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An Urban Experience
is however superior as CT can visualize subtle changes which are often not detectable on radiographs. For visualization of the brainstem and soft tissue structures adjacent to the central vestibular nuclei, a Magnetic Resonance Imaging (MRI) scan is the diagnostic procedure of choice. If in ammatory or infectious disease of the CNS is suspected, cerebrospinal  uid (CSF) examination should also be performed.
Animals suffering from acute vestibular disease often experience nausea and loss of appetite and may therefore need acute supportive care with  uids and antiemetic’s as well as assisted feeding. If the animal is non-ambulatory it should be held in a protected environment until able to coordinate and ambulate normally.
Table 2: Common examples of vestibular disease
CENTRAL
PERIPHERAL
TREATMENT
infection
+
(Otitis media)
Antibiotics (universal)
Nasopharyngeal polyps
+
(often young cats)
Surgical extirpation
Neoplasm
Affecting brain stem
Affecting middle or inner ear
Surgical extirpation of peripheral neoplasms may be possible
In ammatory CNS disease (non-infectious meningoencephalitis)
+
Long-term steroid therapy
Aminoglycoside antibiotics Metronidazole overdose
Toxicity to inner ear tissue
Stop treatment
Hypothyroidism
Hypothyroidism associated polyneuropathy involving vestibular nerve
Treatment directed against hypothyroidism
Idiopathic
Unknown cause
Unknown cause
None - will resolve spontaneously
References
De Lahunta A, Glass EN, Kent M. Veterinary Neuroanatomy and Clinical Neurology. Third edition. Saunders, Elsevier 2009; 319-347.
Kent M, Platt SR, Schatzberg SJ. The neurology of balance: function and dysfunction of the vestibular system in dogs and cats. Vet J. 2010 Sep;185(3):247-58. doi: 10.1016/j.tvjl.2009.10.029.
Munana KR. Head tilt and nystagmus. In BSAVA Manual of Canine and Feline Neurology. Fourth Edition, eds. Platt S, Olby N. British Small Animal Veterinary Association (BSAVA). Wiley 2013;195-212.
Thomsen B, Garosi L, Skerritt G, Rusbridge C, Sparrow T, Berendt M, Gredal H. Acta Vet Scand (2016) 58:40. DOI 10.1186/s13028-016-0219-2.
42ND WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND FECAVA 23RD EUROCONGRESS


































































































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