Feline hyperesthesia syndrome

Feline hyperesthesia syndrome (FHS) is a behavioral condition also linked to some neurological and dermatological disorders. It is also known as ‘rippling skin disease’, ‘neurodermatitis’ and ‘psychomotor epilepsy’. The main symptoms include intense scratching and licking at an area of skin. It can be a distressing problem for cats and their owners, as those cats suffering from the syndrome can self-mutilate quite badly.

 

©Susanne Jutzeler / Pexels

Hyperesthesia is a medical term referring to extreme sensitivity. Feline hyperesthesia syndrome (FHS) is a condition of cats where they develop an area of skin which is extremely sensitive to touch. This sensitivity often leads to a dramatic reaction from the cat, which can be aggressive in nature. The place affected is almost always the same: on the back, just in front of the tail.

The syndrome is a behavioral one, thought to be a compulsive disorder, but is closely linked to both skin and neurological conditions. It can occur in cats of all ages, but the most common age of onset is in younger cats between 1–5 years. Siamese cats seem to be more predisposed, alongside Burmese, Persian and Abyssinians, although any breed or type can be affected.

Types of FHS can be divided into:

• Dermatological: allergic skin disease (including flea allergic dermatitis), food allergies, parasites, infectious dermatitis.
• Neurological: epilepsy, spinal disease (disk disease, myelitis), brain tumor.
• Musculoskeletal: myositis, myopathy.
• Behavioral/true FHS: compulsive, displacement behavior.

This condition is usually first noticed when the owner goes to stroke their cat and they react suddenly, and often negatively. The degree of reaction varies: some merely scratch or lick at the area, others intensively dig at the area, some will become aggressive and bite, seemingly without warning. A common sign is a ‘rippling’ or ‘rolling’ of the skin across the back. Affected cats may salivate, vocalize and their pupils can dilate. Owners may also notice their cats intensively licking, chewing and scratching at that area during routine grooming. Some repetitively chase their tails, or race around the house whilst loudly vocalizing, but also may urinate.

These symptoms can all be distressing, especially as some cats can do a lot of harm to themselves by this form of self-mutilation.

The main aim in diagnosing FHS is to try and find an underlying cause of the hyperesthesia. True behavioral FHS is a diagnosis of exclusion: other sources of sensitivity must be ruled out. This entails carefully examining the whole cat for any underlying issue. Some diagnostic tests may be required to categorize the type of FHS. Ruling out dermatological issues may require blood tests and skin biopsies or scrapes. Neurological and spinal problems usually require imagine such as x-rays or even an MRI to find.

A thorough history and discussion about the cat’s home environment will be very helpful to investigate behavioral causes. Displacement behaviors usually arise when there is a conflict in behaviors: the cat wants to perform one behavior (such as eating), but is prevented by something (such as another cat in the household), and so is frustrated and performs an unrelated behavior (such as grooming) as a coping strategy. If this cycle is repeated over and over, it becomes compulsive and no longer related to the original conflict.

The aim of treating FHS is not necessary to cure the cat, but to ensure they are comfortable and have a good quality of life. If an underlying cause, such as allergic dermatitis, or a source of pain, such as spinal arthritis is suspected, treatment for this should hugely reduce symptoms.

An important part of control of FHS is to make sure there is no underlying itch. Itchy cats tend to groom, which can trigger compulsive episodes. Rigorous parasite control, dietary control if necessary and medications to reduce skin inflammation can all be part of a treatment regime for a cat with FHS. If a neurological cause such as epilepsy is suspected, anti-seizure medication can be important.

If no underlying source of itch or pain has been found, and a behavioral cause is suspected, treatment may be multifaceted. Behavioral management may include modifications to the environment, such as making the cat a ‘safe zone’ in their home environment, or regulating feeding times. Recording episodes in order to identify ‘triggers’ can also be useful to develop coping strategies. FHS is thought to be linked to stress and/or anxiety in cats, so medication to help reduce anxiety can also be useful.

Feline hyperesthesia is a condition that in most cases has to be controlled, rather than cured. The severity of the condition varies hugely, which affects the prognosis for management. If a specific cause of hypersensitivity is discovered, targeted treatments may be needed. Many cats can continue to live happy and active lives with good management of their condition. If no underlying condition is identified, treatment aiming to reduce anxiety and stress, which appear to play a role in the cat’s hyperesthetic reaction, will often be considered as symptomatic approach.