Feline Hyperesthesia Syndrome

You are seated on a chair, with your So cat dozing in front of you on the floor. You reach down to scratch its back, and the cat wakes up, and suddenly Its tail is twitching, its eyes wide open, pupils dilated, very concentrated, and with its back paws, it starts to scratch itself.

Of course, to stop oneself from getting scratched, you get your hand out of the way. Then the cat suddenly ceases the abnormal behaviour after 20 to 30 seconds, spreads out on the floor, and goes back to sleep.

Sometimes, some cats will lick to bite obsessively at their flank, back, or tail instead of scratching. Or your cat is sitting on the windowsill, looking completely serene. And, all of a sudden, she gets up, gets off the windowsill, and runs through your home screaming. What has just happened ?! 

She had an episode called feline hyperesthesia syndrome (FHS), a rare and bizarre disorder. While veterinary neuroscientists continue to make advances in diagnosing and treating many brain-related feline afflictions, some disorders remain a mystery.

Such is the case with hyperesthesia syndrome, an abnormal condition that may affect cats of all ages, but in mature animals, its onset more frequently occurs.

Feline hyperesthesia syndrome (FHS)

First recorded in 1980, Feline hyperesthesia syndrome is a compelling and inadequately understood syndrome that may affect household cats of any age, ethnicity, and sex.

The syndrome can also be referred to as feline hyperesthesia syndrome, apparent neuritis, atypical neurodermatitis, psychomotor epilepsy, Siamese pruritic dermatitis, rolling skin syndrome, and cat twitch disorder. 

Frantic scratching, chewing, or grooming of the lumbar region, usually at the tail’s base, and rippling of the dorsal (anatomy) lumbar skin most commonly define the disorder.

In some episodes, these clinical symptoms usually occur, with cats returning to normalcy afterwards. During these episodes, it can be challenging to distract for affected cats from their actions, and sometimes they tend to be absent-minded or in a trance-like state.

In most cases, the disorder is considered mild, and the syndrome does not worsen until the cat has matured. Overall, as long as the condition does not lead to unnecessary self-aggression and self-mutilation that may lead to infection, the prognosis for the disease is great.

If a cat should mutilate their tail or otherwise be mutilated, they should be taken to a Vet for urgent medical treatment, as an infection may cause them more damage than the wound itself.

Causes And Risk Factors of Feline Hyperesthesia Syndrome

FHS is often referred to as ‘Rippling Skin Syndrome’ and ‘Twitchy Cat Syndrome.’ Certain cat breeds are genetically predisposed to FHS-Persian, Siamese, Abyssinian, and Burmese.

The first episode of FHS typically appears between ages 1 and 5, but any cat’s age may be affected. Equally affected are males and females.

Cats who reside or appear to be nervous or hyperactive in a high-stress setting may be at an elevated risk of developing FHS. While the exact cause of FHS remains unclear, a few hypotheses exist about this disease’s causes.

One theory is that epilepsy is a form of FHS. Another theory is that this is a type of compulsive-obsessive disorder.

Because some breeds are predisposed to FHS, it is also thought that genetics plays a role. An alternative hypothesis is that FHS is caused in various parts of the brain by irregular electrical activity.

Signs of feline hyperesthesia syndrome

Symptoms of FHS are broadly variable. Episodes of the syndrome usually happen at dawn or dusk.

With varying frequency, these episodes range from a few seconds to a few minutes. Oftentimes, once it begins, a cat parent can not interrupt an episode, which can be very distressing.

The spine and tail are the parts of the body that are affected most often. Symptoms may begin as slightly unpleasant but progress to annoying and disabling quickly.

Feline hyperesthesia signs include:

  • Convulsions
  • When pupils are dilated
  • Twitching skin
  • Mutilation of oneself
  • Attacking with the tail
  • Pain when stroked
  • Licking hands or chewing them
  • Vacant looking out into space
  • Running around the house yelling.
  • In normal conduct, a sudden pause, with a surprised look.
  • Sudden and dramatic changes in behaviour ( e.g., aggression increased or decreased, hyperactivity)

The symptoms can be made worse by itchy skin conditions such as flea allergies. Often, many of these signs are observed for some health problems, but the occurrence of these signs does not inherently mean FHS.

