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What is Vestibular Disease?

The term vestibular refers to the inner ear organs of the body.  Vestibular disease in dogs is not a true “disease” as such but actually is a composite of various neurologic signs that occur as a result of a malfunction of some part of the vestibular system.  This system is responsible for the maintenance of balance and the coordination of position of the head, eyes, neck and limbs in space. It can be either peripheral (PVD) or central (CVD) in nature and can be the result of a vestibular lesion or other disease like hypothyroidism (low thyroid function) or hyperadrenocorticism (abnormal excessive presence of adrenocortical hormones, especially cortisol in the body).  Both types of this condition usually present with acute onset (suddenly) and a peripheral vestibular issue may follow a recent ear infection.

Vestibular disease is defined as the sudden, non-progressive disturbance of balance.  It is also known as old vestibular syndrome and canine idiopathic vestibular syndrome. It is usually found more often in older dogs than in younger ones.

Vestibular Disease Average Cost

From 396 quotes ranging from $300 - $2,000

Average Cost

$1,000

Symptoms of Vestibular Disease in Dogs

This condition will likely present suddenly and can be central or peripheral in nature.  The primary and most noted symptoms are:

  • Head tilt to one side or the other
  • Vestibular ataxia (lack of muscle control) often asymmetric (not equal on both sides)
  • Tight circling, falling or rolling
  • Spontaneous nystagmus (rapid involuntary eye movements)
  • Nausea and vomiting similar to that of motion sickness
  • Strabismus (misalignment of the eyes or the condition of having a squint)
  • Disorientation
  • Reluctance to walk or stand
  • Leaning or falling in the same direction as the head tilt    

The most likely symptoms that you will note in your pet in regard to CVD:

  • Depressed mental state in which the animal displays disorientation and poor interaction with other animals and humans
  • Postural defects like the loss of normal strength and proprioception (the sense of knowing where your joints are in space or body awareness)

The symptoms that will likely be most obvious to you, the owner, will be the head tilt and vestibular ataxia noted above.  Seek medical care as soon as possible when these symptoms are noted.

Types 

Vestibular disease is generally a condition that affects older dogs and is usually peripheral or central in nature.  There are several types: 

  • Peripheral vestibular disease (PVD) usually produces leaning in one direction and increased resting nystagmus - this type involves the ear and nerves

  • Central vestibular disease (CVD) usually produces a non-ambulatory animal with decreased resting nystagmus - this type involves the brain
  • Congenital peripheral or central vestibular disease is very rare in puppies

The dysfunction is more common in older dogs but can be secondary to a neoplastic lesion.  The head tilt and positional strabismus is pretty much equal in regard to the symptoms noted in your pet in both types of vestibular disease in dogs.

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Causes of Vestibular Disease in Dogs

There are a number of known or suspected causes of vestibular disease.  Some of these causes are more serious than others and will require some sort of medical assistance or intervention to resolve.

  • Middle ear or inner ear infections
  • Drugs that are toxic to the ear, for example Metronidazole
  • Trauma or injury
  • Tumors (neoplasia)
  • Hypothyroidism
  • Vascular disease, for example, stroke - though a rare cause

Depending on the actual cause of the episode, after a fairly fast onset of the clinical signs mentioned above, there could be a period of relatively rapid improvement of those symptoms and signs with minimal if any medical intervention having been required.

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Diagnosis of Vestibular Disease in Dogs

Diagnosing this disease will require a neurological examination by your local veterinarian.  He or she will need to determine if the vestibular issue is peripheral or central in nature.  Here is what he or she will be looking for in the physical neurological assessment:

  • CVD - Vestibular signs like body awareness on one side only, unilateral paresis (paralysis), altered mental status, cranial nerve deficits (especially those related to cranial nerve V and VII)

  • PVD - Vestibular signs like body awareness as above, normal strength, normal mental status, cranial nerve deficits (cranial nerve VII and Horner’s only)

There will likely need to be some diagnostic testing done as well:

  • MRI of ears and brain
  • CT scan and radiographs - ear infections are better seen and assessed via these imaging methods

  • Blood pressure testing
  • CSF (cerebrospinal fluid) analysis to help in the determination of the presence of inflammatory or infectious disease
  • Testing for viruses versus protozoa
  • Myringotomy (surgical infusion into the ear drum to relieve pressure or drain fluid) for middle ear infections
  • BAER (Brainstem Auditory Evoked Response) to evaluate the hearing channels and pathways which are in close proximity to the vestibular pathways
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Treatment of Vestibular Disease in Dogs

The treatment of vestibular disease in dogs is twofold:

The underlying or root cause of the disease needs to be determined and treated. Your veterinarian will need to identify the possible cause so that she can develop a treatment plan. 

