of the activity. Diagnosis Diagnosing cats with feline hyperesthesia syndrome is extremely complicated. The lack of pathophysiological knowledge requires the syndrome to be diagnosed by eliminating other possible causes of clinical signs. This is a time-consuming and often expensive process that most pet-owners opt-out of, choosing instead to treat the behaviours and signs with a variety of therapeutic trials without a definitive diagnosis. Many of the behaviours associated with feline hyperesthesia syndrome resemble or are identical to behaviours observed in other feline health disorders; for instance, there is significant overlap between psychogenic alopecia and feline hyperesthesia syndrome. Because feline hyperesthesia syndrome affects the endocrine, nervous, neuromuscular and exocrine systems, other disorders that affect these organ systems need to be ruled out. This includes skin disorders that cause pruritus such as allergies, fungal infections, parasites and dermatitis; spinal problems such as arthritis, pinched nerves and slipped discs; and forebrain issues that may lead to phantom pains. Tests that can be used to eliminate these possibilities include a general physical, neurological exam, blood chemistry analysis, urine analysis, radiography, magnetic resonance imaging, muscle biopsy, bile acid tolerance, cerebral spinal fluid analysis, and serologic testing for infectious causes. Behavioural history can be a useful diagnostic tool for this syndrome. Information on a cat's tendency towards obsessive compulsive disorders, anxiety, fear, and over-attachment to its owner is highly advantageous for diagnosis and treatment. Wherever possible, cases of feline hyperesthesia syndrome should be referred to a specialist in feline behaviour for a secondary opinion. Although the syndrome is highly misunderstood and there is still much that needs to be learnt, it is possible to use current knowledge to guide diagnosis. For instance, while the syndrome may affect domestic cats of any breed, age or gender, it's possible to use trends to determine the likelihood that a cat with similar clinical signs as those caused by feline hyperesthesia syndrome is indeed experiencing the aforementioned condition. It is much less likely that a cat that is under a year old and has not reached maturity has the syndrome rather than an alternate ailment that may be causing similar clinical signs. Likewise, if a cat belongs to either the Abyssinian, Burmese, Himalayan or Siamese breeds, then feline hyperesthesia syndrome should be considered a lot more carefully as a cause of any possible clinical signs. Treatment The complexity of feline hyperesthesia syndrome is mirrored in its treatment. Treatment options often