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Head Tilt / Vestibular Syndrome in Cats
Written By hannah hollinger
Published: 09/12/2016Updated: 01/21/2022
Veterinary reviewed by Dr. Linda Simon, MVB MRCVS
What is Head Tilt / Vestibular Syndrome?
A head tilt may be mild and caused by something easy to treat, such as an ear infection or polyp. when a head tilt occurs in conjunction with other more serious signs (such as vomiting and ataxia), we may be dealing with Vestibular Syndrome.
Vestibular syndrome is not a specific disease but a collection of neurological symptoms and behaviors that are caused by a disruption or dysfunction in the vestibular system. This intricate and complicated system of nerves and anatomical elements is responsible for your cat’s sense of balance. The vestibular system also coordinates the movements of your cat's eyes, neck, head and limbs. If vestibular disease is suspected, your veterinarian will need to pinpoint the location of the problem and determine whether the symptoms are originating from the inner ear (peripheral) or the brain stem (central).
If your cat is holding its head at an angle and having trouble keeping its balance, it may be suffering from vestibular syndrome. Vestibular syndrome is a condition that occurs suddenly. It can cause your cat to stumble, fall, list to one side, or tilt its head. You may notice your cats’ eyes moving erratically from one side to another as it struggles to keep its balance. Head tilt is usually one of the first obvious signs of vestibular syndrome.
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Head Tilt / Vestibular Syndrome Average Cost
From 449 quotes ranging from $200 - $2,000
Average Cost
$1,300

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Symptoms of Head Tilt / Vestibular Syndrome in Cats
The most obvious symptom of vestibular syndrome in cats is the odd slant at which your cat holds its head upright. This head tilt occurs in both inner ear and brain stem disorders. Other symptoms of vestibular syndrome may include the following:
  • Lack of balance (ataxia)
  • Uncoordinated movement
  • Stumbling
  • Walking in a circle
  • Falling down
  • Facial drooping
  • Facial paralysis
  • Strabismus (crossed eyes)
  • Nystagmus (eyes moving up and down or back and forth)
  • Nausea
  • Vomiting
Causes of Head Tilt / Vestibular Syndrome in Cats
In many cases, your cat’s head tilt may be a symptom of a benign transitory anomaly. However, it may also indicate a serious underlying health condition. Your cat needs immediate medical evaluation to ensure the best and quickest way to resolve the issue. Here are the most common reasons for head tilt in cats:
  • Bacterial infections
  • Inflammatory disease
  • Reaction to drugs
  • Polyps
  • Tumors
  • Cysts
  • Cancer
  • Idiopathic vestibular syndrome (no known reason)
Diagnosis of Head Tilt / Vestibular Syndrome in Cats
Your cat’s obvious head tilt will be a major symptom your veterinarian will consider when diagnosing the systemic reason for your cat’s health issue. Other diagnostic tests, observations and evaluations may include:
Complete Medical History 
Your veterinarian will want a complete history of your cat’s health including any unusual behaviors or symptoms noticed prior to the head tilt.
Physical Examination
A thorough physical examination is necessary for your veterinarian to determine the cause of the head tilt. This examination may include watching your cat walk around the examination room, taking vital signs and performing both an otoscopic (ear) and neurological exam. 
Blood Tests
Blood tests will help your veterinarian diagnose infections and inflammation that may be causing the head tilt. Test results that register as abnormal help your veterinarian decide what may be the underlying cause of your cat’s vestibular condition. 
Urinalysis
By examining your cat’s urine, the veterinarian can see if there is anything abnormal in the test results that would aid in diagnosing the cause of the head tilt.
Advanced Testing
In some cases, specialized scans that offer advanced imaging such as magnetic resonance imaging (MRI) or computerized tomography (CT) may be necessary to make an accurate diagnosis, especially when the problem appears to be located deep within your cat’s ear or skull.
Treatment of Head Tilt / Vestibular Syndrome in Cats
Idiopathic Vestibular Syndrome
A wait-and-see approach is often used when idiopathic vestibular syndrome is suspected. Your cat’s head tilt will usually disappear on its own, and it seldom returns.
Infections and Inflammation
Your veterinarian will choose appropriate medications depending upon the underlying cause of your cat’s head tilt. Some medicines, like ear drops, may be prescribed as well as oral medications.
Polyps or Tumors
Depending upon the location and size of the polyp or tumor, your veterinarian may recommend surgery to remove the cause of the head tilt.
Drug Reactions
If your cat is having a toxic reaction to a drug, your veterinarian will change medicines and evaluate your cat to see if it needs additional hydration, especially if vomiting has occurred.

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Recovery of Head Tilt / Vestibular Syndrome in Cats
Your cat’s recovery period will depend upon your veterinarian’s diagnosis of the underlying cause of the head tilt. Even a simple ear infection will need follow-up appointments to ensure the infection is under control and that no additional damage has occurred within the cat’s ear. 
Cats who have had surgical intervention to repair the cause of the head tilt need extra care while recuperating. Your veterinarian will want to see your cat on a routine basis until it is completely healed.
If your cat experienced severe vomiting along with the head tilt, your veterinarian may need to keep your cat on IV medications until the vomiting resolves.
A head tilt could be symptomatic of a serious medical condition. To avoid high vet care expenses, secure pet health insurance today. The sooner you insure your pet, the more protection you’ll have from unexpected vet costs.
Head Tilt / Vestibular Syndrome Average Cost
From 449 quotes ranging from $200 - $2,000
Average Cost
$1,300
Top
Head Tilt / Vestibular Syndrome Questions and Advice from Veterinary Professionals
unknown
Three Months

