At a glance
About: Twitching is the small, local, involuntary muscle contraction which is visible under the skin. They may be muscle or neurological in origin.
- Hyperesthesia syndrome
- Poisoning (especially pyrethrin/pyrethrum, used in dog flea treatments)
- Skin parasites
- Hypocalcemia (low blood calcium)
- Vitamin B1 deficiency
- Magnesium deficiency
- Certain medications
Diagnosis: Baseline tests, imaging.
Treatment: This will depend on the underlying cause.
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 due to 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
Low blood calcium levels which can occur as a result of lactation, vitamin D deficiency, pancreatitis, phosphate enemas, chronic kidney disease, and hypoparathyroidism.
Slow intravenous administration of calcium gluconate.
- 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.
- Swishing of the tail
- Tail chasing
- 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.
- 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 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.
- 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 of years which causes a build-up of toxins in the blood. It a common disease in middle-aged to senior cats. Damage to the kidneys can damage the muscles and nerves.
- Increased thirst and urination
- Urinating outside the litter tray
- Decreased appetite
- Weight loss
- Vomiting especially on a morning due to having fasted for several hours overnight
- Drooling (due to nausea)
- Poor coat condition
- Bad breath
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 a prescription diets which contain a lower percentage of protein and less phosphorus
- Encourage fluid intake
- Phosphorous binders
- Anti-nausea medication
- Erythropoietin to stimulate red blood cell production
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 due to 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.
- Excessive salivation
- Ear flicking and facial twitching
- Ataxia (loss of coordination)
- Muscle tremors
- Seizures (can cause brain damage if prolonged)
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 prior to 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 which do not respond to seizure medication).
- Intravenous fluids to maintain hydration.
Thiamine is an essential water-soluble vitamin which performs a number of 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.
- Dilated pupils
- Ataxia (loss of coordination)
- Cervical ventroflexion (necks flexed/rigid, which causes an inability to raise the head, the chin rests near the chest)
- Loss of righting reflexes
- Bradycardia (slow heartbeat)
- 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 end plates, 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.
- Muscle trembling
- Incoordination (ataxia)
- Muscle pain
- Abnormal heart rhythm
The goal of treatment is to manage the underlying cause as well as treat the hypomagnesemia with magnesium infusions or supplements.
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:
- Loss of appetite
- Intermittent fever
As CNS symptoms progress, your cat may experience the following:
- Cervical rigidity (neck stiffness)
- Photophobia (sensitivity to light)
- Wobbly gait
- Hyperesthesia (rolling skin)
- Sensitivity to touch
- 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 which may be administered to kill the larvae
- 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.
Twitching in the 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.
Additional tests may be required depending on your veterinarian’s index of suspicion which may include diagnostic imaging such as ultrasound, Xray, MRI or CT scans.
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