Ataxia is the loss of control of bodily movements. There are many causes such as poisoning, trauma, parasites, nerve damage and infection, which can originate from the brain, ear or sensory dysfunction.
Symptoms can include a wobbly (drunken) gait, swaying, tremors, high stepping gait.
Treatment is aimed at finding and addressing the underlying cause as well as supportive care such as fluids, nutritional support, anti-inflammatories and medications to manage symptoms.
What is ataxia?
Ataxia (pronounced a-tak-sia) is defined as a loss of muscle coordination (incoordination/unsteady gait). This is caused by disorders which affect your cat’s sense of motion and it is a symptom of an underlying condition and not a disease in itself. There are three types of ataxia in cats, cerebellar, vestibular and sensory.
Cerebellar – The cerebellum is a part of the brain responsible for balance and coordination, this type of ataxia occurs when the cerebellum becomes damaged or inflamed.
Vestibular – The vestibular system located deep within the inner ear as well as nerves which travel to the brain. The vestibular system is the sensory system responsible for balance.
Sensory – This type of ataxia relates to a loss of proprioception, the sense of position and movement of the body. For example how a person can touch the tip of their nose with a finger even if their eyes are closed. This is due to dysfunction or damage to the nerves of the spinal cord.
There are a number of causes of ataxia in cats, some causes can overlap between the types of ataxia.
Viral infection such as panleukopenia or feline infectious peritonitis
Parasitic infection of the brain including toxoplasmosis, Cuterebra spp larvae
Any damage to the brain which results in invasion into the brain tissue including bleeding from stroke or trauma, tumours such as lymphoma, meningioma, or a loss of blood supply to the brain
Toxins including chocolate, lead, mercury, marijuana, barbiturates, bromethalin, ethylene glycol (antifreeze), ethanol, snail bait, ivermectin and pesticides
Cerebral hypoplasia – Damage to the cerebellum prior to birth can cause ataxia. Kittens can be affected if they’re exposed to the panleukopenia virus in utero. Other causes include prenatal exposure to toxins and malnourishment of the mother during pregnancy
Meningitis – Inflammation of the meninges which are the protective membranes covering the brain and spinal cord
Encephalitis – Inflammation of the brain
Glycogen storage disease – An inherited condition in Norwegian Forest cats in which the body lacks the necessary enzymes to eliminate unwanted substances from the body
Idiopathic (no known cause), seen more commonly in older cats
Spinal trauma – Most often caused by a motor vehicle accident or a high fall
Nerve damage due to diabetes
Blocked blood vessel (spinal stroke)
Symptoms can vary depending on the type of ataxia your cat has as well as the underlying cause. Balance and coordination disturbances are the most common finding in cats with ataxia.
Generalised symptoms of ataxia:
Clumsy drunken type movements, staggering wobbly gait
Leaning to one side
High stepping gait (known as goose-stepping)
The head may be tilted to one side and the eye movements may be affected
Vomiting (particularly with vestibular ataxia)
Nystagmus, abnormal eye movements in which the eyes dart back and forth
Walking in circles and possibly falling over
Stiff legged gait, front legs may be rigid while the hind legs are splayed wide apart
Poor coordination, misplacing feet
Anorexia (loss of appetite)
Other symptoms may vary depending on the underlying cause of ataxia. For example, a cat high on catnip might also drool and roll on the floor, a cat who has ingested toxins may vomit.
Your veterinarian will perform a complete physical examination of your cat and obtain a medical history from you. He may ask some questions about your cat, has he had access to any poisons, is he on any medications, how long has the ataxia been present, what are you feeding your cat, has he been in any recent accidents?
Other symptoms your cat may display can also give an indication of the possible cause. For example, if he has apparent head injuries or signs of trauma.
Tests he may perform include:
Complete blood count, biochemical profile, and urinalysis to evaluate organ function and look for any abnormalities in the blood cells, look for signs of infection, inflammation, low blood calcium or glucose.
Otoscopic examination of the ears to look for signs of ear infection, polyps, foreign objects.
A cerebrospinal tap may if encephalitis is suspected.
CT scan to look for polyps deep within the middle ear.
Radiographs or ultrasound to evaluate for tumours, portosystemic shunt or fluid buildup (FIP).
Head radiographs or ultrasound to look for possible tumours, water on the brain.
Blood tests for toxoplasmosis.
Fecal tests to look for toxoplasma oocysts.
Treatment depends on the cause of ataxia, severe cases may require hospitalisation.
Supportive care such as fluids, nutritional support, and anti-nausea medications, anti-inflammatories and analgesics as well as treatment to address the underlying cause. Poor coordination can make eating and drinking difficult for your cat, so hand feeding may be required. Cats who are having severe problems moving may need to be turned every two hours to avoid bed sores.
Severely affected cats may have toileting accidents, so the caregiver must be diligent in checking bedding for urine or feces and removing promptly. Litter trays should be placed in close proximity to your cat, however, in some cases, the caregiver may need to regularly place the cat in the litter tray if he is not mobile enough to make his own way there.
Different methods are used to treat poisoning depending on the cause but may involve activated charcoal to absorb some of the poison, stopping the medication if that is the cause, inducing vomiting and stomach lavage.
This is only temporary and your cat will quickly recover. Catnip doesn’t cause any harm to your cat and is fine to eat (and enjoy).
Your veterinarian will assess the extent of the injury. Cleaning up the wound may be all that is necessary, more severe injuries may require surgery. If the brain has been damaged, this may or may not recover.
Feeding your cat a balanced diet, in severe cases, thiamine injections may be necessary.
There is no cure for this condition, however, most kittens born with this condition can live a full and happy (albeit wobbly) life.
Treatment and outcome depend on the severity of the injury.
Treating the underlying cause as well as managing symptoms such as administration of Vitamin D and calcium gluconate.
Lysosomal storage disease
There is no treatment for this disease and the prognosis is poor, in some cases, it can be temporarily managed with diet but ultimately it is fatal.
Drugs to control symptoms, corticosteroids to reduce inflammation but unfortunately in severe cases, euthanasia is the only option.
Surgery, and radiation to treat brain tumours.
Surgery or medical management such as dietary changes.
Sadly FIP is almost always fatal.
Fluids, nutritional support and blood transfusions to treat panleukopenia.
Surgery to remove the polyps.
Intensive supportive care.
Glycogen storage disease
Unfortunately there is no cure for this condition and most cats pass away by 18 months.
Administer glucose, find out and treat the cause which may involve re-evaluating insulin dosages for the diabetic cat.
Administer medications as prescribed by your veterinarian.
Keep your cat confined to the home and away from stairs.
Contact your veterinarian if your cat’s symptoms worsen.