Vestibular Disease and Ataxias

April 22, 2019

Vestibular is an adjective referring to the inner ear but more specifically to balance.


An ataxia is a general term that refers to a flaw in the coordination of arms, legs, head (which can affect the neck as well) and torso.

There are three types of Ataxias. Sensory, vestibular (ear) and cerebellar (part of the brain that deals with balance and coordination )

 

SYMPTOMS:

Sensory Ataxia:


-Incorrectly placed paws
-Increasing weakness with disease progression


Vestibular Ataxia:

-Leaning
-Tipping
-Falling
-Rolling over

If Central Vestibular Dysfunction:
-Abnormal eye movements
-Sensory deficits
-Limb weakness (can be on one side)
-Drowsiness
-Near unconsciousness

-Coma

 

If Peripheral Vestibular Dysfunction:
-Changes in normal mentor status
-Vertical eye movement
-Sensory issues
-Limb weakness

 

Cerebellar:
-Uncoordinated movement of the limbs, head and/or neck
-Walking in large/abnormal steps

-Head or body tremors
-Swaying torso

 

DURATION:


Depends on the type/cause of vestibular disease. Some clears in a few days to weeks others are lifelong conditions that can only be in maintenance.

 

HOW:

There are MANY causes of the various ataxias unfortunately.

The most common cause for Sensory Ataxia is a slow compression of the spinal cord and/or brain stem as well as lesions on the cerebrum located in the brain.

Another common cause is a change in the vestibulocochlear nerve (a nerve located in the ear responsible for transmitting sound and aiding in balance) which results in abnormalities of the head and neck due to a false sense of moving.

A more comprehensive list is as follows:

  • Neurologic

    • Cerebellar (pertaining to the cerebellum dealing with balance)

    • Degenerative:

      • Abiotrophy (prematurely the cerebellum loses function)

    • Anomalous (Deviations from normal function):

      • Underdevelopment secondary to perinatal infection (an infection right before birth) with panleukopenia virus in cats

      • A cyst located near ther fourth ventricle

    • Cancer

    • Infectious – feline infectious peritonitis (FIP)

    • Inflammatory, unknown causes, immune-mediated

    • Toxic

  • Vestibular – central nervous system (CNS)

    • Infectious:

      • Feline infectious peritonitis (FIP), rickettsial diseases ( a variety of diseases caused by bacterial cocci), mycoplasma

    • Inflammatory, unknown causes, immune-mediated

    • Toxic

  • Vestibular—Peripheral nervous system

    • Infectious:

      • Middle ear

      • Fungal

    • Diseases of unknown cause

    • Metabolic

    • Cancer

    • Traumatic

  • Spinal Cord

    • Degeneration of the nerve roots and spinal cords

    • Vascular:

      • Loss of blood to nervous system due to blockage of blood vessels by a blood clot

    • Anomalous:

      • Spinal cord and vertebral malformation

      • spinal cyst

    • Cancer

    • Infectious

    • Traumatic

  • Metabolic

    • Anemia

    • Electrolyte disturbances – low potassium and low blood sugar

 

DIAGNOSIS
Most veterinarians will ask for a complete history of your cat than perform standard tests such as blood tests.

Some veterinarians may proceed to imaging to determine the location of this disease such as the spinal cord, cerebellum or in the vestibular system.
Other tests your veterinarian may perform are computed tomography (CT) magnetic resonance imaging (MRI), myelography (a medium is injected into the spine to see where dysfunction occurs), spinal, chest and abdominal x-rays as well abdominal ultrasounds.

 

TREATMENT:

Determining the root cause is extremely important in determining the right treatment. Most treatments aren’t known until the root is determined first and then it can be treated appropriately in most cases.

 

Conventional

Conventional treatments involve pain management as well as supportive care via IV fluids or tube feeding depending on the severity of the vestibular disease.

 

Medications may be required if there is a bacterial cause such as toxoplasmosis (clindamycin) or Cryptococcus (itraconazole or fluconazole)of corticosteroids primarily for anti inflammatory properties.

Surgery may be required if there are tumors or polyps causing the dysfunction.

 

Changes to the home may be required to prevent further injury such a being aware of stairs that companions could tumble down.


The follow is a list of other treatments depending on the cause of vestibular disease.

Poisoning
Treatment will be dependent on what was ingested.

Head injury
Depending on the severity treatment may be as simple as cleaning the wound while others may require surgery of the brain in which recovery may or may not be possible.

Thiamine deficiency
Thiamine injections may be suggested.

Cerebral hypoplasia (CH)

There is no cure for this condition.

 

Spinal trauma
Treatment and outcome depend on the severity of the injury.

 

Hypocalcemia
Treating with Vitamin D and Calcium gluconate is common

 

Lysosomal storage disease
Unfortunately there is no treatment. Often in most cases this disease is fatal to the animals.

 

Hydrocephalus
Often medications are prescribed like corticosteroids to reduce inflammation. If the case is more severe euthanasia may be the best choice.

 

Tumor
Surgery, chemotherapy and radiation are recommended.

Portosystemic shunt (an abnormal vein that takes blood from the intestines to the heart, bypassing the liver)
Surgery is often required

 

Viral infection
Usually FIP is the cause however this is always fatal and cannot be diagnosed until necropsy.

With Panleukopenia supportive immune boosting care is required which could involve blood transfusions.

 

Nasopharyngeal polyps (located in the inner ear)
Surgical removal is recommended.

 

Brain stroke
Supportive care is required which can include but is not limited to oxygen therapy, anti-seizure medications, fluids and physiotherapy.

 

Glycogen storage disease
There is no cure for the disease and often patients pass by 18 months of age.

 

Hypoglycemia
Treat with insulin and regularly re-evaluate the cat’s condition.

 

Natural

Homeopathic remedies
*Various homeopathic remedies can apply but one should consult with a homeopath.

Species appropriate and nutritionally balanced diet including food rich in Vitamin E and B
Omega 3’s for tissue regeneration and anti inflammatory
Animal chiropractor
Turmeric
Acupuncture
Elk Antler Velvet
Full Extract Cannabis Oil

Other natural treatments specifically can include:

 

Poisoning
Treatment will be dependent on what was ingested. Natural remedies include activated charcoal and hydrogen peroxide to induce vomiting. Please use hydrogen peroxide appropriately, inducing vomiting is not always safe.

 

Thiamine deficiency
A balanced species appropriate raw diet with food rich in thiamine.

 

Hypocalcemia
A balanced species appropriate raw diet with appropriate sources of Vitamin D and Calcium

 

Catnip high
Naturally allow your cat to come down from the plant

Portosystemic shunt
A species appropriate raw diet conducive to liver disease and abnormalities.

Viral infection
Boosting the immune system with a species appropriate diet, herbs and other natural means


In general most with supportive care begin to improve in 72 hours and are completely normal in one to three weeks time.

 

PREVENTION:
There is a wide range of causes so prevention can be difficult however one can:

 

Providing a balanced species appropriate raw diet
Proper storage/eliminate potential toxins
Properly catify your home

 

 

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