We have a lot to learn about Feline Hyperaesthesia Syndrome (FHS), a complex disorder characterized by clinical signs including skin rippling, episodes of running and jumping, excessive vocalization and tail chasing. Some veterinarians consider tail mutilation as a clinical sign although others associate it with neuropathic pain.
This retrospective study took an integrated multi-disciplinary approach. Authors researched signalment, history, clinical presentation, diagnostic work-up and treatment in cases of FHS. Self-trauma to the tail was included. Gabapentin was used in the majority of case reports, either alone or in combination with other drugs.
The lack of clarity in the aetiopathology and systems involved in the manifestation of clinical signs may explain the current tendency to start with therapeutic trials, prior to referral. The study shows that, in some cases, this has potentially resulted in avoidable surgery or the use of unnecessary medications.
FSH cases should first be referred to a behavior specialist. In fact, some experts suggest that it is a displacement disorder that can create compulsive behavior. In some cases where behavior modification protocols and psychotherapy were used, improvements were seen. In other cases, however, the addition of anti-inflammatory and immunosuppressive drugs, was the only way to reduce the clinical signs.
There is a further theory that FHS is an idiopathic form of epilepsy, characterized by focal seizures and supported by the positive response to gabapentin and topiramate therapy – and another that dermatological disease may be involved in the pathogenesis of the syndrome.
This research has limitations, including its retrospective nature and limited number of cases, but it includes not only case reports analysis but also a practical flow diagram of proposed diagnostic pathways that could be helpful for veterinarians whose patients show signs compatible with FHS.
Amengual Batle P. et al. Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective study of seven cases and proposal for integrated multidisciplinary diagnostic approach. Journal of Feline Medicine and Surgery 1-8. DOI: 10.1177/1098612X18764246