Felis ISSN 2398-2950

Feline dysautonomia

Synonym(s): Key-Gaskell syndrome

Contributor(s): Agnes Delauche, Rosanna Marsella


  • Disease first recognized in 1981 and appeared to have largely died out, although recently a few cases reported.
  • Cause: remains unknown.
  • Signs: regurgitation, constipation, third eyelid protrusion.
  • Diagnosis: clinical signs.
  • Treatment: symptomatic only.
  • Prognosis: guarded although some animals appear to make a full recovery.



  • No etiological agent has been identified.
  • A number of theories have been postulated:
    • The disease was a result of treatment of flea infestations.
    • The disease was related to a substance in dried cat food.
    • The disease was related to vaccination or worming programs.
  • But none have been substantiated with any evidence.


  • Changes occur in the autonomic and sympathetic nervous system with all autonomic ganglia being affected.
  • CNS lesions with degeneration of neurons often occurs in more acute cases.
  • Neurological dysfunction   →  
    • Megaesophagus Megaesophagus  →   regurgitation and can   →   death from inhalation pneumonia.
    • Urinary dysfunction   →   distended bladder with overflow incontinence Urinary incontinence.
    • Intestinal dysfunction   →   constipation.


  • Acute disease usually onsets over 48 hours may be up to 7 days.


  • Many epidemiology studies have been performed in an attempt to characterize a possible etiological agent.
  • There does not appear to be any discernible pattern in the distribution of cases:
    • Rural/urban environments.
    • Males and females roughly equally affected.
    • Multicat and single cat households.
    • No consistent managemental factors between cases.


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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Kidder A C, Johannes C, O'Brien D P et al (2008) Feline dysautonomia in the Midwestern United States: a retrospective study of nine cases. J Feline Med Surg 10 (2), 130-136 PubMed.
  • Nunn F, Cave T A, Knottenbelt C et al (2004) Association between Key-Gaskell syndrome and infection by Clostridium botulinum type C/D. Vet Rec 155 (4), 111-115 PubMed.
  • Cave T A, Knottenbelt C, Mellor D J et al (2003) Outbreak of dysautonomia (Key-Gaskell syndrome) in a closed colony of pet catsVet Rec 153 (13), 387-392 PubMed.
  • Symonds H W, McWilliams P, Thompson H et al (1995) A cluster of cases of feline dysautonomia (Key-Gaskell syndrome) in a closed colony of cats. Vet Rec 136 (14), 353-355 PubMed.
  • Bjerkås E, Skancke E (1994) Feline dysautonomia in Norway. Vet Rec 135 (19), 463 PubMed.
  • Levy J K, James K M, Cowgill L D et al (1994) Decreased urinary catecholamines in a cat with dysautonomia. JAVMA 205 (6), 842-844 PubMed.
  • Nash A S, Thompson H, Rosengurt N et al (1994) Feline dysautonomia in group-housed cats. Vet Rec 134 (7), 175-176 PubMed.
  • Patterson C J (1994) Suspected cases of feline dysautonomia. Vet Rec 134 (5), 123-124 PubMed.
  • Sharp N J (1990) Feline dysautonomia. Semin Vet Med Surg (Small Anim) (1), 67-71 PubMed.
  • Edney A T, Gaskell C J (1988) Feline dysautonomia around the world. Vet Rec 123 (17), 451-452 PubMed.
  • Pollin M M, Griffiths I R (1987) Feline dysautonomia: an ultrastructural study of neurones in the XII nucleus. Acta Neuropathol (Berl) 73 (3), 275-280 PubMed.
  • Griffiths I R, Sharp N J, McCulloch M C (1985) Feline dysautonomia (the Key-Gaskell syndrome): an ultrastructural study of autonomic ganglia and nerves. Neuropathol Appl Neurobiol 11 (1), 17-29 PubMed.
  • Sharp N J H, Nash A S & Griffiths I R (1984) Feline dysautonomia (the Key-Gaskell syndrome): a clinical and pathological study of forty cases. JSAP 25 (10), 599-615 VetMedResource.
  • Nash A S, Griffiths I S, Sharp N J (1982) The Key-Gaskell syndrome an autonomic polygangliopathy. Vet Rec 111 (13), 307-8 PubMed.