Feline hyperesthesia syndrome
Hyperesthesia syndrome in cats is a behavioural condition also associated with neurological and dermatological disorders. The disease is also called ‘rippling skin disease’, ‘neurodermatitis’, and ‘psychomotor epilepsy’. Symptoms include intense scratching and licking at an area of skin. The syndrome can be distressing for cats and their owners, as these cats may self-mutilate themselves.
What is feline hyperesthesia?
Extreme sensitivity is referred to as hyperesthesia. FHS is a condition in which cats develop extremely sensitive skin that is exacerbated when they are touched. A cat with this level of sensitivity often reacts in an aggressive manner. Affected areas are almost always on the back, just in front of the tail.
This syndrome is a behavioural one, often considered to be a compulsive disorder, but it is also closely related to skin and neurological problems. Cats of any age can develop this disease, but the most common age of onset is between 1 and 5 years of age. Cat breeds and types that are more susceptible include Siamese, Burmese, Persian and Abyssinians.
FHS can be categorised into the following types:
- Dermatological: allergic skin disease (including flea allergic dermatitis), food allergies, parasites, infectious dermatitis.
- Neurological: epilepsy, spinal disease (disc disease, myelitis), brain tumour.
- Musculoskeletal: myositis, myopathy.
- Behavioural/true FHS: compulsive, displacement behaviour.
What are the signs of FHS?
Owners typically notice this condition when they stroke their cats and they react suddenly and negatively. Various reactions occur: some merely scratch or lick, some dig intensely, and some bite without warning. There is often a rippling or rolling of the skin across the back. Salivation, vocalisation, and dilation of pupils are common in cats suffering from this condition. During routine grooming, owners may also notice their cats intensively licking, chewing, and scratching that area. Many cats may chase their tails or race around the house while vocalising loudly, and some urinate as well.
There can be a lot of distress associated with these symptoms, especially because some cats can cause themselves a lot of harm through self-mutilation.
How can I diagnose FHS?
Identifying an underlying cause of FHS is the main objective when diagnosing the condition. The diagnosis of true behavioural FHS is based on exclusion: other sources of sensitivity must be ruled out. A thorough examination of the entire cat is required in order to determine whether any underlying issues exist. It may be necessary to conduct some diagnostic tests in order to categorise the type of FHS. Testing for dermatological issues may require blood tests and skin biopsies. MRIs and radiographs are usually needed to diagnose neurological and spinal problems.
In order to investigate behavioural causes, it will be very helpful to conduct a thorough history of the cat and discuss its home environment. The reason for displacement behaviours is usually conflict between behaviours: the cat wants to perform one behaviour (like eating), but is prevented by something (such as another cat in the household), which leads to frustration, and the cat performs an unrelated behaviour as a coping mechanism. It becomes a compulsive behaviour if repeated over and over again.
How is FHS treated?
The goal of treating FHS is not necessarily to cure the cat, but rather to make sure it is comfortable and has a good quality of life. When an underlying cause, like allergic dermatitis, or a source of pain, like nerve impingement, is suspected, treatment for these will greatly reduce symptoms.
In order to control FHS, it is important to keep the itch at bay. When cats are itchy, they tend to groom excessively, which can trigger compulsive behaviours. FHS cats can benefit from rigorous parasite control, diet control, and medications to reduce inflammation of the skin. Anti-seizure medication may be necessary if a neurological cause, such as epilepsy, is suspected.
An itch or pain that is not triggered by an underlying cause, but rather by a behavioural cause, may need a multifaceted approach. Modifying the environment, such as creating a ‘safe zone’ in the cat’s home environment, or regulating feeding times, can help with behaviour management. Identifying triggers and developing coping strategies can also be achieved by recording episodes. Stress and/or anxiety may contribute to FHS in cats, so medication to help reduce anxiety may also be helpful.
What is the prognosis?
As a rule, feline hyperesthesia has to be controlled rather than cured. A wide range of severity affects the prognosis for patients with this condition. Identifying a specific cause of hypersensitivity may lead to targeted treatments. With good management of their condition, many cats can live happy and active lives. In the absence of any underlying cause, treatment aimed at reducing anxiety and stress, which play a role in the cat’s hyperaesthetic reaction, will usually be considered as a symptomatic approach.