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Feline Vestibular Disease

Negrin A, Cherubini GB, Lamb C et al: Clinical signs, magnetic resonance imaging findings and outcome in 77 cats with vestibular disease: a retrospective study, Journal of Feline Medicine & Surgery 12:291, 2010.

The medical records of 77 cats were reviewed to describe the epidemiology, clinical and MRI findings in cats with vestibular signs and to identify any association between these variables and patient outcome.  Vestibular disease is defined on the basis of observing a loss of balance, typical ataxia, head tilt, spontaneous/positional nystagmus and/or positional strabismus.  Cats with these signs alone were classified with peripheral vestibular disease (PVD). Cats with a markedly depressed mental state, proprioceptive deficits, and cranial nerve deficits were classified with central vestibular disease (CVD). Forty cats (52%) were designated to have unilateral CVD, one cat had paradoxical vestibular syndrome, and the remaining 36 (47%) cats had PVD, of which 5 had bilateral clinical signs. The most frequent cause of CVD was inflammation including bacterial inflammation as an extension of intracranial otitis interna, feline infectious peritonitis, and toxoplasmosis. Neoplasia was in second place and vascular disease in third as causes of CVD.  In cats with PVD signs, idiopathic conditions and otitis media/interna were equally represented. Most of the cats (9 cases) with presumed idiopathic vestibular disease had rapid and complete recovery. Statistically significant predictors of survival included neurolocalization (central or peripheral vestibular system), age and gender. Magnetic resonance imaging (MRI) was found to be very useful in the diagnosis of both peripheral and central vestibular disease. Prognosis appears to be directly associated with the site (intracranial versus extracranial) rather than the nature of the lesion. [VT]

Related articles:
Rossmeisl JH, Jr.: Vestibular disease in dogs and cats, Vet Clin North Am Small Anim Pract 40:81, 2010.