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.
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.
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.
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
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
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.
Vestibular Disease Questions and Advice from Veterinary Professionals
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Hello, my dog Baby recently started showing signs that sound very similar to Vestibular disease. She is a 12 years old, small shih tzu mix. Her symptoms started Sunday night (2/18) and at first we thought it might've been due to the bath she had the day before (maybe she pulled a muscle when tugging away) because she cried when we lifted her the wrong way. A day or two passed and she was no longer crying when picked up, but was walking very disoriented and not able to eat on her own, so we've been hand feeding her since. She is okay during the day, showing only mild symptoms, but at night she starts wondering the whole house, off balance, and sometimes when we pick her up she'll start to cry as if she was scared or frightened (maybe due to the darkness?). She eats normally when hand fed, drinks water whenever she is thirsty, pees/poos normally, and hasn't thrown up at all. The only problem is with her balance and random crying during late nights when picked up. Should I wait a few days to take her to the vet since her symptoms are very mild? or is what she is presenting something I should be taking more seriously and schedule an appointment asap?
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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!
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I am expat working in Jakarta, my dog Austin is 16yrs old( had since 6wks) Wednesday morning we woke to him in state he currently is that was diagnosed as vestibular.. the vets here told us nothing can be done.. He has rapid eye movement right, head tilt excessively to right, cannot walk without assistance, we were hand feeding him food and water but he has now lost appetite, he tries to move when needs to pee or poo but cannot without help so currently being washed 5-6 times a day.. My question is can I do anything to assist him? Should I be trying to force him to walk or let him sleep? Is there anything I can do that will assist or is his time up? The vets here say he won't recover but the western vets on u tube say they improve with time.. Jakarta is a Muslim city so dogs are not so common or popular so am wanting a western opinion to help me understand whether I'm making Austin suffer or he van in fact recover .. He has all the symptoms at top of article , he became ill Wednesday but with no vomiting, he vomited first time today Sunday and is now not eating or drinking(today) eyes look alert enough .. does not like the medication which we got from vet yesterday (Saturday) first vet Wednesday gave no medication.. has had blood tests both times with nothing overly abnormal for his age( elevated liver kidney) Thankyou
Read more at: https://wagwalking.com/condition/vestibular-disease#
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How did it turn out for Austin? Please update us.
Ps the DVM's response was a bit harsh at the end.
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Our Shiba Inu had his second case of vestibular disease hit 4 weeks ago. He hasn’t shown many signs of improvement. He has had 2 steroid shots and a course of 2 antibiotics. He is still spinning in circles, unable to walk straight from room to room, needs assistance eating and drinking, and just has no real quality of life. Is 4 weeks long enough to know if a dog will recover from vestibular disease? We are starting to prepare ourselves to have him put down. Thank you.
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What was the outcome with your dog? We are going through the same thing right now with our 15 year old shih-tzu.
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I believe my 4 yo. Siberian has vestibular (old dog disease) disease. Symptoms started last night of him being drunken and unbalanced. He's thrown up once that I've seen but all around really drunken and lathargic. He seems better today (the morning after) but not much better.
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Four years old is a bit young for vestibular disease (as in old dog disease) but there are other conditions which affect the vestibular apparatus or others which may cause drunk like symptoms including: poisoning, ear infections, head trauma, oxygen starvation, liver disease, kidney disease to name a few. Ensure Cato is adequately hydrated, but you would need to visit your Veterinarian for an examination and blood tests to rule out any other causes. Regards Dr Callum Turner DVM
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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?
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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.
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We had a 12-13 year old dog suddenly show signs of vestibular disease Nov 2016. Approximately 3 days later she had dramatically improved. However in the following months she quickly lost weight. Wouldn't eat, vomiting, large stools. She was emaciated and walked drunk. Vet found enlarged lymph nodes in April 2017 and suggested lymphoma. Sent us home with anti-nausea meds. Her condition continued to decline and we euthanized in August 2017.
Today her littermate started showing the same sudden symptoms of vastibular disease. Head tilt, unable to stand or walk due to dizziness and unsteasy gate. Won't eat and her left eye twitching back and forth.
I am terrified this is not lymphoma or just plain "old dog disease". I am afraid it is contagious and/or environmental, and I have a 5 month old puppy and a 5 year old dog (not related to the dog showing symptoms) also living in the home.
