Twitching in Cats

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  • At a glance

    • What is twitching? A twitch is a short and sudden jerky movement caused by the involuntary contraction of muscles.
    • Causes: Electrolyte imbalances, certain medications and poisons, thiamine deficiency, feline hyperesthesia, poisons such as pyrethrin, inflammation of the brain, calcium deficiency.
    • Treatment: Treatment will depend on the underlying cause.

    What is twitching?

    Also called fasciculation, twitching is the minor contraction of muscles, in cats, it commonly occurs in the whiskers, nose and tail, but it can happen in any location. The most common causes are underlying cerebellar or neuromuscular diseases.

    Non-medical causes of twitching in cats

    Twitching occurs during REM (rapid eye movement) sleep, which is perfectly normal.

    • Cats often twitch their tail, which is a sign of agitation or excitement.
    • Skin irritation, which may be due to an insect or an irritant such as a grass seed trapped in the fur.

    Medical causes of twitching in cats

    Hypocalcemia

    Low blood calcium levels can occur as a result of lactation, vitamin D deficiency, pancreatitis, phosphate enemas, chronic kidney disease, and hypoparathyroidism.

    Symptoms:

    • Neuromuscular irritability (nervousness, whiskers twitching, facial rubbing, involuntary muscle contractions)
    • Lethargy
    • Stiff legged gait
    • Panting
    • Increased respiration rate
    • Anorexia
    • Fever
    • Convulsions

    Treatment:

    Emergency care:

    Slow intravenous administration of calcium gluconate.

    Maintenance:

    • Vitamin D supplements to help with the absorption of calcium.
    • Once the cat has stabilised, oral administration of calcium gluconate.
    • Echocardiogram (ECG) to check for cardiac abnormalities.

    Feline hyperesthesia (rolling skin disease)

    Feline hyperesthesia is a somewhat mysterious condition characterised by bizarre behaviour which may include: rippling skin along the back, sudden bouts of frantic biting and licking at the tail, pelvis or flank, eyes wide open, dilated pupils and aggression. During an attack, your cat will behave as if he is reacting to hallucinatory stimuli. The condition appears to start in early adulthood, and there is a higher incidence in Siamese, which suggests a possible genetic component, although it can develop in any cat.

    Symptoms:

    • Twitching
    • Drooling
    • Swishing of the tail
    • Seizures
    • Tail chasing
    • Vocalisation
    • Sensitivity to touch, especially along the spine, which may induce aggression.
    • Severe cases of FHS may include self-mutilating by biting, licking and pulling out the hair on the back and tail.

    Treatment:

    • Reduce stress in the household, such as addressing in-fighting between household cats.
    • Provide your cat with an enriching environment such as plenty of play to burn off energy.
    • Give him his own bed, food and water bowls, scratching post so that he doesn’t have to share with other pets.
    • Provide your cat with a routine such as feeding at the same time every day. Also, cats prefer several small meals are better than one or two large meals.
    • Avoid activities such as grooming or petting if your cat becomes aggressive.

    Drug therapy

    • Anticonvulsant medications such as phenobarbital.
    • Anxi-anxiety drugs.
    • Corticosteroids such as prednisolone.
    • NSAIDS (non-steroidal anti-inflammatory drugs).

    Chronic kidney disease

    Chronic kidney disease is a gradual loss of kidney function over months or years which causes a build-up of toxins in the blood. It is a common disease in middle-aged to senior cats. Damage to the kidneys can damage the muscles and nerves.

    Symptoms:

    Treatment:

    There is no cure for chronic kidney disease; the goal is to slow down the progression of the disease and manage symptoms

    • Dietary changes, such as prescription diets that contain a lower percentage of protein and less phosphorus
    • Encourage fluid intake
    • Phosphorous binders
    • Anti-nausea medication
    • Erythropoietin to stimulate red blood cell production

    Poisoning

    Many possible causes of poisoning. Medication, toxic plants, essential oils (including tea tree), and other toxic substances. One of the most common causes of twitching in cats is the inappropriate administration of flea treatments which are for use in dogs. These products contain pyrethrin or permethrin, both of which are toxic to cats and must never be used due to their toxicity in cats.

    Symptoms:

    • Excessive salivation
    • Ear flicking and facial twitching
    • Ataxia (loss of coordination)
    • Depression
    • Lethargy
    • Muscle tremors
    • Seizures (can cause brain damage if prolonged)
    • Hyperthermia
    • Death

    Treatment:

    If the cat has been exposed to a dog flea treatment is on the skin, bathe the cat with dishwashing detergent such as Dawn or Fairy Liquid. Apply the detergent, rinse off. Repeat a further two times. Afterwards, immediately go to your veterinarian. If you don’t feel comfortable bathing the cat, or your cat is difficult to bathe, don’t waste time, go straight to the veterinarian who can bathe the cat.

