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When Touch Hurts: Feline Hyperesthesia Syndrome
March 21, 2016 (published)

cat being petted BigStock

Last summer, I looked out the window and saw our cat, Mikey ― he of the cauliflower ear, stubby tail and facial scar from his previous life on a horse farm ― sitting on our front porch with several of the neighbor kids. Nora, who lives next door, was giving her friends the rundown on Mikey and I heard her say: “He’s a really nice cat, but you gotta watch him, ‘cause he’ll nail you.”

Nora’s warning to her friends was very apropos, as Mikey can lash out without warning, especially after a good amount of petting on his lower back. We typically warn first-time visitors about this, as his overall fluffiness and friendly demeanor make him an instant people magnet. Mikey’s habit of nipping the hand that strokes him is, we believe, that he has feline hyperesthesia syndrome, which is poorly understood. Cats with feline hyperesthesia syndrome have a variety of unusual behaviors, including: rippling of the muscles along the back; running through the house as if being chased; and biting at various parts of their body, including the tail and flank. Severely affected cats can have episodes that look like seizures, with paddling of the feet, crying out, and – apparently - hallucinations.

We say that Mikey has presumed feline hyperesthesia syndrome because there’s no test for it. Instead, it’s a diagnosis that veterinarians back into after ruling out some possible causes that can mimic the clinical signs. These possibilities include: orthopedic problems (arthritis, for example); a bad back; flea bites and an allergy to them; seizures; spinal cord problems; and food allergies. Depending on the type of clinical signs, a veterinarian might recommend the cat be referred to a veterinary neurologist, dermatologist, or behaviorist. The problem with hyperesthesia syndrome is that it has parts that cut across many body systems, including neurology and dermatology, so sometimes it’s unclear what we’re actually treating.

Most cats with feline hyperesthesia syndrome are diagnosed based on patient history. Clients often remark that they see the skin rippling on their kitty and/or see the cat running through the house as if being chased. Of course, not every cat who suddenly takes off down the hallway has it; many cats, especially younger ones, just like a romp from time to time. I have had a few clients complain about their cat biting them after being petted and those cats, rather than having anger issues, seem to better fit the hyperesthesia syndrome “box.”

Unfortunately, there is not one silver bullet to treat this syndrome. Various medications, including anti-seizure drugs (like phenobarbital and gabapentin) are typically used. Sometimes a behavioral medication, like Elavil (amitriptyline) or Prozac (fluoxetine) is tried. Flea treatment and control should be used, even if no fleas are seen. Being fastidious groomers, cats often remove evidence of fleas and flea dirt, so treating for fleas make sense. If after a sufficient amount of time with one medication, there is poor or no response, another can be tried. To confuse the issue further, just because a cat responds to, say, phenobarbital, that doesn’t mean he has feline hyperesthesia syndrome. It’s just as likely that the signs were due to a seizure problem and the anti-seizure drug stopped the episodes.

For clients who don’t wish to try medications for their cats with presumed hyperesthesia syndrome, and for cats who are not severely affected, the owners can manage the environment around the cat. As with our Mikey, the best medicine can be knowing a cat’s limit to petting and stroking and not over-extending those sessions, avoiding areas of the body where the cat does not wish to be touched, and enjoying the cat’s company in ways that don’t provoke a response.


Amy Arandus
February 2, 2018

My cat recently has to come to some sort of possible disc injury or we definitely know she has arthritis and one of her hips and she cracked her sternum somehow she's heavyset we think she jumped off and fell onto something else or was already on something and fell off we're not sure when it happened but in the process here she's become paranoid hallucinating her eyes are Pitch Black it's just heartbreaking I'm going to try anti-seizure medicine but I feel so bad that she never seems to get a break doesn't this come and go?

January 31, 2018

My cat just went through a bout with fleas but was experiencing the symptoms of this before that. It could be both in your case so I'd suggest taking him or her to the vet and discussing this with him. My vet thought of this because he wasn't getting better after being treated for fleas. He was still sensitive to touch. My vet just started mine on prednisole (not sure of spelling) today so we will see.

Amanda Snow
October 25, 2017

My cat just started showing symptoms of Feline Hyperesthesia Syndrome after a couple of days I noticed he has fleas!!  So could he just be reacting to the flea bites or could it be both.  I will be taking him to the vet as soon as I can get an appointment.


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