Neurological Disorders in Cats

Jill Narak, DVM, MS, DACVIM
By Jill Narak, DVM, MS, DACVIM on Feb. 28, 2023
orange longhaired cat on exam table at vet's office with family in background

Veterinary neurologists are specialists who specifically examine and treat diseases of the nervous system. Your cat may never need the care of a neurologist, but it’s helpful to understand neurological disorders in cats so you know what signs to look for and when such a specialist should become involved in your cat’s care.

What Does a Cat’s Nervous System Do?

The cat’s nervous system, which is similar to that of people and all other mammals, includes a brain, spinal cord, and nerves.

Although your cat will never win a Nobel Prize, their relatively well-developed brains allow for executive functions like decision-making, memory, and emotional/behavioral control. You can also thank your cat’s nervous system for your cat’s unique personality.

A cat’s muscles are also controlled by their nervous system. This allows coordinated movement and gives cats special dexterity for hunting and catching food.

Signs of Neurological Disorders in Cats

These are the most common signs of an issue with your cat’s nervous system:

  • Weakness

  • Wobbly gait (ataxia)

  • Off balance, vertigo

  • Fecal or urinary incontinence; having difficulty using the litter box

  • Inappropriate behavior

  • Disorientation

  • Circling

  • Pain (signs of this include vocalizing and not wanting to be petted or picked up like usual)

  • Seizures

  • Hiding

  • Decreased appetite

If you’re concerned about your cat’s health or see any of these signs, call your veterinarian. They can refer your cat for a neurologic evaluation if needed. You can also visit to find the veterinary neurologist nearest you.

Most Common Neurological Disorders in Cats

Thankfully, cats are less troubled by neurologic disorders than dogs. Those most common in cats can be caused by birth defects, infectious disease, an underlying condition, trauma, or unknown reasons related to aging.

Brain Tumors

Starting with the brain, the most feared diagnosis is a brain tumor. However, this diagnosis is not always a death sentence for your cat. The typical types of brain tumors in cats—meningioma and pituitary macroadenoma—are actually quite treatable, and in some cases can be cured.

We don’t know exactly what causes brain tumors in cats, but we do know that they primarily affect older cats. One of the earliest signs of a brain tumor is having seizures at an older age. It’s much less common for cats to have primary epilepsy compared to dogs, so we usually recommend further investigation for feline seizure patients, especially with older cats.

Cognitive Dysfunction

Cognitive dysfunction is another brain disease of aging cats. It’s similar to Alzheimer’s disease in people, where affected cats can seem confused and disoriented, possibly not recognizing their beloved people. We provide treatment with environmental enrichment, high-quality nutrition, and medications to aid sleep.

Hydrocephalus (Water on the Brain)

Some kittens may show confusion or disorientation from a young age, along with difficulty getting along with housemates or learning litter box habits. In these kittens, we would worry most about a birth defect such as hydrocephalus.

Hydrocephalus (“water brain”) is the buildup of cerebrospinal fluid at the expense of normal brain tissue. Affected kittens can still make great pets, but their special needs must be addressed by very caring pet parents.

Cerebellar Hypoplasia

Another birth defect seen in kittens is cerebellar hypoplasia. This is caused by feline panleukopenia virus (feline parvovirus) in pregnant cats that infects their kittens.

The cerebellum is the part of the brain in control of coordinated movements and balance, so you can imagine that these kittens are quite wobbly! This disease is not painful and does not impact the cat’s quality of life. As they grow, they learn to deal with the incoordination the best they can.

Infectious Disease

We also see neurologic disease as a direct consequence of an infectious disease. Most of the culprits are not passed from cat to cat, but picked up in the environment.

Examples include toxoplasmosis and fungal disease, which can affect any part of a cat’s nervous system. Cats can also have neurologic damage due to feline infectious peritonitis (FIP), which is a mutated version of the highly contagious feline coronavirus.

Feline coronavirus usually causes mild to moderate gastrointestinal disease, but in certain cats, the virus can mutate to cause FIP. Affected cats can contract the so-called wet or dry versions. It is the dry version of FIP that may cause neurologic damage and signs.

Vestibular Syndrome (Vertigo)

However, the most common cause of vestibular syndrome is idiopathic, meaning we cannot find the cause, and it typically affects older patients.

Cats also often develop ear infections behind their eardrums, where they can’t easily be seen during a routine ear exam. By itself, an infection can cause vestibular syndrome (vertigo), causing a cat to be off-balance, fall, and act disoriented, with abnormal flicking eye movements (nystagmus).

