🦶 Vet Guide to Plasma Cell Pododermatitis (Pillow Foot) in Cats – 2025 🐾

Plasma cell pododermatitis—commonly known as pillow foot—is a curious and often misunderstood feline condition that causes swollen, mushy paw pads. While it may look alarming, many affected cats experience little to no discomfort, and in most cases, the condition is manageable. In this 2025 guide, Dr. Duncan Houston BVSc explains the symptoms, diagnosis, causes, and treatment options for this immune-mediated condition. 🐱🩺

🔍 What Is Plasma Cell Pododermatitis?

This condition is an inflammatory disease affecting the foot pads of cats. The name refers to the infiltration of plasma cells—immune cells responsible for producing antibodies—into the pads. The inflammation leads to swelling, discoloration, and sometimes ulceration of the pads. 🧪

Because plasma cells are part of the immune system, it's believed the disease has an autoimmune or inflammatory origin. Immune-stimulating infections (such as FIV), allergies, or unknown triggers may initiate the immune response. 🧬

👁️ How to Spot Pillow Foot in Cats

Common Symptoms Include:

• 🟣 Soft, mushy, swollen paw pads
• 💜 Purplish discoloration of the pads
• 🔺 Ulcers or cracks in advanced cases
• 🐾 Multiple feet usually affected
• 🚶‍♂️ Limping or lameness in some cats

Some cats show no signs of pain, while others may become lame or avoid walking on the affected paws. It’s not unusual for all four feet to be involved. 🐾

📋 Diagnosis: How Is It Confirmed?

A diagnosis of plasma cell pododermatitis is often based on the classic appearance of the pads. If uncertainty remains, the following tests can help: 🔬

• 🧪 Bloodwork: Shows elevated lymphocytes, low platelets, and high globulin levels
• 💉 Needle aspirate: Samples cells from the pad to look for plasma cells
• 🔬 Biopsy: Confirms diagnosis if the presentation is atypical

Testing for feline immunodeficiency virus (FIV) is also important, as up to 50% of affected cats test positive. While not all cats with pillow foot have FIV, the connection is notable. 🧬

💊 Treatment Options in 2025

Many cats show no pain and may not require treatment. However, for those with lameness or ulceration, therapy is often needed. Here are Dr. Duncan Houston’s top treatment recommendations: 💼

1. 💊 Doxycycline (First-Line Treatment)

• 📆 Oral administration for at least 2 months
• 💉 Combines antibiotic and immunomodulatory effects
• ✅ About 50% of cats improve significantly

If the condition returns after stopping the drug, it can be restarted. It’s generally well-tolerated. 🧪

2. 💉 Prednisolone (Corticosteroids)

• 💊 Oral or injectable anti-inflammatory treatment
• ✅ Used when doxycycline fails or is not tolerated
• ⚠️ Monitor for side effects: weight gain, increased appetite, diabetes risk

3. 🧴 Cyclosporine

• 💧 Administered as a liquid
• 🌿 Modulates immune response with fewer side effects than steroids

4. 💉 Injectable Options

• 💉 Methylprednisolone acetate (Depo-Medrol®): Long-acting corticosteroid injection
• 💉 Dexamethasone: Shorter-acting steroid, often given regularly at home

5. ✂️ Surgery for Severe Ulceration

• 🦶 In rare cases with extensive ulceration, surgery may be required to remove damaged pad tissue

With treatment, most cats improve or go into remission. The condition often becomes chronic, so relapses may occur, but it's generally manageable. 🐾

🧬 Underlying Factors to Explore

• 🧪 FIV testing is essential—especially in unvaccinated or outdoor cats
• 🥩 Food allergy trials may help in cases that don’t respond to immune therapy
• 🔬 Secondary infections should be ruled out and treated if present

🏥 When to Seek Veterinary Help

If your cat has swollen pads, is limping, or has visible ulcers, contact your vet right away. A diagnosis can usually be made quickly based on appearance and bloodwork. 🧬

If treatment is needed, your vet will help choose the best medication based on your cat’s response and tolerance. 📋

📲 Ask A Vet for Ongoing Support

Not sure whether your cat’s paw problem is pillow foot? Need help managing a recurring case? Use the Ask A Vet app to speak directly with Dr. Duncan Houston or another licensed veterinarian. 🐱💬

Visit AskAVet.com or download the app today for expert support, medication plans, and follow-up care—all from your phone. 📱

💬 Final Thoughts

Plasma cell pododermatitis may sound scary, but with proper diagnosis and treatment, most cats enjoy long-term comfort and mobility. Whether your cat needs medication or just monitoring, you're not alone—Dr. Duncan Houston and the Ask A Vet team are here to help every step of the way. 🐾💖