The Cat Care

Feline Hyperesthesia Syndrome

Feline Hyperesthesia Syndrome in Cats: Diagnosis and Treatment

Most dog owners are acquainted with tail chasing, but is it a typical habit in cats?

What if your cat suddenly starts attacking their tail? Perhaps your cat doesn’t have a problem with their tail, rather they feel uneasy or even painful when you touch them.

Cats have a tendency to exhibit strange habits from time to time. However, unusual behaviors should be investigated by a veterinarian, especially if the signs lead to feline hyperesthesia syndrome, also known as a twitch-skin syndrome or rippling skin illness.

If your cat refuses to be touched, exhibits unpredictable twitching behavior, or seems to be in pain, this uncommon ailment may be the cause.

Rippling Skin Disorder is a common term for “Feline Hyperesthesia Syndrome” (FHS), a disease characterized by a variety of symptoms including anxiety, neurological sensitivity, and widespread agitation.

The key distinction between “normal crazy behavior” that younger, happy, or happy cats show and that of feline hyperesthesia disease is that the latter causes real neurological or central nervous system discomfort in the cat. (change)

Learn about the symptoms of feline hyperesthesia and how the condition is treated.

What is Feline Hyperesthesia Syndrome?

Feline hyperesthesia syndrome (FHS) is an uncommon yet troublesome and “bizarre” condition also termed as a twitch-skin syndrome, rippling skin sickness, or rolling skin syndrome. Feline hyperesthesia may occur in cats of any age, although it is more common in older cats.

Cats with this condition are very sensitive to touch, particularly on their lower back. In fact, the term hyperesthesia literally means “excessive feeling and sensation.”

While any cat may be afflicted, Asian breeds such as Siamese, Burmese, Abyssinian, and Persian are more likely to be diagnosed with it. The majority of cats afflicted by Feline Hyperesthesia Syndrome develop symptoms between the ages of one and five years.

Although veterinarians usually classify FHS as a seizure disease, some classify it as an obsessive-compulsive disorder. Why? Because most clinical bouts of the condition are characterized by short but compulsive scratching, grooming, and rushing about.

FHS is still not completely understood. Some veterinarians think it is caused by nerve disease. Others think it is just a symptom of obsessive-compulsive disorder. Only in recent years have veterinary experts acknowledged Feline Hyperesthesia Syndrome as a true disease.

Symptoms of Feline Hyperesthesia Syndrome (FHS)

FHS symptoms usually manifest as “brief bursts of strange behavior lasting around just a minute or two.”

The majority of episodes begin when you brush or rub the cat’s lower back. In the span of 20 or 30 seconds, your cat may go from calmly sleeping to exhibiting the following startling symptoms:

  • Rippling Skin

The skin on the cat’s lower back ripples noticeably, and the cat bites and scratches at his back or tail.

  • Strong and persistent Meowing

Cats with this condition may sometimes meow loudly for no apparent reason, especially at night.

  • Unusual Eye Appearance

Pupils may dilate and the cat’s gaze blankly into space, and the eyes may look glassy.

  • Erratic Racing 

The cat will often run in circles or sprint away, first in one direction, then in another direction unpredictably.

  • Touch Sensitivity

Petting and any physical touch on the skin may cause severe sensitivity and pain in a cat with this condition.

Some cats may even pee when stroked on the back, or refuse to be petted or handled at all. FHS cats may sometimes swish furiously and then attack their own tail.

It is not unexpected that a disease with so many anxiety-like symptoms has a variety of anxiety-inducing causes, ranging from accidental food toxicity or environmental toxicity, acquired allergy and over-sensitivity, to compulsive behavior in an effort to self-soothe. It is hardly unexpected that this condition is also known as feline psycho-motor epilepsy, unusual neuro-dermatitis, self-mutilation syndrome, or twitchy cat sickness.

Additional Symptoms of Feline Hyperesthesia Syndrome (FHS)

  • Scratching, biting, or licking the back, flanks, or tail.
  • Excessively grooming themselves
  • A visible rippling or rolling of their skin on their back.
  • Salivation.
  • Uncomfortable vocalization.
  • The tail twitches.
  • Urination that is uncontrollable.
  • Running about the house in a frenzy.
  • When petted, there is a display of discomfort.
  • With a weird face, he stares into space.
  • Self-mutilation, such as ripping off clumps of hair or biting their own flesh.
  • Mood swings that occur unexpectedly (often from super affectionate to aggressive, hyperactive, frightened, or depressed).
  • Appearing hallucinations, resulting in chasing after objects that aren’t there or fleeing from an illusory danger.
  • Excessive twitching, as if they’re having a seizure.

