What do we know about diagnosis and treatment of idiopathic vestibular syndrome in dogs and cats : Do we really know what we are doing?

Idiopathic vestibular syndrome (IVS) is a diagnosis of exclusion, with
unclear aetiology, diagnosis and therapy. The aim of the current study
was to better characterize and define IVS, its diagnosis and treatment.
One-hundred-thirteen boarded neurology specialist participated
in an online survey. IVS definition differed, but IVS was
generally defined (n=103) as an acute to peracute onset ‘peripheral’
vestibular syndrome. As gold standard for diagnosis of IVS neurological
exam (NE), MRI, serum biochemistry (SB), complete blood count
(CBC), otoscopy, blood pressure (BP), CSF, T4/TSH were chosen.
There were discrepancies choosing the five most important diagnostics:
North-America, dogs: NE, MRI, SB, CSF, CBC /cats: NE, SB,
MRI, otoscopy, BP; EU, dogs: NE, otoscopy, SB, T4/TSH, MRI, CBC
/cats: NE, otoscopy, SB, MRI, BP. UK, dogs: NE, MRI; T4/TSH, SB,
otoscopy / cats: NE, MRI, SB, BP, otoscopy, SB and CSF. Interestingly,
there was a relative consensus for treatment: IV fluids and
antiemetics. Additional mentioned drugs varied: propentofylline
(only mentioned in the EU) and betahistine, (mentioned in all regions
by single individuals). Despite IVS being a common presentation in
practice, opinions about its definition, diagnosis and treatment differ.
To the authors knowledge there has been no controlled study into
IVS treatment, only into diagnosis. The current study summarises
expert opinion and can provide a basis for future studies into diagnosis
and treatment.