Nystagmus in Dogs

Nystagmus is a rapid, involuntary movement of the eyes. It may appear as though the dogs’ eyes are bouncing up and down in their sockets or moving rapidly back and forth without focusing. This can be characteristic of either a peripheral vestibular disease involving the trauma or inflammation of the inner and middle ear, or central vestibular disease that affects parts of the system located near the brain stem. Dogs can also develop vestibular issues due to advanced age (idiopathic vestibular syndrome) or be born with a physical defect that results in congenital vestibular disease. The peripheral form of the disease is most common, and once the underlying cause is determined, it can usually be cleared up within a few weeks. Central vestibular disease is rare, but due to the prevalence of brain damage, the prognosis for recovery is poor.

• Falling
• Lack of coordination
• Head tilt
• Walking in circles
• Rolling
• Eyes jerking side to side or up and down
• Stumbling
• Disorientation
• Motion sickness

Types

• Peripheral Vestibular Disease
• Peripheral Vestibular Disease is the most common form of this affliction, affecting the inner and middle ear. Once the cause is determined, it can usually be cleared up in a matter of weeks.
• Central Vestibular Disease
• Central Vestibular Disease is the rarest and most life-threatening of these disorders. The central vestibular organs are located at the base of the brain stem and conditions that cause this form of the disease are much more catastrophic.
• Congenital Vestibular Disease
• Puppies who are born with a congenital vestibular disease usually show signs between birth and three months. Prognosis is positive, however, since the dog will likely adapt to the problem and compensate for it naturally. Several breeds have a predisposition for this kind of congenital issue including Doberman, German Shepherd, Beagle, Smooth Fox Terrier, Tibetan Terrier, English Cocker Spaniel, and Akita.
• Idiopathic Vestibular Syndrome, also called Geriatric Vestibular Syndrome
• Idiopathic Vestibular Syndrome occurs in older dogs, and usually come on rapidly with no discernable cause then resolves itself just as mysteriously. Because of the alarming symptoms, it can sometimes be mistaken for a stroke.

Peripheral vestibular disease can be caused by many factors: middle or inner ear infections, perforated eardrum, head trauma, hypothyroidism, stroke, polyps, tumors or as a side affect from medication. Central vestibular disease can be caused by a chronic inflammatory disease, infection, bleeding on the brain, trauma, impaired blood flow, or cancer.

Your veterinarian will conduct a physical and neurological exam and need the animal’s complete medical history including any medications the dog may be taking. They will use and otoscope to exam the dog’s eardrum for signs of irritation or perforation. They will take blood and urine samples for culture and microscopic examination to determine if an infection is present and what kind. They may need to x-ray your dogs’ head to look at the structure of the vestibular system. If tumors or polyps are found, the veterinarian may need to perform a surgical biopsy. An MRI or CT scan could be necessary to rule out tumors, bleeding or other brain-stem abnormalities.

Determining a course of treatment will really depend on identifying the underlying cause. If your veterinarian suspects a medication side effect is causing the issue, they may take the animal off that drug and see if symptoms clear up in a few days. If it’s caused by an infection, the doctor will prescribe antibiotics. If it’s a case of hypothyroidism, management of the metabolic condition should resolve the vestibular issue. Surgery will be needed if polyps or tumors are present. Cancerous tumors of the central vestibular organs can cause devastating brain stem damage, and are often fatal.

During recovery, your veterinarian may also prescribe medications to alleviate symptoms of the vestibular disease. Your dog may need motion sickness medications for vomiting and nausea, and even sedatives for a dog that is severely disoriented. If your dog is dehydrated due to vomiting, it may be necessary for them to stay a night or two in the hospital receiving fluids until the symptoms start to dissipate, and they can eat and drink normally again. If the dog is overwhelmed by dizziness, they may be reluctant to walk and will need to be carried indoors and outside for bathroom breaks. As long as the underlying cause of the vestibular disease is identified and treatable, your dog should recover fully within a couple of weeks.