Head tilt (feline idiopathic vestibular disease? )

[IndyJones]

Does anyone have a cat who has feline idiopathic vestibular disease? Or any experience with an animal who has had it?

Indy has been tilting her head for a while now. One day I came home and there was stuff knocked over and Indy was tilting her head to the right side. She was also a bit wobbly but still able to run and play just fine. Vet guesses she knocked the stuff down when she jumped off a shelf possibly from losing her balance.

She seems better today but still tilting her head to the right. She is eating and drinking and going to the bathroom fine.

From what I have read about FIVD it isn't really something that can be cured. Just managed.

I am looking for some tips on how to manage vestibular disease and experience with this.

 

[daftcat75]

How do you know it's idiopathic and not a middle ear infection?

If it's a middle ear infection, it can get worse eventually infecting the bone. If it gets past the bone, it can go into the brain.

The bad news is that you probably cannot determine a middle ear infection except through a very expensive MRI.

The good news is that unless her VD gets worse, the treatment is approximately the same. A month of antibiotics because the middle ear is a difficult place for antibiotics to reach. It is technically outside the body. The only circulation is within the skin that lines the middle ear.

My Krista just had a really scary time of this. One night, out of nowhere, she jumped off the bed, threw up, and then had an awful time getting back up on the bed. She was having a really hard time walking. She was on her hocks (the lower part of the back legs.) And her eyes were darting back and forth, called nystagmus. She looked like she was having a hypoglycemic episode or had a stroke.
https://thecatsite.com/media/neurologic-nystagmus.423508/

and

https://thecatsite.com/media/miss-weeble-wobble.423507/

See how her head movements are kinda swimming and kinda jerky. If you start seeing this in your cat, you'll want to reconsider that MRI. If you have access to a specialist hospital, you may want to see about scheduling a neurological consult for your cat rather than waiting for it to come to that.

In Krista's case, she couldn't get on anymore like that. She was so wobbly and "neurologic" that she was likely quite nauseated with very little appetite. The neurologist, after looking at the MRI, recommended surgery, and I consented. In her case, the surgery is called ventral bulla osteotomy. They went up through her jaw to drain her middle ear. There was so much junk in there that that was what was causing all the neurological symptoms. Three weeks post-surgery, she still has the head tilt but her nystagmus cleared and her balance is improving. Her appetite is back to normal. She still has another week of antibiotics and the surgeon may recommend longer based on her checkup next week.

 

[daftcat75]

TLDR; it may not be idiopathic. Talk to your vet, get a second opinion, or consult with a neurologist about all the causes (infection, tumor, polyp, idiopathic) of vestibular disorder. Make sure you understand the risks of waiting it out. Determine with your vet whether you might want to try antibiotic treatment. If it's an infection, it might clear up. But it might take awhile because of the circulation challenges of the middle ear. If it's a polyp or a tumor, she may end up needing that surgery. If it looks like it's getting worse, you'll want to consider that MRI test.

 

[daftcat75]

Here's another thread and especially helpful post within that thread about this:
Vestibular Disease - Anyone Ever Hear About This?

 

[catheetiem]

As daftcat75 said, is the FIVD diagnosis certain? There are other conditions that can cause a head tilt and balance issues, such as infection, stroke, brain tumor, etc. My last cat, Kayla, had a head tilt, balance issues, and an inability to turn left (she made 3 circles to the right to go left). The vet was thinking either stroke or brain tumor. Blood pressure results suggested a tumor, so we moved to palliative care; brain tumors have a high chance of a quick recurrence, she was already 15 so we just tried to make her as comfortable as possible. I don't know where you are located, but I'm in Connecticut and my vet estimated the cost of the MRI as several thousand just for the scan alone, no actual treatments.

Kayla had a bad time with it. She was confused why she couldn't move like normal. She had trouble eating and drinking due to the head tilt, she kept getting her nose in the water bowl and would sneeze a bunch of times whenever she drank. She only spent a week in her condition until we decided it was time for her to go, but if we were going to deal with a head tilt long-term I might have tried to angle her food and water dishes the same way as her head tilts, so that her head tilt meets up with the tilt of the bowls. But if Indy is able to compensate for it herself, that's great! I guess just keep an eye out to make sure she's not avoiding her food/water or eating/drinking less because it's hard for her.

And with the wobbles, obviously keep her off of high objects. Kayla limited herself, she knew she was unstable and stayed on the ground with no attempt to jump up to any of her usual spots. She also needed the guidance of walls for her to walk places. Like when she walked down the hallway she needed to be right up against the wall to get there, where previously she would just walk down the middle of the hallway. So I guess I'd keep walls open and uncluttered in case she suddenly needs a guide.