    Treatment will depend on the severity of signs and is aimed at controlling seizures and tremors and supportive care. If the cat is hypothermic or hyperthermic, the cat will need to be stabilised before treatment.

    There is no antidote for pyrethrin/pyrethroid toxicity, the goal of treatment is to manage symptoms.

    • Diazepam (valium) and Methocarbamol to control seizures or tremors.
    • Gas anaesthesia may be necessary for refractory seizures (seizures that do not respond to seizure medication).
    • Intravenous fluids to maintain hydration.

    Thiamine deficiency (vitamin B1)

    Thiamine is an essential water-soluble vitamin that performs several essential roles in the body, including the nervous system. Common causes of thiamine deficiency include homemade diets which consist of large amounts of fish or cooked meat, which destroys vitamin B1, prolonged loss of appetite, malabsorption disorders and excessive urination.

    Symptoms:

    Treatment:

    • Feed a nutritionally balanced diet and avoid diets containing large quantities of fish.
    • Thiamine injections.

    Hypomagnesemia (magnesium deficiency)

    Magnesium is the second most abundant substance in the cells. It is found in the greatest concentrations in the skeletal muscle and the liver but is also in the bones and extracellular fluid (fluid outside the cells). Low magnesium levels in the extracellular fluid can increase the concentration of acetylcholine (a neurotransmitter) at the motor endplates, which can cause involuntary twitching of the muscles. Magnesium deficiency can occur as a result of malnutrition or malabsorption disorders, long-term fluid therapy, chronic diarrhea and/or vomiting, excessive urination (due to kidney disease or diabetes), and the use of diuretics.

    Symptoms:

    • Muscle trembling
    • Incoordination (ataxia)
    • Lethargy
    • Weakness
    • Muscle pain
    • Abnormal heart rhythm

    Treatment:

    The goal of treatment is to manage the underlying cause as well as treat hypomagnesemia with magnesium infusions or supplements.

    Encephalomyelitis

    Inflammation of the brain and/or the spinal cord which may be due to infection (viral such as FIP, FIV and rabies, bacterial, fungal such as blastomycosis, or cryptococcosis or protozoal), immune-mediated, parasitic such as cuterebra, foreign body or idiopathic (no known cause).Symptoms:

    • Lethargy
    • Loss of appetite
    • Vomiting
    • Intermittent fever

    As CNS symptoms progress, your cat may experience the following:

    • Cervical rigidity (neck stiffness)
    • Photophobia (sensitivity to light)
    • Wobbly gait
    • Disorientation/confusion
    • Hyperesthesia (rolling skin)
    • Sensitivity to touch
    • Paralysis
    • Seizures
    • Coma

    Treatment:

    • Broad-spectrum antibiotics will be prescribed to treat bacterial infections
    • Fungal infections will be treated with anti-fungal medications
    • Corticosteroids to control inflammation
    • Anti-seizure medications such as phenobarbital or Valium
    • Supportive care such as fluid therapy and nutritional support
    • For cats with cuterebra, administration of diphenhydramine an antihistamine to prevent an allergic reaction followed by ivermectin an anti-parasitic medication that may be administered to kill the larvae

    Other outcomes

    • FIP is almost always incurable although there have been recent advancements with this heartbreaking disease.
    • Rabies is incurable and euthanasia is sadly the only outcome.

    Diagnosis

    Twitching during sleep is of no concern at all, but if you notice your cat twitching for no apparent reason, especially if accompanied by other symptoms, he should be seen by a veterinarian to determine the cause.

    Your veterinarian will perform a physical examination of your cat and obtain a medical history. He will check for other symptoms which may give a clue as to what is causing the twitching.

    • Is it the ears, tail, face/whiskers or all over the body?
    • What other symptoms (if any) is your cat displaying?
    • Location of the twitching.
    • Any underlying medical conditions?
    • Is the cat on any medications.

    All of these answers can give your vet clues as to the possible cause.

    Diagnostic workup:

    Baseline tests: Biochemical profile, complete blood count, and urinalysis to evaluate organ function, look for signs of infection or inflammation, anemia, mineral and electrolyte imbalances.

    Additional tests may be required depending on your veterinarian’s index of suspicion which may include diagnostic imaging such as ultrasound, X-ray, MRI or CT scans.

    Author

    • Julia Wilson, 'Cat World' Founder

      Julia Wilson is the founder of Cat-World, and has researched and written over 1,000 articles about cats. She is a cat expert with over 20 years of experience writing about a wide range of cat topics, with a special interest in cat health, welfare and preventative care. Julia lives in Sydney with her family, four cats and two dogs. Full author bio