What is it?
Appropriately termed a ‘mystery disease’, feline hyperesthesia syndrome (FHS) has an unknown etiology to date. Clinical signs often include skin rippling over the dorsum, tail chasing and self-trauma, sudden jumping and running for no obvious reason and occasionally vocalization during episodes. Interestingly most cats are young (less than 1 year of age). The etiology has been proposed to be behavioral (due to the lack of identifiable organic disease), seizure disorder (due to the paroxysmal type clinical signs and directed motor activity), or a collection of multiple factors including behavioral and environmental.
How is it Diagnosed?
Obtaining a diagnosis is complex because as of yet, we don’t understand the etiology. <Groan> Therefore, as a neurologist I attempt to rule out organic CNS disease. This includes MRI, spinal tap, sometimes muscle biopsies and electrodiagnostic evaluation for peripheral neuropathy/myopathy. A recent retrospective study evaluated 7 cats with this clinical picture and did not identify any neurologic cause in these cats.1 Treatment with gabapentin, meloxicam, antibiotics, phenobarbital, prednisolone, and topiramate were tried in multiple cats. Clinical improvement was noted in 6 of 7 cats using gabapentin alone (2 cats), gabapentin, cyclosporine, and amitriptyline (1 cat), gabapentin, prednisolone, phenobarbital (1 cat) or gabapentin, topiramate and meloxicam (1 cat). Treatment in my practice consists of anticonvulsants to rule out/in epileptic activity, followed by pain management with gabapentin. Referral to a behaviorist, dermatologist and/or internist is often made as well because of the complex and unknown nature of this mystery disease.
That's it for this week. Short and sweet because, honestly, I thought you could use a little less to read during summer!
Have a terrific week. Keep those consults coming! We've worked through some really interesting cases lately.
