My Cat is Suddenly Losing His Balance and Walking Like He’s Drunk

You wake up one morning and notice your precious feline is having difficulty getting up. Once he’s standing on all fours, he has an odd head tilt and starts walking sideways before losing balance and falling over.

Loss of coordination, or ataxia, can affect the head, legs, or trunk of your cat. It’s a condition of the nervous system that happens when your furry friend loses sensory function.

Depending on where the abnormality occurs, there are three basic types of ataxia.

• Sensory or proprioceptive ataxia occurs when your kitty loses unconscious awareness of where the body is in space. Here, movement will appear abnormal and difficult.
• Vestibular ataxia involves a loss of balance because of abnormal functioning in the vestibular system or the brainstem.
• Cerebellar ataxia happens when there’s a localized lesion in the cerebellum that affects fine motor movement and coordination. Cats suffering from this form of ataxia appear normal at rest but show exaggerated movements and fine head tremors.

Which conditions can cause a cat to suddenly lose balance? (Ataxia)

When your cat shows signs of ataxia, should contact your veterinarian, and schedule an appointment. The doctor will give your kitty a general exam, run some blood work, check his nervous system, and may run some other tests to determine the cause. There are several possible causes of ataxia. Below, we’ll describe the most likely rule-outs.

1. Vestibular Disease

Vestibular disease is one of the most common causes of ataxia in felines. The vestibular system includes a fluid-filled part of the inner ear called the cochlea and a part of the brainstem that helps your cat maintain balance.

Common signs

• Difficulty standing
• Walking like drunk
• Balance issues
• Head tilt to one side
• Leaning against furniture and walls for support
• Painful meowing
• Rolling on the floor
• Nystagmus or rapid eye movements
• Circling to one side
• Stumbling and disoriented
• Facial drooping
• Nausea and vomiting
• Lack of appetite
• Unusual loud meowing

Severity of vestibular disease

While alarming, vestibular disease and its symptoms are usually short-lived and harmless. However, some causative conditions range widely in severity. Disorders that trigger the symptoms include:

• drug toxicity
• infection
• tumors – benign or cancerous
• inflammation
• injury

Treatment & recovery

How your veterinarian treats vestibular disease in your cat will depend on the diagnosis.

• Idiopathic – If there’s no identifiable cause, there’s no specific treatment. However, your kitty should receive supportive care and be kept in confinement to prevent injury. Support may include fluids, assisted feeding, and anti-nausea medicine if needed.
• Toxicity – If the problem is toxicity or an adverse drug reaction, your veterinarian should run diagnostic tests to identify the toxin and administer the antidote or supportive treatment.
• Infection – A bacterial inner ear infection that affects the vestibular canal can be treated with antibiotics.
• Tumors – Depending on the type and location of the tumor that’s affecting the vestibular system, your doctor may recommend surgery to remove the growth or medical treatment to kill the cancerous cells.
• Inflammation – With inflammation, your kitty should have a course of anti-inflammatory drugs.
• Injury – If your cat has a brain injury that affects the vestibular system, he’ll need first aid and supportive care that treats the injury.

In most cases, cats with vestibular syndrome have a highly favorable prognosis with proper diagnosis and treatment. However, if there’s a severe injury or cancer, your furbaby’s prognosis is guarded.

2. Cognitive dysfunction

Cognitive dysfunction syndrome (CDS) or feline senile dementia is a degenerative condition of aging cats. There’s no known cause. According to a 2011 study, nearly one-third of cats 11-14 years old and as many as 50% of cats 15 and older have signs of CDS.

Common signs

The signs of CDS follow the acronym DISHAAL:

• Disorientation
• Changes in Interactions
• Sleep-wake cycle disruption
• House soiling or loss of litter box control
• Changes in Activity
• Anxiety and vocalization
• Learning or memory loss

Severity of cognitive dysfunction

Comparative to Alzheimer’s in humans, CDS is a progressive disease that grows in severity.

Treatment & prognosis

While there is no known cure for CDS, there are things you and your veterinarian can do to increase your cat’s quality of life.

• Your veterinarian may prescribe extra-label treatment with a drug called selegiline to increase dopamine levels in the brain.
• If needed, the doctor may give your cat anti-anxiety medications like Clomipramine (Anafranil) or Fluoxetine.
• At home, you can feed a diet rich in nutrients that may help slow the progression of the disease. Look for food that includes.
  • Omega-3 fatty acids
  • Antioxidants
  • Beta-carotene
  • Vitamin E
  • A-lipoic acid
  • L-carnitine
• You can also provide mental stimulation and interaction with your kitty at home. By maintaining a routine and providing toys that stimulate the brain, you may boost cognitive function.

