Web-Vet TM Neurology Specialists
Feline Hyperaesthesia & Orofacial Pain Syndromes
Feline Hyperaesthesia Syndrome
The majority of the 7 cats in this retrospective study were young, with a median age of 1 year at the onset of clinical signs, male (n = 6) and with access to the outdoors (n = 5). Multiple daily episodes of tail chasing and self-trauma were reported in five cats, with tail mutilation in four cats. Vocalisation during the episodes (n = 5) and rippling of lumbar skin (n = 5) were also reported. A definitive final diagnosis was not reached in any of the cats in which all testing was normal, but hypersensitivity dermatitis was suspected in two cases. A variety of medications was used alone or in combination. Clinical improvement was achieved in six cases; in five cats complete remission of clinical signs was achieved with gabapentin alone (n = 2), a combination of gabapentin/ciclosporin/amitriptyline (n = 1), gabapentin/prednisolone/phenobarbital (n = 1) or gabapentin/topiramate/meloxicam (n = 1).
Feline Orofacial Syndrome
This case report describes a 4-year-old female Himalayan cat with anorexia, ranula and unilateral lesions of the tongue. Clinical signs ranged from pawing at the mouth to tongue self-mutilation during severe pain attacks. First-line treatment with non-steroidal anti-inflammatory drugs and opioids could not prevent further pain attacks. Successful treatment was achieved with administration of pregabalin and minimisation of potential stress factors. No clinical signs of pain were observed in a follow-up period of 2 years.
This report describes the findings from a case series of 113 cats including 100 Burmese. FOPS is suspected to be a neuropathic pain disorder and the predominance within the Burmese cat breed suggests an inherited disorder, possibly involving central and/or ganglion processing of sensory trigeminal information. The disease is characterised by an episodic, typically unilateral, discomfort with pain-free intervals. The discomfort is triggered, in many cases, by mouth movements. The disease is often recurrent and with time may become unremitting — 12% of cases in this series were euthanased as a consequence of the condition. Sensitisation of trigeminal nerve endings as a consequence of oral disease or tooth eruption appears to be an important factor in the aetiology — 63% of cases had a history of oral lesions and at least 16% experienced their first sign of discomfort during eruption of permanent teeth. External factors can also influence the disease as FOPS events could be directly linked to a situation causing anxiety in 20% of cats. FOPS can be resistant to traditional analgesics and in some cases successful management required anti-convulsants with an analgesic effect.