Changes

==Introduction==

==Introduction==

The incidence of hyperaesthesia is not known, but it may be more common than once thought and could play a significant part in other behavioural problems such as inter-cat aggression.

The incidence of hyperaesthesia is not known, but it may be more common than once thought and could play a significant part in other behavioural problems such as [[Feline Aggression Towards Cats|inter-cat aggression]].

'''Age of onset varies''' but, if the condition starts in early adulthood, it can cause the breakdown of previously excellent relationships between cats sharing a household. Historically affected cats will begin to resent play or contact with conspecifics, becoming progressively more irritable and aloof from them. The cat may also begin to resent human contact. Analysis of specific incidents will show that play or grooming began to initiate bouts of hyperaesthesia, which then lead to aggression [often by the other cat].  

'''Age of onset varies''', but if the condition starts in early adulthood, it can cause the breakdown of previously excellent relationships between cats sharing a household. Historically affected cats will begin to resent play or contact with conspecifics, becoming progressively more irritable and aloof from them. The cat may also begin to resent human contact. Analysis of specific incidents will show that play or grooming began to initiate bouts of hyperaesthesia, which then lead to aggression (often by the other cat).  

The behaviour is highly bizarre but is often overlooked by the owner as a quirk of the cat’s personality. They may consider it to be playful or amusing, unless it becomes frequent or involves self-trauma. The fact that the cat suffers from hyperaesthesia may only come to light as a result of investigating some other behavioural problem. It is unknown whether hyperaesthesia occurs in discrete bouts or, in fact, produces an ongoing altered perception of touch contact. '''The fact that bouts maybe triggered by contact implies that touch sensation is persistently altered in some way'''.

The behaviour is highly bizarre but is often overlooked by the owner as a quirk of the cat’s personality. They may consider it to be playful or amusing, unless it becomes frequent or involves self-trauma. The fact that the cat suffers from hyperaesthesia may only come to light as a result of investigating some other behavioural problem. It is unknown whether hyperaesthesia occurs in discrete bouts or, in fact, produces an ongoing altered perception of touch contact. '''The fact that bouts maybe triggered by contact implies that touch sensation is persistently altered in some way'''.

====Differentials====

====Differentials====

*[[:Category:Allergic Skin Diseases|Allergic skin disease]] [atopy, food allergy]

*[[:Category:Allergic Skin Diseases|Allergic skin disease]] (atopy, food allergy)

*[[:Category:Arthropods|Ectoparasites]]

*[[:Category:Arthropods|Ectoparasites]]

*[[Seizures|Epilepsy]] [petit mal type – limbic location]

*[[Seizures|Epilepsy]] (petit mal type – limbic location)

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

*Local or referred pain (spinal lesion, intermittently [[Patellar Luxation|luxating patella]], etc)

*[[Hyperthyroidism]]

*[[Hyperthyroidism]]

*[[:Category:Central Nervous System - Pathology|CNS pathology]]

*[[:Category:Central Nervous System - Pathology|CNS pathology]]

====Signs====  

====Clinical Signs====  

Signs indicative of hyperaesthesia are very variable, but include:

Signs indicative of hyperaesthesia are very variable, but include:

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

*Skin or muscle twitching or rippling (commonly thoracolumbar or at the tail base)

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

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

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

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

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

*Ear twitching (often as if the cat is alert to a sound behind it)

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

*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.

*Bouts are often accompanied by vocalisation  

During these attacks, the cat’s behaviour is generally indicative of a '''state of 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 of 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

====Drug Therapy====

====Drug Therapy====

Drug therapy is frequently beneficial for hyperaesthetic cats, which respond well to serotonin reuptake inhibitor (SRI) drugs like '''Clomipramine''' [Clomicalm] and the more selective serotonin reuptake inhibitor (SSRI) 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 once daily, to a higher dose rate 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 (SRI) drugs like '''[[Clomipramine]]''' and the more selective serotonin reuptake inhibitor (SSRI) drug '''[[Fluoxetine]]'''. 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 once daily, to a higher dose rate 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.

The effect of serotonergic drugs is to reduce the severity and frequency of the hyperaesthetic attacks, and it may become easier to distract the cat from the behaviour. Response to normal touch should be diminished so that the cat may then be desensitised and counter-conditioned to the stimuli and events that previously triggered an attack, such as stroking and grooming. Care must be taken if there is any risk that disinhibition may release aggressive behaviour during handling.

The effect of serotonergic drugs is to reduce the severity and frequency of the hyperaesthetic attacks, and it may become easier to distract the cat from the behaviour. Response to normal touch should be diminished so that the cat may then be desensitised and counter-conditioned to the stimuli and events that previously triggered an attack, such as stroking and grooming. Care must be taken if there is any risk that disinhibition may release aggressive behaviour during handling.

====Summary of Treatments 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 .

*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.