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Symptoms and Treatment for Vestibular Disease in Cats

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I love to share advice and tips gleaned from my own experiences.

If your cat has a tilted head, always get it checked out because it could be something serious.

If your cat has a tilted head, always get it checked out because it could be something serious.

Vestibular disease mainly impacts the balance and coordination of a cat. The most common symptoms of this condition are a tilted head and balance issues, but we will explore that further below.

Why Is the Vestibular System Important?

This system helps cats

  • maintain balance and posture,
  • orientate themselves
  • and control the movement and balance of their body.

If their balance is impacted, it is harder for them to find their centre of gravity. This condition is not something you can predict.

Symptoms of Vestibular Disease in Cats

According to PetMD, the main symptoms to look for if you suspect that your cat has this condition are:

  • tilted head
  • repeatedly falling or leaning to one side
  • issues walking straight
  • abnormal eye movement referred to as nystagmus
  • abnormal eye position referred to as strabismus
  • walking around in circles (less common)
  • nausea and diarrhea independently or together, especially after a seizure (less common)
  • the head or paws suddenly jerk for no apparent reason

What Causes This Disease?

Vestibular disease can be caused by a number of issues that a blood test and/or physical exam might help identify early on. According to Cornell University's College of Veterinary Medicine, here some factors that can cause this condition:

  • Bacterial infections
  • Inflammatory disease
  • Reactions to drugs
  • Growths such as polyps, tumours or cysts
  • Ear infections in the inner or middle ear
  • Genetics
  • Ingested toxins
  • No apparent cause, also known as idiopathic vestibular disease
  • Hypothyroidism
  • Stroke
  • Meningitis

Does My Cat Have Vestibular Disease?

Here are some key things you should look for if your cat has a tilted head or a seizure followed by a tilted head.

  • What direction did your cat’s eyes move in? Were they going side to side, up and down or rotating around in their head?
  • Is your cat leaning to one side when they're walking?
  • Were they unconscious at any time?
  • If your cat had a seizure prior to the tilted head, how long did it take for them to come around after it?
  • Were they listless or lethargic and if so, for how long?
  • Did your cat try to respond to you?
  • What did your cat’s pupils look like? Were they enlarged or were they contracted?

Knowing the answer to these questions will help your veterinarian correctly diagnose your cat and determine the cause, if there is one. Until a full exam is done on, your veterinarian won’t be able to give you an exact diagnosis.

Symptoms that could identify that your cat has vestibular disease.

Symptoms that could identify that your cat has vestibular disease.

The Difference Between Peripheral and Cerebellar Central Vestibular Disease

Peripheral Vestibular Disease

Peripheral vestibular disease relates to issues affecting the inner or outer ear. You need to look for some of the following symptoms to understand if this is the cause of your cat's tilted head.

  • The nystagmus (involuntary movement of the eye) will be either horizontal or rotatory.
  • The pupil might contract on the side of the head that is tilted.
  • If they show no sign of paralysis and their overall posture and reaction returns to normal, it could be peripheral vestibular disease.
  • If this is the cause, the head tilt will be in the direction of the side they have the issue with.
  • After a seizure, your cat should be mildly alert, but it could be bewildered. If they begin to recognize your voice and respond to noise but are still a little bit disorientated, it might be an inner or middle ear issue.

Cerebellar Central Vestibular Disease

If the vestibular disease is central in nature, this is a brain issue. Some things you could look for that will help you understand if this is the cause of your cat’s vestibular disease are as follows:

  • According to the World Small Animal Veterinary Association, if the nystagmus of the cat's eye (involuntary eye movement) is vertical in any direction, then this is a key sign that it is a central vestibular issue which unfortunately relates to issues with the brain.
  • Your cat might tilt their head in the direction where the pain is, or they might not, so in this case, this won’t be useful.
  • If there are any issues with paralysis, or they can’t move their body or struggle to move its limbs and is unresponsive, then this could be a key indicator of a brain issue. The longer it takes for your cat to wake up and walk around, the more serious the issue is.

