Hmmm, maybe cat scratch fever…lol…really, I don’t know.

Maybe try another kind of cat litter. See if it improves.

Be on the lookout for good-looking strays that enjoy sleeping on nails.

“There are a number of possible causes of nail bed infection (paronychia). When one or two nails on the same foot are involved a bacterial infection is very likely. When more than one or two nails are involved or when the problem occurs on more than one foot it is more likely that there is an underlying problem leading to the visible nail disease. The most common underlying cause in cats is probably feline leukemia virus infection. Other possible problems include immune mediated diseases such as phemphigus, hyperthyroidism, lymphosarcoma, vasculitis and fungal infections.

Testing for feline leukemia and feline immunodeficiency virus would be a good idea. A fungal culture might be helpful. Sometimes bacteria or yeast can be seen on an impression smear from an affected toe and bacterial cultures can sometimes be helpful, too. Biopsy of an affected area is a good idea. In your cat’s case it might be worthwhile to consider biopsy of one of the other affected areas since diseases like phemphigus frequently affect the face, ear tips or other areas in addition to the feet.

If cortisones are helpful it is likely that using antihistamines and fatty acids in combination may help to prolong the time between cortisone injections but that may not be the best course of action in all cases. It would be good to discuss this with your vet so that you know what he or she thinks the problem is, specifically, and to see if extending the time between cortisone injections is a good idea. If your vet has been hesitant to suggest a biopsy or other testing, that may be something to discuss as well.”

It sounds like you should see a specialist. If there is a vet school in your area, see the internal medicine people or the derm. I have seen cats with a disease called pemphigus that similar symptoms (the autoimmune disease), dogs get a disease called lupoid onychodystrophy, but I’m not sure if cats get it too, only seen that one in dogs. But a specialist would be able to tell you for sure and treat it properly too.

I saw this a lot in kitties with Feline Leukemia. Have you had him tested?