Cats may sometimes suddenly lose their ability to orient themselves and become somewhat tipsy. And some cats are more than just a little dizzy—they cannot even stand. That is quite a worry for an unprepared owner.

We term this feline vestibular syndrome, or idiopathic vestibular disease. Now that’s a big mouthful of words. What we are really saying is that the vestibular system, which is a part of “control central” for the cat’s balance gets out of kilter, and for no obvious reason.

The root of the problem is proposed to be due to changes involving the peripheral vestibular system which is seated deep within the inner ear. Current thinking is that the special endolymphatic fluid in the semicircular canals, or the interface with the special sensory cells lining the canals becomes abnormal. Inflammation, abnormal endolymph fluid circulation, or toxic insults involving the receptors or nerve have all been proposed to result in these balance problems. Nobody has been able to confirm a single common cause for these cases.

There is no obvious pattern to this problem. We see cases here, there and everywhere, though some studies find a slight increased incidence of this disorder in late summer and early fall. Some veterinarians also see a tentative association with recent outbreaks of respiratory infections.

Cats may cry out, roll around, have a head that tilts way off to one side, eyeballs that oscillate back and forth, may lean against walls or furniture, fall down, and seem “out of it”. Sometimes if both ears are affected, the head may not be tilted much and kitty may not want to move at all. The affected cats most certainly are as puzzled as we are.

The afflicted cats will still have normal hearing, and the above signs go away, even without any specific treatment. Other potential causes for balance problems such as polyps, ear infections or ear cancers, encephalitis (e.g., FIP, toxoplasmosis), spinal cord pathology, drug toxicity, and blue-tail lizard toxicity (in Southeast US) will be ruled out.

In more serious cases, your veterinarian will advise admission to the hospital so that supportive care (sedation, anti-nausea treatment), and protective soft bedding in a quiet kennel can be provided to help prevent injury. In some cases, fluids and supportive nutrition will be given until Kitty is back drinking and eating well. If the cat is well enough for home care, careful restriction indoors, and away from staircases will need to be done until balance returns to normal.

Excellent improvement is usually seen in 2-3 days. It can take a few weeks to fully recover normal head orientation and full mobility though. A cat with any of the signs of vestibular disease should be assessed by the veterinarian promptly and if idiopathic vestibular disease is confirmed—that is a better diagnosis than many others that produce these sorts of signs.