 

[IndyJones]

Now Indy is acting like her old self aside from the head tilt which seems to be deliberate rather than involuntary. She does it when looking directly at a person or object. After some talking with the vet she thinks Indy hit her head on the shelf jumping up there and it's just bruised. Can't go in because of social distancing so drop off and zoom conference.

She is still trying to jump on high objects including the heat pump wall unit which is just a few feet below the ceiling despite being scolded. Typical cat.

 

[posiepurrs]

I have a girl who was fine when I left for work and when I got home 8 hours later, she couldn't walk without falling over, her head tilted and she had nystagmus. Rushed to the vet. We did not have an MRI but did treat with long term antibiotics and anti nausea medicine. Diagnosed as Idiopathic vestibular disease. My vet, to inject a little humor in a frightening situation called it drunken cat syndrome. I used a kennel to put her in to keep her from harming herself, and used a very low box as a litterbox ( 2 cardboard trays from cat food cases put together to make a big tray). It took about a week before she could walk without falling over. This was several years ago and she still has a head tilt.

 

[IndyJones]

I have an update. She was acting drunk again last weekend and I got a recording that I gave to the vet. I have a confirmed diagnosis that Indy has idiopathic vestibular disease.

Unfortunately there's no cure for it other than managing her episodes when they happen. They could do some further investigating such as mri screening but feel it is unnecessary and it would be expensive. However she should live a long relatively normal life. I decided to not have imaging done.

She has a permanent head tilt. But is otherwise a healthy cat.

 

[daftcat75]

confirmed diagnosis that Indy has idiopathic vestibular disease.

That's a bit of an oxymoron. Idiopathic means they don't really know what caused it.

If she's not pawing at her ears, scratching her ears excessively, or shaking her head, it's probably not an ear infection or polyp. If it's a tumor, there's probably not much you can do about that anyway. As long as she doesn't seem bothered by it, her appetite is good, and she's not throwing up, it's probably safe to accept that idiopathic diagnosis. I'd ask your vet for any signs to watch for that might indicate something more troubling.

 

[Tik cat's mum]

I have a kitten that had peripheral vestibular disease it was horrible. He had cat flu then the vet said he didn't think he needed antibiotics. The day after he could hardly walk was falling over and going round in circles. We rushed him to the emergency vet who gave him antibiotics and antimflamatry shots. He said suspected middle ear infection. My vet gave him a weeks supply of antibiotics the morning of his check up he had none left to take by the time of the vet appointment 3 hour's after he was due his next antibiotics his head tilt was back and bad. We went with the wait and see he was on antibiotics for 8 weeks in total. He has a slight head tilt vet said that won't go. But it was hard work because he was a kitten and still tried to do what kittens do. He still isn't the best at balancing. Lol. But it does not stop him doing anything he has learnt I think to componsate for his head tilt. He never pawed at his ear or had any sign of discharge which would of given us a clue something was going on.

 

[IndyJones]

This is a picture of Indy's head tilt. She looks grumpy because she didn't want to stand still for the camera. She kept wanting to flip on her back

 

[maggie101]

While ago someone had a similar problem with thier cat. Probably find it in a search

 

[IndyJones]

While ago someone had a similar problem with thier cat. Probably find it in a search

Oh I meant she wanted to flip on her back for belly rubs, that photo was taken minutes before I posted it.

 

[maggie101]

My cat did that right after I gave her advantage. She rolled on her back and got it all over her

 

[cat nap]

This is a picture of Indy's head tilt. She looks grumpy because she didn't want to stand still for the camera. She kept wanting to flip on her back

She is Beautiful IndyJones ...very soft looking fur.
How old is your Indy?
She does not look grumpy to me...just the 'I wonder what food is being served, tonight'...look.

Does your Indy tend to walk in circles?
And do you have to place her food dishes, up on some books, boxes, or wood...to raise them off the floor?

(Have you ever heard of Vertigo in humans, and the 'Canalith Repositioning Procedures'?
I wonder if you can try some of these gentle movements with cats?
It's called the Epley and Deep Head Hanging maneuver to treat this type of vertigo in humans..but you would have to ask your Vet..if they do anything like this for cats.)

 

[IndyJones]

Indy only walks in circles when she wants me to put the food bowl down I don't notice any effects from the vestibular disease besides her head tilt. There's the odd time she falls but not sure there's a connection.

Indy always takes whatever most difficult or complicated way to get around is. Jumping right from the top of the fireplace to the sofa to the floor for example instead of just jumping down. It's a little electric fireplace about waist height so not like it's a big drop.

I really don't think vertigo is a huge issue for her, I have one of those ergonomic computer chairs and she can perch on the very thin top of the back of it no problem.