When your cat is touched on the back, they may begin compulsively licking and biting their body, especially their front paws, if they have Feline Hyperesthesia Syndrome.

It is extremely typical for cats to exhibit seizure-like behavior (falling over, leg-paddling, drooling, or vocalizing) soon after an episode of FHS, lending credence to the idea that it is linked to epilepsy.

These symptoms may be exacerbated if the hyperesthesia cat self-mutilates in an attempt to alleviate the painful consequences of the episode, notably via compulsive scratching and biting.

The vigilant caregiver may benefit from utilizing a calendar to record the day-to-day or week-to-week recurrence of each of these nervous behaviors, since each may seem “normal” if observed rarely or one at a time.

How long can Feline Hyperesthesia Syndrome (FHS) last?

FHS episodes may recur on a daily, monthly, or biweekly basis, with some cats experiencing bouts nearly constantly for days on end. It may be impossible to divert the cat or assist in any way during an episode, making it stressful and very frustrating for cat owners.

The symptoms are episodic, which means they come out of nowhere and then vanish just as quickly. If your cat has Feline Hyperesthesia Syndrome, they will remain symptom-free in between episodes.

What Should you do if you think Your Cat has Feline Hyperesthesia Syndrome?

If you notice your cat exhibiting symptoms of feline hyperesthesia syndrome, schedule an appointment with your standard veterinarian. They will examine your cat to rule out other causes of the symptoms, such as an injury, skin disorder or flea infestation causing severe itching, or painful conditions such as orthopedic, spine, or nerve problems.

If your veterinarian is unable to identify the source of the symptoms, the very next step would be to see a veterinary neurologist for another assessment and further testing.

Possible Causes of Rippling Skin Disorder in Cats

It is critical to the first rule out any other possible physical causes:

  • Pansteatitis (Steatitis, Yellow Fat Disease)

Pansteatitis is a condition of accumulation of unsaturated fatty acids coupled with a deficiency of vitamin E.

It is most often induced in cats by the intake of red tuna on a regular basis, and other experts have implicated it on non-nutritional homemade diets. The resulting “sick fat” deposits may be very uncomfortable for cats.

  • Brain Involvement

A possible brain infection, skull injuries, or tumors should be examined by a veterinarian, especially in FSH cats with seizures.

  • Fleas Allergies

Itchy skin caused by flea bites may be the source of erratic behavior in cats, and this possibility should be reasonably simple to rule out by inspecting the skin under the coat.


Poisonous exposure to environmental or dietary heavy metals, such as arsenic or mercury-containing foods or substances, usage of toxic flea treatments, flea collars containing dubious chemicals, or consumption of home cleaning products and pesticides, should be avoided.

There are two major hypotheses on how FHS develops in cats, according to current veterinary research.

The first is that it is a nerve disease that affects your cat. It’s unknown whether the nerves are damaged by a pinched disc in the spine or seizure-like activity in the brain.

The second hypothesis is that it has nothing to do with nerve pain and is just an obsessive-compulsive disorder.

Assuming that all of the aforementioned reasons can be and have been checked out. Rippling Skin Disorder will most likely be regarded as a kind of OCD (Obsessive-Compulsive Disorder) or a stress-related illness, and appropriate nutritional, environmental, and behavioral measures may be implemented in such instances.

Diagnosing Feline Hyperesthesia Syndrome

  • Unfortunately, FHS is an exclusionary diagnosis. This means that before a diagnosis of Feline Hyperesthesia Syndrome could be established, your veterinarian will need to rule out other diseases.
  • Feline hyperesthesia syndrome may be difficult to diagnose, owing to its rarity. If you observe any of the following symptoms in your cat, take him to the doctor to rule out any more serious medical conditions:
  • Spinal issues include osteoarthritis, pinched nerves, and slipped discs
  • Flea infestations, fungal infections, and mite infestations are examples of skin diseases.
  • Certain skin diseases, such as Flea Allergy Dermatitis, may mimic FHS symptoms. Your doctor will perform a complete physical exam to look for fleas and tiny, red, raised lumps (papules) on your cat’s skin that is indicative of flea bites.

Cats, particularly elderly cats, are afflicted by osteoarthritis. Arthritis in elderly cats was not often identified until recently. This is due in part to pet owners failing to see the symptoms at home, and in part to the fact that it is difficult for a veterinarian to understand a cat’s stride in an office environment. The most frequent sites for arthritic changes in a cat are the lower back, rear legs, and tail. Your veterinarian will also want to ensure that your cat’s rear-end sensitivity isn’t caused by arthritis.

Your veterinarian will need to conduct a number of diagnostic procedures before concluding that your cat has FHS. A comprehensive physical and neurological exam, urine studies, blood chemistry,  x-rays, an MRI, and other tests may be performed.

