Feline symmetrical alopecia: trichogram and psychogenic alopecia
4-year-old spayed female Siamese with symmetrical alopecia on the ventral abdomen and medial thighs. The skin is not inflamed. The owners insist they never see her licking and suspect a hormonal problem. The trichogram shows most hairs with irregularly fractured tips.
What is the interpretation and the most appropriate next step?
chevron_right Show answer and explanation
A. Endocrine alopecia: measure T4 and perform a dexamethasone suppression test
Endocrine alopecia is rare in cats and leaves intact tips. Fractured tips indicate the hair is broken by grooming.
B. Psychogenic alopecia because she is Siamese: start clomipramine or fluoxetine
Oriental breeds are predisposed, but psychogenic alopecia is a diagnosis of exclusion; most of these cats actually have a pruritic disease.
C. Telogen effluvium: reassure and wait for regrowth
Telogen effluvium shows telogen roots with intact tips and diffuse loss, not fractured tips in areas reachable by the tongue.
D. Self-induced alopecia: strict flea control, an elimination diet and ruling out dermatophytes before considering other causes
Correct. Many cats groom in secret. Fractured tips confirm a self-induced origin and require a search for pruritus: fleas, food allergy, feline atopic skin syndrome, dermatophytes, or pain (e.g. cystitis in the caudal abdomen).
lightbulb Key takeaway
In cats, symmetrical alopecia is almost always self-induced, and a trichogram proves it in minutes. Only after strict parasite control, a properly conducted elimination diet, ruling out dermatophytes and assessing environmental allergy can psychogenic alopecia be considered, ideally by identifying the stressor.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.