Diagnosis of feline Hyperesthesia syndrome 

FHS is a disorder of exclusion, meaning that other diseases must be ruled out before FHS can be diagnosed.

The FHS diagnostic process is lengthy. Be prepared for your cat to undergo a great deal of testing before your veterinarian approves an FHS diagnosis if your cat has any of the symptoms mentioned above.

Secondly, a history of the symptoms would be needed by your veterinarian, he or she might ask;

  • What signs have you noticed?
  • When the symptoms began,
  • Symptom magnitude
  • FHS episode frequency and length

Present a video clip of one of your cat’s FHS episodes to your vet, if possible. They will start leaving out any disorders that might explain your cat’s symptoms if your veterinarian suspects FHS.

A physical examination, blood work, urinalysis, skin tests, a neurological exam, and spinal x-rays typically begin with basic diagnostic testing.

The illness that your veterinarian can rule out are below:


Flea allergy dermatitis and atopic dermatitis involve common itchy skin conditions. To treat the scratching, the veterinarian can first recommend flea control and anti-inflammatory medicines (corticosteroids).

Your vet could prescribe supplements with omega-3 fatty acids as well.


Your vet will then suggest neurological disorders, such as epilepsy and spinal disease if symptoms continue after treating the skin. Spinal x-rays and a neurological exam will be needed for this. You could be referred to a veterinary neurologist by your vet.


If your cat is still not getting better, you will need to rule out painful orthopaedic disorders such as osteoarthritis. It is possible to try pain medicine and complementary therapies (acupuncture, massage).

FHS will become the potential cause of your cat’s symptoms if any of these disease types have been ruled out.

Caring for cats with FHS

When your doctor has made the FHS diagnosis, it will be time to formulate a care plan to alleviate your cat’s pain and improve her quality of life. For recovery, behavioural modifications and drugs are used.

For each affected pet, care plans need to be personalized.

Behavioral Modification

Behavioural improvements, such as those mentioned below, will decrease your cat’s stress and anxiety, all of which can cause episodes of FHS.

The following modifications can help:

  • Redirect your cat away from tension triggering circumstances.
  • Create and sustain a regular everyday feeding and playtime schedule
  • Eliminate rivalry in a multi-cat household for resources ( e.g., multiple protected areas, different feeding places, multiple litterboxes)
  • Providing environmental enrichment, such as hiding treats around the house, participating in interactive playtime, and providing cat-friendly structures such as windowsill perches.


Behavioural alterations might not be enough to tackle all cases FHS adequately. This is when it comes to medicine. At present, specifically for FHS, there are no FDA-approved drugs.

Luckily, other treatments may be used to treat the effects of the syndrome:

  • Suitable inhibitors of serotonin: These medications ensure that the brain has enough serotonin, a neurotransmitter. Serotonin influences mood and may also decrease the obsessive-compulsive behaviour of a pet. Prozac and Zoloft are examples.
  • Anti-seizure drugs: If seizures are involved in your cat’s FHS episodes, then anti-seizure medicines such as phenobarbital and gabapentin may minimize the frequency of outbreaks. Typically, these drugs are started at a low dose. Track your cat’s reaction to the drugs so that your veterinarian can know if dose changes are to be produced. To determine the liver and kidney function of your animal, your vet will conduct periodic blood tests. Ideally, your cat will be able to be fully weaned off medicine, but individual cats will require lifelong medical therapy to manage FHS.

Ultimate Thoughts

FHS is a disorder that is complicated and stressful. Left unmanaged, your cat’s FHS can be crippling and significantly affect their quality of life.

There should be no delay in making a veterinary appointment if you find signs of FHS in your pet. Work closely with your veterinarian to develop a management plan to mitigate your cat’s symptoms and restore its standard quality of life.


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