Diagnosis

While some illnesses can be difficult to diagnose, with vestibular disease, the earliest indicator that your cat has this condition is a tilted head. If it's isn't obvious to your veterinarian that their tilted head is caused by an ear issue, then further investigation is required to determine the issue.

Here are some tests your vet may run.

1. Blood Test Count

They will do a blood test count on your cat to check the levels of their red and white blood cells, their platelets, the hemoglobin and their haematocrit.

2. Blood Chemistry Test

This test will show how the kidneys, liver and other organs are performing in the body.

3. Thyroid Test

They might also do this test to see if your cat has an under-active thyroid as this is also something that can affect the vestibular nerve.

4. X-Ray

If everything looks good in the previous tests, then they will do a chest x-ray. This is so they can check the organs to see if there are any abnormalities that could be causing the issue.

5. MRI

The last resort is to carry out an MRI. This allows your veterinarian to get a look at your cat's entire body to see if the disease is caused by a central or peripheral issue.

A clinical study carried out in 2013 on cats with vestibular disease reported that an MRI identified a thiamine deficiency in some cats as the cause of this condition.

Treatment

Ear Issue

If they determine it is an ear issue, then once the issue is treated, your cat should recover within a few weeks. Most often they will be given anti-nausea medicine, an antibiotic and steroids, and maybe medicine for the dizziness.

This medicine is given to encourage them to eat, and the antibiotics and steroids will treat any infection and inflammation that is causing the issue. After the medicine has run its course, you should see an improvement but the head tilt could remain.

Brain Issue

However, if your veterinarian determines that the vestibular disease is a central issue that relates to the brain, then this changes the outcome.

If the cause is a tumor, an infection, or some form of a deficiency, the treatment will vary from cat to cat depending on what prognosis is.

What If My Cat Is Still Tilting Their Head After Treatment?

If your cat continues to have a tilted head and issues with their balance even after their treatment is finished, this could be because of damage done to the nerves that control balance.

This is irreversible and in all likelihood, it means that your cat will continue to have a tilted head for the foreseeable future. But it's important you follow up with your vet.

Steps you can take to protect a cat who has vestibular disease.

Steps you can take to protect a cat who has vestibular disease.

How to Safe Proof Your Home

There are a few things you can do to make your home safer for a cat that has a tilted head.

  • In your kitchen, leave your chairs out from the table or completely under the table.
  • Don't keep your chairs more than two inches apart.
  • If your cat jumps up on the kitchen or patio window, put a chair or a yoga block under it so they don't have to jump so high to reach it.
  • If they climb the stairs in your home, don't leave them unattended as they could fall.
  • If your cat loves jumping on the sofa, you need to buy a yoga block. This is going to be an essential item in your home in assisting your cat on it's journey to getting up on the sofa and onto the patio window sill.
  • If they continuously sleep on the couch, then try to free up some space and remove unused cushions.

When your cat has a tilted head, the world is seen from a different perspective. They need extra space when thinking about jumping onto things.

10 Things to Do When Your Cat Has a Seizure

  1. Stay calm.
  2. Try not to let their pitiful meows upset you because you are scared and in pain.
  3. Do not touch your cat if possible when it is having an episode. If they are not on the floor, then try to secure them in the area where they are sitting. If they are on a window sill, then obviously you might need to remove them from this area, but wait and see if the cat will jump down by itself.
  4. Try to secure your cat in one area of the room where they are having the seizure in.
  5. If you can, sit on the floor with them for emotional support.
  6. When the seizure looks to be slowing down and your cat is coming around, talk to them and pet them if they let you, but if they do not want to be touched, then stop it.
  7. A seizure can seem quite long when you are witnessing it for the first time. But in fact, it's probably less than a minute.
  8. Once your cat is over it, do not move them. Let them relax and recover from this episode.
  9. After another five minutes, your cat might seem fine and get up to walk around. If they don't get up, don't move it, let it decide when it is ready to get up.
  10. Eventually, once your cat starts feeling normal, they will get up, walk over to you, start meowing, and look for some attention.

