Chronic, persistently self-traumatising cat!

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Mon, 07 Jun 2010 15:33:56 GMT

1. I am not against steroids.

2. I am not against symptomatic treatment.

3. Yes, a lot of my patients do benefit from my 'feline and dermatological grey matter.'

4. I rarely run allergy tests or order vaccine from Holland

5. If you're going to the expense and risk of trialling ciclosporin which may take 2-4 weeks to show any benefit, then you may as well be sure you are using it for the right reasons.

6. There is more than one effective treatment for an itchy cat just as there is there is more than one reason why a cat may itch.

Final word.

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Sat, 05 Jun 2010 12:38:28 GMT

Can I suggest tapering the steroids off then giving them as necessary, probably at least 10mg daily, or more if needed, but as a single bolus and keep doing it until total resolution, might take a month of about 4-7 day pred bolus [or short acting injection?]

Er, see how this idea of steroid side effects gains credence, and see why.

The idea posted here of bandaging the area and my added suggestion is taping the same side foot too.

Distracts the cat and protects the probably healing area.

Re: Chronic, persistently self-traumatising cat!

Bob Russell — Sat, 05 Jun 2010 10:34:49 GMT

Wow - great arguments going - healthy debate!

These cats are a real problem - as things stand this cat is being kept comfortable on preds, flea control is as good as we can make it. It is on hypoallergenci. Steroid side effects are obvious - fat, lazy etc but its life is tolerable for the moment.

Many of your suggestions have given me ideas as to things to try. The owner is going to try 'glue-on nails' (cat not owner).

Unfortunately the owner does not want me to refer the case and is amazingly impressed that her cat is being discussed on this forum! I have not shown her the debate as it really is vet only but she is grateful that so many people are helping!

Thanks again and keep the bright ideas coming as I suspect this cat will challenge me for all its life! Next discussion will be how to control its diabetes when it gets to that stage!!!!

Re: Chronic, persistently self-traumatising cat!

Louise6732 — Sat, 05 Jun 2010 07:28:07 GMT

[quote user="Anthony Todd"]What is the real evidence, apart from anecdotal, for "stress" causing self-trauma? I know it's widely quoted.[/quote]

I have no idea. All I'm saying is that there is no harm in plugging in a Feliway diffuser and using some Zylkene to try and help!

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Sat, 05 Jun 2010 06:30:54 GMT

[quote user="Louise Alexander"]as we all know cats are very good at hiding the stress and expressing it in strange ways - i.e. self trauma![/quote]

What is the real evidence, apart from anecdotal, for "stress" causing self-trauma? I know it's widely quoted.

If "stress" is the cause why do steroids, which, AFAIK, have no psychological effects in the cat, resolve the condition.

I suspect it's the concurrent flea control given but not attributed.

The only cats I've seen traumatising their faces turned out to be food allergies, or, at least, resolved permanently when the diet was exclusive, with no change in "stress" levels, nor continuous steroids ;-)

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Sat, 05 Jun 2010 06:19:29 GMT

"]Well sometimes clients just want the convenience treatment"

Nah, clients don't want a diagnosis they want relief of symptoms and so does the cat, for heaven's sake!

Cats, and clients really don't want you to

]flex your feline and dermatological grey matter, run hugely satisfying allergy tests, cover everything in Feliway, and order a nice immunological injectable from Holland, whilst taking every dust mite, flea and pollen minimisation measure humanly possible short of placing the cat in a vaccuum!

they just want to cat to get better.

And do any cats, come on, be honest, actually benefit from your extra grey matter in these chronic skin cases?

And don't forget to give most of the credit to the Advantage etc. you gave them whilst waiting for the copious test results, to say nothing of the belt of Depomed the boss gave it whilst you had the weekend off 'cos he/she couldn't let the poor animal traumatise itself any more.

[quote user="Vikki Halliday"]surgically excised such a persistnet lesion[/quote]

Yes, sometimes works really well, totally curative. I've never been game 'cos if you get it wrong you're back to square one squared with a lesion twice the size and not a stitch left in 24 hours.

