Feline orofacial pain syndrome (FOPS) is a distressing neuropathic pain disorder primarily affecting Burmese cats, as well as related breeds such as Siamese, Tonkinese, and Burmilla. It causes episodic pain and discomfort around the mouth and head, often leading cats to injure themselves by clawing or biting their face and tongue. Although vets do not yet fully understand the condition’s causes, a strong genetic predisposition exists, particularly in these pedigree breeds.
This article explains which cats are most commonly affected, how FOPS presents itself, and offers up-to-date advice on diagnosis, treatment, and management in 2025 for keeping your feline friend comfortable.
Although any cat can theoretically develop FOPS symptoms, Burmese cats are most frequently diagnosed with this painful disorder. Other breeds more commonly affected include Siamese, Tonkinese, domestic shorthairs, and Burmilla. Burmese cats are particularly susceptible due to hereditary factors related to neuropathic nerve sensitisation causing the pain.
FOPS is thought to be inherited as an autosomal recessive trait, meaning affected cats receive faulty genes from both parents. It is important to note the condition is not contagious between cats. Diagnosis remains challenging and mostly involves recognising behavioural signs of facial pain, such as pawing at the face or self-mutilation, especially one-sided discomfort. Vets will carefully exclude other causes through thorough oral and dental examinations as flare-ups often follow teething or oral disease like periodontal problems.
Veterinary diagnosis is largely clinical due to a lack of specific tests, making awareness of breed predisposition crucial for early recognition.
FOPS is episodic, with cats often experiencing flare-ups triggered by factors such as stress, including changes like house moves or boarding in catteries, fights with other cats, or dental issues. Movements involving the mouth such as eating, grooming, or vocalisation can also provoke pain episodes. Some cats may go long periods without signs, whereas others suffer more frequent or severe bouts. Careful management of stress and excellent oral hygiene are key to reducing flare-ups.
There is no known cure for FOPS, but treatment focuses on managing symptoms and minimising flare-ups. Standard painkillers like NSAIDs are often ineffective due to the neuropathic nature of the pain. Instead, vets commonly prescribe antiepileptic drugs with neuropathic pain-relieving properties, such as gabapentin or pregabalin.
Environmental enrichment and behavioural modifications to reduce stress are vital supportive measures. Maintaining excellent oral health via regular dental check-ups helps prevent pain triggers from dental disease.
In cases where cats injure themselves during episodes, buster collars may be necessary to prevent self-mutilation. Steroids or antibiotics may be prescribed to treat injuries. Surgery can sometimes be required for severe tongue damage.
Long-term management and close veterinary monitoring are essential as FOPS may become chronic or worsen over time.
Owners and breeders should avoid breeding cats affected by FOPS or those closely related to affected individuals to reduce hereditary transmission. Ethical breeding and regular health screening help protect future generations of Burmese and related cats.
Education about FOPS signs and early veterinary intervention improves quality of life for affected cats, emphasising the importance of responsible pet ownership.
Feline orofacial pain syndrome is a complex neuropathic pain condition predominantly affecting Burmese and some related breeds. While it remains incurable, recognising flare-ups early and working closely with your vet to manage symptoms and reduce stress can help keep your cat comfortable.
Maintain routine dental care and monitor behavioural changes, especially stress-related triggers. Avoid breeding cats with the condition. By staying informed and proactive, owners can improve their cat’s wellbeing and longevity despite this challenging syndrome.