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Hyperesthesia Syndrome in Cats
Published: April 28, 2023
Anneliese Heinrich Msc, DVM
Tuxedo cat showing signs of Hyperesthesia Syndrome
This cat is showing signs of Hyperesthesia Syndrome

Feline hyperesthesia syndrome (FHS) is known by several names including “rolling skin disease”, “neurodermatitis”, neuritis, psychomotor epilepsy, and pruritic dermatitis. Hyperesthesia means “too much feeling.” It can be difficult to determine whether the cause is behavioral or medical without additional diagnostics, such as an MRI or EEG.

Clinical signs of feline hyperesthesia syndrome (FSH) can range from mild to self-mutilating. Common behaviors seen include:

  • rippling or rolling of skin and muscles over the back, ears, head, or tail;
  • excessive staring at their tail, then attacking their tail or sides;
  • biting at the base of their tail, front legs, and paws;
  • running around while meowing in a distressed manner;
  • aggression towards people or other cats. Some cats may show an increase in affectionate behavior;
  • big, dark, round (dilated) pupils.

To diagnose FHS, other conditions related to the skin and nervous system must be ruled out first. These include:

  • dermatologic causes: flea, food, environmental, or seasonal allergies; skin infections or parasites, auto-immune diseases, anal sac disease;
  • neurological conditions such as seizures or neuromas (painful nerve bundle) which may form in cats after declaws or tail injuries;
  • pain: frostbite and orthopedic conditions such as arthritis, injury to the tail, hips, or back;
  • compulsive disorders: may be a primary behavior problem starting from one of the above conditions, then worsening over time;
  • toxins: Pyrethrin/pyrethroid, Organophosphate/carbamate toxicosis;
  • gastrointestinal diseases that are accompanied by changes to appetite, vomiting or diarrhea, flatulence or constipation;
  • urinary conditions, particularly in male cats with a urinary blockage.

To rule out underlying medical causes, expect your veterinarian to do a full physical, orthopedic, and neurological exam to determine the cause. Diagnostics may include radiographs, blood work or urinalysis, skin swabs or skin scrapes.

Treatment for FHS depends on the cause. Your veterinarian may recommend medications, supplements, weight loss or rehabilitation. Treatment of skin conditions may require antibiotics, medications for itch and inflammation or diet change.

If a physical cause cannot be found, antidepressant and anti-anxiety medications may be prescribed.

In addition to medications, there are some treatments that apply to all cats with clinical signs of FHS such as:

  • avoid known situations that cause the behavior in your cat, such as petting;
  • avoid punishing the behavior verbally or physically. This causes conflict and is not likely to stop the behavior;
  • provide a calm, predictable environment for your cat;
  • provide different types of enrichment; 

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