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Sat, 05 Jun 2010 06:01:21 GMT

[quote user="Kate Richardson"]Firstly miliary dermatitis ISN'T a diagnosis! It is a description of a skin reaction[/quote]

Oh gosh, does it matter really, we all used to know what it looked like and, if we follow your reasoning, for many years it would have been called miliary hormonal deficiency, not to mention the pred. deficiency as well. And I wouldn't like to argue with Joan Joshua!

What should we now have to call "lick granulomas"?

Most of the time we treat symptoms not diagnoses anyway or don't you give antiemetics for vomiting and antiepilectics for "fits", which are both descriptions of symptoms and not a diagnosis?

I remember a pathologist stating firmly that she never commenced treatment until she had a diagnosis; I hope you treat earlier than that 'cos sometimes the patient will have to wait for ever.

[quote user="Kate Richardson"]Why are you SO pro-steroids?[/quote]

Why not? They work! Sure do relieve the symptoms quickly and completely with early intervention. Definitely not quickly in the OP, I agree.

[quote user="Kate Richardson"]but in most cases there are side effects, sometimes they are minor or acceptable, in relation to the benefits given, but often they do cause a problem. [/quote]

NO [I can use capitals too] In few cases there are side effects [Westies particularly get polyuria/polydipsia] always they are mild, short term and acceptable in relation to the benefits given and I admit, urinating everywhere in the house is a big problem for the owner.

Never really worked out if this was dose related but i suspect it was. This was using short acting preps by injection.

[quote user="Kate Richardson"]the disasterous effects of long-term repeated depo-medrone -[/quote]

Well I never have, but then, as I have pointed out, an effective dose given when necessary and never repeated unless it is necessary, should be the only regime. I wasn't a fan of the 5000 Betsolan boxer, would have rather given a big dose in one hit at the first sign of symptoms and well prior to a diagnosis, if any.

I kept Westies itch free, for the first time in years, which had been through the whole diagnostic gamut taking months, itching all the while, with the minimally effective dose of oral pred, in one dose, only when and if ,definite signs of skin changes began to appear. We got the dose well down as, given early, the dose seems to be much less, polyuria didn't seem to be noted so maybe it is dose related, come to think of it.

[quote user="Kate Richardson"]the best treatment available? And yes I know there are some animals that are untabletable etc etc[/quote]

Steroids are the best treatment available for an animal tearing its skin apart with no obvious local cause. This is not to say that fleas, ectoparasites etc. are to be ignored but to give relief to the animal immediately. And I know that scabies and demodex are steroid no-nos.

The OP's case would have started with the above, and early effective steroids and consideration of an underlying cause may have prevented this nasty prolonged sequel.

Maybe it wasn't treated at all due to the lack of a diagnosis......;-)

As an aside, and I shouldn't admit this, but if I got no response to steroids after 48hours maximum, then I had an urgent and thorough rethink and thought very seriously of a change in "diagnosis" and treatment. Can think of a nice "staph hypersensitivity" on the hind legs of a lab. which, when I did a proper workup by using a Wood's lamp, was obvious ringworm...... Dear ol' steroids let me down in that one!

[quote user="Kate Richardson"]a logical work up of a skin problem[/quote]

Sure a logical workup is a a part of the treatment process but exactly what workup does "miliary dermatitis" need, apart from a mental one which can be pretty comprehensive in itself.

If by "workup" you mean the fashionable full monty of bloods, biopsy/scrape thyroid assay, adrenal assay wood's lamp etc. you'd be accused of gouging fees and wasting time for nothing, all the while the cat is itching madly and getting worse by the hour, and may even get to the OP!

Re: Chronic, persistently self-traumatising cat!

Vikki Halliday LLB — Fri, 04 Jun 2010 23:24:02 GMT

[quote user="Kate Richardson"]Wouldn't be reaching for cyclosporin without a biopsy first or a definitive diagnosis of allergy.[/quote]

No reason to decline trial treatment, as ciclosporin works well in non-specific allergies, and .

[quote user="Kate Richardson"]Aside from it being off licence[/quote]

yes but is there anything other than steroid specifically licenced for non-antibiotic/flea preventative responsive dermatoses in cats?

[quote user="Kate Richardson"]

[quote user="Anthony Todd"]

So sub-lesional Dmed given as soon as irritation recurs didn't work? Ovarid 5 mg weekly didn't work? ie give healing with no irritation? I must say that is unusual unless the treatment wasn't given quickly enough and often enough. [Same works for lick granulomas]

I found Depomed much more effective than any oral dose of pred. and sublesional seemed to work better [might as well give the dose where it was needed?

