Mary Allen
Healthy cats are masters of balance. It looks all the more worrying when they suddenly become unbalanced.
It usually happens all of a sudden: the cat has just jumped off the sofa in a lithe manner, the next moment it staggers, falls down again and again, or doesn’t get up at all. She holds her head to one side, appears disoriented, and shows violent movements of the eyeballs. And similar to seasickness, the impaired sense of balance, known in technical terms as a vestibular syndrome, is accompanied by severe nausea. “The symptoms of a disturbance in the vestibular system are often very dramatic, but fortunately there is often a less serious illness behind them. The prognosis is good in many cases,” says veterinarian Veronika Stein, who has been Professor and Head of Neurology at the Vetsuisse Faculty in Bern since 2016. It is important to use the clinical symptoms to find out which part of the vestibular system is diseased.
How good the treatment prospects depend primarily on the cause. This can be in the ear or in the brain because both are needed for the sense of balance: the balance organ in the inner ear and the vestibular nuclei in the brainstem and a small part of the cerebellum, in which the incoming information is processed. In order to localize the underlying disease, the veterinarian carries out a neurological examination, in which, among other things, the gait pattern is analyzed and the reflexes are checked.
Tumors and Infections
The correct interpretation is often not easy, says Stein. “But there are also some very clear indications, for example, a clouded consciousness usually indicates that it is a central vestibular syndrome, so the problem lies in the brainstem.” In the brain, among other things, tumors, which occur primarily in older cats, but also infectious diseases such as toxoplasmosis can cause a disturbed sense of balance. Another possible cause is poisoning, which is usually accompanied by severe nausea, excessive salivation, and vomiting.
For an exact diagnosis, it is usually necessary to visualize changes in the brain using magnetic resonance imaging. The prognosis is generally worse than that of the far more common “peripheral vestibular syndrome”. This occurs when a middle ear infection spreads to the inner ear and the vestibular system inside. After the inflammation has been successfully treated, the rest of the body is also restored to balance.
In rare cases, a malformation of the vestibular system can be congenital. For example, kittens can become infected with the parvovirus (cat disease) in the womb or during birth, which causes immense damage to the cerebellum, among other things. If such a cat survives, depending on the extent of the damage, it will probably never be able to jump onto furniture or balance on a railing. But if she tries again and again, there is a risk of injury. “In some cases, we have to weigh up with the owner whether it is better to redeem the animal,” says the veterinarian.
If the underlying condition can be treated, support the recovery phase by being there for the animal, providing a calm environment, avoiding stress and excitement, and providing water and food frequently. This applies in particular if the “idiopathic or geriatric vestibular syndrome” has been diagnosed. This is particularly common in older dogs and less common in cats. However, the exact causes are not yet known. “One theory says that there is a mismatch between the production of fluids in the inner ear and the resorptive processes, i.e. the absorption of substances,” explains Veronika Stein. The symptoms usually go away on their own after a few days.