Successful treatment of a Himalayan cat with feline orofacial pain syndrome

Feline orofacial pain syndrome is a neuropathic pain disorder in cats, characterised by oral discomfort and tongue self‐mutilation. The pathogenesis of feline orofacial pain syndrome remains unclear, but trigger factors such as dental disease and environmental stress have been described. Feline orofacial pain syndrome is a diagnosis of exclusion, and suggested treatment includes administration of non‐steroidal anti‐inflammatory agents, opioids and adjuvant drugs for analgesia. This case report describes a 4‐year‐old female Himalayan cat with anorexia, ranula and unilateral lesions of the tongue. Clinical signs ranged from pawing at the mouth to tongue self‐mutilation during severe pain attacks. Although no dental disease was present, a dominant and suppressive partner cat may have had a stressful influence. First‐line treatment with non‐steroidal anti‐inflammatory drugs and opioids could not prevent further pain attacks. Successful treatment was achieved with administration of pregabalin and minimisation of potential stress factors. No clinical signs of pain were observed in a follow‐up period of 2 years.