Still gets absorbed systemically though. Oral pred should work just as well if it is truely indicated and at least dose can be controlled

[/quote]

Why are you SO pro-steroids?

[/quote]

Come on Kate, I think in Anthony's defence he was merely trying to say that a lot of younger graduates are scared off using steroids by those in ivory towers giving absolute worst case nightmare scenarios where animals have been persistently managed on high doses for very long periods of time with little monitoring of the condition originally treated.

[quote user="Kate Richardson"]Maybe you are so used to seeing animals on steroids that you have forgotten what a non-predded up 'normal' animal looks and behaves like![/quote]

Ouch girl, put those claws away!

[quote user="Kate Richardson"] Is Depomedrone used as a convenience treatment (for vets as well as for owners?) rather than the best treatment available? And yes I know there are some animals that are untabletable etc etc [/quote]

Well sometimes clients just want the convenience treatment, and whilst you can offer them the best gold plated and platinum standard investigation in the world, some will always make an informed decision to go for the "easy" option. If you have given the client the benefit of your knowledge, offered all the diagnostic tests known to man, and the best treatment for the active longevity of a non-predded animal, I think that's all you can do.

If they choose depo, well, it's their choice, innit?

However there are those rare gems of clients that allow you to flex your feline and dermatological grey matter, run hugely satisfying allergy tests, cover everything in Feliway, and order a nice immunological injectable from Holland, whilst taking every dust mite, flea and pollen minimisation measure humanly possible short of placing the cat in a vaccuum! But they are few and far between unfortunately.....

However, I digress.

My senior vet has just recently surgically excised such a persistnet lesion, and whilst not being my treatment of choice, so far seems to have done the trick. Perhaps a local neuro problem, or a permamently scarred area was causing enough pain for the cat to continually self harm. Interesting.

Re: Chronic, persistently self-traumatising cat!

Louise6732 — Fri, 04 Jun 2010 19:26:18 GMT

Not a huge help but think this is important to consider in self-traumatising cats:

I saw a British shorthair a few months ago whos owner had passed away and the cat was rehomed through an animal santuary. Within 2weeks of rehoming the cat was self-traumatising its face. The cat had been very nervous in the new home, so I discussed the usual 'coping strategies' for behavioural issues - places to hide, Feliway, Zylkene etc. I think I also used short acting steroids (working full time means a few months ago is the distant past!) in the hope it would help settle it down, I'm not a huge fan of steroids 1st line for derm cases but this was quite bad and I felt I needed to take action! Sadly the cat didn't get better and was returned to the sanctuary as the new owners couldn't cope. I don't know what is happening with it now.

I never got the chance to work the case up as I only saw the cat that once, but I really feel that there was a big behaviour component in this case. I think it is difficult for owners to appreciate their cat may be stressed, as we all know cats are very good at hiding the stress and expressing it in strange ways - i.e. self trauma!

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Fri, 04 Jun 2010 12:48:20 GMT

[quote user="Anthony Todd"]Miliary derm. disappeared and FAD was, at last, recognised as the usual cause but has diminished staggeringly since the introduction of the liquid drop-on flea drugs. I haven't seen true miliary derm. or heard about it for 10 years at a guess. It was probably the commonest diagnosis in feline practice after ear mites.[/quote]

Firstly miliary dermatitis ISN'T a diagnosis! It is a description of a skin reaction

[quote user="Anthony Todd"]

I really am convinced that the side effects of long term steroids have been exaggerated as I have seen animals on continuous betamethasone literally for years with no apparent side effects. In my first job we had a boxer that had apparently had 5000 tabs and was still going strong!!

[/quote]

[quote user="Anthony Todd"]

I found Depomed much more effective than any oral dose of pred. and sublesional seemed to work better [might as well give the dose where it was needed?

