Cats from remote places carry unusual maladies


The three kittens in the carrier peered out curiously. “We weren’t going to get purebreds again,” one of the owners said. The couple had shared their home for years with a beautiful pair of Burmese cats who were now gone. “Then we read about Tonkinese and couldn’t resist.”

Looking at that trio of exquisite faces peeking through the grate, I understood completely, but I didn’t know much about the breed. To me the word Tonkinese conjured up images, not of cats, but of the musical South Pacific. (“How far away, Philadelphia, P.A….from coconut palms and banyan trees and coral sands and Tonkinese.”) I, too, was curious, so I did a little research.

Tonkin is the name given by the French to the northernmost region of Vietnam. In the 1900s, indigenous people from this area emigrated to work on colonial plantations on the island of Vanuatu (formerly called the New Hebrides). Referred to as “Tonkinese” by westerners, James Michener wrote about them in “Tales of the South Pacific,” on which the famous musical was based. So what about Tonkinese cats? Are they from Vietnam, too?

The breed called Tonkinese was developed in North America in the 1960s by crossing Siamese and Burmese cats, so let’s start there. Siamese cats are thought to date back at least to the 1600s. Their introduction to the West began with a pair named Po and Mia given to a departing British Consul-General by the Siamese king in 1884 (Siam, of course, being modern day Thailand). The Siamese Cat Society of America was founded in 1909. Over the decades Siamese breeders altered their appearance to have a thinner body, elongated head, long, skinny legs, and unusually large ears. The Burmese breed began with a single small walnut-brown cat named Wong Mau brought from Asia by a sailor in 1930 and given to Dr. Joseph Thompson in San Francisco. The doctor bred Wong Mau to Siamese cats and, using selective breeding, developed a consistent coat color called sable. Burmese eventually became recognized as a separate breed, with four officially accepted colors — sable, champagne, platinum, and blue.

In the mid-1960s, two breeders in North America began crossing Siamese and Burmese, working to develop a specific “moderate” breed they agreed to call Tonkinese. So, no, Tonkinese don’t actually come from the Tonkin region of Vietnam, but they are descended from cats that originated in southeast Asia. Tonkinese now come in 12 officially recognized colors with varying levels of contrast between body color and “points.” Most have dramatic aqua eyes. Because they started out as hybrids, theoretically Tonkinese are less likely to have inherited medical issues than breeds like Burmese, which have narrower gene pools.

One of the three kittens had an upper respiratory infection, giving his owners a bit of a scare, but this fairly common condition is rarely serious, and Kitten One soon recovered. Then, at five months old, Kitten Two suddenly began pawing his face. We’re not talking gentle rub-the-face-with-the-paw. Two was having repeated intense episodes of frantically clawing at his mouth. His dad even shot a video for me.

“Let’s take a look,” I said calmly, trying to soothe the owner’s anxiety. Two was acting the way a dog does when a bone or stick gets lodged in the mouth. I expected to find something in Two’s mouth, remove it, and be a hero. But I couldn’t see anything unusual. “Let me check under his tongue,” I continued. Occasionally cats playing with string or thread will get it caught around the tongue causing similar behavior. Nope. Nothing under the tongue. The only thing I could see was Two was teething. His adult canines and premolars were erupting and the associated gums were a bit red.

“We read on the Internet about some kind of serious mouth problem in this breed,” the owner volunteered.

“I think he’s just teething,” I stammered, “but I’m not sure.” We decided I would give Two pain medication and keep him for observation while doing further research.

Who knew? It’s called FOPS. Feline Orofacial Pain Syndrome. First recognized in the 1990s, it is characterized by severe oral pain and self-mutilation. It is most common in Burmese cats. Signs can be intermittent or continuous and can be triggered by eating, drinking, grooming, or stress. Current information suggests that there are two different age ranges when FOPS is likely to occur. The first is around six months of age and is associated with teething.

Bingo. There’s our diagnosis for Two.

The second time it occurs is often between 10 and 12 years old. FOPS is defined as “neuropathic pain,” an exaggerated response to a normally painful stimulus. It appears to be a genetic dysfunction of the processing of information from the trigeminal nerve in the brain. Definitive diagnosis is based on clinical signs and by ruling out everything else. This could mean dental X-rays and referral for expensive tests like MRI. The more I read, the more worried I became. Often multiple drugs are needed to control symptoms, sometimes even anticonvulsants. In one study, 10 percent of cases ended up with unremitting, severe self-mutilation leading to euthanasia.

Luckily, Two responded to the first pain medication we tried. He was still pawing, but much less. One article reported that antibiotics can be helpful in cases with underlying dental infections, so we gave an injection of long-acting antibiotic and sent him home with additional doses of pain medication. In case things got worse, we ordered a second recommended drug in kitten-sized tablets from a compounding pharmacy. But we never needed them: within a few days, Two seemed back to normal. I breathed a cautious sigh of relief.

Seventy percent of FOPS cases recur. All we can do right now is hope that Two is in the other 30 percent. Because of the suspected genetic basis, individuals with the syndrome should not be bred. Two’s owners are fine with that. They just want One, Two, and Three to live long, happy, and healthy lives.