Cutaneous asthenia, also called dermatosparaxis or Ehlers-Danlos syndrome (EDS), is a group of inherited connective tissue disorders. Affected animals have fragile skin that stretches too far, and often loose joints [1][2]. The underlying problem is faulty collagen, the protein fibres that give skin its strength [1][2].
Skin that tears can also have other causes, including illnesses that make the skin thin and fragile later in life [5]. If your pet’s skin tears easily or seems unusually stretchy, have your vet check it.
Very fragile skin in adult cats that is linked to other illnesses is covered in our post on hair loss in cats.
What cutaneous asthenia is
In people, doctors recognise many EDS subtypes, each tied to a different gene, and the right subtype helps decide outlook and care [1][2]. Researchers now sort cases in dogs and cats the same way [1][2][3]. The shared signs are skin that stretches too far, joints that move too much, poor wound healing and easy bruising [2].
Cases have been reported in many breeds and in mixed-breed animals. In cats, an inherited form has been reported in Burmese cats from Australia, Europe and New Zealand [4], and in a Bengal, a domestic shorthair and two shelter cats [2].
How it is inherited
The pattern depends on the gene:
- Severe (dermatosparactic) form: in the dogs studied, an affected animal carried two faulty copies of the ADAMTS2 gene, one from each parent. This fits a recessive pattern, so parents can carry the gene without showing signs [1].
- Classical form: one faulty copy of the COL5A1 gene was enough to cause signs in the cats and dogs studied [2][3]. In one cat the change was shown to be new, not inherited from either parent, and the authors thought this likely for the other cats too [2].
Gene studies
- A 2024 study of 7 client-owned dogs with signs of the classical form found 6 different COL5A1 variants [3].
- A 2022 report described 8 dogs with the severe form carrying ADAMTS2 variants, including Pit Bull Terrier and Alapaha Blue Blood Bulldog puppies and an adult Catahoula Leopard Dog [1].
- A 2022 study of 4 cats with signs of EDS found three separate COL5A1 variants. Genome sequencing let the authors confirm the classical subtype in these cats [2].
What you may notice
Signs reported in the studies include [1][2][3][4]:
- Skin that tears or splits after minor bumps, play or scratching, sometimes starting in the first weeks of life.
- Thin skin that stretches much further than normal, and extra skin folds, for example on the face.
- Many wounds at different stages of healing, and thin, sunken (atrophic) scars.
- Bruising, blood-filled swellings (hematomas) and painful swellings over the elbows and hocks.
- Loose joints and, in some puppies, eyelid openings that are narrower than normal.
- In Burmese cats, dark crusted areas of dead skin (eschars) and thin, hairless patches [4].
In the 2024 dog study, the most common signs were fragile skin (all 7 dogs), overly stretchy skin (all 7), loose joints (6 of 7) and thin scars (5 of 7) [3].
In one Burmese kitten, skin lesions appeared after a routine spay. They were later put down to the kitten struggling while a catheter was placed and anaesthesia was started [4].
Other causes of fragile skin
Not all fragile skin is inherited. Feline skin fragility syndrome is a condition a cat acquires during life, with skin that becomes very thin and fragile. It has been linked to diseases with too much steroid hormone, and has also been seen with severe inflammatory, infectious or cancerous disease [5]. A 2017 report described three cats whose fragile skin came with rapid, severe weight and muscle loss (cachexia) without steroid involvement; their skin later looked normal again under the microscope [5].
This is one reason fragile skin that appears in an adult pet needs a vet visit.
How it is diagnosed
- Signs and history: fragile, overly stretchy skin from a young age, with or without loose joints, is what usually raises the suspicion [1][2][3].
- Skin stretch measurement: vets can measure how far the skin stretches with a skin extensibility index. A raised index supported the diagnosis in Burmese cats [4], and it was measured in the cats in the 2022 study [2].
- Skin biopsy: samples can show abnormal collagen under the microscope, and electron microscopy can show irregular collagen fibrils [1][2]. In the Burmese cats, routine biopsy, even with special stains, did not settle the diagnosis [4], so a normal biopsy does not always rule it out.
- Ruling out acquired causes: especially in adult cats [5].
- Genetic testing: in the studies above, gene sequencing identified the likely variant in affected dogs and cats [1][2][3]. Your vet can tell you whether this is useful for your pet.
Living with fragile skin
None of these sources describes a treatment that corrects the collagen defect. Care focuses on preventing and treating skin injuries.
- Wound care: wounds tend to come back throughout life [1][2]. Let your vet decide how each wound is closed and dressed.
- Itching and rough play: in the cat study, wounds followed scratching or lively play, and itchiness from a second skin problem made things worse [2]. Ask your vet to look for and manage anything that makes your pet scratch.