Still gets absorbed systemically though. Oral pred should work just as well if it is truely indicated and at least dose can be controlled

[/quote]

Why are you SO pro-steroids? I have nothing against them in the right situation, and have used them to great effect in many cases, but in most cases there are side effects, sometimes they are minor or acceptable, in relation to the benefits given, but often they do cause a problem. Maybe you are so used to seeing animals on steroids that you have forgotten what a non-predded up 'normal' animal looks and behaves like! I have seen the disasterous effects of long-term repeated depo-medrone- it is much more of a hassle to have to inject your cat twice daily with insulin than it is to take it to the vets every 4-6 weeks for an injection. Is Depomedrone used as a convenience treatment (for vets as well as for owners?) rather than the best treatment available? And yes I know there are some animals that are untabletable etc etc

Why does a cat not deserve a logical work up of a skin problem as you would in a dog? Would you reach for the depo-medrone in a similar canine case?

Oh and I am neither an academic nor a new grad (alas, wish i could go back a few years...!)

Re: Chronic, persistently self-traumatising cat!

sophia guymer — Thu, 03 Jun 2010 22:13:52 GMT

I have recently (last few months, only work 2am a week so that is recently to me ) seen two cats with similar (though may be not as long standing) problems. After reading all your replies I feel rather embarrassed to say that I jumped to assuming it to be pure self harming 'knowing' I was not going to find the problem, 'cats have been put on earth to confuse vets!' (I have in the past tried to find a diagnosis, even biopsy etc but not found anything and ended up with the same treatment:)

loosely bandaged the neck (strangely enough they seem to accept it fine) and showed the owner how to do this so they can keep a good bandage on at home. Preds (starting at 1mg per kg bid for 3d, then uid) and ceporex.

I won't let the o take the bandage off until the wound is completely healed. I do try to get the dose of the preds down to a eod quite soon to reduce side effects. If the cat is not scratching, take the bandage off only supervised, still no scratching? then half the preds dose but put the bandage back on first, after a week, try again with bandage off, still no itching, stop or half preds again with bandage on for a week. etc etc, very slow with leaving bandage off during night as can be back to square one after one night.

Both of them fine now without tx and without bandage. Will never know what started it off, have warned that anything might set it off again (stress, fleas etc).

Actually I do always advice people to get an activity ball to put the dried food in ( if they feed this) and get a little laser light to help with the hunting instinct, relieve some stress. Especially with indoor cats but also with cats that do go out.

Nuvan top: glad we have moved on BUT when fleas are jumping off an anaesthetised cat I wish we still had a can stashed away somewhere!

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Thu, 03 Jun 2010 15:01:09 GMT

[quote user="Bob Russell"]The only thing that has worked has been 5mg pred twice daily!!![/quote]

Er, I think you said short acting, but if 5mg pred bid works why stop early? Only total resolution seems to break the cycle.

[quote user="Bob Russell"]potentially toxic levels of OP compounts[/quote]

Yeah well, that might be why I persisted with these dangerous long acting steroids ;-)

Re: Chronic, persistently self-traumatising cat!

Bob Russell — Thu, 03 Jun 2010 14:30:59 GMT

Tried depomed when I first saw the cat to reduce the misery while the suspected weakness in flea control was rectified. It failed miserably to make any difference. The only thing that has worked has been 5mg pred twice daily!!!

Nuvan Top - I wonder how many of us have taken in potentially toxic levels of OP compounts as a result of that little orange can!!!

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Thu, 03 Jun 2010 14:19:38 GMT

I found Depomed much more effective than any oral dose of pred. and sublesional seemed to work better [might as well give the dose where it was needed?

It may take about 6 months, with occasional relapses later, for a flea problem in a warm house with egg buildup to be eliminated and remember the eggs live for up to 2 years... And you've got to get the larva too, and do all cats and dogs in the household.

You guys don't realise how lucky you are! Prior to Advantage etc. there was only Nuvan Top, effective, if used religiously every 7 days, but psychologically hated by many cats, dreaded by clients and it stank the place out. But not as bad as Malathion, another effective predecessor which really really stank the whole street out! Apart from that nothing was effective.

AFAIK the "hormonal cause of "miliary derm." started with Joan Joshua who claimed it was caused by a lack of testosterone and used that as her treatment. What she didn't add was she gave them 1mg of pred daily as well!!! It's in her book.

Then Ovarid was introduced, remarkably effective, made them fat and happy and probably diabetic but literally tons was used on large numbers of cats for some years without anyone noticing the side effects. [Difficult to blame Ovarid totally as it coincided with the rise of dried carbohydrate based cat food.......]