Supportive care comes into play as well in the form of things like:

  • Intravenous fluids if your dog is dehydrated
  • Anti nausea medication to prevent or limit vomiting
  • The administration of a medication called propentofylline to hasten the brain’s natural ability to compensate after any unilateral vestibular damage occurs
  • Close monitoring of your pet during treatment
  • Antioxidants and essential fatty acids to assist the body’s healing powers
  • Quiet environment if the nystagmus persists or if it goes away and then returns
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Recovery of Vestibular Disease in Dogs

Research has revealed that there is some experimental benefit to be gained from the use of the medication propentofylline in rats as it has shown some increasing of the speed at which the brain is able to compensate after unilateral vestibular damage.  If this medication option is utilized, then it will, of course, require close monitoring of your pet during treatment.

Additionally, the nystagmus can make an occasional return suddenly and last for a brief period of time.  If your pet experiences this symptom reappearance, you should keep your pet in a quiet environment during that period of time and you should monitor him closely.  If the nystagmus persists, then your veterinarian will need to re-examine and re-investigate the physical condition of your companion. Depending on the cause and the type of vestibular disease identified, the end result could be permanent damage in which your beloved family pet displays a permanent head tilt, balance issues, and disorientation. There may be adjustments needed in the home environment and by the family to deal with any permanent physical or neurological damage following vestibular disease, in order to keep him safe.

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Vestibular Disease Average Cost

From 396 quotes ranging from $300 - $2,000

Average Cost

$1,000

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Vestibular Disease Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

dog-name-icon

Pistol

dog-breed-icon

Staffordshire Bull Terrier

dog-age-icon

12 Years

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

Fair severity

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1 found helpful

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

Fair severity

Has Symptoms

Head Tilt
Vomiting
Off Balance
Stumbling

This morning around 430am I heard my dog start to vomit. He fell a short distance. Very unsteady on his feet. Reluctant to walk/stand. Rushed to ER vet in fear of stroke. No eye movement. Still within the first 24 hours. His regular vet is on vacation. Seems to be improving, lots of rest and good appetite. Fear of something worse going on.

Sept. 7, 2018

Pistol's Owner

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Sandra

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cross

dog-age-icon

2 Years

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

Mild severity

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0 found helpful

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

Mild severity

Has Symptoms

Eye Movement
Nystagmus
Instability
Falling Over

Since we rescued Sandra at 1 year old she would randomly hold her head to the side and stumble around for very short periods of time. The frequency remains but the severity is getting worse. She drops to the ground now with her head on one side and when I support her head I see her left eye displaying nystagmus. This can last 10 seconds to 1 minute then she’s back to normal frantically zipping around with no lasting effects. Obviously this cannot be old dog vestibular disease but could it be congenital vestibular disease? She eats fine, exercises fine but has these little moments. I must say that the moments do mostly tend to occur when she is excited. What could this be and is there any treatments for her?

Aug. 31, 2018

Sandra's Owner

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Brandy

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Border Collie

dog-age-icon

13 Years

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

Fair severity

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1 found helpful

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

Fair severity

Has Symptoms

Eyes Twitching, Head Tilt

My 13 yr border collie ( onset of this disease was Tuesday ) was diagnosed with vestibular disease and heart murmur last Wednesday. She spend the night in emergency care on fluids IV and blood profile to rule out kidney and liver disease As of today she still having a hard time standing,walking and going down the stairs so we have to carry her outside so she can potty. Today was the first day she eat with out me using a baby medicine syringe. My question is how long will this vestibule disease last. My husband feels we should put her sleep.

July 17, 2018

Brandy's Owner


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3320 Recommendations

Some cases of vestibular disease are idiopathic (we don’t know the cause) and these cases may spontaneously resolve within ten or so days; however there are many other causes for vestibular disease and when an underlying cause is determined it may also need to be treated or managed. You should keep an eye on Brandy for the time being and monitor for any improvement in severity. Regards Dr Callum Turner DVM

July 17, 2018

I'm so sorry for you loss. You did the right thing considering her diagnosis. It doesn't make things any easier however. May time and all the wonderful memories you have with Brandy lift your spirits...

July 19, 2018

Mv M.


Sad news, my beautiful baby girl Brandy was Put down today turns out she had a brain tumor

July 19, 2018

Brandy's Owner

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Moose

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Shih Tzu

dog-age-icon

14 Years

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

Serious severity

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2 found helpful

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

Serious severity

Has Symptoms

Head Tilt

My shitzu is 14. Blind, enlarged heart and kidney levels are elevated. 5 days ago I came home and he seemed as if he had a stroke - falling on his side, difficulty standing up, walking in circles etc. I took him to the vet thinking it was time but the think he has vestibular disease. He's been on Propentifylline and robenacoxib for 5 days and not showing much improvement. The walking is a bit better, but head tilt is worse, he is shaking a bit and he only eats/drinks if we hand feed him. I know the vet said to wait two weeks and if there are no improvements we then consider our options but I'm worried he is suffering, particularly since he is also blind. Any advice?

