What It Is:
Vestibular disease is a condition that affects a cat’s balance system, which controls coordination, posture, and spatial orientation. The vestibular system includes parts of the inner ear and brainstem that help your cat stay upright and aware of movement. When this system is disrupted, it leads to sudden and often dramatic signs such as head tilting, unsteady walking, and disorientation.
Vestibular disease can be idiopathic (no known cause) or the result of underlying illness, trauma, or infection.
🐾 Common Symptoms
Symptoms typically come on suddenly and may include:
- Head tilt
- Loss of balance or stumbling
- Falling or rolling to one side
- Circling
- Rapid eye movement (nystagmus)
- Nausea or vomiting
- Reluctance to stand or move
- Disorientation or confusion
Despite how alarming these symptoms appear, many cases are not painful, and some resolve on their own.
🦠 Causes and Types
There are two main types of vestibular disease in cats:
Peripheral vestibular disease
Affects the inner ear or vestibular nerve
Common causes include:
- Ear infections
- Polyps or tumors in the ear canal
- Head trauma
- Certain medications (especially ear drops that are toxic to the inner ear)
- Idiopathic cases with no identifiable cause
Central vestibular disease
Affects the brainstem or central nervous system
Causes may include:
- Brain tumors
- Inflammatory diseases
- Infections like toxoplasmosis or FIP
- Stroke or vascular events
- Thiamine (vitamin B1) deficiency
Peripheral disease is more common and usually has a better prognosis.
🔍 Diagnosis
Diagnosis is based on clinical signs, medical history, and diagnostic tests. Your vet may perform:
- Physical and neurological exam
- Ear exam using an otoscope
- Bloodwork to check for infections or metabolic problems
- X rays or CT scans to evaluate the ear or skull
- MRI if central disease is suspected
- CSF analysis in cases of brain inflammation
Identifying whether the disease is central or peripheral helps guide treatment and predict outcome.
💊 Treatment
Treatment depends on the underlying cause and whether the condition is peripheral or central.
Options may include:
- Antibiotics or antifungals for infections
- Anti nausea medications to reduce vomiting
- Steroids or anti inflammatories for inflammation
- Surgical removal of ear polyps or tumors if present
- Supportive care, such as fluids and assisted feeding
- Vitamin supplements for nutritional deficiencies
- Time and rest in idiopathic cases, which often resolve in days to weeks
Most cats improve with proper treatment, though full recovery may take time.
🩺 Prognosis
Prognosis depends on the type and cause:
- Idiopathic vestibular disease usually improves within one to two weeks, though mild head tilt may persist
- Peripheral disease often responds well to treatment
- Central disease may have a more guarded prognosis, depending on the cause and response to care
Early veterinary attention improves the chance of full recovery.
💡 Cat Owner Note
When your cat suddenly starts tilting their head or walking like they are drunk, it can be terrifying. But don’t panic. Vestibular disease often looks worse than it is. Many cats bounce back quickly with treatment or even just time and rest. The key is getting them checked out right away to rule out anything more serious.
❓ Frequently Asked Questions About Vestibular Disease in Cats
Is vestibular disease painful for cats?
Usually not. While symptoms are dramatic, most cats do not experience pain — just confusion or nausea.
Can vestibular disease go away on its own?
Yes. Idiopathic cases often resolve within a few days to weeks with supportive care.
Is vestibular disease contagious?
No. It is not contagious and cannot spread to other animals or humans.
What is the difference between peripheral and central vestibular disease?
Peripheral disease affects the inner ear or nerves, while central disease affects the brainstem. Central forms are often more serious.
Can older cats get vestibular disease?
Yes. It is most commonly seen in senior cats, especially idiopathic cases.
Will my cat fully recover?
Many cats recover completely or adapt well, though some may have a permanent head tilt or occasional balance issues.