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Vestibular disease

ffelis

Introduction

  • Cause: disturbance of the central or peripheral vestibular system.
  • May be secondary or idiopathic.
  • Signs: ataxia, falling/rolling, leaning to one side, head tilt (unilateral) or wide excursion of the head from side to side (bilateral), circling, nystagmus.
  • Diagnosis: signs.
  • Treatment: depends on cause.
  • Prognosis: reasonable to good, depending on cause.
    Follow the diagnostic tree on Vestibular Disease Vestibular Disease.

Pathogenesis

Etiology

Central vestibular disease

Peripheral vestibular disease

  • Otitis media Otitis media:
    • Extension of otitis externa Otitis externa.
    • Retrograde infection via eustachian tubes.
    • Hematogenous.
  • Nasopharyngeal polyps Nasopharyngeal polyp.
  • Idiopathic.
  • Neoplasia.
  • Congenital disease.
  • Toxicity:
    • Aminoglycoside antibiotics.
    • Topical iodophors.
    • Chlorhexidine Chlorhexidine.
  • Trauma:
    • Fracture of temporal bone.
    • Tympanic bulla damage.

Timecourse

  • Acute onset over days.
  • Signs may persist for weeks or months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Negrin A, Cherubini G B, Lamb C et al (2010) Clinical signs, magnetic resonance imaging findings and outcome in 77 cats with vestibular disease: a retrospective study. J Feline Med Surg 12 (4), 291-299 PubMed.
  • Rossmeisl J H Jr. (2010) Vestibular disease in dogs and cats. Vet Clin North Am Small Anim Pract 40 (1), 81-100 PubMed.
  • Thomas W B (2000) Vestibular dysfunction. Vet Clin North Am Small Anim Pract 30 (1), 227-249 PubMed.
  • LeCouteur R A & Vernau K M (1999) Feline vestibular disorders Part 1 - anatomy and clinical signs. J Feline Med Surg (2), 71-80 PubMed.
  • Vernau K M & LeCouteur R A (1999) Feline vestibular disorders Part 2 - diagnostic approach and differential diagnosis. J Feline Med Surg (2), 81-8 PubMed.
  • Schunk K L (1988) Disorders of the vestibular system. Vet Clin North Am 18 (3), 641-665 VetMedResource.
  • Burke E E, Moise N S, de Lahunta A (1985) Review of idiopathic feline vestibular syndrome in 75 cats. JAVMA 187 (9), 941-3 PubMed.

Other sources of information

  • de Lahunta A, Glass E (2009) Vestibular system - special proprioception. Veterinary Neuroanatomy and Clinical Neurology. 3rd edn. W B Saunders, Elsevier, St Louis, Missouri, pp 319-347.
  • Munana K R (2004) Head tilt and nystagmus. In: BSAVA Manual of Canine and Feline Neurology. 3rd edn. S R Platt & N J Olby eds. BSAVA, pp 155-171.

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