Peripheral vestibular syndrome in cats: Clinical presentation, diagnostic findings and outcome in 196 cases

Disorders of the vestibular system are frequent in cats. This study aimed to describe the clinical presentation, diagnostic findings, underlying aetiologies and outcome of cats with peripheral vestibular syndrome (PVS).

This was a retrospective study of cats presented with PVS at four referral hospitals. All of the cats underwent magnetic resonance imaging or computed tomography of the head. Multivariable logistic regression analysis was performed to identify clinical variables associated with the most common diagnoses.

A total of 196 cats were included. The most common diagnosis was otitis media/interna (OMI) alone (n = 91) or with aural polyps (n = 49), followed by idiopathic vestibular syndrome (IVS) (n = 47), middle ear neoplasia (n = 7) and congenital vestibular syndrome (n = 2). A diagnosis of OMI was associated with younger age (odds ratio [OR] = 0.993, 95% confidence interval [CI]: 0.986‒1.000, p = 0.044), longer duration of clinical signs (OR = 1.034, 95% CI: 1.008‒1.061, p = 0.009), history of otitis externa/upper respiratory signs (OR = 5.245, 95% CI: 1.849‒14.882, p = 0.002), facial nerve paralysis (OR = 6.531, 95% CI: 1.287‒31.335, p = 0.023) and Horner syndrome (OR = 15.804, 95% CI: 2.014‒124.02, p = 0.009). Follow-up data for 104 cats revealed full recovery in 33 cats, partial recovery in 67 cats and no recovery in four cats.

The limitations of this study include its retrospective nature, multicentre approach and incomplete outcome data.

OMI is the most common cause of PVS in cats and is associated with younger age, longer duration of clinical signs, history of otitis externa/upper respiratory signs, facial nerve paralysis and Horner syndrome. The majority of cats diagnosed with OMI and IVS experience at least partial recovery from the vestibular signs.