If left untreated, these ear infections can become brain abscesses, leading to more severe signs such as seizures and decreased mental activity.

Another very common cause of vestibular syndrome in cats is stroke, typically secondary to an underlying cardiovascular, metabolic, or endocrine disorder.

Vestibular syndrome can also be caused by disease of the cerebellum or brainstem, such as with FIP, brain tumors, or stroke. In the Southeastern United States, cats can become vestibular from (wolf worm) larvae traveling through the brain, leading to feline ischemic encephalopathy. This is most commonly seen in the warm spring, summer, and fall months. 

Spinal Cord Issues

Less commonly, cats are diagnosed with spinal cord problems. These issues cause gait abnormalities, including weakness and a wobbly gait. Causes can range from trauma of the spine to infectious disease such as FIP to an intervertebral disk herniation. Advanced imaging such as a CT scan or MRI is often recommended to diagnose spinal issues.

Neuromuscular Disorders

Cats can also have weakness due to neuromuscular disorders. This type of weakness is rather unique to cats. They aren’t able to do much exercise, they have weakness in their head and neck and can’t lift their head, and they may also look like they are walking on their wrists or ankles.

Some of these disorders are commonly associated with other metabolic or endocrine disorders such as kidney disease or diabetes mellitus. Others are autoimmune disorders, like myasthenia gravis, which can be caused by certain treatments for hyperthyroidism. You can also see this with thiamine deficiency associated with an unbalanced diet.

How Vets Diagnose Neurological Issues in Cats

The very basis of feline neurology is a comprehensive neurologic examination. This is a specialized physical exam that evaluates a cat’s behavior, posture, reflexes/responses to stimuli, and ability to walk and place their paws.

Cats cannot tell us when they are in pain, and it’s very hard for most pet parents to determine this because they hide it so well. But a veterinary neurologist will be able to determine if your cat is in pain during their exam.

Your vet will also take a thorough history, which can give clues to help zero in on a neurologic condition. In particular, they will ask about your cat’s interactions with their people and housemates, litter habits, and appetite. If you can, take a video of your cat’s abnormal behavior to show the vet, because several diseases can mimic neurologic disorders (and vice versa).

Veterinary neurologists can use a cat’s history and neurologic examination findings to pinpoint where the problem is within the nervous system, and we then use further testing to diagnose what the problem is.

Your vet will probably perform laboratory testing to rule out metabolic, endocrine, or infectious issues that can affect the nervous system. Your vet might also take x-rays of your cat’s spine to check for any abnormalities that may cause pain or difficulty walking.

The information obtained from the neurologic examination will help the specialist determine which components of the nervous system are affected. Then they will be able to work with your regular veterinarian to develop a list of probable diseases causing the problems. This in turn informs any further neurodiagnostic testing, such as CT scan, MRI, spinal tap, or electrodiagnostics.

Treatment for Neurological Disorders in Cats

The treatment will vary widely depending on the specific issue your cat has. But for the most part, if your cat does in fact have a neurologic disorder, there will be a treatment for it.

The treatment plan may range from antibiotics and/or steroids for an infectious or inflammatory condition to surgery to fix a spinal injury. We can cure certain types of brain tumors with surgery, and other types of brain or spinal cancer may respond well to chemotherapy or radiation therapy.

Can You Prevent Neurological Disorders in Cats?

The nervous system, especially the brain, can react to abnormalities elsewhere in the body. This is why it’s very important to keep your cat’s preventive care up to date.

Yearly (or biannual) physical exams and age-appropriate lab work is recommended so you and your vet can manage syndromes such as chronic kidney disease, hypertension, hepatitis, and diabetes. These can have neurologic consequences including stroke, seizures, decreased mental ability, and difficulty walking/weakness.

It’s also important to follow vaccination and preventive medication guidelines because viral and parasitic diseases can have neurologic implications. Follow your veterinarian’s guidance for medications, because some flea and tick preventatives that are safe to use in dogs are toxic in cats, leading to potentially fatal tremors and seizures. Certain antibiotics can also cause neurologic damage if used outside of the veterinarian’s recommended dosing and duration.  

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Jill Narak, DVM, MS, DACVIM


Jill Narak, DVM, MS, DACVIM


Dr. Jill Narak will join Huntsville Veterinary Specialists & Emergency in September 2019, as the only full- time board-certified veterinary...

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