Changes

'''Stress-related causes for hair loss and self-injury should only be considered once all medical causes have been eliminated'''. However, stress is known to alter immune function, either exacerbating auto-immune disease or allergy, or causing immune suppression. The precise effect appears to depend upon the type of stress the individual experiences. Living in a stressful social or physical environment will therefore contribute to the worsening of many of the medical conditions that are differentials for compulsive overgrooming. Success in the treatment of these conditions may improve if the cat’s living conditions are improved.

'''Stress-related causes for hair loss and self-injury should only be considered once all medical causes have been eliminated'''. However, stress is known to alter immune function, either exacerbating auto-immune disease or allergy, or causing immune suppression. The precise effect appears to depend upon the type of stress the individual experiences. Living in a stressful social or physical environment will therefore contribute to the worsening of many of the medical conditions that are differentials for compulsive overgrooming. Success in the treatment of these conditions may improve if the cat’s living conditions are improved.

===Feline Orofacial Pain Syndrome===

===Feline Orofacial Pain Syndrome (FOPS)===

The clinical signs are characterised by '''exaggerated licking and chewing movements, with pawing at the mouth'''. Typically the discomfort is '''unilateral''' or worse on one side and can be episodic or continuous. In the episodic version the distress usually occurs after eating and lasts between 5 minutes and 2 hours. There is a short prodromal period of anxiety preceding the episode. The cat will claw at its face, attempting to claw at, catch and pull at its own tongue. Episodes of FOPS are often triggered by mouth movements during eating or grooming, indicating a problem of allodynia. As a result, cats will often become anorexic or stop grooming. Self-mutilation may be very severe, involving partial removal of the tongue.The aetiology and genetic basis of this condition are under investigation. Two groups of FOPS cases are observed; those with continuous symptoms, and those with intermittent bouts of symptoms. FOPS can begin at any age, but in most cases seen in older animals there may have been a history of a brief episode of facial pawing earlier on in life, even if that did not lead to tongue damage. This implies that there is a lifelong sensitivity issue that is exacerbated by certain medical problems. Oral health plays a significant role, with FOPS being associated with dental disease (such as [[Periodontal Disease|periodontal disease]] and [[Feline Odontoclastic Resorptive Lesions|dental resorptive lesions]]), dental eruption and mouth ulcers. It is also common for FOPS to become symptomatic after dental work, particularly removal of tartar or teeth, when either dental neck lesions are exposed or tooth roots are not completely removed. Treatment involves resolute of the underlying problem, such as ulcers or dental problems, combined with the use of analgesic drugs, including those typically used for neuropathic pain. Temporary management may be needed to prevent severe self mutilation (e.g. use of an elizabethan collar)

Although not a problem of over grooming, FOPS may be presented by owners as a grooming problem. The clinical signs are characterised by '''exaggerated licking and chewing movements, with pawing at the mouth'''. Typically the discomfort is '''unilateral''' or worse on one side and can be episodic or continuous. In the episodic version the distress usually occurs after eating and lasts between 5 minutes and 2 hours. There is a short prodromal period of anxiety preceding the episode. The cat will claw at its face, attempting to claw at, catch and pull at its own tongue. Episodes of FOPS are often triggered by mouth movements during eating or grooming, indicating a problem of allodynia. As a result, cats will often become anorexic or stop grooming. Self-mutilation may be very severe, involving partial removal of the tongue.The aetiology and genetic basis of this condition are under investigation. Two groups of FOPS cases are observed; those with continuous symptoms, and those with intermittent bouts of symptoms. FOPS can begin at any age, but in most cases seen in older animals there may have been a history of a brief episode of facial pawing earlier on in life, even if that did not lead to tongue damage. This implies that there is a lifelong sensitivity issue that is exacerbated by certain medical problems. Oral health plays a significant role, with FOPS being associated with dental disease (such as [[Periodontal Disease|periodontal disease]] and [[Feline Odontoclastic Resorptive Lesions|dental resorptive lesions]]), dental eruption and mouth ulcers. It is also common for FOPS to become symptomatic after dental work, particularly removal of tartar or teeth, when either dental neck lesions are exposed or tooth roots are not completely removed. Treatment involves resolute of the underlying problem, such as ulcers or dental problems, combined with the use of analgesic drugs, including those typically used for neuropathic pain. Temporary management may be needed to prevent severe self mutilation (e.g. use of an elizabethan collar)

==Treatment==

==Treatment==