Changes

==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.

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.

It is sometimes possible to redirect the cat onto an alternative behaviour once an attack has started, by calling the cat and engaging it in play or some other non-tactile distraction. A ‘recall’ type response can be easily conditioned by calling the cat before offering a food treat or playing a game. This strengthens the response during distraction.

It is sometimes possible to redirect the cat onto an alternative behaviour once an attack has started, by calling the cat and engaging it in play or some other non-tactile distraction. A ‘recall’ type response can be easily conditioned by calling the cat before offering a food treat or playing a game. This strengthens the response during distraction.

Drug therapy is frequently beneficial for hyperaesthetic cats, which respond well to serotonin reuptake inhibitor drugs like Clomipramine [Clomicalm, Novartis] and the more serotonin selective drug Fluoxetine [Prozac]. These drugs are commonly used to treat compulsive disorders and do appear to provide considerable relief for hyperaesthetic cats. Onset of action is 4 or more weeks. The dose of Clomipramine may need to be increased from an initial dose rate of 0.25mg/kg once daily, to 0.5mg/kg once daily or greater if initial response is insufficient after 6-8 weeks. Higher doses are associated with increased adverse effects such as sedation and it is important that genuine response to therapy is not confused with undesirable profound sedative effects which will suppress all sorts of behaviour, including the reaction to hyperaesthetic sensations. SRI drugs like Clomipramine reduce the threshold for seizures, which makes it particularly important to rule out petit mal type epilepsy as a differential.

Drug therapy is frequently beneficial for hyperaesthetic cats, which respond well to serotonin reuptake inhibitor drugs like Clomipramine [Clomicalm, Novartis] and the more serotonin selective drug Fluoxetine [Prozac]. These drugs are commonly used to treat compulsive disorders and do appear to provide considerable relief for hyperaesthetic cats. Onset of action is 4 or more weeks. The dose of Clomipramine may need to be increased from an initial dose rate of 0.25mg/kg once daily, to 0.5mg/kg once daily or greater if initial response is insufficient after 6-8 weeks. Higher doses are associated with increased adverse effects such as sedation and it is important that genuine response to therapy is not confused with undesirable profound sedative effects which will suppress all sorts of behaviour, including the reaction to hyperaesthetic sensations. SRI drugs like Clomipramine reduce the threshold for seizures, which makes it particularly important to rule out petit mal type epilepsy as a differential.

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.

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

====Summary of Treatments 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