Clinical signs, magnetic resonance imaging findings and outcome in 77 cats with vestibular disease: A retrospective study

Abstract

Medical records of 77 cats that had clinical signs of vestibular disease and magnetic resonance imaging (MRI) of the head were reviewed retrospectively. The aetiological, clinical and MRI characteristics were described and evaluated for a relationship with patient outcome. Forty cats (52%) had signs of central vestibular dysfunction (CVD), which was part of a multifocal disease in 17 cats (43%). The most frequent causes of CVD were inflammatory conditions (18 cats; 45%), including bacterial inflammation as an intracranial extension of otitis interna (five cats; 13%), feline infectious peritonitis (three cats; 8%) and toxoplasmosis (two cats; 5%). Neoplasia (12 cats; 30%) and vascular disease (four cats; 10%) were respectively the second and the third most frequent causes of CVD. Thiamine deficiency was diagnosed in one cat based on MRI findings and improvement following vitamin B(1) supplementation. Of 37 cats (48%) with peripheral vestibular dysfunction (PVD), idiopathic vestibular syndrome (IVS) was suspected in 16 (43%) and otitis media/interna was suspected in 16 (43%). Within the group of cats with evident MRI lesions, the location of the imaged lesions agreed with the clinical classification of vestibular dysfunction in 52/55 (95%) cats. Most of the cats (nine cases; 56%) with presumed IVS had rapid and complete recovery of their clinical signs. As most of these cats presented with progressive clinical signs over 3 weeks they were classified as having 'atypical' IVS to differentiate them from cats with the typical non-progressive IVS. No underlying systemic diseases were documented in any of these cases. Statistically significant predictors of survival included neurolocalisation (central or peripheral vestibular system), age and gender. No difference in survival was observed between cats with presumed idiopathic peripheral syndrome and cats with otitis media/interna.

Vestibular disease in dogs: association between neurological examination, MRI lesion localisation and outcome

“…Outcome analysis was possible in 81 cases (87.1%).Other studies (De Lahunta & Glass , Negrin et al . , Lowrie ) consider that the outcome of animals with peripheral lesions is better than of animals with central lesions but our data does not support this assumption. The bias in our study arising from MRI examination of the head as an inclusion criterion would exclude dogs with mild peripheral vestibular signs that are most likely to recover without a complete diagnostic work‐up.…”

Doenças de asininos e muares no semiárido brasileiro

“…Dos casos interpretados como de origem traumática, todos foram secundários a traumatismo cranioencefálico. À semelhança dos resultados encontrados nesse estudo, doenças inflamatórias e neoplásicas também foram as categorias mais prevalentes em um estudo recente sobre doenças vestibulares em gatos (Negrin et al 2010 (Schunk & Averill 1983). A ausência de anormalidades físicas da membrana timpânica e alterações radiográficas da bula timpânica ou porção petrosa do osso temporal, hormônios tireoidianos dentro dos parâmetros de referência, ausência de histórico de trauma ou ingestão de medicamentos tóxicos foram os critérios utilizados para fazer o diagnóstico da doença vestibular idiopática, ou seja, por exclusão das principais enfermidades supracitadas (Schunk & Averill 1983).…”

Concurrent idiopathic vestibular syndrome and facial nerve paralysis in a cat

“…Idiopathic vestibular syndrome and idiopathic facial nerve paralysis are diagnoses of exclusion . MRI is considered the gold standard for investigation of intracranial causes of vestibular dysfunction . Furthermore MRI provides soft tissue contrast that radiography and computed tomography cannot, allowing better assessment of neoplastic and inflammatory conditions of the ear …”