July 5, 2018

Moose's Owner


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recommendation-ribbon

3320 Recommendations

If Moose is being affected by vestibular disease it may take another ten days or so to see improvement, however during this time his overall quality of life will be affected especially being blind he wont have any visual frame of reference. You should follow your Veterinarian’s instructions, continue to monitor for improvement and follow up with your Veterinarian if there is no improvement after ten days. Regards Dr Callum Turner DVM

July 6, 2018

Thank you. Tomorrow is day 7 and it's only getting worse. He hasn't stood up or walked in 2 days. I just feel like this is cruel to him and not right.

July 6, 2018

Moose's Owner

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Boudreaux

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Boxer

dog-age-icon

9 Years

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

Moderate severity

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0 found helpful

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

Moderate severity

Has Symptoms

Not Eating
Dizziness
Side-To-Side Eye Movement

My Boxer has shown signs of dizziness, "drunk" walking, and occasional side-to-side eye movements for the past few days. The eye movement hasn't happened in 48-72 hours though. No vomiting, drinks water, will not eat much. We believe he had a stroke 1-2 months ago. Given his age (9yrs old), we do not believe an MRI and any chemo etc would be good for him if it were a tumor. Assuming its vestibular disease, how optimistic can we be on recovery or will this be a slow decline? Should he be on an antibiotic or anything we can do to improve things? Thanks!

June 15, 2018

Boudreaux's Owner

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recommendation-ribbon

3320 Recommendations

If Boudreaux has vestibular disease, any treatment would be dependent on the underlying cause; if there is an ear infection which is causing vestibular disease then antibiotics would be indicated but if the cause is due to idiopathic vestibular disease (unknown cause), no treatment is required and symptoms may resolve spontaneously after ten days or so. However, stroke and neurological tumours may also cause vestibular symptoms so I cannot give any assurance it is idiopathic or other cause. Regards Dr Callum Turner DVM

June 16, 2018

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Jozi

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Border Collie

dog-age-icon

2 Years

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

Moderate severity

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0 found helpful

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

Moderate severity

Has Symptoms

Unbalanced

We have a Border Collie, Jozi who is about 1 and half years / 2 years old. My son told me that he was sleeping when Jozi fell off the bed, then when she started walking it look it looks like she is battling to walk like she walking more to the one side and then wants to lie down on that side, it looks like she's drunk and struggling to stay up. Do you perhaps know what could have happened it only happened a few hours ago and we are unsure what to do.

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Aria

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Lab mix

dog-age-icon

11 Years

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

Moderate severity

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1 found helpful

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

Moderate severity

Has Symptoms

Uncoordination
Head Tilt
Tires Easily
Drunken Gate
Drunken Gate Ear/Sinus Infec

I just want to thank everyone else for sharing their stories. This can be a very frustrating experience and it is difficult to have patience. It is also difficult to strike the balance between doing too much (and wearing the dog out) and doing too little (and risk things like dehydration and bed sores). The stories shared by everyone have been so helpful. Our dog is currently going through this. It is day 10, and the nystagmus in the eyes has gone, but she still is very uncoordinated on her feet; so much so that she still doesn’t try to stand too often. Still has head tilt. One “sign” of improvement that I’ve not seen mentioned is what I have called “the two o’clock rush.” The past two days our girl will get a little boost of energy (not a lot, a little) right around two o’clock in the afternoon. Yesterday it lasted until around four to four-thirty and then she was very tired again. Anyone else have an experience like that? The vet still has not been able to rule out more serious causes like a brain tumor, but the only symptom of brain tumor that we have seen is the disruption of the vestibular system, which began in the middle of treatment for a very stubborn ear/sinus infection. We are not opposed to having a scan done to determine other causes - in fact, we probably will - but for now we are in waiting. Seeing as how this problem presented itself toward the middle of the ear/sinus infection, we are fairly comfortable being patient. I appreciate so many people sharing their stories on here. It can be so difficult to be patient with these symptoms, and reading other stories has been a great source of encouragement for us to be patient - even as people have told us to just have her put down. Our vet told us that it is not time for that and all the evidence tells us to just wait it out for however long it takes. Our girl still has a way to go, but she is not in pain. She eats and drinks, she is getting a lot of rest, and responds to us. So we’re just waiting it out and staying in contact with the vet.

