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What is Disorientation?

Disorientation can occur acutely, or develop and worsen over time depending on the cause. You may notice that at times, or consistently, your dog is developing what seems to be a struggle to maintain a balanced position, or perhaps all of a sudden his eyes cannot focus and dart back and forth. Disorders related to the vestibular system can be broken down into peripheral and central disease. It is a common neurological condition in dogs, with no predisposition to sex or breed.

Disorientation, head tilt, and loss of balance are all common to an upset in the vestibular system. This system is responsible for maintaining and stabilizing the position of the head (which thereby gives the body stability), and the eyes during head movements. Vestibular disease will interfere with your dog’s entire sense of balance. It is important to take your dog to the veterinarian in order to correctly diagnose the cause and rule out other conditions such as an ear infection, stroke or hypothyroidism.

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Symptoms of Disorientation in Dogs

There are many symptoms associated with vestibular disease. Prompt attention by a qualified primary veterinary caregiver is the best course of action and will result in the most positive prognosis. Schedule a visit for your dog with the appropriate veterinarian without delay if you see any of the following abnormal signs:

  • Head tilt (this can range from mild to severe)
  • Darting eyes (nystagmus)
  • Eyes which are abnormally aligned and may be accompanied by a squint (strabismus)
  • Drooping eyelid or presence of third eyelid (Horner’s syndrome)
  • Facial paralysis
  • Head tremor
  • Circling
  • Falling or rolling to one side
  • Unsteady gait (ataxia) or inability to walk
  • Unable to stand, or uses a wide stance
  • Vomiting or Nausea
  • Development of motion sickness when in a vehicle
Types

Vestibular disorders are either peripheral or central. The vestibular system is an important and critical part of the central nervous system, coordinating an animal's vision (focus) and gravity (detected by skin receptors which pick up on external pressures). The sense of orientation experienced by your pet will be affected by the proper function of these neural systems.


Two of the more common causes of Peripheral Vestibular disease are:

  • Idiopathic vestibular disease

    - This is a peripheral disorder. It presents with acute onset and severe nystagmus (rapid, darting eyes), which causes extreme vertigo because the eyes cannot focus on the horizon. The episode lasts between a few days to a few weeks, and usually the dog can be nursed through the condition with favorable recovery (occasionally a dog will end up with a permanent mild head tilt).. Some owners have been known to confuse idiopathic vestibular disease episodes as seizures. This condition tends to occur in senior dogs and can be called 'The Drunken Sailor Disease' due to the way they walk. Importantly, symptoms should not progress.

  • Inner ear disease

    - Peripheral as well, inner ear disease has a slower progression and those affected may exhibit varying degrees of facial paralysis and Horner’s disease (drooping eyelid). The most common cause is otitis media (inflammation of the inner ear), with bacteria moving into the eustachian tube of the ear. Antibiotics can work well as a cure but may need to be given at high doses and for prolonged periods.


  • Central vestibular disease

    - The prognosis is less optimistic for this type of disorientation in dogs. There can be brainstem damage, leading to cranial, motor, position and movement difficulties. Illnesses such as Lyme disease and liver dysfunction can precipitate central vestibular disease.

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Causes of Disorientation in Dogs

The causes for disorientation in dogs are not always completely understood; further studies will hopefully enlighten the medical field as to some of the mysteries of this condition.

Peripheral vestibular disease


When the ear and/or local nerve are affected, this is referred to as 'peripheral vestibular disease'. Potential causes include:

  • Idiopathic Vestibular Disease
  • Nasopharyngeal Polyps (more common in cats)
  • Neoplasia (growth of abnormal tissues) within the vestibular system
  • Conditions that cause a defect in chemical reactions in the body such as hypothyroidism (which can also cause central vestibular disease)
  • Ototoxicity due to antibiotics
  • Bacteria from otitis media
Central vestibular disease
  • Head trauma
  • Stroke
  • Antibiotic toxicity
  • Neoplasia
  • Thiamine deficiency
  • Granulomatous meningoencephalitis
  • Liver disease (with metabolic brainstem degeneration)
  • Lyme disease
  • Canine distemper
  • Rocky Mountain Spotted Fever
  • Ehrlichiosis, which is a tick-borne bacterial infection
Vestibular syndrome / Idiopathic Vestibular Disease
  • Thought to be a complication of old age, but can be seen in middle-aged dogs
  • Studies show it may be related to inflammation of nerves connecting the inner ear to the cerebellum that controls equilibrium, spatial orientation and body balance

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Diagnosis of Disorientation in Dogs

Prompt veterinary care is essential in order to diagnose the cause of the disorientation that your pet is experiencing. Having no balance, or having the sense of being unable to focus and walk will affect your dog in many ways. The veterinarian will concentrate on making your dog comfortable first and foremost. If the nausea and spatial disorientation are extreme, your veterinary caregiver will administer medication to ease the symptoms. Some pets, who have been too distressed and imbalanced to drink, for example, will be given intravenous fluids to hydrate them and improve their circulation.

The veterinarian will ask for a history of your pet’s behavior over the past weeks, and will want to know if you can pinpoint how and when the symptoms began. The assessment of the nystagmus (eye movement direction, horizontal or vertical for example) can help lead to a diagnosis. 

