Yesterday we talked about the basics of feline hyperesthesia and how it can be diagnosed. Today let’s focus on treatment. What can be done once you and your vet are reasonably certain that your cat has feline hyperesthesia?

First, look at your cat’s environment. If you can pinpoint anything that seems to be stressing him out, deal with it. Separate housemates that do not get along. Feed animals separately if meal times are a contentious time. Close the curtains if the goings-on outdoors are too stimulating for your cat.

Next, make ample use of environment enrichment since boredom is a big stressor for companion animals.

• Pet and play with your cat.
• Put on music or a "cat video" when you have to be gone.
• Provide a perch for your cat so he can comfortably watch what’s going on outside as long as this isn’t a trigger for him.
• Put out a little cat nip and change the toys that your cat has access to on a regular basis.
• Provide scratching posts and structures to climb on.
• Feed at the same time at least twice a day. If you feed only dry food, try offering some canned.
• Keep your cat’s schedule as predictable as possible.

If you are with your cat when an episode begins, try to distract or redirect him. Sometimes tapping the skin that is twitching with your finger will help, or you can try tossing a favorite toy in front of him. Never punish or scare your cat, however. Cats that suffer from feline hyperesthesia cannot control their actions.

In severe cases, anti-anxiety medications are usually necessary as well. Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine or Tricyclic Antidepressants (TCAs) like clomipramine are reasonable choices to start with. If an SSRI or TCA alone is not sufficient, adding a benzodiazepine (e.g., lorazepam) to the mix might help.

The goal of treatment is to find the lowest dose of as few medications as possible that effectively control the cat’s symptoms while avoiding undesirable side-effects like sedation, incoordination, loss of appetite, vomiting, diarrhea, etc. Once an effective treatment protocol has been found and a cat’s behavior has been acceptable for about six months or so, you can consider tapering off the medications. This is a very gradual process and should take one or two months to complete. If your cat’s symptoms return at any point, you will need to reintroduce the medications at the last effective dose. You can try weaning him off the drugs again in another 4-6 months, but keep in mind that many cats with feline hyperesthesia syndrome do require lifelong treatment.

To summarize, feline hyperesthesia is a diagnosis of exclusion, but once you and your veterinarian are confident in the diagnosis, treatment options exist that can help dedicated owners manage this frustrating condition.

Dr. Jennifer Coates

Image: Death to the cat toy! by Emily / via Flickr