaces. If you’ve ever noticed your cat’s paws looking unusually puffy or oddly colored, pillow foot could be the culprit.
What Does Pillow Foot Look Like?
The hallmark of this disease is the dramatic swelling of one or more paw pads. The pads often appear soft and “mushy,” taking on a deep pink or purple hue with visible white striations. In advanced cases, the swelling can progress to open sores or even bleeding. While the metacarpal (front) and metatarsal (hind) pads are most commonly affected, digital (toe) pads can also show symptoms—though usually less severely.
- Swelling: Pads become noticeably enlarged and puffy.
- Color changes: Deep pink or purplish color with white streaks.
- Ulceration: In severe cases, open wounds may develop.
- Lameness: Some cats limp or avoid walking due to pain.
The disease doesn’t discriminate by age, breed, or gender, but domestic and neutered male cats seem more susceptible. It’s common for multiple feet to be involved at once; rarely does only one pad suffer.
What Causes Pillow Foot?
The root cause remains a bit of a mystery. What’s clear is that plasma cells—mature B-lymphocytes responsible for antibody production—invade the tissue of the paw pads. This infiltration likely stems from immune system dysfunction. Several factors may play a role:
- Feline Immunodeficiency Virus (FIV): Between 44% and 63% of affected cats test positive for FIV.
- Feline Leukemia Virus (FeLV): Some associations have been reported.
- Allergies: Both environmental and food allergies may contribute; seasonal relapses support this theory.
The consensus is that an immunologic basis underpins pillow foot—sometimes with multiple contributing factors in a single cat.
Other Symptoms to Watch For
Pillow foot primarily targets the paws, but it can occasionally manifest elsewhere. Rarely, you might notice:
- Nasal bridge swelling
- Mouth inflammation (stomatitis)
- Kidney inflammation (glomerulonephritis)
- Lymph node enlargement
- Mild fever or appetite loss
Cats may limp or reduce their activity due to discomfort. Interestingly, some show no signs of pain despite pronounced changes in their paws.
How Is Pillow Foot Diagnosed?
Your veterinarian will start with a physical exam focused on the classical appearance: soft, swollen pads affecting several feet. To confirm diagnosis:
- Cytology/Biopsy: Fine-needle aspiration or biopsy reveals abundant plasma cells in affected tissue.
- Bood tests: Elevated globulin levels and lymphocyte changes are common findings.
- Viral screening: Testing for FIV and FeLV is recommended given their association with the disease.
Differential diagnoses include tumors, insect bites, eosinophilic granuloma complex, and bacterial/fungal infections—most of which typically affect just one pad rather than several at once.
Treatment Options for Affected Cats
Treatment focuses on calming the immune response that drives inflammation. The mainstays include:
- Doxycycline: An antibiotic with immunomodulatory effects; about half of cats improve after two months of therapy.
- Glucocorticoids: Prednisolone or dexamethasone may be used if doxycycline fails to bring improvement.
- Cyclosporine: An immunosuppressive agent considered when other treatments aren’t effective.
If medical therapy doesn’t resolve severe or ulcerated lesions, surgical removal of affected pads might be necessary. Most cats respond well to medication alone and can live comfortably with proper management. Some require intermittent or long-term treatment to keep symptoms at bay. Regular veterinary checkups help monitor for flare-ups and medication side effects.
The Outlook: Prognosis and Recovery
The prognosis for pillow foot is generally favorable—most cats achieve remission with medical therapy. Relapses are possible but manageable. Rarely, complications like immune-mediated kidney inflammation or amyloidosis develop; these can be serious or even fatal. If surgery is needed, recovery typically takes two to four weeks depending on how much tissue was involved and post-operative care quality.
Caring for Your Cat With Pillow Foot
If you suspect your cat has pillow foot—or notice any sudden changes in their paw appearance—it’s best to consult your veterinarian promptly. Early detection allows for more effective management and helps your cat stay comfortable over time. With attentive care and regular follow-up visits, most cats lead happy lives despite this unusual condition.
