Feline hyperesthesia syndrome and feline psychogenic alopecia are two interesting, and often overlapping syndromes of cats. The names are quite a mouthful!
“Hyperesthesia” means “abnormally increased sensitivity of the skin.” It may begin with signs typical of feline psychogenic alopecia, and then escalate. It is known by many names including “rolling skin syndrome,” “twitchy cat disease,” “neuritis,” and “atypical neurodermatitis.”
Cats with this syndrome are extremely sensitive when touched along the spine, down the back, and to the base of the tail. The clinical signs seen are:
- Rippling of the skin over the back
- Muscle spasms and twitching
- Twitching of the tail.
- Cats may exhibit strange behaviors in response to touching such as tail chasing, biting at the tail, flank and sides, to the point of self-directed aggression. They run, jump, hallucinate, vocalize, and even turn around and hiss.
- They may self-mutilate with extreme biting, licking, chewing, and plucking of the hair (sometimes called “barbering” or “fur mowing”). This behavior leads to hair loss and sometimes to severe skin lesions.
It is difficult to distract the cat from these behaviors once they begin. The sequence of events varies. Your cat might twitch first, then focus on that spot to lick and chew; or, he might be grooming, then start to twitch, then progress to other signs mentioned above. Behaviors that might mimic feline hyperesthesia syndrome are estrus (cats in heat), and certain types of seizure disorders.
The “hyper” behaviors may be provoked by petting or stroking your cat. Hyperesthesia is often found in highly aroused, anxious, or aggressive cats. The exact cause is unknown, however stressful events in your cat’s life may provoke it by causing severe anxiety. It is thought that changes in brain chemicals occur during chronic anxiety and that this can lead to the hyperesthesia disorder.
Stressors that can trigger anxiety include:
- moving to a new home
- a change your schedule
- the addition or subtraction of a family member, including other animals
- aggression among cats in the household
- moving furniture around
- seeing a new animal outside
- boredom and frustration
- underlying pain may also play a part in this syndrome. Pain is a strong stimulus for anxiety in cats.
There is no diagnostic test for feline hyperesthesia syndrome, and as in psychogenic alopecia, it is diagnosed by eliminating other diseases from consideration such as:
- diseases of the skin (allergies, external parasites, and skin infections, among others)
- underlying painful conditions such as back pain, arthritis, anal sac disease, muscle pain, spinal disease, bite wounds, abscesses, cancer, or organ problems.
As you can see, the list of possibilities is very long, so your veterinarian must do a thorough physical examination and a variety of diagnostic tests including skin tests, blood tests, viral tests, biopsies, X-rays, and perhaps others. Videos of your cat’s behavior may be helpful. Sometimes referral to a veterinary specialist such as a dermatologist or neurologist is necessary. When all underlying medical diseases have been eliminated or properly treated, feline hyperesthesia syndrome is diagnosed by exclusion.
Ongoing anxiety is thought to cause alteration of brain chemicals, so hyperesthesia may then continue on independent of the original underlying condition that triggered it.
Feline hyperesthesia syndrome is treated by decreasing stress in your cat’s life. Try behavior modification, increasing playtime with your cat, and decreasing his boredom by enriching his environment with stimulating activities. Some examples:
- Hiding dry food treats around the house so he has to hunt for them
- Teaching him to do simple tricks for a food reward
- Give him lots of attention and play with him at least 10 minutes daily.
- Supply him with escape routes, such as perches, cubbies, and hiding tents if he is the victim of aggression by other cats in the household or separate the cats.
- Do not punish his behavior as this might increase his anxiety and worsen his compulsive behavior syndrome.
- Schedule frequent recheck examinations with your veterinarian. An underlying medical condition may become evident over time.
Sometimes anti-anxiety or anti-depressant medications, such as medications that increase serotonin (a brain chemical), may be helpful and will be prescribed by your veterinarian. These drugs are usually given for about twelve weeks, or until the symptoms decrease, then slowly tapered. Some cats may not be able to taper off the drugs and will require them indefinitely. Your veterinarian will monitor his condition with blood tests during this time period. Many of these drugs are not approved for this syndrome in cats, so your permission is required. Your veterinarian may also refer your cat to a behavior specialist for additional treatment of this unusual syndrome.