Vestibular Disease in Cats

Cats may sometimes suddenly lose their ability to orient themselves and become somewhat tipsy. And some cats are more than just a little dizzy—they cannot even stand. That is quite a worry for an unprepared owner.

We term this feline vestibular syndrome, or idiopathic vestibular disease. Now that's a big mouthful of words. What we are really saying is that the vestibular system, which is a part of "control central" for the cat's balance, gets out of kilter for no obvious reason.

Cause of Vestibular Disease in Cats

The root of the problem is proposed to be changes involving the peripheral vestibular system which is seated deep within the inner ear. Current thinking is that the special endolymphatic fluid in the semicircular canals or the interface with the special sensory cells lining the canals becomes abnormal. Inflammation, abnormal endolymph fluid circulation, or toxic insults involving the receptors or nerve have all been proposed to result in these balance problems. No one has been able to confirm a single common cause for these cases.

There is no obvious pattern to this problem. We see cases here, there and everywhere, though some studies find a slightly increased incidence of this disorder in late summer and early fall. Some veterinarians also see a tentative association with recent outbreaks of respiratory infections.

Signs of Feline Vestibular Syndrome

The signs of vestibular disease in cats can be quite alarming to owners, who often believe their feline friend is having a stroke. These signs include:

• Vocalizations that may sound anguished
• Rolling around on the floor
• A head tilt to one side
• Nystagmus, or eyes that oscillate back and forth
• Leaning against walls or furniture in order to walk
• Falling down
• Vomiting
• Seeming "out of it"

Sometimes, if both ears are affected, the head may not be tilted much and the kitty may not want to move at all. Affected cats are most certainly as puzzled by these sudden occurrences as we are.

Other Potential Causes of Balance Problems in Cats

If your cat develops any or all of the above signs, your veterinarian will do a thorough examination to determine whether vestibular disease is to blame. Some other conditions that cause balance problems in cats include:

• Polyps, infections, or tumors in the ear canal
• Encephalitis: infection of the lining of the brain, which may be caused by such illnesses as FIP or toxoplasmosis
• Spinal cord disease or trauma
• Drug toxicity
• Blue-tail lizard toxicity (in the southeastern US)

Treatment of Vestibular Syndrome in Cats

Excellent improvement in the signs of vestibular disease is usually seen in 2-3 days. It can take a few weeks to fully recover normal head orientation and full mobility. A cat with any of the signs of vestibular disease should be assessed by a veterinarian promptly, and if idiopathic vestibular disease is confirmed, it is a better diagnosis than many others that produce these sorts of signs.

Treatment for vestibular disease is supportive and includes:

• Keeping your cat in a well-padded area where she can't fall down stairs or otherwise get hurt because her balance is off.
• If she is not getting up on her own at all, you will need to help your cat change positions every hour or two to prevent sores.
• You may need to carry your cat to the litter box and back. She may have accidents where she is laying, so you will need to be diligent with checking her bedding, changing it, and washing and drying her off as necessary.
• You may need to bring food and water to your cat and ensure that she eats it.
• Your veterinarian may prescribe anti-nausea medications or anti-motion sickness drugs to help your cat be more comfortable. Do not give your cat any medications without speaking with your veterinarian first. Cats are extremely sensitive to many human medications and can become very sick or die if they are given.

In more serious cases, your veterinarian will advise admission to the hospital so that more aggressive supportive care such as sedation, intravenous fluid, and injectable medications can be provided.

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