Vestibular Disease in Cats

By Tammy Hunter, DVM; Malcolm Weir, DVM, MSc, MPH; Ernest Ward, DVM

What is vestibular disease in cats?

Vestibular disease is when a cat suddenly develops incoordination, falling or circling to one side, involuntary darting of the eyes back and forth (nystagmus), a head tilt, and often nausea or vomiting. These clinical signs usually appear suddenly, often in less than an hour.

The vestibular apparatus is in the inner ear and is responsible for maintaining our balance and sense of orientation and direction. Whenever the vestibular apparatus is diseased or damaged, balance and coordination are adversely affected, resulting in symptoms involving equilibrium (balance).

What causes vestibular disease?

dog-earcanal_updated2017-01-01Vestibular disease can affect cats of all ages. Conditions such as middle- and inner-ear infections are common causes of the disease. Tumors are a less common cause but must be considered, especially in older cats. Exposure to certain toxins and drugs can also cause symptoms that mimic feline vestibular disease. Most cases are idiopathic, meaning the exact cause is unknown.

"Most cases are idiopathic, meaning the exact cause is unknown."

Siamese and Burmese cats have been associated with an inherited or congenital form of the disease. Many affected cats are also deaf.

How is vestibular disease diagnosed?

There are no specific tests for feline vestibular disease. Most cases are diagnosed based on clinical signs. Tests such as magnetic resonance imaging (MRI), skull radiographs (X-rays), blood and urine tests, spinal fluid analysis, and ear cultures and cytology (examination of any discharge or fluids found in the ear canal) are typically performed to rule out a more severe cause. Your veterinarian will determine which tests are appropriate for your cat based on medical history, clinical signs, and physical examination findings.

How is the condition treated?

Because the exact cause is often unknown, there is no specific medical or surgical treatment. Antibiotics or anti-fungal medications will be used in middle- or inner-ear infection cases. In idiopathic vestibular disease, treatment is focused on reducing motion sickness, nausea, and vomiting. Many cats require assistance eating and drinking during the initial stages of the condition when their balance is most affected.

"Many cats require assistance eating and drinking during the initial stages of the condition when their balance is most affected."

How long will it last?

Idiopathic vestibular disease is a short-term, self-resolving condition. Signs are usually the worst during the first 24-48 hours, then steadily improve. It does not continue for months. Usually, uncontrollable eye movement disappears within days. Older affected dogs can have a residual, often permanent, head tilt, but this rarely occurs in cats.

Is it contagious to other cats?

There is no evidence that idiopathic feline vestibular disease can be transmitted between cats or other animals, including humans.

What is the prognosis?

The prognosis depends on the cause of the vestibular disease. As mentioned, idiopathic vestibular disease often resolves within days, and your cat may not show any residual effects. Other causes, such as tumors, have a much more guarded prognosis.

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