Vestibular Disease in Dogs
Vestibular Disease in Dogs - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost
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.
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Average Cost
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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
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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.
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
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Chocolate lab
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Kailani
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1 Year
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1 found this helpful

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1 found this helpful

My pet has the following symptoms:
Diarrhea
Nausea
Falling Over
Walks In Circles
Cannot Walk Straight
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?
April 30, 2018
1 Recommendations
Vestibular disease may occur in dogs of any age but are more common in older dogs; however other causes for similar symptoms may include head trauma, poisoning, inflammation of the central nervous system among other causes. You should keep an eye on Kailani for the time being but visit your Veterinarian if symptoms progress or there is no improvement. Regards Dr Callum Turner DVM
May 1, 2018
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Chocolate lab
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Mila
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14 Years
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1 found this helpful

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1 found this helpful

My pet has the following symptoms:
Inability To Walk, Dizziness
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.
April 22, 2018

1 Recommendations
There are many causes for vestibular disease, but many cases are idiopathic meaning that we don’t know what the underlying cause is; supportive care is best making sure that Mila is comfortable. I cannot say whether this is a new case or a continuation of the previous one but you should visit your Veterinarian again for an examination. Regards Dr Callum Turner DVM
April 22, 2018
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?
May 24, 2018
Melanie G.
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Labrador Retriever
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Emma
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14 Years
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2 found this helpful

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2 found this helpful

My pet has the following symptoms:
Standing
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.
March 27, 2018

Answered by Dr. Michele K. DVM
2 Recommendations
I'm very sorry for the loss of your Emma. Geriatric Vestibular Disease does tend to resolve within 24-48 hours, but there are many other causes of the signs that she was showing that may not have ended up as well. Brain injury, tumors and neurologic problems can be quite severe. Without having seen her, I can't comment in great detail about her situation, but if you and your veteirnarian came to that decision, it is best to trust that it was the right one.
March 28, 2018
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.
March 28, 2018
Emma's Owner

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.
March 29, 2018
Sophia J.
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Shih Tzu
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Baby
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12 Years
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2 found this helpful

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2 found this helpful

My pet has the following symptoms:
Disorientation
Sad
Confused
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?
Feb. 23, 2018
Answered by Dr. Michele K. DVM
2 Recommendations
Than you for your email. One form of vestibular disease does present with signs of imbalance, but it is not typically painful, and tends to resolve over about 24 hours. Other causes of vestibular disease and imbalance are possible, such as inner ear infections, spinal trauma, or brain disease. Since she is not improving rapidly, and seems to be painful at times, it would be best to have her seen as soon as possible, as they can evaluate her, determine what might be going on, and get her treatment if needed. I hope that all goes well for her.
Feb. 23, 2018
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Vestibular Disease Average Cost
From 396 quotes ranging from $300 - $2,000
Average Cost
$1,000
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