Conditions that need to be ruled out before FHS

Other diseases that must be ruled out before establishing an FHS diagnosis include:

  • Flea allergy dermatitis (itching and hair loss caused by a cat’s allergic response to flea saliva) 
  • Fungal skin diseases such as yeast or ringworm
  • Epilepsy
  • Arthritis
  • A Pinched nerve
  •  A slipped disc 
  • Mite infection 
  • Nutritional deficiency
  • Hyperthyroidism (is a condition in which the thyroid gland produces too much thyroid hormone in the bloodstream).
  • Toxin exposure Pain from abscesses, bite wounds, or impacted anal sacs
  • Neurological problems such as brain tumors, head trauma, or brain infection

If a veterinarian suspects Feline Hyperesthesia Syndrome, she will conduct a comprehensive examination and a battery of diagnostic tests to rule out any other medical problems. The veterinarian may send the cat to a neurologist (a specialist in all aspects of the neurological system) or a dermatologist (skin specialist).

If you think your cat has FHS, one of the greatest things you can do before going to the doctor is to film your cat during an episode and bring the footage with you to your appointment.

If the above-mentioned skin issues, arthritic changes, and other changes are checked out, your veterinarian may begin to suspect FHS as the cause of your cat’s sensitivity.

Treating Feline Hyperesthesia Syndrome

When treating a hyperesthesia cat, it is critical to avoid any physical activity which may irritate or overstimulate the cat, such as scratching his back. Create a quiet atmosphere, provide moderate playing and enrichment, and adhere to a schedule to help decrease your cat’s anxiety.

Some veterinarians opt to treat FHS with medication, which may include one or a combination of the following:

  • Anti-seizure drugs, such as phenobarbital or gabapentin
  • Antianxiety medicines like amitryptiline or Prozac
  • Prednisone and other anti-inflammatories

There are a few treatments available based on the two hypotheses of what causes FHS.

  • If your veterinarian believes that your cat’s symptoms are caused by OCD, he or she may prescribe a mood stabilizer such as fluoxetine or amitryptiline.
  • Your veterinarian may also suggest behavior modification techniques like as frequent feeding, engaging play, and environmental enrichment such as toys and puzzle feeders.
  • If nerve pain is suspected to be the cause of your cat’s FHS, your veterinarian may give an anti-seizure medicine such as phenobarbital as well as a nerve pain medication such as gabapentin.
  • Of course, no matter which camp your veterinarian belongs to, they will modify their treatment plan depending on your cat’s reaction. While Feline Hyperesthesia Syndrome can indeed not be treated, cats with this condition may have a happy, healthy life with appropriate medical care.

Consult your veterinarian if you believe your cat’s odd behavior is the consequence of FHS.

How to Reduce Stress to Treat Feline Hyperesthesia Syndrome?

  • Because stress is one of the underlying causes of Feline Hyperesthesia Condition, decreasing stress in cats may assist with this syndrome.
  • Some of the greatest methods to decrease anxiety in cats are to provide stability in their daily routines.
  • Give them lots of chances to “be cats” (by offering places to climb, sleep, scratch, and hide), and to make them feel secure.
  • Other stress-reduction strategies include: playing with your cat on a regular basis to offer him both mental and physical activity (feather toys on a wand work great for this).
  • Provide interactive toys that your cat may use while you are not there, such as puzzle feeders, ball tracks (which hold a ball within a circular track).
  •  Or indeed any toy that moves or interacts with him when he plays with it.
  • You can also hide dry goodies around the house, so he has to look for them.
  • Feeding at least twice a day on a consistent basis.
  • Add window perches, kitty condos (which offer a vertical area for cats), fish tanks, scratching posts, cat trees to make the residence cat friendly.
  • Cat shelves can make your house more cat-friendly (a series of staggered shelves mounted to the wall that creates a kitty highway above the ground.)

How to Reduce Stress to Treat FHS in a House with Multiple Cats?

Stress and conflict, such as aggressiveness between two cats in a home, often aggravate hyperesthesia symptoms, particularly when the reason is behavioral. Consider this if you have several cats in your home. To decrease stress, try the following:

  • Food and feeding schedules should be consistent — changes in food and routine may be very stressful for cats.
  • Make lofty hiding and perching areas available — cats feel safer when they are higher up.
  • In multi-cat homes, provide enough of litter pans and food bowls so that a shy cat does not have to panic about being picked on by the more aggressive cat while attempting to eat or excrete.
  • Anticipate stressful events and attempt to avoid them, as well as redirect behavior via training or play.
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Is there any Drug Therapy to Treat Feline Hyperesthesia Syndrome?

