What is feline hyperesthesia syndrome (or twitchy cat disease)?
Feline hyperesthesia syndrome (FHS) is the strangest cat disease you’ve probably never heard of.
It goes by several different names, including “twitchy cat syndrome” and “rolling skin syndrome” – an attempt, I think, to describe this problem, because nobody really knows what it is.
The word “hyperesthesia” actually describes it best. “Hyper” means “more than usual” and “esthesia” is the ability to feel sensations. That’s what feline hyperesthesia syndrome is: the cat is feeling some extreme sensations and, in some cases, appears tormented by it.
The point of this post is to explore what we know about FHS, what research has been done to explain this disease so far, and what veterinarians are doing to diagnose and treat it.
What are the symptoms of feline hyperesthesia syndrome?If you’re reading this post, it might be because your cat is displaying some worrisome symptoms, and you want to know if THIS is what is going on with your cat.
The problem is that many of the symptoms, which are wide-ranging, can actually be signs of other diseases, many of which have known treatments. If your cat has any of the symptoms on this list, and you fear it might be FHS, seek out the help of a good veterinarian. Express your concern about this particular syndrome, but be open to the idea that it may be something else.
The best way to describe feline hyperesthesia syndrome is by showing a cat in the throes of it. Hopefully the videos in this post will make some of the potential symptoms clear. FHS involves muscle contractions, usually on the back or near the tail, that a cat seems unable to control, as well as some changes in behavior that appear related to these muscle spasms.
Here are some of the symptoms a cat with FHS may display.
- A rippling or twitching of the skin on a cat’s lower back, close to the base of the tail. Sometimes the rippling seems triggered by touch, but other times it seems spontaneous.
- Dilated (wide) pupils.
- Frantic jumping and running.
- Excessive meowing, howling, crying, or hissing.
- Tail chasing.
- Biting or licking of the lower back, tail, sides, or back paws.
- Extreme or frantic grooming, especially along the sides or tail
- Apparent pain or discomfort when touched.
- Uncontrolled urination or defecation.
- Moodiness, or a mood that swings from affectionate, to aggressive, hyperactive, or depressed.
- Staring into space, sometimes with a strange expression.
- A fixation with the tail.
- Pulling out clumps of fur.
- Appearing to chase things that aren’t there, or running away from something that isn’t there. 
Episodes are typically short: only a minute or two.
It’s not a good idea to pet a cat in the middle of one of these events, even if you are just trying to soothe him. Petting appears to sometimes make an episode more severe, and a cat can become aggressive and bite you.
What causes feline hyperesthesia syndrome?FHS is a poorly understood condition. Veterinarians and researchers have varying theories about the cause of FHS, but no one knows for sure what it is.
Is it a neurological condition, with the twitches and sensitivity caused by something misfiring in a cat’s nervous system, such as a seizure disorder? 
Is it dermatological? Is something unseen irritating a cat’s skin, causing him severe discomfort?
Or is it psychological, an offshoot of obsessive-compulsive disorder, for example, that causes a cat to feel compelled to lick and bite her own fur?
In truth, this is a condition that has stumped scientists so far.
How is feline hyperesthesia syndrome diagnosed?Because veterinarians don’t yet know what FHS is, the only way to diagnose this disease is to eliminate all of the things that it is not. A good vet will first look at all of the other potential causes for your cat’s strange behavior.
Your vet will likely start with a physical examination of your cat, including his skin. Your vet may look for signs of flea allergies, food allergies, mite infections, or fungal infections. She may also look for a wound or abscess in the skin that could be causing pain.
Your vet might decide to conduct a neurological examination. He might be looking for signs of head trauma, a brain tumor, brain infection, or epilepsy.
Your vet is also likely to consider other sources of pain, such as arthritis, a pinched nerve, or slipped disk.
Your vet may recommend bloodwork, including a complete blood count and chemistry profile, checking liver and kidney function, and looking for thyroid disease, or exposure to a toxin.
Depending upon your vet’s initial findings, the severity of your cat’s symptoms, and your willingness or ability to pay for additional tests, she may recommend additional studies, which could include anything from a skin scraping to check for a fungal infection, to a muscle biopsy, and/or an X-ray or MRI of your cat’s spine.
Don’t be surprised if your vet refers your cat to a specialist, such as a veterinary dermatologist, or neurologist.
Because feline hyperesthesia syndrome is only diagnosed by eliminating all other potential causes for your cat’s behavior, this is, unfortunately not a straightforward (nor inexpensive) road.
How you can help your vet diagnose FHS
One of the most useful things you can bring to your veterinary appointment is a video of your cat’s behavior.
Thank goodness for cellphones.
How is feline hyperesthesia syndrome treated?
