EXPRESS: Lack of Association Between Inner Ear FLAIR Suppression on MRI and Laterality of Clinical Signs in Feline Idiopathic Vestibular Syndrome.

Feline IVS MRI findings do not reliably correlate with clinical lateralization, suggesting different pathophysiology than dogs.

This study investigated whether feline idiopathic vestibular syndrome (IVS) exhibits similar MRI findings to canine IVS, specifically examining fluid-attenuated inversion recovery (FLAIR) suppression patterns as indicators of altered endolymph composition. Twenty-five cats with IVS and lateralized clinical signs underwent brain MRI with manual region of interest analysis on T2-weighted and FLAIR sequences. Unlike previous canine studies where 93% of affected ears showed reduced FLAIR suppression corresponding to clinical lateralization, no such correlation was found in cats. Only 14 of 25 cats (56%) demonstrated abnormal MRI findings ipsilateral to clinical signs, while 11 cats (44%) showed discordance. Inner ear structure measurements similarly revealed no consistent association with clinical lateralization. These findings suggest that feline IVS may have different underlying pathophysiology compared to canine IVS, potentially involving mechanisms beyond endolymph composition changes detectable by conventional MRI sequences.

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