Miliary derm. disappeared and FAD was, at last, recognised as the usual cause but has diminished staggeringly since the introduction of the liquid drop-on flea drugs. I haven't seen true miliary derm. or heard about it for 10 years at a guess. It was probably the commonest diagnosis in feline practice after ear mites.

At risk of being burnt at the stake and/or drawn and quartered by the academics and recent graduates I must add this:

Of course no drug should be given unnecessarily or for longer than necessary but corticosteroids, given in effective doses only as soon as irritation recurs, has changed almost all itchy miserable animals lives, with no significant long-term side effects.

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Thu, 03 Jun 2010 13:41:41 GMT

Wouldn't be reaching for cyclosporin without a biopsy first or a definitive diagnosis of allergy. Aside from it being off licence, this is a young cat and I would be aiming to get a diagnosis first, rather than continually trialling different meds. You end up spending as much money on trial therapies and cat and owner will get cheesed off very quickly with constant pill popping and revisits (unless something works of course) but at this age, resolution of the problem should still be aimed for, and then control if it cannot be cured.

Re: Chronic, persistently self-traumatising cat!

Vikki Halliday LLB — Thu, 03 Jun 2010 13:17:25 GMT

You could trial a combination of Ciclosporin and antihisamine if you are thinking allergic source, otherwise I'd go with the sub-lesional depo-med.

It sounds like it may be one of the strange immune-mediated lesions we seem to never quite get to the bottom of, and in these cases the cats are usually kept comfortable on 4-6 weekly depomed injections plus antibiosis as required.

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Thu, 03 Jun 2010 11:48:13 GMT

Nuvan Top! Blast from the past!

Re: Chronic, persistently self-traumatising cat!

Bob Russell — Thu, 03 Jun 2010 11:38:19 GMT

I tried ovarid through despiration rather than science. I remember the days (just!) when the more senior members of a practice considered most of these to be hormonal issues related to neutering!!! We used to go through box after box of the stuff - it was in the days of Nuvan Top!!!

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Thu, 03 Jun 2010 11:28:34 GMT

Sounds like you are doing a good job so far, these cases as in all skin cases, are frustating and requite time and patience from all involved!

Can I ask did the convenia make any difference? I know I have had a few cases where convenia should have worked but didn't, so changed to oral abs (either cephalexin or amoxyclav) and did get a good response, but did need to treat for 4-8 weeks to completely eliminate possibility of infection.

Do many people still use Ovarid? I haven't used it in years.

Amitryptilline and feliway definitely worth trying, as sounds as though 'stress' is a component of the problem, if not the entire cause. Worth identifying stress factors at home if possible. I find most cat owners have absolutely no idea about 'normal' cat behaviour and what can potentially stress them and in some cases can be such simple little things. if cat responds to amitryp and feliway, may be worth getting a feline behaviourist involved.

Still wouldn't cross FOPS off the list though, but it is a diagnosis of exclusion.

Good luck!

Re: Chronic, persistently self-traumatising cat!

Bob Russell — Thu, 03 Jun 2010 09:43:28 GMT

A bit more information I think. Inherited from another practice there was a massive 5x3cm raw lesion on right side of neck over jugular. Breed is a moggy. Flea control was poor (Frontline) but fair compliance rate. We changed to 3 weekly advantage for its rapid knock down effect as FAD related issues were my first concern. For comfort the cat was given a short acting cortisone and convenia.

The diet was changed to hypoallergenic (Royal Canin) bloods were taken to exclude FeLV/FIV, biochem and haematology were unremarkable.

To cut a long story short I prescribed high dose prednisolone 5mg bd - it does improve but as soon as the dose is reduced things flare up rapidly and dramatically. I have warned the owner that this dose is likely to cause problems - both in the short term and long term. Low dose steroids were useless.

I have discussed the possibility of some form of neurological problem but the breed is 'wrong' and the other possibilities are statistically more likely.

The cat is a neurotic mess so psychological issues are likely. Obsessive compulsive disorder may be part of the problem.

Next step is going to be antidepressants. I am trying to get the owner to invest in Feliway. It seems these cases involve chipping away at the layers!

