The word hyperesthesia means an increase in sensitivity. If you have a cat with this syndrome you probably know exactly what is meant by this. These cats act as though they have pain from simply being touched; most commonly in the region of the lower back.
These cats have skin that twitches at the slightest touch. Some cats will attack their tails and even run around yowling in pain. Milder forms of this occurs and is shown as licking or biting paws in response to petting. Itchy skin, such as flea bite allergy, make the problem much more prominent. Some cats actually convulse when petted in certain ways.
Hyperesthesia syndrome is felt to be a type of compulsive disorder, usually initiated when the cat is in conflict. The cat wants to perform one behavior but is prevented from doing so and ultimately in frustration performs another behavior. After a while, this second behavior, which frequently is grooming, is performed compulsively.
Typically, patient is a young cat – one to five years – and is most commonly an Oriental breed such as a Burmese, Siamese, Abyssinian, or Persian, though any breed of cat can be involved.
The goal of treatment is ultimately to provide the cat with good life quality, free from discomfort. The cat should not have seizures, self-mutilate, become incontinent or act aggressively during an episode. Medication may not be needed if the cat merely undergoes compulsive grooming in response to certain types of petting or if episodes can be avoided by refraining from touching certain body areas of the cat. If the cat is triggering episodes on its own through normal grooming, intervention is probably necessary.
A good first step is to manage itching. Itch stimulation leads to grooming, which can lead to a full-blown episode of compulsive self-mutilation or even seizing so it is important to make sure obvious sources of itch are controlled. This means that there should be no fleas in the cat’s environment and medication (such as corticosteroids) should be used to relieve any skin inflammation. Omega 3 fatty acid supplements can be added to the diet to decrease the skin’s sensitivity to itch. Controlling the itch may be all that is needed to prevent episodes.
If the cat is still having excessive episodes despite reduction in itch stimulation, a more neurologic approach may be needed. If seizures are part of the problem and controlling the itch does not control them, then medication for seizures and neuropathic pain should be used.
If compulsion is more the problem than seizures, then medications such as prozac may be used along with the use of toys or other stimulating objects to distract the cat out of an episode. Because the episodes seem to have their roots in behavior conflict, the cat’s environment needs to be stabilized with scheduled feedings, plenty of toys, and minimized competition for refuge and the litter box with other cats. Inner conflict can be avoided if the cat feels free to engage in normal activities without being bullied by other pets or limited by available resources.
Since the tail is often the target of self-mutilation, it is important to rule out sources of pain such as old injuries (especially old tail fractures or broken hip bones) that might cause sudden nerve or muscle spasms.
Cats respond differently to treatments with some responding to itch relief alone while others require seizure control plus itch relief and so on. While we are not always able to get 100% resolution, your cat should be managed to allow a good quality of life free from mutilation and inappropriate pain perception.
Urban Animal Veterinary Hospital
1327 Yale St
Houston, TX 77008