Changes

====Differentials====

====Differentials====

• Allergic skin disease [atopy, food allergy]

*Allergic skin disease [atopy, food allergy]

• Ectoparasites

*Ectoparasites

• Epilepsy [petit mal type – limbic location]

*Epilepsy [petit mal type – limbic location]

• Local or referred pain [spinal lesion, intermittently luxating patella, etc]

*Local or referred pain [spinal lesion, intermittently luxating patella, etc]

• Hyperthyroidism

*Hyperthyroidism

• CNS pathology

*CNS pathology

====Signs indicative of hyperaesthesia==== are very variable, but include:

====Signs====  

• Skin or muscle twitching or rippling [commonly thoracolumbar or at the tail base].

Signs indicative of hyperaesthesia are very variable, but include:

• Sudden bouts of intense grooming, self-mutilation or attacks on rear quarters, feet or tail.

*Skin or muscle twitching or rippling [commonly thoracolumbar or at the tail base].

• Freezing, with tail swishing, and then sudden turning or darting movements.

*Sudden bouts of intense grooming, self-mutilation or attacks on rear quarters, feet or tail.

• Ear twitching [often as if the cat is alert to a sound behind it].

*Freezing, with tail swishing, and then sudden turning or darting movements.

• Sudden bouts of increased arousal, with the cat dashing about and jumping as if pursued or pursuing an invisible ‘opponent’.

*Ear twitching [often as if the cat is alert to a sound behind it].

• Bouts are often accompanied by vocalisation.  

*Sudden bouts of increased arousal, with the cat dashing about and jumping as if pursued or pursuing an invisible ‘opponent’.

*Bouts are often accompanied by vocalisation.  

During these attacks, the cat’s behaviour is generally indicative of a state alarm and as if it is reacting to hallucinatory visual, auditory or tactile stimuli. The bouts may occur without any obvious trigger, in which case the first sign may be skin twitching. Bouts also occur during handling or stroking by the owner, or grooming and play by other cats.

During these attacks, the cat’s behaviour is generally indicative of a state alarm and as if it is reacting to hallucinatory visual, auditory or tactile stimuli. The bouts may occur without any obvious trigger, in which case the first sign may be skin twitching. Bouts also occur during handling or stroking by the owner, or grooming and play by other cats.

When deciding on treatment it is important to examine situations in which the attacks are most likely to occur. Specific triggers should be identified, such as:

When deciding on treatment it is important to examine situations in which the attacks are most likely to occur. Specific triggers should be identified, such as:

• Human contact  

*Human contact  

Stroking certain places [usually the back]

#Stroking certain places [usually the back]

Grooming

#Grooming

Play

#Play

• Contact with other cats

*Contact with other cats

Play

#Play

Allogrooming

#Allogrooming

===Treatment===

===Treatment===

The number and character of attacks should be recorded during the 7-14 days before treatment begins, to give a baseline of frequency and severity. The cat’s environment should be improved in accordance with general recommendations, especially if social stress in a multi-cat household is thought to be an underlying factor. The aim should be to introduce activities that use up the cat’s time and energy budget and give it greater control over access to resources. For example, introduce activity feeding using toys that dispense portions of the cat’s daily food allowance as they are played with. Making these changes in multi-cat households will help to reduce overall competition and social stress, which can only be beneficial to all of the cats.  

The number and character of attacks should be recorded during the 7-14 days before treatment begins, to give a baseline of frequency and severity. The cat’s environment should be improved in accordance with general recommendations, especially if social stress in a multi-cat household is thought to be an underlying factor. The aim should be to introduce activities that use up the cat’s time and energy budget and give it greater control over access to resources. For example, introduce activity feeding using toys that dispense portions of the cat’s daily food allowance as they are played with. Making these changes in multi-cat households will help to reduce overall competition and social stress, which can only be beneficial to all of the cats.  

Specific triggers of the behaviour should be identified and prevented, for example:

Specific triggers of the behaviour should be identified and prevented, for example:

• Stop stroking the cat along its back or in other areas that trigger an attack of hyperaesthesia.

*Stop stroking the cat along its back or in other areas that trigger an attack of hyperaesthesia.

• Avoid grooming.

*Avoid grooming.

• Redirect play between cats using fishing toys or laser pointers so that the hyperaesthetic cat is not pushed or pounced on during play.

*Redirect play between cats using fishing toys or laser pointers so that the hyperaesthetic cat is not pushed or pounced on during play.

• Keep other cats amused using activity feeders and play so that the hyperaesthetic cat does not become the victim of predatory play.

*Keep other cats amused using activity feeders and play so that the hyperaesthetic cat does not become the victim of predatory play.

If the attacks usually require some kind of triggering event, these first steps may substantially reduce their frequency. These cats will also possess a number of conditioned associations between normal activities and the initiation of a hyperaesthetic attack. For example, the approach of a person or another cat may predict when a bout is likely to occur. This kind of negative association heightens stress and anxiety, which may in turn contribute to the worsening of the condition. Reducing factors that trigger hyperaesthetic attacks will therefore have direct and indirect effects on the frequency of attacks.

If the attacks usually require some kind of triggering event, these first steps may substantially reduce their frequency. These cats will also possess a number of conditioned associations between normal activities and the initiation of a hyperaesthetic attack. For example, the approach of a person or another cat may predict when a bout is likely to occur. This kind of negative association heightens stress and anxiety, which may in turn contribute to the worsening of the condition. Reducing factors that trigger hyperaesthetic attacks will therefore have direct and indirect effects on the frequency of attacks.

Once long-term drug therapy is producing a stable improvement, there should be a regular 6-monthly case review to make sure that beneficial environmental changes remain in place and drug therapy is still effective. Otherwise there is a significant chance of relapse.  If permanent therapy is required, then drug dose and type may need to be changed more than once during the cat’s lifetime in order to maintain effectiveness.

Once long-term drug therapy is producing a stable improvement, there should be a regular 6-monthly case review to make sure that beneficial environmental changes remain in place and drug therapy is still effective. Otherwise there is a significant chance of relapse.  If permanent therapy is required, then drug dose and type may need to be changed more than once during the cat’s lifetime in order to maintain effectiveness.

Treatment: Feline hyperaesthesia syndrome

====Summary of Treatment for Feline Hyperaesthesia Syndrome====

• Record baseline rate and severity of hyperaesthetic attacks as a comparison for future reassessment.

*Record baseline rate and severity of hyperaesthetic attacks as a comparison for future reassessment.

• Provide an enriched environment  

*Provide an enriched environment  

• Identify and minimise exposure to events or stimuli that trigger hyperaesthetic attacks.

*Identify and minimise exposure to events or stimuli that trigger hyperaesthetic attacks.

• Consider use of an SRI [Clomipramine] or SSRI [Fluoxetine] drug.

*Consider use of an SRI [Clomipramine] or SSRI [Fluoxetine] drug.

• Desensitise and counter-condition responses to approach, touch, grooming and other activities that may be associated with hyperaesthetic attacks.

*Desensitise and counter-condition responses to approach, touch, grooming and other activities that may be associated with hyperaesthetic attacks.

===Prognosis===

===Prognosis===