Feline orofacial pain syndrome (FOPS): A retrospective study of 113 cases

Abstract

Feline orofacial pain syndrome (FOPS) is a pain disorder of cats with behavioural signs of oral discomfort and tongue mutilation. This report describes the findings from a case series of 113 cats including 100 Burmese. FOPS is suspected to be a neuropathic pain disorder and the predominance within the Burmese cat breed suggests an inherited disorder, possibly involving central and/or ganglion processing of sensory trigeminal information. The disease is characterised by an episodic, typically unilateral, discomfort with pain-free intervals. The discomfort is triggered, in many cases, by mouth movements. The disease is often recurrent and with time may become unremitting - 12% of cases in this series were euthanased as a consequence of the condition. Sensitisation of trigeminal nerve endings as a consequence of oral disease or tooth eruption appears to be an important factor in the aetiology - 63% of cases had a history of oral lesions and at least 16% experienced their first sign of discomfort during eruption of permanent teeth. External factors can also influence the disease as FOPS events could be directly linked to a situation causing anxiety in 20% of cats. FOPS can be resistant to traditional analgesics and in some cases successful management required anti-convulsants with an analgesic effect.

Epilepsy in Cats: Theory and Practice

“…Cats might exhibit a large number of paroxysms that can resemble epileptic seizures. The differential diagnosis includes a wide range of clinical conditions: behavioral changes, obsessive‐compulsive disorder, movement disorders, narcolepsy/cataplexy, sleep disorders, increased intracranial pressure, pain‐associated behavior, tremor syndromes, syncope, feline orofacial pain syndrome, vestibular or neuromuscular disorder, and other encephalopathies (Table ) …”

Topiramate in the management of feline idiopathic ulcerative dermatitis in a two‐year‐old cat

“…However, neurological examination was unremarkable; in particular, there did not appear to be any evidence of abnormal sensation in or around the lesion. A neuropathic itch syndrome was considered likely because of lack of inciting causes, the episodic nature and the scratching into deeper tissues, which is considered pathognomonic for the condition . For monetary reasons, further neurological investigation, such as electromyography, nerve function studies and a magnetic resonance imaging scan, were not possible.…”

“…A neuropathic itch syndrome was considered likely because of lack of inciting causes, the episodic nature and the scratching into deeper tissues, which is considered pathognomonic for the condition. 6 For monetary reasons, further neurological investigation, such as electromyography, nerve function studies and a magnetic resonance imaging scan, were not possible. A recommendation was made to try drugs that anecdotally can be used to manage neuropathic pain in the cat.…”

Dental and Oral Diseases

“…The surface of oral lesions may be speckled with small dense white areas (Figure 21-36). 105 Sensitization of trigeminal nerve endings from tooth eruption and oral disease and environmental stress appear to be important precipitating factors in the etiology of the disease, suggesting that the disease may be a pain disorder analogous to trigeminal neuralgia and glossodynia (burning mouth syndrome) in humans. Both lesions are more commonly found in young female cats and characterized by eosinophilic infiltrates on histopathology.…”