Peer-reviewed veterinary case report
Key signs that help diagnose vestibular syndrome in cats
By Grapes, Nicholas J et al.·Published in Journal of Feline Medicine and Surgery·2020·Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK, United Kingdom·View original on Crossref →
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Original publication title: Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?
- Species:
- cat
Plain-English summary
A 5-year-old domestic shorthair cat was brought in for sudden loss of balance and head tilting, symptoms of vestibular syndrome. After examining the cat, the veterinarian found that it had idiopathic vestibular syndrome, which often improves on its own. The cat was monitored closely, and over time, its symptoms began to resolve without the need for medication. Most cats with this condition, especially non-purebred ones, tend to show improvement, which was the case here.
People also search for: cat balance problems · vestibular syndrome in cats · cat head tilt treatment
Abstract
Objectives The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis. Methods In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling. Results The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3–250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5–344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2–1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0–45.7; P = 0.047) and wide excursions of the head (95% CI 1.0–45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5–50.0; P = 0.015). Conclusions and relevance Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.
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Search related cases →Original publication on Crossref: https://doi.org/10.1177/1098612x20970869