This case report describes a 16-year-old male neutered domestic short haired cat that presented for acute ataxia and weakness. History and clinical signs led to the identification of the patient’s three most critical problems: hypertension, hypokalemia, and central vestibular neuropathy. Further diagnostic testing led to a chief diagnosis of Feline Primary Hyperaldosteronism. Resultant pathology in several organ systems was documented, including the kidneys, eyes, brain, and heart. Treatment of primary hyperaldosteronism should be appropriate to the adrenal pathology resulting in the disease and may include adrenalectomy and/or medical management. Pharmacological treatment is aimed at improvement of hypokalemia and reduction of hypertension and the associated risks to various tissues.