Page 858 - Problem-Based Feline Medicine

850 PART 10 CAT WITH SIGNS OF NEUROLOGICAL DISEASE

The vestibular signs are peripheral and can be unilat- Head tilt with tipping, rolling or falling developing at
eral, or bilateral. birth or in the first 12 weeks of life. The head tilt can be
marked and may vary with time.
The signs may develop acutely following exposure to
a high dose or after prolonged administration (> 14 The clinical signs are non-progressive and decrease in
days). Cats with renal dysfunction are at risk because severity with time, but usually persist for life.
decreased renal excretion of many drugs results in
higher plasma concentrations.
Diagnosis
The vestibular signs may disappear following dis-
Diagnosis is based on characteristic signs in a kitten
continuation of the drug.
from a susceptible breed.
Diagnosis
BLUE-TAILED LIZARD INGESTION
The history of use of a drug potentially toxic for the
vestibular receptors, topically or systemically. Classical signs
The vestibular signs may appear immediately following ● Southeastern United States.
an ear flush, or following topical treatment with a toxic ● Unilateral peripheral vestibular signs
medication, in a cat that has a perforated tympanic following the ingestion of a blue-tailed
membrane. lizard.
● The cat also salivates, vomits, trembles
and is irritable.
Prevention
Avoid using any medication in the external ear canal if
Clinical signs
the tympanic membrane is perforated or cannot be visu-
alized. This includes ceruminolytic agents and deter-
Acute onset of unilateral peripheral vestibular dis-
gents.
turbance following ingestion of the blue-tailed lizard.
The syndrome has not been well substantiated.
CONGENITAL VESTIBULAR DISEASE
Varying degrees of vestibular signs associated with
salivation, vomiting, trembling and irritability.
Classical signs
Spontaneous recovery occurs in most cats.
● Unilateral or bilateral vestibular signs
present at birth or developing in the first Death may occur.
12 weeks of life.
● Siamese, Burmese and Tonkinese cats. Diagnosis
● Head tilt and tipping or rolling.

Acute onset of unilateral peripheral vestibular signs in
Clinical signs a cat living in southeastern United States with access
to lizards. Signs are indistinguishable from the idio-
Reported in Siamese, Burmese and Tonkinese cats.
pathic vestibular syndrome although salivation, vom-
Usually unilateral vestibular signs, but can be iting and trembling are less common with the
bilateral. idiopathic disease.