Although there are no FDA-approved medicines to treat Feline Hyperesthesia Syndrome at this time, there are several that may help decrease the intensity of symptoms.

  • Serotonin-enhancers are a kind of medication that seems to be especially beneficial for cats with FHS.
  • Serotonin is a neurotransmitter in the brain that aids in mood stabilization, aggressiveness reduction, and the prevention of obsessive-compulsive behaviors.
  • Prozac, Clomicalm, Paxil, and Zoloft are all-powerful serotonin boosters.
  • Because FHS is believed to be linked to epilepsy, some veterinarians prescribe the anti-seizure medicine phenobarbital (as stated above), which may be coupled with other medications used to treat FHS to create a personalized therapy plan for each cat.
  • Gabapentin, another anti-seizure drug used to treat nerve pain in humans, is now also showing promise in treating FHS in cats.
  • The aim of pharmacological treatment is to achieve a balance in which the cat is not sedated, but yet has a few episodes of FHS as feasible. After then, the dose may be progressively decreased until the cat is fully weaned off the drug(s).

Some cats with FHS, on the other hand, may need medicine for the rest of their lives.

Are there any Alternative Options to treat FHS?

Acupuncture and massage therapy are two more therapeutic options for FHS that are gaining popularity in the veterinary world.

These are believed to be helpful because they assist to decrease stress and nervous system overstimulation, which are often the underlying causes of Feline Hyperesthesia Syndrome.

Pharmaceutical Intervention for PHS

  • There are no medicines authorized by the US Food and Drug Administration to treat FHS or any other compulsive condition in cats.
  • As a result, owners should be notified about the potential dangers as well as the various benefits of using behavior medicines.
  • It is usually prudent to do adequate laboratory tests to ensure normal hepatic and renal function fefore giving these medicines, which are processed and removed by the liver and kidneys.
  • It is also beneficial to repeat tests 4 weeks after starting treatment to assess the medication’s impact on organ (especially hepatic) function.
  • SSRIs, tricyclic antidepressants (TCAs), and benzodiazepines are the three major types of medicines used to treat FHS.

When administering any of these medicines to cats, it is recommended to start at the lower end of the dosage range and gradually increase the amount as required to get the desired result.

This method reduces the risk of severe adverse effects such as prolonged anorexia or extreme sedation.

  • When the frequency of the behavior has been reduced to an acceptable level, therapy should be continued for 4 to 6 months.
  • The dose can then be gradually reduced (25% reduction every 1 to 2 weeks) until the patient has been weaned off the drug. 
  • If the behaviour returns or becomes more frequent throughout the weaning phase, the previously effective dosage should be resumed.

Selective Serotonin Reuptake Inhibitors (SSRI)

Dosages recommended for cats with FHS:


  • 0.5 to 2.0 mg/kg PO q24h


  • 0.5 to 1.0 mg/kg PO q12-24h

Tricyclic Antidepressants

Of the TCAs, clomipramine (0.5 to 1.0 mg/kg PO q24h)7 may be used to treat FHS. 


Dosages are recommended for cats with FHS. 


  • 0.125 to 0.50 mg PO q8-24h


  • 0.20 to 0.50 mg/kg PO q12-24h

Do not self-medicate and always consult the vet before making any decisions.


It’s no secret that cats can be a bit odd, with their own personalities and erratic tastes. However, your cat’s unusual behavior may be a sign of a medical issue. Feline hyperesthesia syndrome, also known as a twitch-skin syndrome, is one of these medical conditions to be considered when your cat begins to behave usually.

The good news is that, when appropriately treated, feline hyperesthesia is usually a minor problem. The majority of the fight is in identifying the condition, not to mention dealing with the frightening, perplexing symptoms that a hyperesthesia cat may exhibit.

It may have a significant effect on the cats’ quality of life. Even while it does not seem to develop or worsen once it occurs, FHS may put afflicted cats at risk for infections by scratching and biting at their own skin. And, as you would expect, the mental anguish of continuously feeling tortured by a power from that they can never escape must be very irritating for them!

Anti-seizure medicines (such as phenobarbital or gabapentin), antianxiety meds (such as amitryptiline or Prozac), and/or anti-inflammatory medications (prednisone) show varying degrees of effectiveness. To prevent triggering episodes, keep the surroundings as quiet as possible and avoid touching the cat’s rear region. Generally speaking, the prognosis is favorable, although long-term drug usage may be required to control the symptoms as well as feasible.

If you think that your cat may be suffering from FHS, please consult with your veterinarian. 

Although FHS is not regarded as fully curable, it is possible to control it and offer your kitty a happy, comfortable life with stress management methods and the proper use of medicines.