Vestibular Disease

When most of us think of felines we picture extremely coordinated and graceful animals. They have no problem navigating through small openings, walking across narrow platforms or jumping to great heights. In order to perform such acts cats must first take in information about how they are oriented in space and about how they are positioned relative to the ground. Cats take in this information via three different neural systems. The skin allows the cat to detect pressure and gravity so he can stay oriented up and down. The visual system allows the cat to focus on the horizontal and vertical to better orient himself in space. And the vestibular system allows the cat to detect rotating and linear accelerations. Based on the information from these three systems the brain then tells the body how to act and how to move in different situations (standing still, jumping, running etc.).

Vestibular disorders occur when there is some sort of trauma or damage to the vestibular system, an important part of the Central Nervous System. When there is some sort of trauma or damage to the vestibular system a variety of neurological problems can be seen including trouble walking, lack of coordination, tilted head, circling, abnormal eye movements and vomiting.

The vestibular system is located in the middle ear and has two different types of receptors. One type detects rotational acceleration and decelerations allowing the cat to sense when he is turning or rolling. The second type allows the cat to detect linear acceleration and deceleration allowing the cat to sense which way is up and which way is down. These receptors are comprised of tiny hair cells which protrude into the fluid-filled semi-circular canals in the ears. As the cat moves the fluid also moves and sways. This allows the hair cells to take in information by evaluating their position in the fluid and how the fluid is situated around the cells. Thus the cat can know if he is right-side up, upside down, standing straight up, leaning to a side, or falling. The brain then processes this information and tells the different parts of the body (legs head, neck, eyes etc.) how to act and how to move. Cats with vestibular disease may start to become very clumsy, have trouble walking in a straight line, have balance problems, and start exhibiting head tilts or abnormal eye patterns.

Symptoms to look for:

  • tilted head
  • lack of coordination
  • trouble walking
  • circling
  • nystagmus (abnormal movement of the eyes)
  • Horner’s Syndrome
  • lack of balance
  • facial ticks
  • motion sickness/vomiting
  • rolling or falling to one side

Treatment: What type of treatment is prescribed is usually based on the cause of the vestibular disease. There are three main causes of vestibular disease: peripheral (originating in the ear), central (originating in the brain), idiopathic (of unknown origin). To determine the origin of the vestibular disease your vet may perform a physical exam, a neurological exam, a CT scan, an MRI, an x-ray, blood work and an inner ear exam. Such tests usually lead to the vestibular disease being classified as central or peripheral. And if an origin can’t be definitively determined the disease may be classified as idiopathic.

Central vestibular disease can be caused by inflammatory diseases, infectious diseases and neoplasia. Thus your vet may first want to rule out diseases such as FeLV, FIV, FIP, cryptococcosis and toxoplasmosis.

Peripheral vestibular disease can be caused by ear infections, otitis media, fungal infection, mites and neoplasia. Thus your vet should also examine the ear canal. If examining your cat doesn’t point to central or definitive peripheral vestibular disease it is usually classified as idiopathic vestibular disease which usually comes on very quickly and will produce severe symptoms. Unlike central and peripheral vestibular disease, idiopathic vestibular disease usually clears up on its own within a few days or possibly a few weeks. For this reason there is no treatment for idiopathic disease other than time. Many vets will suggest monitoring the cat for a few days to see if the symptoms start to subside. Cats with idiopathic vestibular disease may have a residual head tilt and may have recurring episodes or bouts of symptoms.

If the symptoms persist or if the vestibular diseases is classified as peripheral or central, drug therapy may be recommended including antibiotics and corticosteroids. If you suspect your cat has vestibular disease consult your vet for a full exam and accurate diagnosis.