involve a significant trial-and-error phase to figure out what will work for the individual affected cat. This relates back to the dispute on the cause of the syndrome, as depending on the veterinarian's personal scientific beliefs and the clinical signs present, the veterinarian may recommend different treatment methods. Generally, the first step to treating the syndrome is to eliminate or reduce environmental factors that may cause outbreaks, stress, or anxiety. This is usually done by identifying behaviour that precipitates attacks and limiting factors that lead to this behaviour. Most cases require owners to either stop or limit touching the cat's lower-back, maintain scheduled feeding times, and organise specific play times. If behavioural modification does not lessen signs of the syndrome, then pharmacological solutions may become necessary. The type of drug used will depend on the suspected underlying cause. Listed below are several types of drugs that may be used to treat the condition or its symptoms, common drugs used in the treatment of this condition have been included as examples of each type of drug: Anti-inflammatory drugs, such as prednisolone, will be used if it is suspected the cause is related to dermatitis or other skin conditions. Antiepileptic drugs will be used if the cause is suspected to be seizure related. Phenobarbital is the most effective of these drugs but does not work on every cat. Gabapentin may be used for both its analgesic and antiepileptic properties. It must, however, be xylitol free, as xylitol is toxic substance for several animals. Behaviour modifying drugs are used when a behavioural disorder is the suspected cause. These may include selective serotonin reuptake inhibitors, tricyclic antidepressants, or benzodiazepines. Carnitine and coenzymes are used when it is suspected that myopathy is the cause of the attacks. Other treatments have also been attempted such as acupuncture or the use of Elizabethan collars and tail bandaging. Acupuncture has been successfully used as treatment within at least one suspected case of feline hyperesthesia syndrome. In extreme cases, the Elizabethan collar and tail bandaging become necessary to stop self-mutilation. Where a successful treatment is found, the treatment must generally be continued for the life of the cat, with clinical signs often reappearing when treatments are discontinued. References External links World Small Animal Veterinary Association – World Congress, Vancouver 2001. Dr. Jon Syndromes in cats