A 2-year-11-month-old female spayed cat was at the Small Animal Teaching Hospital of Ghent University presenting with hyperactivity, scratching and licking all over her body and an abnormal urination behaviour. Nothing remarkable was found on the dermatology and neurological examination. Based on the owner’s history and video material, the presence of feline hyperaesthesia syndrome (FHS) was hypothesised. A symptomatic treatment with gabapentin was established for a month without any significant improvement. An elimination diet with hydrolysed protein sources was started and, as a result, the dose of gabapentin was reduced after three days and completely stopped after one week. With the exception of two non-intentional exposures to non-hypoallergenic diets and the challenge with new protein sources by the owner, the cat has been free of symptoms, with the exception of a slight reaction in the lumbar area (significantly reduced in comparison before starting the diet), and without the use of medication. In conclusion, an elimination diet should be considered as part of the diagnostic plan for FHS and should not be delegated to the last step if the patient’s condition allows it.
Amengual Batle P, Rusbridge C, Nuttall T, Heath S, Marioni-Henry K. Feline hyperaesthesia syndrome with self-trauma to the tail: Retrospective study of seven cases and proposal for an integrated multidisciplinary diagnostic approach. J Feline Med Surg. 2019 Feb;21(2):178-85. https://doi.org/10.1177/1098612X18764246
Backonja M, Beydoun A, Edwards K, Schwartz SL, Fonseca V, Hes M, LaMoreaux L, Garofalo E. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus. A randomized controlled trial. JAMA. 1998 Dec 2;280(21):1831-6. https://doi.org/10.1001/jama.280.21.1831
Barzman DH, Jackson H, Singh U, Griffey M, Sorter M, Bernstein JA. An atypical presentation of pediatric acute neuropsychiatric syndrome responding to plasmapheresis treatment. Case Rep Psychiatry. 2018 Jun 28;2018:8189067. https://doi.org/10.1155/2018/8189067
Ciribassi J. Understanding behavior: Feline hyperesthesia syndrome. Compend Contin Educ Vet. 2009 Mar;31(3):116-32.
Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: A review. Allergy. 2010 Aug;65(8):933-45. https://doi.org/10.1111/j.1398-9995.2010.02342.x
Ferro MA, Van Lieshout RJ, Ohayon J, Scott JG. Emotional and behavioral problems in adolescents and young adults with food allergy. Allergy. 2016 Apr;71(4):532-40. https://doi.org/10.1111/all.12829
Hidese S, Nogawa S, Saito K, Kunugi H. Food allergy is associated with depression and psychological distress: A web-based study in 11,876 Japanese. J Affect Disord. 2019 Feb 15;245:213-8. https://doi.org/10.1016/j.jad.2018.10.119
Horwitz D, Neilson J. Psychogenic alopecia/overgrooming: Feline. In: Horwitz D, Neilson J, editors. Blackwell’s five-minute veterinary consult clinical companion: Canine and feline behavior. Oxford, UK: Wiley-Blackwell; 2007. p. 425-31.
Joshi P, Mofidi S, Sicherer SH. Interpretation of commercial food ingredient labels by parents of food-allergic children. J Allergy Clin Immunol. 2002 Jan;109(6):1019-21. https://doi.org/10.1067/mai.2002.123305
LaMotte RH. Allodynia and alloknesis. In: Schmidt RF, Willis WD, editors. Encyclopedia of pain. Berlin, Germany: Springer-Verlag; 2007. p. 52-5.
de Lorimier LP. Feline hyperesthesia syndrome. Compendium. 2009 Jun;31(6):254.
Macpherson R, Cousins MJ. Acute pain. In: Schmidt RF, Willis WD, editors. Encyclopedia of pain. Berlin, Germany: Springer-Verlag; 2007. p. 17-24.
Mandigers P, German AJ. Dietary hypersensitivity in cats and dogs. Tijdschrift Diergeneeskunde. 2010 Oct 1;135(19):706-10.
Mandigers P, Bergknut N. Feline hyperesthesia syndroom [Feline hyperaesthesia syndrome]. Tijdschrift Diergeneeskunde. 2016 Jul;141(7):30-1. Dutch.
Parker G, Watkins T. Treatment-resistant depression: When antidepressant drug intolerance may indicate food intolerance. Aust N Z J Psych. 2002 Apr;36(2):263-5. https://doi.org/10.1046/j.1440-1614.2002.00978.x
Roudebush P. Ingredients and foods associated with adverse reactions in dogs and cats. Vet Dermatol. 2013 Apr;24(2):293-4. https://doi.org/10.1111/vde.12014
Rudzki L, Pawlak D, Pawlak K, Waszkiewicz N, Malus A, Konarzewska B, Galecka M, Bartnicka A, Ostrowska L, Szulc A. Immune suppression of IgG response against dairy proteins in major depression. BMC Psychiatry. 2017 Jul 24;17(1):268. https://doi.org/10.1186/s12888-017-1431-y
Ruel HLM, Steagall PV. Adjuvant analgesics in acute pain management. Vet Clin North Am Small Anim Pract. 2019 Nov;49(6):1127-41. https://doi.org/10.1016/j.cvsm.2019.07.005
Smith NA, Germundson DL, Combs CK, Vendsel LP, Nagamoto-Combs K. Astrogliosis associated with behavioral abnormality in a non-anaphylactic mouse model of cow’s milk allergy. Front Cell Neurosci. 2019 Jul 16;13:320. https://doi.org/10.3389/fncel.2019.00320
Tsuda M, Shigemoto-Mogami Y, Koizumi S, Mizokoshi A, Kohsaka S, Salter MW, Inoue K. P2X4 receptors induced in spinal microglia gate tactile allodynia after nerve injury. Nature. 2003 Aug 14;424(6950):778-83. https://doi.org/10.1038/nature01786
Tuttle J. Feline hyperesthesia syndrome. J Am Vet Med Assoc. 1980 Jan 1;176(1):47.
Virga V. Behavioral dermatology. Vet Clin North Am Small Anim Pract. 2003 Mar;33(2):231-51. https://doi.org/10.1016/S0195-5616(02)00102-X
WSAVA – World Small Animal Veterinary Association. Global nutrition guidelines [Internet]. Ontario, Canada: World Small Animal Veterinary Association. 2020 [cited 2020 Feb 6]. Available from: https://wsava.org/global-guidelines/global-nutrition-guidelines/.
Yamasaki R, Fujii T, Wang B, Masaki K, Kido MA, Yoshida M, Matsushita T, Kira JI. Allergic inflammation leads to neuropathic pain via glial cell activation. J Neurosci. 2016 Nov 23;36(47):11929-45. https://doi.org/10.1523/JNEUROSCI.1981-16.2016
Yang PC, Jury J, Soderholm JD, Sherman PM, McKay DM, Perdue MH. Chronic psychological stress in rats induces intestinal sensitization to luminal antigens. Am J Pathol. 2006 Jan;168(1):104-14. https://doi.org/10.2353/ajpath.2006.050575