42 found this helpful

42 found this helpful

My pet has the following symptoms:
Falling Over
My kitten keeps falling over when she tries to walk. Her head keeps shaking uncontrollably
Dec. 20, 2020
Answered by Dr. Linda S. MVB MRCVS
42 Recommendations
I'm sorry to hear this. Balance issues and trembling may indicate an issue with the cerebellum area of the brain and cab be seen with certain infections or inflammation. Other considerations would include an ear infection or toxicity. Regardless, your little one needs to be seen by a vet so we can determine what is going on and start the most appropriate treatment.
Dec. 20, 2020
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Kitten
7 weeks

11 found this helpful

11 found this helpful

My pet has the following symptoms:
Throwing His Head Back And Can’T Walk
What can help with this
Sept. 28, 2020
Answered by Dr. Michele K. DVM
11 Recommendations
Thank you for your question, I'm sorry that your kitten is not feeling good. Without being able to examine your kitten, I'm not sure what to do to help him or her I think he may have a problem with blood sugar, or he may have a problem with his nervous system. It would be best to have the kitten seen by a veterinarian, as they can examine him and see what might be going on, and let you know what treatment might help. I hope that all goes well for the kitten.
Oct. 3, 2020
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Inbred Farm kitten
3-4 weeks

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Limp Neck
My kitten was doing fine then allthe sedden her head went to the left and she couldn't lift it now its been about an hour and she cant move it at all.
Sept. 28, 2020
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your question. There are many diseases that can cause this in kittens. I hope that you were able to get care for her and that she is okay.
Oct. 9, 2020
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Tabi
Sixteen Years

15 found this helpful

15 found this helpful

My pet has the following symptoms:
Head Tilt
Should my cat be let outside at night with a head tilt?
Sept. 27, 2020
Answered by Dr. Michele K. DVM
15 Recommendations
Thank you for your question. I apologize for the delay in my response, this venue is not set up for urgent emails. I would not let my cat outside with a head tilt, no. There are too many things that can hurt a cat, especially if their balance is off.
Oct. 13, 2020
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Siamese
Five Years

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Head Tilt <2 Months
Head tilt
Sept. 25, 2020
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your question. I apologize for the delay, this venue is not set up for urgent emails. I hope that your pet is feeling better. If they are still having problems, seen by a veterinarian, as they can examine them, see what might be going on, and get any testing or treatment taken care of that might be needed.
Oct. 22, 2020
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Black and white
Newborn from feral mother
3 Weeks

1 found this helpful

1 found this helpful

My pet has the following symptoms:
Head Tilt
My grandparents cat recently had a litter of kittens and shortly after having them she moved them somewhere they wouldnt be found.Today when we were over I picked up one of them and notice that the kittens head drooped to the right side, she had brought the kittens back to the porch, I then sat it down and carefully tried to bring the kittens head up to a normal position, but when it stopped half way I immediately stopped and gently let its head go back to how it was. I talked to my mother and she said it may be possible that it has some fused vertebrae, could that also be the reason? Please help, I am very worried. Also I couldnt post with out a condition rating, so I put moderate.
short hair
Tilley
11 Years

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Head Tilt
Vomiting
Irritable
My cat, who is now about 11 years old has had a head tilt for the 10 years I have had her. I got her as a rescue at one years old and they (adoption agency) told me her head tilt was from issues with ear mites when she was little? She is now starting to act weird like she's in a very bad mood all of the time and doesn't want anything to do with my other two cats. She hisses at them, fights with them (she is a lot smaller than they are too). I have to try to keep them away from each other. Not sure if there is an underline additional problem. She throws up 4-5 times a week (it's normal for her over the years - I think she eats too fast but not sure)
Unknown
Fluffy
2 Months

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Sleepiness
Tired And Lack Of Appetite
My 2 month old Kitten woke up today normal but after it had her nap, she had her head tilted downwards and seemed very tired and sleepy. It didn't want to eat anything(even though it loved eating alot) Gave it a neck massage but its still that way.
Devon Rex
Rusty
15 Months

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Head Tilt To The Right
My 15 month old suddenly had a head tilt to the right with no other symptoms. He saw a neurologist who did an MRI and Spinal Tap. No infection was found but on two views of the MRI a very faint shadow appeared in the brain stem. It has been determined that he had a stroke. His tilt has gotten a little better but still appears when he jumps or runs. Anyone know if he may continue to improve?
Domestic shorthair
Solstice
9 Years

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Head Tilt
Hi, my cat Solstice about 3 weeks ago started stumbling randomly and not eating or drinking. Took her to the ER vet where she was given fluids and oddly enough ate a little bit of wet science diet kitten food. Went to primary vet the following day where she had a CBC, chem profile and urinalysis. Suspected UTI but other than that, normal bloodwork. Given orabax for 2 weeks. Returned to vet a few days later as head tilt and non eating continued and was diagnosed with middle ear infection (one ear drum ruptured). Given saline for flushing ears and meclizine for motion sickness. Also given a convenia injection and cerenia injection. Eating most days, but very little and losing weight about 2 pounds so far over the 3 weeks. Still has head tilt and stumbling, now also a hard swelling behind the left ear. Was given a metacam injection for pain, and followed up with 5 days of onsior. Yesterday began dragging herself and not walking or eating again. Am wondering if this is all due to an ear infection, or possibly another cause? Any advice would be greatly appreciated! Thank you so much!
Head Tilt / Vestibular Syndrome Average Cost
From 449 quotes ranging from $200 - $2,000
Average Cost
$1,300

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