Life Outlook

If your cat has a continuous head tilt, it could take them a few weeks to get back to normal. This means that they need to adapt to seeing the world at this new angle.

Jumping on window sills, chairs, and sofas in the beginning won't always be as smooth as it previously was, so you will have to introduce some changes into your home to help them adjust to their new environment.

Also, be prepared for your cat to become extra clingy and demand more attention from you during this phase.

References

Brooks W, (2019), Vestibular Disease in Dogs and Cats - Veterinary Partner - VIN, Veterinarypartner.vin.com, https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951444

Gonçalves R, (2011), Vestibular Disease: Part Two- Treatment and Prognosis, Vettimes.co.uk, https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/vestibular-disease-part-two-treatment-and-prognosis.pdf

Cornell Feline Health Centre, Vestibular Syndrome, vet.cornell.edu, https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/vestibular-syndrome

Moon S (2013) Clinical signs, MRI features, and outcomes of two cats with thiamine deficiency secondary to diet change,Ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885747/

Vestibular Diseases of Cats and Dogs (2003), World Small Animal Veterinary Association, www.vin.com, https://www.vin.com/apputil/content/defaultadv1.aspx?id=7054886&pid=12886

This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

© 2020 Sp Greaney

Comments

Sp Greaney (author) from Ireland on August 20, 2020:

@ Adrienne Farricelli, yes when we got the diagnosis from the veterinarian I was very surprised. She mentioned the exact same thing you said here, that it's usually dogs who get it. Very rare in cats.

It's one of those condition you never want to witness and any pet owner that does, will become very parnoid about any future health issues their pet has.

Adrienne Farricelli on August 19, 2020:

We used to see vestibular disease a lot in dogs when working at the vet's office. I don't recall seeing cases of it in cats, maybe it's a bit less widespread or I couldn't see what was going on since most cats were carried in their carriers and we had a vet who worked mostly with cats and I didn't work much with him. Nevertheless, the symptoms are disturbing, and I am sure distressing for the poor cats.

Sp Greaney (author) from Ireland on July 26, 2020:

@ Devika Primic, thank you. It's one of those conditions that can sneak up on a pet owner and can cause stress for them and their cat.

Devika Primic on July 26, 2020:

Your advice is useful and a must read indeed! I know a lot of people who have cats and this is so important to know for a cat owner. Informative and well-researched.

Sp Greaney (author) from Ireland on July 18, 2020:

@Liza, thanks. Ah the poor kitty, hope he is doing well. I think when you have a cat that has some health problems you just become more perceptive. It's a good way to be. Your husband will be on top of things as soon as they happen.

Liza from USA on July 18, 2020:

My husband and I adopted a cat five years ago. In the past five years, he had several conditions that required us to bring him to a vet. Luckily, nothing serious. If anything, my husband is an expert about the cat than me. He knows when our cat acting weird which means, we need to bring him to see a vet. I agreed with Pamela and Ivana, thank you for a well-written article, especially for people who has a cat as a pet.

Sp Greaney (author) from Ireland on July 09, 2020:

@Pamela Oglesby, thank you. Yes, it's a very scary condition I wouldn't wish on any cat owner.

Pamela Oglesby from Sunny Florida on July 09, 2020:

Thank goodness I never saw this problem in any of my cats over the years. This article gives us a wealth of information because you covered this disorder so thoroughly.

Sp Greaney (author) from Ireland on July 09, 2020:

@Ivana Divac, thanks for commenting. Yes, it's one of those less common conditions.

Ivana Divac from Serbia on July 08, 2020:

This is a very informative and well-written article. Thank you for sharing such an important article for all cat owners!