It’s a Tuesday and on your schedule is a cat who cannot blink. Not sure where to start? Good news! Today’s TidBit Tuesday should help you! Let’s jump in…
A study published in the Journal of Veterinary Internal Medicine in Sept/Oct 2026 by Dr. Stefaniuk and associates evaluated idiopathic facial nerve paralysis in cats. We know that this is a common occurrence in dogs, often in concert with vestibular nerve disease, but little is published about cats.
Results:
Thirteen cats met the inclusion criteria. The median age at onset of signs was 2.5 months old. Most cats were outdoor cats, a few exclusively indoor and 5 cats had unknown habitat. Twelve of 13 cats had an initial complaint of a lack of ability to blink. Signs were unilateral in 10/13 cats (77%). Dropping food/salivation was noted in 3/13 cats. Vestibular signs were noted in 8 cats (62%), which is a similar percentage as dogs. Signs of vestibular disease included head tilt, ataxia, head swaying and horizontal nystagmus. Vestibular signs were bilateral for cats with bilateral facial nerve paralysis.
MRI findings
There were a total of 16 clinically affected facial nerves (because some cases were bilateral). Of these 16, 4 (25%) had thickening and 7/16 (44%) had contrast uptake. About half of the cats had digastricus muscle atrophy. When combining all the variables, only 2 of 16 nerves were considered normal on imaging.
CSF findings
CSF was collected in 11/13 cats and revealed a normal TNCC and protein in 10 of 13 cats. The one abnormal CSF analysis demonstrated an increased in mononuclear pleocytosis.
Treatment
Ten of 13 cats received eye lube, 3 of 13 cats received various doses of prednisolone and 1 cat received clindamycin. Follow-up was obtained in 9 cats: 6 with unilateral disease and 3 with bilateral disease. Of the 6 cats with unilateral facial nerve paralysis, 5 were reported by owners to have recovered completely, 1 cat had partial recovery. Of the 3 cats with bilateral facial nerve paralysis, it was an even split: 1 cat completely recovered, 1 cat had unilateral recovery with partial recovery on the other side, and 1 cat did not recover at all. Residual deficits included dropping food, ptyalism, facial asymmetry. All cats with vestibular signs recovered but 1 cat sustained a second event and was euthanized after the second event. The median time to maximal recovery was 4 months.
Key Points:
· Younger cats are more commonly affected than older cats
· Unilateral facial nerve paralysis is more common, but bilateral disease does happen in cats
· Vestibular signs may be seen concurrently with facial nerve paralysis
· Recovery is likely, but owners should anticipate 4+ months to recovery
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