Vestibular Disease in Cats: A Helpful Guide

The grace, balance, and speed of cats is legendary in the animal kingdom – from lions roaming the plains on a hunt to the sleepy tabby perched atop a suburban couch. Masters of movement, it becomes suddenly and immediately obvious when a cat isn’t feeling his best. Uncharacteristic wobbling, head-tilting, or a sudden inability to move in a coordinated way immediately raises red flags for cat owners. There’s one medical culprit that is often the cause in these cases, particularly if the symptoms are rapid-onset: feline vestibular disease.

Owing its namesake to the vestibular system, an inner ear and brain collaboration, vestibular disease (also known as idiopathic vestibular disease) presents as deeply concerning issues that can easily be mistaken for a stroke. In cats, this disorder manifests as a sudden cluster of symptoms that add up to a lack of balance and an inability to orient the body. When it strikes, a cat can go from his normal daily activities to a nearly-prone position on the floor, unable to stand up or orient his eyes to look in one direction.

It also isn’t typically caused or exacerbated by surrounding environment or external causes, which puzzles pet owners that reflexively start looking for reasons. In order to safeguard his overall health, a cat suspected of having vestibular system should be examined by a vet as soon as possible for confirmation.  

What Is Vestibular Disease in Cats?

When a cat comes down with vestibular disease, he won’t slowly start showing symptoms – it will be a sudden occurrence, often going from healthy and well to afflicted in as little as an hour. The symptoms progress as rapidly as they do because of the importance of the vestibular system, which essentially governs the inner ear. In both humans and animals, this system helps not only maintain balance, but allows a sense of acceleration, direction, and positioning as well. Without that biological barometer, a sensitive, evolved-to-hunt animal like a cat is left completely helpless. Even if the last thing he “hunted” was a can of wet food for breakfast, he is still driven by a biological urge to hunt, track, and pounce. The inability to do these can send his primal brain into a panic, and that means his owner will need to stay calm and reassuring to prevent further injury during diagnosis and recovery. 

What Are The Symptoms Of Idiopathic Vestibular Disease in Cats?

When a cat is afflicted by vestibular disease, he will start to show rapid-onset symptoms, which may include any or all of the following:

  • Stumbling or drunk-like movements, particularly when he moved normally only moments or hours prior.
  • Misjudging jumps or spaces when attempting to navigate a room, or walking into objects.
  • Falling off of edges or spaces, such as the top of a couch, which he normally navigates without issue. 
  • Fast, rapid “tracking” glances that present as an involuntary jerking eye movement, called nystagmus. 

If signs like these are observed, it’s important that he be taken to an animal care specialist as soon as possible. While idiopathic vestibular symptoms will eventually resolve on their own, his inability to navigate his environment could leave him temporarily unable to eat, drink, or use the bathroom normally without medication and assistance from his owner.

Ruling Out Look-Alike Issues

No cat owner wants their beloved pet to feel sick or disoriented, and vestibular disease – a problem that typically clears up on its own – is very common in cats. These two facts aren’t always related, however, and what appears at first glance to be an easy-to-deal-with issue could be masking a much deeper feline health concern. Ultimately, only a veterinary professional is qualified to rule vestibular disease in or out in a patient, but these simple filters could speed up the diagnosis:

  • How long has he been exhibiting symptoms? Vestibular disease is not gradual or subtle, it will appear in the space of an afternoon and appear to leave a cat nearly, if not fully, incapacitated. If something has been slowing his step or making him clumsy over weeks and months, it may be another issue, such as an inner-ear tumor or brain concern.
  • Has he been eating or ingesting anything unusual? Cats in the wild are known to eat grass to induce vomiting, in turn ridding their bodies of hairballs and other debris. When a cat is indoor only, he may turn to houseplants and floral arrangements to accomplish the same thing. Unfortunately, a number of those common greens and flowers can leave a cat sickened or poisoned, even in a few bites. If a plant is being considered for home decor and it isn’t clear how it will affect a housecat, it’s best to follow the golden rule: when in doubt, don’t leave it out! 
  • Has his environment changed recently? A cat is smaller and much closer to the ground than his human owner, which means chemicals like floor and carpet cleaners have a much more significant impact on his respiratory system. Likewise, perfumes, scented candles, and essential oil diffusers have all been shown to be harmful to cats. When these items deposit fragrance molecules into the air, they land on fur and are licked off and ingested during grooming. If too much is ingested, it can manifest as a poisoning issue that leads to organ failure in felines.
  • Has he caught, fought, or eaten prey animals recently? While a cat is a natural “mouser,” if he captures and attempts to fight or eat a rodent or bird that’s been poisoned, he’ll be poisoned as well. It may take longer to manifest in his system due to his comparative size, but the symptoms may mimic those of vestibular disease in the interim, which is why a diagnostic vet visit is so important.
  • Has his diet or medication changed recently? While it’s unlikely that a new food or medication would have such visibly concerning effects on his balance, it’s also not impossible. Food allergies in cats or an interaction with an existing medication can cause a loss of balance or nausea as easily as a sudden bout of vestibular disease.  

Most of these questions will also be covered in the course of a diagnostic visit at the vet’s, but a cat owner can consider these questions and have answers ready to ensure speedy support. Ruling out other “look-alike” issues with similar symptoms allows for a faster diagnosis and symptom treatment. 

Why Are Cats Affected With Vestibular Disease?

