Feline atopic syndrome: An insight into its effects on the central nervous system through vestibular disease

A 2-year-old male Abyssinian cat was presented with a left head tilt, lethargy, compulsive walking with a left-circling tendency, medial strabismus, a delayed pupillary light reflex, abdominal papules, and severe pruritus that began at 4 mo of age. Imaging revealed mineral opacity foci in the left ear, and magnetic resonance imaging confirmed heterogeneous signal changes, suggesting a diagnosis of otitis interna. No abnormal findings were observed on cerebrospinal fluid tests. Treatment with prednisolone, antibiotics, a hypoallergenic diet, and probiotics led to the resolution of skin issues and neurological improvement. Despite a persistent head tilt after more than 5 mo, there was no recurrence of severe neurological symptoms during the tapering off of prednisolone treatment. Key clinical message: This is the first case report illustrating the potential impact of feline atopic syndrome on the central nervous system. It emphasizes the importance of viewing feline atopic syndrome as more than just a skin disorder.