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Oliver

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cockapoo

dog-age-icon

18 Years

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

Critical severity

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1 found helpful

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

Critical severity

Has Symptoms

Throw Up Unable To Stand Head Tilt

We have an 18 year old cockapoo, his name is Oliver. Four weeks ago my husband came home from work to find that he had thrown up and was laying near the front door with his head completely turned, he could not stand, when we tried to stand him up, he would fall to the side. We took him to the Emergency hospital recommended on our vets answering machine (they were closed) and we were told that he had Old Dogs disease, vestibular disease. We were given medication, a pill for motion sickness, one for vomiting and a antibiotic. Oliver would not take the medication, he would not eat although he was drinking water. He did not eat for 5 days and I saw that he was weak because of it. At this point I am carrying him out to go to the bathroom. I called his vet and took him in, they confirmed what I was told at the hospital and I was basically told that I could only hope that he passes in his sleep. I was given canned dog food that is loaded up with vitamins, since he would not eat on his own, I gave it to him through a small syringe. I would take him out in the morning, feed him and take him out again. I was going home at lunch time to take him out and feed him, I was told he should eat three times a day. After 4 days or so Oliver was showing signs of improvement. I then went to the feed store and purchased a larger syringe to get more food into him, all the while giving him the antibiotics that I would mix in the food. I also purchased baby food and canned pure pumpkin to mix in so he would not get tired of the taste. After a week and a half or so, I gave him a treat (he would not take them up to now) and he ate it. On week two I then starting to feed him his regular food, which is boiled chicken, rice and veggies, usually string beans or peas. We are not approaching week five (5), I no longer go home at lunch time, since I can leave his water, he knows where it is and he mostly waits for my husband to get home from work to go out, I leave pads down just in case, which he has used, I give him a light breakfast before I leave. I walk Oliver with harness because his head is still tilted, but he still enjoys going for walks. His sense of smell is very strong, which is so important because he is blind and deaf. I am sharing this only because I was advised to put him to sleep but my heart could not, I was told he was not in pain, so I wanted to give him every fighting chance. Because of his age his routine is pretty much the same as it was before he became ill. Oliver gets excited when I am arrive home, he smells me I am sure, because my husband says he does not exhibit the same behavior when he is home. Because of his age, I know that someday soon he will say good-bye or I will have to make the decision of putting him to sleep, but that decision will be made because it is the best for him, not because he has become an inconvenience. I guess what I am trying to say is, sometimes its okay to listen to your heart and gut. For everyone that received a final diagnosis, tumors and such, well you know that there was nothing else you could do, so do not beat yourself up.

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Pinky

dog-breed-icon

Pom-mix

dog-age-icon

10 Years

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

Moderate severity

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0 found helpful

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

Moderate severity

Has Symptoms

Nystagmus, Head Wobble, Wide Leg Stance
Wide Leg Stance

I have a foster rescue pom mix who was found frozen and unconscious. We initially thought the nystagmus was from the freezing but it could also be a head injury as one side of his mouth had all damaged teeth. I worked with him for 3 months now, and hes made significant improvements all round but still has the continuous eye movements. We cleaned and removed the bad teeth, hes been eating and walking, has learned his name and knows us. I want to help him regain better quality of life if i can help limit the eye movements. He clearly has trouble seeing clearly Is there anything that can be done at this point or after 4 months is it possibly as good as it may get? TIA

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Hope and Faithy

dog-breed-icon

German Shepherd

dog-age-icon

13 Years

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

Serious severity

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0 found helpful

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

Serious severity

Has Symptoms

Head Tilt, Imbalance, Throwing Up

This may be a first as far as vestibular disease in old dogs. We have 2 GSDs who are litter mates (almost 13 years old). On a Tuesday morning 1/9/19, the one started her morning as usual, but at 9:30 she tried to get up, but lost all ability to balance, walk, sit, even laying was difficult. Took her to the vet and was diagnosed with ODVD. She was given antibiotics and prednisone. That evening she was making some progress, but still needed help. Never vomited at all. After 24 hours she did not need help, and was pretty well back to normal. About 10 that evening (12 hours after the first dog) her littermate sister was throwing up everywhere and had no balance and rapid eye movement. I tried to give her some motion sickness pills and called into the vet to get some meds. She got sick on those anti biotics though, so I took her in on that Fri, and they diagnosed her also with ODVD. The one who got it last has always had ear infection problems and has still got some imbalance problems after 2 1/2 weeks. How long do you think it may be until she fully recovers? She still has the head tilt and weak on one side (left).

Vestibular Disease Average Cost

From 396 quotes ranging from $300 - $2,000

Average Cost

$1,000

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