CDS is a progressive, terminal disease, but treatment may slow the advancement of the disease and improve your cat’s quality of life.

3. Seizures

A common neurological condition in cats, seizures occur when a burst of uncontrolled electrical impulses surges through the front of the brain. While they can occur in any age feline, they’re more likely in middle-aged and older cats. The most common cause of seizures is epilepsy, but other factors can also trigger them.

Common signs

Read our article: What seizures look like in cats. The primary signs include:

• Loss of consciousness
• Uncontrolled crying
• Rigid extension of the legs
• Drooling or excessive salivation
• Fluttering or twitching of the eyes, eyelids, or whiskers
• Disorientation
• Involuntary defecation and/or urination
• Champing, chewing, or tongue biting
• Cessation of breathing

Following a seizure, your cat may appear out of it and may not recognize you or its surroundings. Learn more: What seizures look like in cats.

Severity

The severity of the seizure can range widely depending on the cause and whether it affects a focal part of the brain or the entire frontal lobe. Some causes of seizures are reversible with the appropriate care and treatment.

Treatment & recovery

Treatment options start with supportive and emergency care. Follow-up care and medications depend on the diagnosis of an underlying cause for the seizures.

• Emergency care – If your cat has a seizure while at the clinic, your veterinarian will give him diazepam or phenobarbital to help shorten the duration.
• Supportive care – Afterward, he may offer oxygen or fluids as needed and provide a heating pad to help regulate your kitty’s body temperature.
• Follow-up care – After the seizure is done, your veterinarian will provide treatment based on the diagnosis. If there’s an infection, he will administer antibiotics. For lead or other toxicity, he will provide medications to reverse the effects. If your furbaby had epilepsy and repeated seizures, he will prescribe an anticonvulsant drug such as.
  • Clonazepam
  • Diazepam
  • Gabapentin
  • Phenobarbital
  • Levetiracetam
  • Zonisamide

The prognosis for seizures depends on whether they’re triggered by a reversible or long-term condition. Sometimes, seizures will not occur again once the underlying cause is resolved. For cats with epilepsy, the condition is lifelong but often manageable with medication.

4. Feline infectious peritonitis (FIP)

Feline infectious peritonitis (FIP) is caused by feline coronavirus (this is not COVID-19). It’s highly infectious among cats but does not cross over to other species. Depending on the cat population, The feline coronavirus prevalence ranges from 36 to 75% with the higher prevalence occurring in catteries or multiple-cat households. Of those with coronavirus, only about 10% will develop FIP.

Common Signs

• Unexplained fever
• Vomiting and diarrhea
• Loss of appetite
• Weight loss
• Fluid build-up in the chest and abdomen
• Difficulty breathing
• Lethargy
• Neurologic signs – wobbly gait and blindness
• Seizures

To diagnose FIP, your vet may conduct a polymerase chain reaction (PRC) which can detect small amounts of a virus. A blood test or X-ray may be used, but these are nonspecific.

Severity

FIP currently has no known cure. It is a progressive disease that goes from bad to worse and will end in death.

Treatment & recovery

Treatment for cats with FIP is supportive and meant to keep your feline as comfortable as you can. Your veterinarian may prescribe corticosteroids to reduce inflammation and broad-spectrum antibiotics to prevent secondary infection. Other than that, strive to keep your kitty warm and comfortable. Unfortunately, FIP is almost always fatal.

5. Strokes

A stroke occurs when normal blood flow to a part of the brain is disrupted either by a clot or a blood vessel rupture. It may occur in response to another condition, like a parasite or tumor, or have no identifiable trigger.

Common signs

• Unequal pupil size
• Head tilt
• Ataxia and loss of balance
• Muscle spasms
• Confusion
• Circling
• Head pressing
• Behavioral changes
• Depression
• Weakness
• Abnormal eye movements
• Coma

Severity of strokes

The severity of a stroke can vary based on the location, length, and extent of blood flow disruption. Additionally, early treatment and supportive care reduce the severity of a stroke’s long-term effects.

Treatment & recovery

Early supportive treatment can include:

• Oxygen therapy
• Intravenous fluids
• Anti-seizure or anti-inflammatory medications
• Comfort support and help with cleaning up involuntary urination and defecation

Long-term treatment may involve

• Treating the underlying cause if it can be identified
• Physical therapy to determine and address ongoing neurologic deficits

Prognosis following a stroke depends on the primary cause and the extent of brain damage caused by the stroke. If vital areas of the brain are affected, euthanasia may be the best option.