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My 15 year old dog has Vestibular disease. It came on suddenly 2 weeks ago. He did have an ear infection and spent 3 days in the hospital. A week ago he was making some progress. Up and walking with us helping him balance. Now he is unable to get up or walk. He cries to get up and go outside. What do you think is going on.
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My dog was staying with some other people temporarily and when he returned home he was exhibiting the symptoms of this tubular syndrome they have not cleared up they have in fact gotten worse he did experience a rather severe flea infestation while he was with them that resulted in really bad worms and I'm wondering if he may have some sort of parasites or some sort of bacterial infection in the middle ear that has been left untreated we've gone to the vet and had blood test done and awaiting the results how will the vet determine if there is an ear issue if there is any vestibular damage that may be permanent how do we determine if there might be brain tumors or in fact brain cancer also how can I know if he may have had a stroke
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About a week ago I posted a question about my 15 year old lab having Vestibular syndrom (our vet determined most likely ideopathic but had not ruled out an ear infection yet). He was recovering very well and was almost back to his old self. He was walking around fine but was still a little wobbly with a head tilt. The other morning he was outside by himself for a few minutes and I believe he got excited by the neighbors dogs and while trying to run to the fence he fence he fell into the pool. When I found him I believe he had not been able to swim or stay above water due to his condition. I pulled him out and he was obviously traumatized by the incident. I rushed him to the emergency vet where he stayed for about 4 hours. They did blood tests and X-rays and he seemed fine from the pool incident but his vestibular symptoms had come back full fold. I explained to them he had been recovering from it before but they tried to have their neurologist do the same tests. At this point, Peanut was not even able to stand on his own so they were very limited in the tests they could do short of an MRI, which they were not capable of doing, and it is extremely expensive. They had sedated him to take the X-rays and had a chance to look in his ear and rule out an ear infection (which the other vet had not done) but they sent him home with the diagnosis of a greater risk of central as opposed to peripheral but they could not give me a difinitive answer as to why. They were working under the impression that he had a severe case of Vestibular symptoms come back while he was in the yard even through I told them i was almost positive he fell in while getting exited with the neighbors dogs as that is what happens every morning and the pool is very close to that part of the fence. I tried to explain all the previous tests the last vet was able to do and how he was recovering fine until the trauma of falling in the pool. From what I understood they just didn't know and were guessing. I took him home and continued with his motion sickness medicine. For the 1st 2 days he had not been able to stand at all. He keeps trying to roll over (to the left, the same side as his head tilt), However, he has been eating and drinking fine. The eye twitching is not as bad as the 1st time and he is very alert. When I woke up this morning I found him standing on his own. It did not last for very long but I took it as a good sign. Basically I just want to know if an incident like the trauma of falling in the pool could cause his recovery to regress or does his current symptoms lean more towards a more serious issue which I may need to euthanize him for. An answer I have paid a lot of money to find out but keep getting different answers. I don't want my dog to suffer and have no quality of life but I also don't want to put him down if there is a possibility he will recover as he did last time. I just need someone to clarify if it is possible the fall triggered his past symptoms since he was not fully recovered.
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My dog,Kailani,is a chocolate lab and only a year old. I have looked at the signs and symptoms of vestibular disease and she has been showing most of them.
She was fine yesterday, but today she started to lay on her side and whine and avoid eye contact.When she would get up, she would wobble and fall over and then get back up then walk around like she is drunk.
She has had ear infections in the past, but it is all cleared up now and the vet told us her ears are good a week ago, but now this has popped up.
Does she have this disease at such a young age?
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Our 14 year old dog Mila had a bout of vestibular disease that popped up 4 months ago and took a good 6 weeks to recover from. She's been on Dramamine still daily (1-2 vs 4) as this seemed to help but now today it seems to either have flared up again or it's still the same but she has same symptoms as before unable to get up. The first time she went to the vet for all th tests that came back clear. Is this the same episode or a new one? I'm concerned about her muscle atrophy from just a few months ago when she didn't eat for 4 days or walk for almost a week. I'm also concerned about her quality of life although up until now she's been her happy recovered sweet self.
