Head Tilt / Vestibular Syndrome in Cats

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.

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

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)

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.

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.

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.