When should I see a vet

If your cat is walking like it’s drunk or having trouble standing, contact your veterinarian as soon as possible. While the symptoms may point to vestibular syndrome, they are also common with more serious conditions like a stroke. It’s imperative that you get your kitty in for an exam so that he can get the treatment he needs.

What will my vet do if my cat has balance issues?

When you take your cat to the veterinarian because he’s losing balance and walking funny, the doctor will:

• Collect a history
• Perform a general physical exam
• Conduct a neurological assessment
• Examine the ears with an otoscope for
  • Infection
  • Inflammation
  • Tumors and your doctor finds it
  • Possibly take a CT scan or MRI if needed, and the equipment is available

Based on the findings of the examination and testing, your vet will recommend a course of treatment.

How frequent is vestibular disease in cats?

Vestibular disease doesn’t seem to affect a particular age, sex, or breed. However, there is usually a seasonal increase during the summer months.

As the top rule out for balance problems and ataxia in cats, vestibular disease is something you should understand. Let’s look at the types, symptoms, and causes of this syndrome.

How does my cat’s vestibular system work?

The vestibular apparatus of the inner ear has a series of fluid-filled tubes that communicate with a part of your cat’s brain stem. Together, these two components regulate your kitty’s balance and sense of direction and orientation.

Types of vestibular disease in cats

Vestibular disease can be central or peripheral. These types can vary in severity.

• Central vestibular disease is based in the brainstem and is usually a more serious form of the disease.
• Peripheral vestibular disease involves the inner ear or the nerve pathway toward the brainstem.

General symptoms of vestibular disease in cats

The onset of vestibular disease symptoms is usually sudden and can be disconcerting. Usually, the condition resolves, so it’s not a cause for major concern.

• Rhythmic eye movement (nystagmus)
• Difficulty standing up
• Circling or walking sideways
• Head tilt
• Vocalizing
• Nausea and vomiting

Potential causes of vestibular disease in cats

We can’t always identify the cause of vestibular disease. However, there are some common explanations for the condition.

1. Ear infections

Usually, ear infections in cats aren’t very common. Sometimes the infection involves the outer ear (Otitis externa) and other times it includes the middle ear (Otitis media).

Symptoms

Cats with ear infections can display some signs that are like vestibular disease along with Scratching the ear

other symptoms:

• Disorientation
• Loss of balance
• Head tilt
• Shaking of the head
• Yellow or black discharge – if it looks like coffee grounds, your cat probably has mites
• Swelling and redness of the ear canal and pinna
• Waxy buildup
• Strong odor

Causes

If your kitty doesn’t have ear mites, it’s hard to pinpoint the cause. Other potential causes for ear infections include:

• Yeast or bacterial overgrowth
• Wax or hair buildup in the ear canal
• Allergies
• Autoimmune issues
• Tumors or polyps in the ear canal
• Eardrum rupture
• Foreign bodies like grass awns
• Diabetes mellitus

Treatment Options

For external ear infections, your veterinarian will prescribe ear drops to treat the underlying cause. If your kitty has a middle ear infection, the vet may start with an injectable antibiotic and prescribe oral medications for follow-up at home.

2. Cerebellar Hypoplasia

With cerebellar hypoplasia, the brain fails to develop normally. The affected part, or cerebellum, is the area of the brain that helps control balance, coordination, and fine motor skills.

Causes

Cerebellar hypoplasia is caused by the feline panleukopenia virus. When this virus infects a pregnant queen, it can pass through the placenta to the developing kittens. During the final weeks of pregnancy and the first few weeks after birth, the virus attacks the dividing cells in the cerebellum.

Symptoms

You probably won’t notice symptoms until affected kittens are old enough to stand and walk around on their own. Signs vary depending on the severity of the infection and can include:

• Uncoordinated walking
• Jerky movements
• Swaying from side to side
• Goose stepping
• Mild head tremors

Treatment

There is no treatment for this condition.

3. Tumors or growths

While not a common cause of vestibular disease in cats, it is a consideration, particularly if your kitty is older. Any growth, cyst, or polyp that affects the inner ear or brain stem can impact the vestibular system.

Symptoms

Tumors or growths of various kinds can be cancerous or benign. If they impinge on or affect the vestibular system, you may see:

• Head tilt
• Confusion or disorientation
• Ataxia
• Circling
• Nausea and vomiting
• Nystagmus

Causes

The presence of a growth or tumor means there is abnormal cell growth. It can be caused by an environmental or biological factor like:

• UV radiation
• Viruses
• Chemical pollutants
• Genetics
• Hormones

Treatment options

The treatment depends on the cause of the tumor. Cancerous growths call for radiation or chemotherapy, while some cysts require antibiotics.

