The early days of treating Feline Hyperesthesia

minnie's mom

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Hello all! I have been lurking on this site for weeks now, so I thought I'd go ahead and join the conversation. It has been a doozy of a few weeks.

My husband and I rescued Minnie in 2016 when she was about a year old. We picked her up off the street so we didn't have any information to go on other than she was sweet, snuggly, and adorable. She has always been rambunctious and energetic and has gotten herself into plenty of trouble these last five years. My husband and I are both completely and utterly obsessed with her.

A few months ago we noticed that Minnie was grooming her tail aggressively, and paying more attention to it than normal. I tend to overreact, and so I listened when my husband told me that it was probably nothing to worry about.

HUGE MISTAKE.

On January 10th of this year, Minnie was sleeping on my lap when I noticed that the tip of her tail was damp with blood. She went to the vets office the next day where they told us that she had been biting at her tail, and it was so badly damaged that they advised we amputate the last 2.5 inches, which we ultimately did later that week. At first her tail was healing well, but about a week or so after the initial amputation she developed an aggressive infection at the surgery site, which we believe has finally resolved.

Unfortunately, throughout this whole process she has continued to attempt to attack her tail. She has been in an e-collar since before the surgery and her tail was bandaged until about a week ago, but she still manages to step on it and attempt to bite it through her cone (which causes the cone to hit up against the tip). For weeks she's been going at it near constantly while she is awake, especially at night.

She was on an extremely high dose of gabapentin in the weeks following the surgery and it wasn't helping. After our regular vet recommended that we consult with a dermatologist, we were finally told that she in all likelihood has Feline Hyperesthesia. She took her off of gabapentin and put her on prednisolone for swelling and itching, amitriptyline for the behavior, and buprenorphine in the interim while the amitriptyline kicks in. She has been on these new meds for five days and her behavior has significantly improved. She is going after her tail a lot less frequently (4-5x a day rather than every waking moment) and the duration of the episodes are down to several seconds. I know the signs are promising, but I am nervous that they will all start up again when we take her off of the buprenorphine in a few days.

I know there are others on here that have gone through the same thing, so I guess I'm just hoping that there is someone out there with advice about how to get through these early days while we're still figuring things out.
 

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Furballsmom

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Hello, and welcome!!

This post is from a member who isn't active any longer (Aditto3), but hopefully it gives you a bit of hope;
"Hi again! Sorry it has been so long since I replied. I was waiting on an official diagnosis. Audrey is definitely an FHS kitty. We have been on quite a journey with her. BUT I am proud to say that the vets are quite impressed with our handling of her and her episodes are getting better without any major medications or even the declawing that they suggested. It takes a lot of patience, but with the help of Rescue Remedy calming drops and hefty doses of catnip all through the house, a safe room when things get too bad and tons and tons of playing and attention...Audrey is starting to settle into a routine that makes her episodes less severe. I am pretty sure I am almost an expert on FHS or kitty schizophrenia as it seems more apt to call it since meeting Audrey. I am thankful every day for her! We will give her the best life we can! :)"

In case you haven't seen either of these articles, they may have some information that's of use (the surefire strategies article is being updated, but Cat Music might be something that helps);
Feline Hyperesthesia – TheCatSite Articles
Stress in Cats – The Ultimate Guide – TheCatSite Articles
 

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I don't have any experience with Feline Hyperesthesia, but wanted to post and welcome you to TCS. Sorry though for the situation that brought you here. Sending vibes that things settle down soon for your precious girl. :vibes::vibes::vibes::vibes::vibes:

You may have already seen some of these threads, but here's what a TCS search on Hyperesthesia found:
Search Results for Query: Hyperesthesia
 
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minnie's mom

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Thank you both for sharing these resource! I've been googling pretty frantically since this all started, and it's hard to know where to start, especially since it seems like there's no real consensus on what causes FHS and how to treat it. It also sounds like Minnie has a pretty severe case since it's progressed to self-mutilation. :sigh:

I tried catnip with her, and she really liked it, but briefly freaked out at her tail at the end of our 'nip session. I think she overstimulated it since she was rolling around on the floor, but I'm willing to try again. We're nothing if not determined!

We're approaching one week on the prednisolone and amitriptyline, and finished the last dose of the buprenorphine. Fingers crossed we continue to improve!
 
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minnie's mom

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Minnie update: We are on day 9 of the prednisolone and amitriptyline. On Wednesday morning, she had a really severe episode that lasted for about 25 minutes. I called the vet in a panic and she suggested that we continue the buprenorphine for another week, as some cats need to be on pain management for a while to "break the pain cycle," but she went 36 between episodes before we gave her another dose of buprenorphine! Progress!

I've taken to keeping track of when she goes after her tail so that I have some concrete data about how often, how severe, and if there are any patterns. It's hard to feel hopeful after 7.5 weeks of stress, especially because there's not a whole lot of information out there about what works/ what to expect, but I'm doing my best. Hoping to share more good news soon.
 
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minnie's mom

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Starting to go a little crazy over here...

Minnie is approaching the 14 day mark on prednisolone and amitriptyline but it's starting to feel like we're going backwards. She's pretty consistently been having 4-5 brief episodes a day for the last two weeks, but today has been all over the place. As per the vet's instructions, we started weaning the prednisolone down to .25ml on Saturday and are only giving her the buprenorphine once every 24 hours since Monday. I'm supposed to update the vet again tomorrow and I'm afraid she's just going to tell us to go back to what we were doing initially.

She also said that the amitriptyline can take 6 weeks to work, and the idea of doing this for another 4 just to determine IF it's going to work is discouraging. I've gotten very little sleep over the last eight weeks and it's starting to show. I bought Minnie an iPad so she can watch YouTube for cats.

