For a cat with suspected flea dermatitis, which initial steps are recommended?

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In suspected flea dermatitis, the main idea is to break the flea bite cycle and address the obvious cause first. Start with thorough flea control for the cat and implement environmental measures to reduce flea exposure. If the symptoms persist despite effective flea control, then it’s appropriate to pursue diagnostic testing for other allergies, such as intradermal skin testing, and consider allergen immunotherapy as a management option. This stepwise plan explains why pursuing testing and immunotherapy only after fleas have been addressed is the most sensible approach: you’re not overlooking fleas, but you’re recognizing that ongoing dermatitis after flea control may indicate another allergic etiology that requires diagnostic workup and targeted treatment. The other options skip or delay this essential sequence—ignoring fleas, starting antibiotics without addressing the flea source, or relying only on diet changes—making them less appropriate as initial steps.