Ataxia (unsteady gait) may be difficult to interpret because of the stress that your dog is going through as a result of the imbalance issues, and the possible need of support for your dog to be able to walk. A non-slippery surface may be required because your pet will find any flaw in the surface difficult to navigate in his state.

Indications for the veterinarian may be facial paralysis (as in peripheral) or a change in mental activity or weakness on the entirety of one side (as in central). If your veterinary professional is unable to determine the diagnosis of why your pet is disoriented, she may choose further diagnostic tools.

After a complete physical and neurological examination, the veterinarian may decide to analyze baseline diagnostics by checking blood pressure, complete blood count, urinalysis, thyroid level and serum biochemical profile. Examination of the ear canal, or very careful removal of substances of the ear canal (for analysis) may be done.

If the veterinarian has a suspicion of a central lesion, or after a few days or weeks the symptoms are not ceasing, more intensive testing may be ordered. MRI (to image the brain or middle and inner ear) could be ordered to look for central or peripheral disease. If further testing is necessary, a further diagnostic option is a spinal tap to rule out meningitis or encephalitis.

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Treatment of Disorientation in Dogs

It should be noted that some types of disorientation in dogs can clear up on their own while others may point to a more serious condition. A central vestibular disorder generally carries a poorer prognosis for successful treatment because the brainstem area does not respond well to neurosurgery. There are drugs currently under study with the hopes of offering a solution to the disease, as in the case of tumors for example.

In the case of peripheral disorders, the scenario is quite different. Please note the following treatment procedures that may accompany a diagnosis of a peripheral disorientation (idiopathic, inner ear or vestibular syndrome):

  • All treatments will be based on the underlying cause
  • Medication for nausea, vertigo and dizziness may be necessary
  • Intravenous therapy can be utilized if your dog needs fluid recovery because he has not been eating or drinking enough
  • Sedatives are sometimes used to calm dogs as a part of the recovery process
  • Idiopathic vestibular disease tends to resolve with time and the support of the owner
  • The inner ear responds well to antibiotic treatment but the duration of medication must be carefully monitored in order to fully treat the infection
  • Surgery and radiation can be an approach to resolve abnormal tissue growth
  • Complications due to antibiotic toxicity may be eradicated after the antibiotic is stopped
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Recovery of Disorientation in Dogs

As is the case with any time that your pet is ill, follow up with the veterinarian is always part of the equation. The recovery process may be a challenge, but with your care and practical support, your dog can often resume a sense of normalcy. Your primary veterinary caregiver will remind you that patience as you await results is key with a diagnosis of any vestibular complication.

Remain calm and caring at all times. Offer comfort, warmth, and attention. Aid your dog as necessary with his balance needs as he navigates his new 'wobbly' life. Dietary changes might be suggested, as will a follow-up visit at the clinic a few days after the initial appointment. It should be noted that a head tilt may remain, even after your pet recovers. Relapse of vestibular disease may occur, depending on the underlying cause.

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Disorientation Average Cost

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Average Cost

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Written by hannah hollinger

Veterinary reviewed by: Linda S.

Published: 11/16/2015, edited: 03/05/2021

Disorientation Questions and Advice from Veterinary Professionals

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Chihuahua

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10 Years

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Unknown severity

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1 found helpful

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Unknown severity

Has Symptoms

Loss Of Balance

Issue started this morning woke up to my dog trying to vomit and after helping her out noticed she was also having issues standing and holding her balance didn't seem to be having any issues at all the night prior this happened in the morning couldn't find a ny veterinarian open at the moment kept an eyw on her since and she's got way better but still seems a bit disoriented just wondering if there's anything you guys might have an idea could be a reason for this and if it moght be best to visit a veterinarian even though she's made a bog improvement on her own?. Any help would be appreciated.

March 14, 2021

Owner

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Dr. Sara O. DVM

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1 Recommendations

Hello. There are many reasons for this. Neurologic issues such as seizure or stroke, low blood sugar, or something else. It would be best for your vet to see her even if she is improving just to make sure there is nothing underlying going on. I would make sure she is eating and drinking and not having diarrhea. Keep an eye on her until your vet opens and you can have her seen.

March 14, 2021

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pit

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4 Years

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Unknown severity

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3 found helpful

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Unknown severity

Has Symptoms

Walking Into Walls Crying Falling Almost Like Blind

What's wrong with her

Feb. 23, 2021

Owner

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Dr. Maureen M. DVM

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3 Recommendations

Hi, Sorry about that. These are signs of a neurological condition either due to infection of toxins, brain injury, or tumor. For such cases, it would be a good deal to have him thoroughly examined by a vet and some scans carried out to diagnose what could be wrong. Good luck

Feb. 23, 2021

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Labrador R

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Thirteen years

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Unknown severity

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9 found helpful

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Unknown severity

Has Symptoms

Sudden Onset Of Dizziness And Nausea

This started earlier today. Now he stands with a wobble and has thrown up a couple of times.

