Head Tilt and Disorientation in Cats

Idiopathic Vestibular Disease in Cats

Head tilt is a medical condition that may be indicative of a serious underlying disorder, usually of the vestibular system. If a cat is tilting its head frequently to either side of the body (away from its orientation with the trunk and limbs), this is an indication that the cat feels imbalanced. The cat may even struggle to retain a balanced posture and fall.

A common cause of head tilting in cats are disorders of the vestibular system, a sensory system located in the inner ear which provides information needed to hold the body in an upright position and move about confidently. In essence, the vestibular system "tells the body where it is in relation to earth— whether it is upright, up-side-down, moving, being still, etc.

Symptoms and Types

• Abnormal head posture

• Head tilt to either side

• Stumbling, lack of coordination (ataxia)

• Constantly falling over

• Eye movements erratic, apparent inability to focus

• Circling (turning in circles)

• Nausea, vomiting

Causes

Although the underlying cause for vestibular disease is unknown, the following factors may contribute to the condition:

• Ear injury

• Brain disease

• Metabolic diseases

• Neoplasia (abnormal tissue growth)

• Nutritional deficiencies (e.g., thiamine deficiency)

• Toxicity (e.g., use of toxic antibiotics in the ear)

• Inflammation of the central and inner ear canal due to bacterial, parasitic, or other type of infection

Diagnosis

Your veterinarian will perform a complete standard physical exam, including a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel. You will also need to give a thorough background history of your cat's health leading up to the onset of symptoms. The results of the blood tests are usually normal, though changes may be present depending on whether there is an existing disease, such as an infection. Further tests will be required to diagnose underlying systemic diseases like thyroid problems, and infections.

Nutritional status will be evaluated, and you will need to recount your cat's normal diet, along with supplements or additional foods you may have fed to your cat. Thiamine deficiency, for example, can be the result of feeding your cat food that does not have B1, the source for thiamine, in its ingredients. Thiamine deficiency can also result from over consumption of raw meats and fish.

To determine if an ear infection is present, your veterinarian will thoroughly examine your cat's ear canal and will take a sample of the material present within the ear canal for further testing. Visual diagnostic tools, X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) may be required to confirm a middle ear disease. Another important test used to diagnose this disease is a cerebrospinal fluid (CSF) analysis. (CSF is a clear, watery liquid that surrounds and protects the brain and spinal cord.) The results of a CSF analysis is useful in the diagnosis of inflammation and/or infection within brain. A bone biopsy may also be performed is an advanced test to confirm the involvement of the bone due to tumor or infection.

Treatment

In case of severe disease, your cat may need to be hospitalized for treatment and supportive care. Fluid replacement therapy is required in patients with fluid deficits due to frequent vomiting. These patients don’t require a special diet except in those cases where some nutritional deficiency is present. For example, thiamine supplements are often required in patients with head tilt due to thiamine deficiency.

In some cases, surgery is required to treat the underlying disease. If an ear infection is present, your veterinarian will prescribe broad-spectrum antibiotics that can enter and eradicate the infection in the brain and middle ear.

Living and Management

The prognosis is highly variable depending on the underlying disease. If the head tilt is due to involvement of the ear, chances for complete recovery are fairly high. In some cases, head tilt may persist. You will bring your cat to your veterinarian for regular follow-up examinations. Follow treatment guidelines strictly and give medications at proper doses and time. Incorrectly medicating your animal is one of the most preventable accidents with pets. In addition, do not use any drug of your own, or any drug that has not been approved by your veterinarian, especially in the ear, as it may complicate symptoms further.

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Circling in Hamsters

Hamsters are very active so it’s normal to see them running around their cages and on their exercise wheels. But if your hamster suddenly begins circling and tilting its head to one side while it is running around then this indicates something more concerning. Veterinary care may be necessary if your hamster is circling, so being able to recognize this issue is important for your hamster’s health.

Causes of Circling in Hamsters

Circling in hamsters occurs when a hamster has a head tilt. Head tilts are usually a result of an inner ear infection due to bacteria but other causes may be present.

With an inner ear infection, bacteria from a dirty environment or a respiratory infection enters the ear canal. The pressure that the infection causes inside the ear canal may result in a hamster feeling off-balance and in pain. This results in circling when it walks and some hamsters may even fall over.

Neurological problems due to trauma or a brain disease like epilepsy can also cause circling in hamsters. These issues are not as common as a bacterial infection in the ear but are still possible reasons for this type of behavior.

Diagnosing the Cause for Circling in Hamsters

While circling in hamsters may be an obvious behavior to observe, in order to know for sure what is causing this some tests may need to be run.

Since an ear infection is the most likely reason for the circling, debris from inside your hamster's ear may be looked at under a microscope. This will check to see if bacteria from an infection is present and, if it is, an ear infection will be diagnosed.

Neurological problems are harder to diagnose. If your hamster was recently injured before the circling began then this may mean it suffered head trauma at some point. Being dropped, grabbed by a dog, or crushed in a door or piece of furniture are all types of injuries that may cause head trauma.

