Vestibular Disease in Cats

Most mammals, including cats, get their sense of balance and spatial orientation from a system of organs in the inner ear and connected parts of the brain, together called the vestibular system. When this system is disrupted, a cat's ability to balance is affected.

There are two forms. Peripheral vestibular disease, the more common type, stems from problems affecting the inner ear and nerves, not the brain itself. Central vestibular disease is much less common but considerably more serious, since it originates within the central nervous system. Both forms cause loss of balance and symptoms resembling vertigo or dizziness. Vestibular disease in cats can look alarming, especially given how sudden and dramatic the onset often is, but most cases, particularly the peripheral form, improve on their own within days to a few weeks.

Peripheral vestibular disease results from irritation of the nerves connecting the inner ear to the brain. Possible causes include:

• Ear infections

  Chronic or recurrent inner and middle ear infections.

• Ear cleaning

  Overly aggressive ear cleaning, or ear cleaners used inappropriately with a ruptured eardrum.

• Head trauma

  Injury to the head can disrupt the vestibular system.

• Tumors or polyps

  Growths affecting the ear or nearby structures can irritate vestibular nerves.

• Certain medications

  Including aminoglycoside antibiotics and loop diuretics.

• Congenital defects

  Present-from-birth defects of the vestibular system.

• Idiopathic vestibular disease

  Where no specific cause is found common in cats, with some cat-specific features. In parts of the northeastern United States, cases spike seasonally between late spring and early fall, a pattern that's been linked to Cuterebra larval migration (a botfly parasite) as a possible trigger. Unlike the dog version, feline idiopathic vestibular disease shows no particular breed, age, or sex predisposition, and can affect either one or both sides.

• Central vestibular disease

  Can result from inflammatory disease, infection (including feline infectious peritonitis, or FIP), trauma, bleeding in the brain, reduced blood flow, or cancer.

A physical and neurological exam helps determine whether the disease is peripheral or central. For suspected peripheral disease, your vet will examine the ears closely with an otoscope. Bloodwork, urinalysis, and cerebrospinal fluid analysis may be used to rule out other causes, and imaging such as MRI or skull X-rays is typically recommended if central disease is suspected or if symptoms are severe.