4. Trauma

If your kitty experiences head trauma that affects the middle or inner ear, it can negatively affect the vestibular system.

Symptoms

The symptoms of trauma to the middle or inner ear include:

• Head tilt
• Nystagmus
• Balance issues
• Reluctance to walk
• Exaggerated movements

Causes

Trauma to the middle or inner ear is usually caused by an ear infection or a ruptured eardrum.

Treatment options

When a cat ruptures their eardrum, treatment begins with flushing the ear canal, usually under sedation. After that, and depending on the physical exam findings, your veterinarian may administer:

• Topical or oral antibiotics
• Antifungal treatments
• Corticosteroids to control pain and inflammation
• Surgical repair if indicated

5. Ototoxic medicines

There are some medications that exert toxic effects on the hearing and vestibular nerves of some cats. That’s why it’s always important to consult your veterinarian before giving any medications to your kitty.

Symptoms

Ototoxicity can be unilateral or bilateral. The symptoms of ototoxicity resemble those listed above for ear trauma.

Causes

Drugs that can have ototoxic effects include:

• Some antibiotics
• Diuretics like furosemide
• Chemotherapeutic drugs

Treatment

There is currently no treatment for ototoxicity.

6. Hypothyroidism

Hypothyroidism occurs when a cat’s thyroid gland doesn’t produce enough thyroid hormone. In some felines, it’s a congenital (from birth) condition, while others develop it later in life.

Symptoms

Symptoms can vary depending on whether the condition is acquired or congenital. They include:

• Mental dullness
• Lethargy
• Wobbly gait
• Abnormal or stunted growth
• Thin fur or hair loss
• Dry or scaly skin
• Weight gain

Causes

The causes depend on the type of hypothyroidism:

• Incomplete thyroid development
• Iodine deficiency
• Hyperthyroid medicines (iatrogenic)

Treatment

Your veterinarian will prescribe an oral thyroid medication that supplements the thyroid levels in the blood.

7. Vitamin Deficiencies

Thiamine deficiency affects the Central Nervous System, resulting in lesions of the oculomotor and vestibular nuclei, the caudal colliculus, and lateral geniculate nucleus.

Symptoms

The earliest neurological sign is vestibular ataxia, progressing to seizures, dilated nonresponsive pupils, and ultimately coma.

Causes

The main causes of thiamine deficiency include:

• the inability to absorb thiamine
• the inability to process thiamine
• decreased level of thiamine in food

Thiamine is destroyed by the heating process for food preparation, meat preservatives which inactive the thiamine, and feeding food rich in thiaminase.

Treatment

There are two methods to increase thiamine with a deficiency, depending on the severity. For less severe cases, owners can increase thiamine supplementation via nutrition. For more severe cases, Thiamine may need to be administered via IV.

How can I make my home safer for my cat if he has balance issues?

Depending on the severity of the ataxia symptoms, cats suffering from balance issues may need to be confined to a crate while they’re undergoing treatment. Otherwise, your kitty should be kept in a padded area that has no access to stairs, ledges, or other drops.

Frequently asked questions

How can I tell if my cat has an ear infection?

If your cat has an ear infection, you’re likely to notice:

• Head shaking
• Rubbing at or scratching the ear
• Redness around the ear
• Head tilt
• Excessive, dark brown ear wax
• Black or yellow discharge
• Foul or unpleasant odor

Contact your veterinarian if you notice these symptoms. He can examine the ear canal and confirm the diagnosis.

How can I tell if my cat had a stroke?

If your cat has a stroke, the symptoms are similar to vestibular disease and include:

• Abnormal eye movements
• Falling over to one side
• Circling
• Unsteady gait or ataxia
• Balance issues
• Head tilt
• Head pressing
• Muscle spasms
• Unequal pupil sizes

Any time you notice signs like these, contact your veterinarian. She can conduct an exam and run tests to help rule out other potential causes and confirm the diagnosis of a stroke.

What does a seizure in a cat look like?

Usually, a single seizure will have a short duration. It usually starts with your kitty collapsing on the ground and having rigid limbs. After this, she may have convulsions or uncontrolled muscle contractions and appear to be paddling. Some cats will snap and champ their jaws. Others lose bladder and bowel control.

Will wobbly kitten syndrome go away?

Wobbly kitten syndrome is another term for cerebellar hypoplasia. This condition won’t go away because it’s congenital. However, kittens and cats with the syndrome can thrive and live full lives.