Dec. 21, 2020

Owner

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Dr. Sara O. DVM

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9 Recommendations

Hello, So sorry to hear about your dog. Some older dogs get Vestibular disease and will walk a little wobbly and be very dizzy. Your vet can prescribe your dog some nausea medications. Many times this will slowly correct with time if there are no underlying issues causing this such as an ear infection. Also, vomiting can be due to dizzyness. YOu can try motion sickness medication that is over the counter called meclazine. If this does not help, your dog will need to be seen by your vet.

Dec. 21, 2020

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Pit Bull

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Eleven Years

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Unknown severity

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3 found helpful

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Unknown severity

Has Symptoms

Wobbly,Stifness,Thirsty ,And No Urination

She's normally like a puppy running and playing ,now she's stif barely moves can't get up without help and wants lots of water but will not urinate

Dec. 19, 2020

Owner

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Dr. Linda S. MVB MRCVS

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3 Recommendations

This is a very big concern indeed. My first thought would be acute kidney failure which can be brought on by a toxicity such as grape or raisin ingestion, but there are lots of possibilities. She needs to see a vet immediately and they will likely run tests such as a blood test. Treatment will then depend on what is found.

Dec. 19, 2020

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Chihuahua

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two

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1 found helpful

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Unknown severity

Has Symptoms

Bobbing Head Lickings Lips Acts Scared

She get doing this like she has gotten ahold of something but it might happen once every few days

Dec. 16, 2020

Owner

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Dr. Michele K. DVM

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1 Recommendations

Thank you for your question. It is possible that your dog is getting into something toxic, or may be having a neurological problem. If this is something that is continuing to happen, it would be best to have her seen by a veterinarian. They will be able to examine her and see what might be causing this, and see what treatments she might need.

Dec. 16, 2020

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Roxy

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German Shepherd

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11 Years

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Mild severity

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0 found helpful

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Mild severity

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Not Responsive

about 1:30 this morning my puppy was on my bed and starting growling and barking at my almost 11 year old german shepherd. I called the shepherd a couple of times and she did not respond normally she would come right to me even in the middle of the night. I got up and went to her she was not moving her eyes were open but she looked confused or out of it or something. I started petting her and talking to her she finally moved to another position but not a lot of movement. this morning she seems fine. What happened?

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BabyGirl

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Chihuahua

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15 Years

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Moderate severity

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Moderate severity

Has Symptoms

Head Tilting, Circling, Drool

I have a 15 yr old Diabetic Chihuahua mix, she has had two episodes of head tremors that I thought might be a sugar drop so I gave her a few treats and she seemed to be fine after a few minutes. I spoke to the doctor and he said it could have been just what we thought. However, now its a few months later and for the last couple of days she has been having different episodes of head tilting, circling falling to the side and drooling a bit. The first couple of times this happened we gave her a treat and she popped out of it within a few minutes but today its happened and it's taking her much longer. Is this something that needs attention right away or as I have been reading about Vestibular disease will it go away itself? Should I panic and take her to the emergency vet or schedule a regular appointment?

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Jack

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Cocker Spaniel

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11 Years

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Mild severity

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Mild severity

Has Symptoms

Tilting Head Up And Down

Hi My 11 year old working cocker spaniel has started tilting his head (up and down) and staring at the ceiling and appers to be spooked, he has no other symptoms eats well loves going out on his walks he only does this indoors, he is and was always a very active dog (hill walking munro's etc ), vet suspects its neurological but why dosent he do this when he is out walking or outdoors .? he has had ticks on him over the years and i always inspect him when we come off the hills or back from walks and remove any with the proper tools, could it be lyme's disease and is it treatable ......Thanks in advance

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Rocky

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Yorkshire Terrier

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2 Years

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Fair severity

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Fair severity

Has Symptoms

My 2.5 year old 4lb. male pure bred Yorkie has been having episodes of disorientation. He will be asleep and all of a sudden wake up looking disoriented, eyes wide open and hind leg is up and not being able to really walk straight. He is also shaking at the time. He has had about 4 episodes in front of me, not sure if he has had more when he’s not in my presence. However, once I hold him and reassure him he is back to normal like it never happened. He is otherwise quite healthy and eats dry dog food and sometimes wet food all from the vet. If anyone has any knowledge with this please comment.

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Izzo

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Scottish Terrier

dog-age-icon

5 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Disorientation
Lethargic
Crying
Blindness
Abnormal Behavior
Not Wanting To Close His Eyes

Initial symptoms started about 3 weeks ago in my mom's 5 year old Scottish terrier mix; lethargic, not wanting to eat or drink, unsteady gait. Seen the vet nearly 2 weeks ago and was dx with bronchitis started on steroids. Labs came back normal. Still lethargic, increased eating and drinking, appeared to have a seizure last week. Since, continuous crying, doesn't seem to see very well (which vet put eye cream when we were there and seems to have affected eye sight). Normal urine output, is stooling, at times normal, other times runny and smells really bad. Vet can't see him again for 3 more days. I am seriously concerned. Parents did pull a tick off him several weeks ago. If infected wouldn't the labs shown that?

Disorientation Average Cost

From 67 quotes ranging from $300 - $2,500

Average Cost

$1,500

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