Vestibular syndrome

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The vestibular syndrome ( vestibular syndrome ) is understood to mean the occurrence of a typical combination of pathological symptoms that are associated with disorders of the organ of equilibrium (also the vestibular apparatus). Vestibular syndrome occurs primarily in dogs and cats and is one of the most common neurological diseases in these pets. The syndrome manifests itself in sudden onset of symptoms such as eye tremors, head tilt, unsteady gait and vomiting. Similar symptoms occur in humans with diseases of the inner ear such as Menière's disease or vestibular neuritis .

causes

A number of different causes can be considered as triggers for vestibular syndrome. Depending on the localization of the underlying disease, a distinction is made between two basic types, which can be easily distinguished from one another on the basis of the different severity of the symptoms: the peripheral and the central vestibular syndrome. While the rarer, central vestibular syndrome is due to infections (e.g. distemper , FIP , toxoplasmosis ) and inflammatory processes ( encephalitis ) or lesions in the area of ​​the central nervous system or brain stem , the more common, peripheral vestibular syndrome is due to problems in the periphery of the inner ear responsible, which directly affect the organ of equilibrium. The peripheral vestibular syndrome is also often based on inflammatory processes, which can result from ascending middle ear infections, especially in cats but also from polyps and, more rarely, tumors. If the peripheral vestibular syndrome is due to a hereditary malformation of the organ of equilibrium, one speaks of a congenital vestibular syndrome , which occurs even in small puppies or kittens. On the other hand, degenerative processes in old dogs often lead to the development of a geriatric vestibular syndrome . Disorders of the endolypatic flow caused by thickening of the perilymph in the area of the semicircular canals , but also autoimmunological processes, circulatory disorders and drug-induced intoxication (poisoning) of the inner ear are discussed as triggers for this . The exact cause is not yet known, so one speaks of idiopathic vestibular syndrome as an alternative . In rare cases, an underactive thyroid ( hypothyroidism ) can lead to the development of a vestibular syndrome.

Symptoms

The vestibular syndrome occurs in the form of mostly one-sided, neurological deficits that are reminiscent of stroke symptoms in humans. The animal has balance or coordination disorders ( ataxia ), can sometimes no longer stand on its legs, often shows a noticeable tilt of the head, the eyes squint ( strabismus ) or have aimless, rhythmic eye movements ( nystagmus ). The symptoms are directly related to the damage to the equilibrium apparatus. The animal can no longer orient itself in space and suffers a more or less pronounced attack of dizziness, which often also causes nausea and vomiting . The animals often appear disoriented and shiver. In milder forms, the symptoms are less clear, the animals show gait abnormalities, but can cope with the dizziness to some extent and behave relatively normally.

Diagnosis and treatment

The vestibular syndrome can be recognized quickly on the basis of the striking symptoms (especially nystagmus, head tilt, ataxia, vomiting). The veterinarian will try to localize the disease (central or peripheral vestibular syndrome) based on anamnesis , otoscopy and neurological examinations and to determine the cause of the disease using differential diagnosis. Further examinations (e.g. blood tests, MRI ) may be required for this. Treatment is often aimed at first relieving symptoms, particularly in idiopathic vestibular syndrome. B. by antiemetics , infusion therapy that stimulates blood circulation, possibly also sedatives . If an underlying disease can be diagnosed, this determines the course of further treatment.

Treatment prospects (prognosis)

The prognosis of vestibular syndrome depends on the localization of the disease. While central vestibular syndrome often indicates serious and difficult-to-treat illnesses, peripheral vestibular syndrome is often easy to manage. Idiopathic vestibular syndrome, which regularly - sometimes spontaneously, without treatment - disappears completely within a few days to two weeks, shows the best prospects. However, recurrences are possible. In some cases, the head may be slightly tilted, but this does not seem to affect the quality of life of the animal any further.

Individual evidence

  1. ↑ AF Koutinas (α Φ Κουτινας), AM Danourdis (α Μ Δανουρδης), ZS Polizopoulou (ζ Σ Πολυζοπουλου): Canine and feline vestibular syndrome . In: Journal of the Hellenic Veterinary Medical Society . tape 57 , no. 1 , November 27, 2017, ISSN  2585-3724 , p. 63–68 , doi : 10.12681 / jhvms.15011 ( ekt.gr [accessed February 6, 2019]).
  2. ↑ The Vestibular Syndrome in Dogs and Cats Vertigo and Staggering - by Dr. Tanja Steinberg. Retrieved February 6, 2019 .
  3. ^ A b c Elisabeth Posselt: The idiopathic vestibular syndrome in old dogs. Ludwig-Maximilian University of Munich, July 19, 2017, accessed on February 6, 2019 (German).
  4. ↑ a b c d e f g h i j Susanne Steenbeck: Retrospective analysis of prognostic factors in the canine vestibular syndrome. Ludwig-Maximilian University of Munich, July 20, 2007, accessed on February 6, 2019 (German).
  5. ↑ a b c d Clinic for Small Animals: The Vestibular Syndrome. Justus-Liebig University of Giessen, accessed on February 6, 2019 .
  6. ↑ John H. Rossmeisl: Vestibular Disease in Dogs and Cats . In: Veterinary Clinics of North America: Small Animal Practice (=  Diseases of the Brain ). tape 40 , no. 1 , January 1, 2010, ISSN  0195-5616 , p. 81–100 , doi : 10.1016 / j.cvsm.2009.09.007 ( sciencedirect.com [accessed February 6, 2019]).
  7. ↑ Laura Harvey: Vestibular Disease . In: Textbook of Small Animal Emergency Medicine . John Wiley & Sons, Ltd, 2018, ISBN 978-1-119-02899-4 , pp. 137–145 , doi : 10.1002 / 9781119028994.ch23 ( wiley.com [accessed February 6, 2019]).
  8. ↑ Knowledge and information - all about dogs. Retrieved February 6, 2019 .
  9. ↑ Mahajan, S. et al .: Idiopathic vestibular syndrome in a Labrador dog and its therapeutic management . Ed .: Indian J. Vet. Med. Vol. 34, No. 2 , 2014, p. 162-163 .