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My 15 year old shih-tzu is experiencing the same thing. It started 9 days ago, I took him to the vet and within the next day I was seeing an improvement, then 4 days later it came back and we are now going on the 5th day of him not walking that well and falling over. What was the outcome with your dog?
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Hi, 6 days ago my 14 year old lab mix was diagnosed with Vestibular syndrom. He was throwing up and could not even stand up on his own and could not walk without instantly falling over. The vet was not able to determine conclusively if it was ideopathic or if he may have an ear infection because he would not let the vet look into his left ear (no other signs indicate an infection). She said he would need to possibly come back to be sedated to look at the ear. She sent him home and he's been taking motion sickness meds. Since then he has started walking on his own but still wobbly and stumbling. He is drinking on his own and eating when I hand feed him. He seems aware and happy and trying to play with my other dog but still has a severe head tilt. I have also been watching his eyes and they are no longer flickering side to side. Since he progressing every day do you think sedation to check his ear is still necessary?
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Unfortunately after my last post Peanut accidentally fell in the pool. He was not able to swim on his own or keep his head above water. I got him out and rushed him to the vet and it seems like he is back to day one of his vestibular disease. He is not vomiting and he is eating and drinking a lot of water but he cannot stand and keeps trying to roll over when he is laying down. The vet let me take him home. They were able to check his ear and there is no ear infection so if he does not improve they may be leaning on the side of central rather than peripheral. it has been 48 hours and he is more alert and wanting to sit up on his own so we are hoping he will improve again and the trauma of the fall just set him back a little bit in his recovery.
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On 3/19/18 my 14 year old Black Lab couldn't walk when I woke up. I got her into the vert and he "thought" that it was ODVD. He really didn't examine her too much. He said he could give her medicine for the nausea but that was it. He really didn't talk to me about a course of treatment or the possibility of recovery. He basically said it was a wait & see situation.
I thought she had a stroke so I was expecting the worse. We then started talking about putting her down. She had some health issues but nothing major. She had been on carprofren for about two years due to but her recent blood tests came back "pristine" (in the words of the vet). Although I was in no frame of mind to make the decision, I decided to put her down mainly because the vet made it seem hopeless.
When I got home, after putting her down, I started researching ODVD and found that the dizziness would have gone away within 72 hours and she would have recovered in 2-3 weeks. I am not dealing with extreme guilt and remorse because I think she could have pulled through.
But after reading some of the posts, it seems like I may have done the right thing. This is the first website that talks about relapses and dogs not recovering. I just need some confirmation that I did the right thing. If you have any questions, please ask.
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Emma, my 14 year old black lab also passed away yesterday from a stroke.( I did not know this until the vet called the next day after he passed) I found him when laying on the kitchen floor and he could not move. He had used the restroom on himself and was very weak. My mom and I had carry him to the vet's office. She did check his ears and his breathing and asked me about his symptoms. She took blood and she sent me home with ear medicine and joint medicine. Not once did she suggest putting him to sleep. He would not eat or drink anything and could not walk. I should have known better. I thought because he had only been really sick for a few hours, I had to give him a fighting chance. That night about 9, he was able to walk to the door but he fell over onto his side in what looked like a seizure. It lasted for at least a minute. (He had experienced another stroke) I thought he was not going to make it through the night. The vet was closed. My initial reaction was to take him to the emergency room to have him put to sleep, but decided against it because he began to raise his head and look around and was alert. He finally settled down and slept most of the night. I felt he could make it until the morning, and the blood test would tell us more. I checked on him all night. The last time I checked he was actively passing away. Needless to say I freaked out. He was gone in a matter of minutes, but it was still traumatic to witness. I don't think he was in pain, but guilt consumed me because I know I should have put him to sleep earlier that night. I wrote all that to say, PLEASE don't feel guilty about easing your pet's suffering. I now feel guilty that I did not because watching a pet die a natural death is not something I want to do again.
I just don't understand why he didn't do more. He didn't look in her ears, do blood tests, urinalysis or anything. She did have spondylosis, maybe that went into his decision?
I also feel he should have encouraged me to take more time to make the decision since neither he nor I were sure that it was the right call. I have talked to another vet that said he encourages taking time to make such a permanent decision. He usually offers to keep the pet overnight for observation.
Sorry, I know I need to move on. But I am very upset and feel that my baby was put down needlessly.
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