Much like the same disorder in dogs, many cases of feline vestibular disease are idiopathic, which means they appear without a clear reason or cause behind them. However, inner ear infections are a common trigger, where they can be identified – the inflammation and swelling associated with an ear infection can disrupt the vestibular function. 

If a cat has recently had ear mites or other parasites like fleas or ticks, they could very easily cause issues with the inner ear: these hitchhikers often burrow or shelter in the ear, where they are harder to shake or scratch away. A vet will be able to diagnose a physical infection or injury in the ear with an examination, and can help speed recovery with antibiotics or cleaning procedures.

If no physical cause can be found, there’s a very good chance it’s an idiopathic case and time is the best medicine. Most cases of feline vestibular disease will clear up by themselves in a matter of days, with the most significant healing seen approximately one to two days after symptoms emerge. Before that time, the observable symptoms will be at their most severe, and it’s important for concerned cat owners to bear in mind that the condition, if confirmed by a vet, is only temporary. 

Are All Cats Susceptible To Vestibular Disease?

All cats – indoor, outdoor, feral, and domesticated – can come down with vestibular disease, though it’s important to remember that it cannot be transmitted to other animals or humans. Certain breeds of cats, such as Siamese and Burmese, have been found to have higher incidences of congenital vestibular disease. Additionally, deaf cats are also at a higher risk of affliction, due to existing damage or malformation of the inner ear. 

Apart from avoiding obvious external triggers – e.g. keeping a cat exclusively indoors to avoid feral fights and parasites – there isn’t much an owner can do to reliably prevent vestibular issues. If they occur, they aren’t a condemnation of the quality of life and care a cat receives, either: it simply happens, and it can occur in cats of any age and level of health.

Treatments For Feline Vestibular Disease

Once it’s been determined as a causal factor, a vet will typically instruct a cat owner to support their pet as time heals the issue. This may mean proactive grooming/trimming of the tail and back haunches on long-haired breeds, who may struggle to use the litter box without a sense of balance. A vet may also prescribe medications to mitigate nausea and vertigo as a cat’s vestibular system struggles to right itself: he’ll need that extra food energy for healing back to his normal self. Depending on the severity and progression of the vestibular healing cycle, a cat may also be temporarily admitted for intravenous fluids to ward off dehydration. 

If there is an external cause behind the vestibular issues, he may also be prescribed antibacterial or antifungal medication to reduce swelling and inflammation as the body heals itself. During this time, his owner needs to be extra vigilant about keeping potential infectants away from his compromised immune system. Potential causes can be discussed with the vet and eliminated back at home to keep healing moving forward. These may be as simple as washing bedding in antibacterial soap and hot water, or deep-cleaning the cat’s normal environment prior to his arrival back home.

How Can I Help My Cat’s Vestibular Disease?

While admittedly more severe through a cat’s eyes, vestibular disease is similar to a bad bout of drunkenness or seasickness in a human being. He’ll feel like he can’t get up off the floor, and will struggle to perform simple tasks, such as walking to the kitchen for a drink of water or food. Even if he manages to find his way there, he’ll immediately feel nauseous once he eats or drinks, thanks to his jittering eyes. 

His owner can offer support by remaining physically near him, which will reassure him with a steady, stable, and tangible presence to lean on. A healthy dose of understanding and patience may be required, as well: cats that do not feel well are often compelled to lash out in a fight-or-flight response. 

He may need to be lifted in and out of the (clean) litterbox for a few days while his sense of balance returns, and there may be an accident or two as he remembers how to navigate. To cut down on messes, an owner may want to lay down disposable wee-wee pads to absorb any accidents and make cleanup easier. For long-haired breeds, this may also be a prudent time to trim long hair away from the tail and back haunches to make the “litter process” go a little more smoothly during recovery.

Finally, soft bedding and enclosures, such as a cat carrier, should be used to reinforce a feeling of safety and comfort in the evenings and while unattended. If he continually falls against a hard floor or surface, he may injure himself, and a sense of panic may keep him from trying over and over. While his sense of balance should return naturally in a few days, a little extra padding in the interim will ensure he’s back on his feet free of bumps and bruises. 

Summary: Identifying & Treating Feline Vestibular Disease

Feline vestibular disease isn’t something to take lightly, but it’s also a disease that will largely heal itself in time. Once diagnosed, an owner simply has to support a cat’s own healing process until he’s back on his own four paws again. The symptoms of the disease can be frightening, particularly because of its sudden-onset tendency, but a well-educated owner is the best defense against further injury or feline discomfort.

Sources Cited:
  1. Ward, Ernest, DVM; updated by Malcolm Weir, DVM, MSc, MPH. “Vestibular Disease in Cats.” VCA Hospitals.com, (no publish date), https://vcahospitals.com/know-your-pet/feline-vestibular-disease. Accessed July 14, 2019.
  2. “Vestibular Syndrome.” Cornell University College of Veterinary Medicine (vet.cornell.edu), (no publish date), https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/vestibular-syndrome. Accessed July 14, 2019.
  3. McDonnell, Jay, DVM, MS, Diplomate ACVIM (Neurology). “8 Questions About Feline Idiopathic Vestibular Disease.” Veterinary Neurology & Imaging Of The Chesapeake (vetneurochesapeake.com), (no publish date), https://www.vetneurochesapeake.com/uncategorized/8-questions-about-feline-idiopathic-vestibular-disease/. Accessed July 14, 2019.
  4. “Vestibular Disease in Cats.” Wag Walking.com (no publish date), https://wagwalking.com/cat/condition/vestibular-disease. Accessed July 14, 2019.

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