Many thanks for the replies. I think we are treating this cat in the right way but not as systematically as we should have done! I must develop a step by step protocol for cats in the same way I do for dogs - it is illogical that I don't do this already!!!!

Re: Chronic, persistently self-traumatising cat!

Bob Russell — Thu, 03 Jun 2010 09:22:07 GMT

Hate to say it. I did use ovarid for a trial - results were poor!

Re: Chronic, persistently self-traumatising cat!

Anthony Todd — Thu, 03 Jun 2010 01:04:44 GMT

[quote user="Bob Russell"]Routine parasite control etc is extremely good!![/quote]

[Hoping I'm not teaching anyone to suck eggs!]

In who's opinion? As these begin, 99 times out of 98 with a local irritation and are self-perpetuating when they get to a certain critical size. FAD is usually the initiator.

Gaps in flea control can be confirmed by asking what day of the week or month the treatment is given, not "Do you do it weekly/monthly?". I am sure "monthly applications" should be 28 days at most and, in warm conditions, probably less. The casual once a month which is usually every 5-6 weeks or more is no good, but is once in May, once in June.....

I insisted clients mark the date on the calendar; every 28 days!

And make sure that applies to all cats and dogs in the house!

The other critical thing is to keep treating until the lesion is completely repaired or self-perpetuation kicks in again [as with lick-granulomas] and some cats produce a massive lesion overnight.

Sub-lesional Depomedrone, given within 24 hours max, of the start of a re-lesion worked well for me, usual dose rate with or without Ovarid only when re-lesion appears, not continuously, 5mg at a time. And it helped to give the owner a supply to give immediately irritation was seen.

Anything applied locally usually added to the irritation and made it worse!

Low dose steroids continuously didn't work for me.

Bandaging the back feet protected the area and really distracted the cat which is important too, not that the owners were impressed.....

IME these lesions are not seen with the classic allergic dermatitis lesions but seem to be totally separate and, I submit, more a local reaction rather than systemic but those better than me will comment I hope because the condition is common and persistent if not totally healed.

Re: Chronic, persistently self-traumatising cat!

Robert Wilson — Wed, 02 Jun 2010 22:56:38 GMT

hi Bob

I have a couple of these cases on the go (trauma/self-harming to nape of neck), one of which has controlled on Amitripylline and the other on Amitripylline & Ovarid. I know the risks etc but cats and owners seem happy.

Hope this helps. [quote user="Bob Russell"]

I have inherited a nightmare cat. It is 2 years old and has been tearing its neck to bits for over a year (mostly not on my watch). Routine parasite control etc is extremely good!!

How would you investigate this situation? I am not looking for specifics for this cat but more a 'protocol' to cover this type of case.

I have managed to get this one to heal to a 1cm area but no better but would like to know how you would tackle a cat that has torn itself to shreds.

[/quote][quote user="Bob Russell"]

I have inherited a nightmare cat. It is 2 years old and has been tearing its neck to bits for over a year (mostly not on my watch). Routine parasite control etc is extremely good!!

How would you investigate this situation? I am not looking for specifics for this cat but more a 'protocol' to cover this type of case.

I have managed to get this one to heal to a 1cm area but no better but would like to know how you would tackle a cat that has torn itself to shreds.

[/quote]

Re: Chronic, persistently self-traumatising cat!

Kate Richardson — Wed, 02 Jun 2010 20:24:31 GMT

What breed is it?

FAD unlikely from what you are saying re parastite control. What treatments has it had in the past and what has it responded too, even if only temporaily?

Has it had a long (ie minimum 4-6 weeks continuous antibiotics?

Has it had a hypoallergenic diet trial?

Usual skin things- rule out the things you can rule out, and end up with a diagnosis based on exclusion. If end up with diagnosis of allergy, then range of options.

One thing I would consider though is Facial Oral Pain Syndrome- mainly seen in Burmese- but can be other breeds. Claire Rusbridge (neurologist) http://www.veterinary-neurologist.co.uk/fops.htm has a good website with lots of info on the syndrome. But you have to rule out everything else first. But gives some good guidelines on what to rule out eg dental pain, allergies etc

Hope that helps

Kate

Re: Chronic, persistently self-traumatising cat!

Laurence Webb — Wed, 02 Jun 2010 19:12:34 GMT

Ovarid?