Living with Feline Hyperesthesia Syndrome

Anti-convulsant and anti-obsessional drugs can help your affected cat live a normal life.

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Q: My aunt’s cat Maya, that we believe is 10 years old, was recently diagnosed with Feline Hyperesthesia Syndrome. She adores Maya but doesn't know whether to seek a specialist’s help, continue to live with the cat as normal but avoid touching her very sensitive back or put the cat to sleep. Maya constantly bites her back and tears the fur out, without drawing blood. As long as we have had Maya, her back has always had ripples, but we never thought it would become something so dangerous to her health. What course of action is in Maya's best interest?
A: Feline Hyperesthesia Syndrome (FHS) (also called “rolling skin syndrome”) is a condition that usually appears in cats between the ages of 1 and 4. Siamese and other Asian breeds have a higher prevalence of this syndrome.

Clinical signs of FHS include sudden bouts of hyperactive (sometimes aggressive) behavior, frantic grooming around the tail or flank, an obsession or fixation with the tail (including occasionally viciously attacking the tail), rippling or rolling of the skin (hence the name “rolling skin syndrome”), dilated pupils with a strange look to the eyes, extreme sensitivity to touch along the spine (sometimes, petting or scratching the cat along the spine can trigger the bizarre behavior), sudden mood swings and loud crying or meowing. Cats can show any or all of the behaviors described above.

No one knows exactly what causes FHS, but there are a few possible explanations. It may be a type of seizure activity, and the fact that some affected cats respond to anti-convulsant medication seems to support this explanation. Another possibility is that this is a form of obsessive-compulsive disorder, with the obsession being that of self-directed grooming. The fact that many cats respond to anti-obsessional medications is in support of this argument.  Some people feel that it is caused by a combination of the two. There may be an inherited tendency toward FHS, given that certain Asian breeds are more susceptible to FHS.

There is no test to diagnose FHS. A diagnosis of FHS is made after other causes of the clinical signs are excluded by diagnostic tests, and by a positive response to treatment. Blood tests and other diagnostic tests will likely be necessary to rule out medical causes that may be confused with FHS, including hyperthyroidism, parasitic skin infections, skin allergies, etc.

Effective anti-obsessional drugs include clomipramine (clomicalm) and fluoxetine (Prozac). Be aware that it might take 3 or 4 weeks for an initial response to the drug. By 16 weeks, the full effect of the drug should be known. When anti-obsessional therapy is ineffective or only marginally effective, try anti-convulsants. The first drug to try in cats is usually Phenobarbital. With appropriate environmental and pharmacologic treatment, affected cats often can be rehabilitated and lead normal lives. 

Arnold Plotnick, DVM

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Reader Comments

U.L.    Miami, FL

3/25/2011 5:36:12 PM

Our 1 1/2 year old kitty is on pheno (1/4 grain twice a day)for this. Seems to be working pretty well, although she is not "cured". I wrap it in a greenies pill pocket. Much more economical than compounding it into a gel like we were doing.

Jan    Gordonville, TX

9/2/2010 5:20:42 PM

My 3 year old cat, LucyLu, was diagnosed with FHS a year ago. With vets help, we tried anti-depressants, then phenobarbital combined with reduced dosages of steroid. LucyLu has for 4 months been on increased dosage of phenobarbital - 30 mg per day and no steroids (she is 10 1/2 pounds). She is doing well - few seizures - and just small episodes when I give her the evening dose. Her meds are compounded by local pharmacy and mixed with fish oil. This works better than having to try and split the pills into 3/4 as they splinter. Would recommend this method as you get more constant dosage. I'm still looking for ways to be able to get her off the meds even though she is still very active during the day - follows me around, not really sleeping like the other 2 cats - and would welcome any advice I could get on natural treatments. Please share any other information on this disease. Thanks writing this article.

diane    Las Vegas, NV

3/22/2010 10:02:37 AM

My cat has this--it happens so suddenly! She always had a "twitchy" tail--we thought it was cute. But the tail grooming, racing around and seeing things that aren't there was crazy. It is horrible to watch! She had one episode the first day, several the next, then I took her to the vet and wouldn't leave until they did x-rays and bloodwork. She is on phenobarbitol twice a day. It seems to really be doing a great job. She's good with swallowing the tiny pills-afterwards she gets treats. If you suspect something--get to a vet ASAP. I am convinced if I had let it go a week she'd be in bad shape. My vet wasn't as familiar with cat stuff as he was with dog stuff. I actually printed out information from the internet and took it in for him to read up on the disorder.

Jasper    Waynesburg, PA

2/23/2010 3:32:32 PM

I'm convinced my car has this disorder and it all started with the good cat/evil cat observation: ears pinned back and the rapid head turning left to right with a burst of energy running around the house. second sign was the touching towards the base of the tail and hissing and Obsessive licking around the base of the tail. third sign: skin ripple as if something is crawling on her skin. I am now at the tail mutilating and the convulsions. Her meds were started yesterday for this disorder and it's very disturbing to witness an attack.

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