Vestibular Disease in Cats

What Is Vestibular Disease in Cats?

Vestibular disease in cats is a neurological condition that affects balance and coordination due to disruption of the inner ear or brain.

If you’ve ever experienced dizziness or vertigo, then you’ve experienced the vestibular system when it stops working. The vestibular system controls balance and coordination in both humans and other mammals, including cats. It is located in the inner ear and the brain.

When this system is disrupted, the cat's world view and axis is shifted. It becomes challenging to tell which way is down and which way is up.

Consequently, cats suffering from vestibular disease may develop a head tilt, fall over, and have trouble walking. Oftentimes this unsettling feeling of loss of balance leads to nausea and vomiting.

Vestibular disease in cats usually comes on very suddenly and is more common in Siamese and Burmese breeds. While it’s most commonly seen in senior cats, felines of any age can be affected.

Symptoms of Vestibular Disease in Cats

Common symptoms of vestibular disease in cats include:

• Rapid, jerking eye movements (nystagmus)
• Head tilt
• Circling or falling to one side
• Loss of balance (ataxia)
• Vomiting, nausea, decreased appetite
• Facial drooping, Horner’s Syndrome

Causes of Vestibular Disease in Cats

Vestibular disease in cats occurs when something damages the vestibular apparatus in the inner ear or brain.

Oftentimes, no underlying cause is found, and it is classified as idiopathic vestibular syndrome. “Idiopathic” means the cause is unknown.

Vestibular disease may be caused by:

• Inner or middle ear infection
• Unknown cause (idiopathic)
• Bacterial or inflammatory conditions of the brain, like Feline Infectious Peritonitis (FIP) or intracranial empyema (brain abscess)
• Drug reaction
• Cancerous tumors, cysts, or polyps that grow in regions near the inner ear or brain (more common in senior cats)
• Thiamine deficiency

How Veterinarians Diagnose Vestibular Disease in Cats

Vestibular disease in cats is most often diagnosed based on a veterinarian’s physical examination and by ruling out underlying causes.

There is no one test that will confirm this disease. Instead, the vet will thoroughly examine your cat and look for signs of problems that could cause vestibular disease, like an ear infection or a growth that may be disrupting the vestibular apparatus.

Blood work may be recommended to screen for signs of an underlying systemic infection. The vet may recommend X-rays of your cat’s skull to check for any obvious masses. Ear cultures may be helpful if signs of an ear infection are present.

Occasionally, referral to a veterinary neurologist may be in order if advanced diagnostics like MRI or CT scans are needed.

Treatment of Vestibular Disease in Cats

Treatment of vestibular disease in cats depends on whether an underlying cause is identified.

If there are underlying causes (like an inner ear infection or polyp), treatment involves addressing that cause.

Antibiotics may be useful if there is an infection present, or anti-inflammatory drugs if inflammation is contributing to the disease. Sometimes surgery is needed to remove troublesome polyps or growths if your cat is otherwise healthy and a good candidate for anesthesia.

In most vestibular patients, no underlying cause is ever found. Fortunately, this disease often improves on its own over a couple days, with the majority of signs resolving over a few weeks. Very rarely will cats have a subtle head tilt or facial drooping long after diagnosis.

During recovery, supportive care is important. Helping your cat access food and water—and assisting with litter box use—may be necessary. Anti-nausea medications, like Cerenia, are often beneficial initially while your cat is experiencing dizziness and vertigo.

Sometimes hospitalization is required for a few days until the worst signs pass.

Recovery and Management of Vestibular Disease in Cats

The prognosis for vestibular disease in cats is generally good, with most cats recovering within two to three weeks.

The worst signs usually last 24 to 48 hours. Most patients make a full recovery and do not experience repeat episodes.