There is, unfortunately, no protocol for treating FHS. Veterinarians are often on their own, making educated guesses about what may provide relief for an individual cat.
Since we don’t know what causes FHS, it’s possible that there is more than one cause, and consequently, more than one potential treatment.
A hydrolyzed protein diet helped one FHS cat
(*This post contains affiliate links and I may be compensated if you make a purchase after clicking on my links.)
In one study, a single cat’s symptoms completely disappeared after switching the cat’s food to a hydrolyzed protein diet. This suggests this particular cat might have been suffering from a hypersensitivity to food.
Hydrolyzed proteins are those that have been broken down in size, in the hope that an allergic or overactive immune system won’t recognize them.
Royal Canin Veterinary Diet, Purina ProPlan Veterinary Diet, Hills Prescription Diet z/d, and Blue Buffalo Natural Veterinary Diet, are examples of this type of diet. But you should probably discuss this option with your vet before changing what your cat eats.
Various medications helped other FHS cats
In a retrospective study involving seven cats, six showed an improvement in symptoms with medications, although some of the cats experienced the return of symptoms after some time.
Vets tried a variety of drugs with these seven cats, in combination and alone, including:
- Anti-seizure drugs, including gabapentin, phenobarbital, and topiramate.
- Pain medications, including meloxicam and tramadol.
- Steroids, including prednisolone.
- Immunosuppressants, including cyclosporine.
- Antidepressants, such as clomipramine, fluoxetine, and amitriptyline.
Two additional FHS cats were helped with anti-seizure medications
In a final study, two young cats with FHS returned epilepsy-like readings on an EEG, which detects abnormalities in brain waves. They were both helped with anti-seizure medicines.
Anecdotally, some vets will perform an epidural injection in cats that appear to have lower back or tail pain in an attempt to provide relief.
Some FHS cat guardians have tried a nutritional supplement with some success
If you read online discussions, you may find that some cat guardians have tried a nutritional supplement called alpha-casozepine, made from a naturally occurring protein in cows’ milk. This product is sold by Vetoquinol under the name of Zylkene Calming Supplements, and is available over the counter.
Please discuss the use of any supplements with your vet.
Should I worry if my cat has FHS? Will my cat survive this disease?
FHS is not life threatening, but that doesn’t mean that it isn’t serious.
Some cats truly appear to be tormented by their condition, and thus finding a treatment that seems to help is necessary for them to have a good quality of life.
Self-mutilation is often a component of this disease, and cats who overgroom or pull out their own fur can damage their skin and experience resulting infections.
It’s important to try to find a solution that helps your cat.
Are some cats or breeds more prone to FHS than others?
Feline hyperesthesia syndrome is much more commonly diagnosed in younger cats. It is most often noted within a cat’s first year of life, and the majority of cats who are diagnosed with FHS are less than seven years old.
This doesn’t mean that cats grow out of the disease, but that it first arises in cats when they are younger.
Siamese cats, and cats who share a genetic background with Siamese cats, seem to be most prone to feline hyperesthesia syndrome. These include Burmese, Persian, and Abyssinian cats.
This suggests that FHS might be, in part at least, a genetic disorder, although this is far from established. Regardless, cats displaying the symptoms of FHS should not be bred.
What should you do if your cat has FHS?
First and foremost, recognize that your cat has no control over her symptoms. If she bites, or becomes aggressive during an episode, understand that your cat isn’t misbehaving and that it’s no reflection on your relationship.
Don’t handle your cat during an episode, or try to comfort him, even if the symptoms are frightening. There is a possibility that handling could make the symptoms momentarily worse, and you are at risk of being injured by your cat.
Try to manage your cat’s stress at home. There’s some thought (not substantiated, however) that stress might be a contributing factor in this disease. Remember that what you think is stressful is not what your cat thinks is stressful. Try to avoid even the smallest changes in your cat’s life, and try to adhere to a strict routine around the cat things, like feeding and litter box changes.
But most of all, seek veterinary attention for your cat. Even though so much about this disease is unknown, a compassionate and patient vet can work with you and your cat to try to find something that eases her discomfort.
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Dawn LaFontaine is a lifelong animal lover who always seems to have a little pet hair in her keyboard. Her blog, Kitty Contemplations, helps cat guardians better understand and care for the special beings they share their lives and homes with. Her cat-products business, Cat in the Box, sells beautiful, well-made, and award-winning products that she designed to meet the biological needs of cats.
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Amengual Batle P, Rusbridge C, Nuttall T, Heath S, Marioni-Henry K. Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective study of seven cases and proposal for an integrated multidisciplinary diagnostic approach. Journal of Feline Medicine and Surgery. 2019;21(2):178-185. doi:10.1177/1098612X18764246. https://journals.sagepub.com/doi/10.1177/1098612X18764246
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