- Tell other vets: if your pet has been diagnosed, mention it to any vet who treats or sedates it. In the Burmese kitten, skin lesions followed struggling during catheter placement [4]. The owner of one adult dog had vet checks done at home to avoid wounds from car travel [1].
- Long-term plan: the 2015 review discusses long-term care of affected Burmese cats [4]. Ask your vet for a plan that fits your pet.
If the skin tears
Cover the wound gently with a clean cloth or dressing, press gently if it is bleeding, and call your vet. Do not try to close or treat the wound at home.
Outlook
Outcomes vary between studies:
- A 2021 review says EDS usually affects a dog’s wellbeing only a little, because the effects are mostly limited to the skin. It notes that the serious organ and heart complications seen in people have not been described in cats and dogs [6].
- In the 2024 study of 7 dogs with the classical form, the median age at last follow-up or death was 12 years (range 6.5 to 14 years) [3].
- In the 2022 report of the severe form, puppies with one ADAMTS2 variant were put to sleep in their first weeks because of severe skin fragility, while the adult Catahoula Leopard Dog with a different variant lived into adulthood [1].
- In the 2022 cat study, one cat was put to sleep after a very large tear wound, despite surgery and emergency care [2].
These are figures and statements about groups of animals in particular studies. They do not prove that a treatment caused an outcome, and they cannot predict how one pet will do. Your vet can explain what the findings mean for your pet.
When to see your vet
See your vet if your dog or cat has:
- Skin that tears or splits easily [1][2].
- Skin that is unusually loose or stretchy, or hangs in folds [2][3].
- Wounds that keep coming back or heal with thin scars [1][3].
- Swellings filled with blood or fluid, or bruising [1].
- Loose joints [3].
- Skin that becomes fragile in adulthood, especially in a cat [5].
FAQ
Is cutaneous asthenia the same as Ehlers-Danlos syndrome?
Yes. Older reports in cats and dogs use cutaneous asthenia or dermatosparaxis; newer gene studies use Ehlers-Danlos syndrome and its subtypes [1][2].
Can a pet be born with it?
Yes. It is a genetic condition, and in the severe form skin wounds appeared from about two weeks of age [1].
Is it fatal?
Many affected dogs live long lives [3][6], but severe forms have been described [1]; see the Outlook section above.
Can fragile skin in an older cat be something else?
Yes. Fragile skin acquired in adulthood has been linked to excess steroid hormones and to other serious illnesses [5].
Can it be cured?
No source here describes a cure. Care aims to prevent and treat skin injuries; your vet can advise what fits your pet.
The bottom line
Cutaneous asthenia is a group of inherited collagen disorders that cause loose, overly stretchy, fragile skin [1][2]. Vets base the diagnosis on the signs, skin stretch measurement, biopsy and sometimes gene testing [1][2][4], and in adult cats they also look for acquired causes of fragile skin [5]. If your pet’s skin tears easily or seems unusually stretchy, see your vet, and if the skin tears, cover it gently and call your vet.
This article is for general information and does not replace a visit to your veterinarian. If your pet’s skin tears or a wound does not heal, contact your vet.
Sources
- Jaffey JA, Bullock G, Guo J, et al. Novel Homozygous ADAMTS2 Variants and Associated Disease Phenotypes in Dogs with Dermatosparactic Ehlers-Danlos Syndrome. Genes (Basel). 2022;13(11):2158. Open access, CC BY 4.0. https://pmc.ncbi.nlm.nih.gov/articles/PMC9690363/
- Kiener S, Apostolopoulos N, Schissler J, et al. Independent COL5A1 Variants in Cats with Ehlers-Danlos Syndrome. Genes (Basel). 2022;13(5):797. Open access, CC BY 4.0. https://pmc.ncbi.nlm.nih.gov/articles/PMC9140822/
- Bullock G, Jaffey JA, Cohn LA, et al. Novel COL5A1 variants and associated disease phenotypes in dogs with classical Ehlers-Danlos syndrome. J Vet Intern Med. 2024;38(5):2431-2443. https://pubmed.ncbi.nlm.nih.gov/39175162/
- Hansen N, Foster SF, Burrows AK, et al. Cutaneous asthenia (Ehlers-Danlos-like syndrome) of Burmese cats. J Feline Med Surg. 2015;17(11):954-963. https://pubmed.ncbi.nlm.nih.gov/26486982/
- Furiani N, Porcellato I, Brachelente C. Reversible and cachexia-associated feline skin fragility syndrome in three cats. Vet Dermatol. 2017;28(5):508-e121. https://pubmed.ncbi.nlm.nih.gov/28560784/
- Roberts JH, Halper J. Connective Tissue Disorders in Domestic Animals. Adv Exp Med Biol. 2021;1348:325-335. https://pubmed.ncbi.nlm.nih.gov/34807427/