Seizures are a symptom that will coincide with epilepsy, another neurological issue. There is no test for epilepsy. In these instances, continued close observation may be required and videoing any unusual behavior could be helpful for your vet.

Treatment of Circling in Hamsters

Persistent or severe circling in hamsters always merits a visit to your veterinarian.

If the behavior is caused by an ear infection, antibiotics that are safe for a hamster to take will need to be prescribed as treatment. Without them, permanent damage can occur to your hamster's ear and the circling may never stop. Infections can also lead to more serious complications that, in extreme cases, can be life-threatening. Oral antibiotics and sometimes pain medications may be needed to treat the infection. If ear debris is visible a gentle cleaning may also be helpful.

If the circling is not due to an ear infection then it may be more difficult to treat. Brain damage from seizures or head injury can be permanent. Some circling will resolve over time on its own but some hamsters may have permanent circling. If the circling is so bad that it affects your hamster's quality of life and it is unable to eat then euthanasia may be discussed.

How to Prevent Circling in Hamsters

Hamsters are small pets that like to hide. It can be difficult to notice when they are acting a little strange in their cages, but regular observation of your hamster's normal activities can help detect the beginning of a problem. This, along with regular cleaning of the cage and washing of the cage accessories, can help prevent ear infections that cause circling.

In order to prevent head trauma that can result in circling, be sure to only allow children to handle your hamster when they are sitting on the ground. This will decrease the likelihood of your hamster falling and getting hurt. When the child is done holding your hamster, either bring the cage to the floor to put them back in it or gently take your hamster from the child so that you can carefully put it back in its cage yourself.

Keep your hamster safe if you have dogs or cats in the house when they are out of their cage and make sure that their cage is secure and locked over at all times.

Accidents can happen but they are far less likely to occur if you supervise carefully and take extra precautions.

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Encephalitis: Brain Inflammation in Dogs

Encephalitis in Dogs

The term encephalitis refers to an inflammation of the brain. However, it also may be accompanied by the inflammation of spinal cord (myelitis), and/or the inflammation of the meninges (meningitis), membranes which cover the brain and spinal cord.

German short-haired pointers, Maltese, and Yorkshire terriers are all found to be predisposed to encephalitis.

Symptoms of Encephalitis

Although symptoms may vary depending on the portion of brain affected, they typically appear suddenly and are rapidly progressive. Such symptoms include:

• Fever

• Seizures

• Behavioral changes (e.g., depression)

• Decreased responsiveness

• Head tilt to either side

• Paralysis of face

• Uncoordinated movements or circling

• Unequal size of pupils (anisocoria)

• Smaller sized pinpoint pupils

• Decreased consciousness, which may worsen as disease progresses

Causes of Encephalitis

• Idiopathic (unknown cause)

• Immune-mediated disorders

• Post-vaccination complications

• Viral infections (e.g., canine distemper, rabies, parvovirus)

• Bacterial infections (anaerobic and aerobic)

• Fungal infections (e.g., aspergillosis, histoplasmosis, blastomycosis)

• Parasitic infections (e.g., Rocky Mountain spotted fever, ehrlichiosis)

• Foreign bodies

Diagnosis of Encephalitis

You will need to give your veterinarian a thorough history of your dog’s health, including the onset and nature of the symptoms, and possible incidents that might have precipitated the unusual behaviors or complications. Your veterinarian may then perform a complete physical examination as well as a biochemistry profile, urinalysis, and complete blood count (the results of which will depend on the underlying cause of the encephalitis).

If your dog has an infection, the complete blood count may show an increased number of white blood cells. Viral infections, meanwhile, may decrease the number of lymphocytes, a type of white cells (also known as lymphopenia). And abnormal reduction in platelets (small cells used in blood clotting) is a good indicator of thrombocytopenia.

To confirm lung involvement and related complications, your veterinarian may require chest X-rays, while MRIs and CT-scans are used to evaluate the brain involvement in detail. Your veterinarian may also collect a sample of cerebrospinal fluid (CSF), which is then sent to a laboratory for cultures. This is necessary for definitive diagnosis and to determine the severity of the problem. If culture assays are unsuccessful, a brain tissue sample may be necessary to confirm the diagnosis, but this is an expensive procedure.

Treatment of Encephalitis

Your veterinarian will focus on reducing the severity of the symptoms, such as brain edema and seizures, and halt the progression of the disease. Severe forms of encephalitis require immediate hospitalization and intensive care. For instance, those suspected of having bacterial infections will be given broad spectrum antibiotics, which can reach the brain and spinal cord.

Living and Management

With proper treatment and care, symptoms gradually improve within two to eight weeks; however, the overall prognosis depends on the underlying cause of the condition. For example, in some dogs, symptoms may reappear once treatment is discontinued. In such instances, a second round of treatment (or long-term treatment) may be required to save the dog's life.

Your veterinarian will schedule regular follow-up exams to evaluate the effectiveness of the treatment and the dog's state of health. Your vet may even recommend a new diet for the dog, especially if it is frequently vomiting or severely depressed.

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