Yes... I bought an iPad for my cat.

I've been trying just about every suggestion I've read on the internet: increased playtime, offering a variety of toys, keeping a feeding schedule (she was already on one so this was easy), playing videos and music, not scratching her back, reducing stress as much as possible, etc. The only thing I can think of that we can't provide her with right now is her favorite comfortable spots. Because she's in a cone, she is having trouble getting up on her cat tree, and we had to invert her igloo bed (she tried to get into it when we first put her in the cone- it was really sad to watch).

On top of all of this, on Monday I found out that I am going back to work in person in a week. I have been working remotely for most of the last year and have been able to watch her basically 24 hours a day since this all started, so now I'm super nervous that things are going to go wrong while I'm not home.

I just feel like I'm doing everything wrong, and nothing is getting better, and that I'm slowly losing my mind. I just don't know how to move forward from here. :sniffle:
 

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Would a brief time boarding her at the vets be of any help so they could monitor her?

Alternatively can you set up a camera so you can see what she is doing while you're away at work? Would your work allow you a little more time at home?
 
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minnie's mom

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Would a brief time boarding her at the vets be of any help so they could monitor her?

Alternatively can you set up a camera so you can see what she is doing while you're away at work? Would your work allow you a little more time at home?
A camera is a great idea! I've been thinking about getting one for a while! Any recommendations?

I'm a teacher so there's no way for me to continue to work from home as long as my school remains open. I can ask the vet about boarding her, but she gets agitated at the vet's office and they often have to sedate her when the examine her, so I think it would do more harm than good. My husband is also working from home so she won't be completely alone. It's more my anxiety about her than anything.
 

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I have a cat with FHS and while we have had some close calls, it is frankly nothing like you are experiencing. Forgive me if I missed the fact that you might have consulted a veterinary neurologist but I think that would be my next move. You aren't making that much progress despite very serious attempts to help Minnie and this is very hard on all of you.
 
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minnie's mom

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I have a cat with FHS and while we have had some close calls, it is frankly nothing like you are experiencing. Forgive me if I missed the fact that you might have consulted a veterinary neurologist but I think that would be my next move. You aren't making that much progress despite very serious attempts to help Minnie and this is very hard on all of you.
We brought her to a speciality hospital and had an appointment with a dermatologist and the neurologist, but we were seen by the dermatologist first. When she and I spoke she said that she consulted with the neurologist while she had Minnie sedated, and the neurologist said that unless we wanted to do an MRI (which would cost anywhere from $3000-$4000) that there wasn't really anything she would recommend differently from what the dermatologist was already telling us to do.She went on to say that she afraid that even if we did the MRI, she wouldn't find anything/ wouldn't find anything that would change the course of treatment. I asked the dermatologist her honest opinion and told her that despite having spent $6000 on this process already, I would pay for the MRI if she thought it was the right thing to do. She said that based on what she was seeing + her conversation with the neurologist we should try this first, so we cancelled the neurology appointment.

I have a follow up conversation scheduled with the dermatologist today, so I'll see if she thinks we should reschedule the neurologist at this point, but it's important to note:
1. WE are eight weeks into this process (from the day we discovered her bleeding tail, through amputation and infection to now), but we only changed her to these new medications two weeks ago when we switched her care to the dermatologist. We will be looking for a new primary care vet as well because I think our old vet really delayed the healing process (that's a story for another time though).
2. Minnie's tail is healing! Her hair has grown back and the swelling has gone down significantly.
3. The dermatologist has remained positive through all of her follow ups so far and thinks we're seeing improvement. Maybe she is improving and I'm just too close to this process to see it?

fionasmom fionasmom Can you tell me a little about your experience with FHS and what worked for you? I'm finding the internet very overwhelming.
 

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I certainly hope that you are seeing the tip of the iceberg for improvement and that things may be on the mend. That is a valid point of view, especially with the tail healing.

Changing vets is a good idea if you are in any way dissatisfied. I have done it several times in my life and it has always been for the better.

Yes, the catch with the MRI is it might show nothing and I don't know of any less expensive test that would give an indication of something else that is wrong. FHS is possibly a seizure disorder although that is debated. From having seen Chelsea's actions compared to a cat I had years ago who had seizures but not FHS I am inclined to agree with that.
 
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minnie's mom

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fionasmom fionasmom I'm willing to believe anything about FHS right now! Thank you so much for sharing your thoughts.

After following up with the dermatologist on Thursday night, she recommended that we go back to our original dosages of buprenorphine and prednisolone for a bit, and Minnie almost instantaneously calmed down. She still thinks that we're on the right track with the amitriptyline and wants to give it more time to work. I asked her about seeing the neurologist and she said that we certainly could, but reiterated what the neurologist said when they spoke, and said that she thinks a veterinary behaviorist is a better next step if Minnie doesn't continue to improve. She's going to give me some names to check out when we follow up again next week.

I'm obviously hopeful that we won't need to do an MRI because as much as I am willing to do whatever I need to for Minnie, it's still a lot of money. I'm going to see how she does over the next week, and then reassess.
 

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At this point, I would continue all the meds if you are getting results. I think that most of us shy away from long term med use for ourselves or our pets, but it has to be done in many cases and Minnie is certainly responding which is giving all of you some peace.

I completely agree with not throwing $3000 away if you don't have to. Jamie has had two ultrasounds for suspected kidney disease (he is young) and while they were only about $1000 total they also showed absolutely nothing either time despite continued suspicious blood tests.

I am not familiar with cat behavior modification but it certainly has to be worth a try and won't cost what an MRI would.
 
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