The vestibular system is a complex network of sensors in the inner ear and brain that helps an animal maintain balance and thus remain upright when walking, standing, or sitting. Most animals, including humans, have a vestibular system. Many things can disrupt this delicate system, which can lead to balance difficulties.
Vestibular disease often occurs suddenly and with very noticeable symptoms in dogs. The dog may feel dizzy and fall to the side. The head and eyes may be in an unusual position. The dog may also vomit. These signs are consistent with vestibular dysfunction, which often resolves on its own depending on the cause.
What is Vestibular Disease?
Vestibular disease occurs when there is a problem with the vestibular system. The vestibular system is a part of the nervous system that controls balance and eye movements. It includes the inner ear, the brainstem, a part of the brain called the vestibulocerebellum, and a cranial nerve in this area called the vestibulocochlear nerve. The vestibular system allows animals (including humans) to maintain balance and orient themselves according to head position. Additionally, their eyes can follow movements without feeling dizzy.1
If one or more of these areas are affected, the dog will show signs of dizziness – the feeling that the room is spinning – and is considered to be suffering from some type of vestibular disorder. This disorder may also be called “old dog vestibular disorder” because it occurs most often in older dogs, although it can sometimes affect young dogs as well.
Symptoms of Vestibular Disease in Dogs
Most dogs with balance problems initially appear clumsy and disoriented. This is because they suffer from dizziness due to the problem in the vestibular system. Symptoms often begin suddenly. Vestibular disease is sometimes mistakenly interpreted as a stroke, but this is not the usual cause. The most common symptoms include:
Dogs with vestibular disease are often quite dizzy. This generally manifests itself as staggering, walking in circles, inability to walk straight, or wobbling. Your dog may not want to stand or walk at all, or he may try to run but fall over. Head tilt is common and you will notice that your dog will drift in the same direction as the head tilt when walking. The dizziness may cause your dog to vomit. If you look closely, you’ll probably notice your dog’s eyes moving back and forth or up and down quickly; this is called nystagmus.
Causes of Vestibular Disease
A vestibular disorder occurs when there is a disorder in the vestibular system. The problem may originate in the inner ear, the brain, or both. There are several possible reasons for this.1
Diagnosis of vestibular disease in dogs
Your veterinarian will perform a complete physical examination of your dog and will likely also take blood and urine samples to look for signs of systemic disease or dysfunction. X-rays of your dog’s head may be ordered to look for tumors or structural abnormalities. Your own description of your dog’s symptoms can also be helpful.
If all tests are normal, and especially if your dog is older, the diagnosis is likely idiopathic vestibular syndrome, the most common form of this disorder.
Treatment
Treatment options for vestibular disease depend on the cause of the problem.
For idiopathic vestibular syndrome, treatment includes supportive care until symptoms resolve on their own. Most dogs recover from the worst symptoms within a few days, although full recovery can take months and in some dogs the head tilt is permanent.1 Anti-vertigo medications such as meclizine are often prescribed along with anti-nausea medications. Treatment is similar if the cause of vestibular dysfunction was a stroke or vascular accident.
Dogs that have suffered vestibular trauma may improve with supportive care (e.g., dogs with idiopathic vestibular syndrome). Some are candidates for surgery to repair the damage. Hospitalization with intensive care may be required during recovery.
If the vestibular disease is a result of hypothyroidism, the veterinarian will recommend thyroid supplementationbegin. Supportive treatment may be required initially until the medication begins to work.
If the dog has an inner or middle ear infection, treatment may include topical ear medications and/or oral medications to eliminate the source of the infection (often bacteria and/or yeast growth). Dogs may have debris in their ears that must be removed under general anesthesia.
Tumors and cysts are usually diagnosed after advanced imaging such as CT or MRI. In some cases, surgery may be performed to remove the tumor or cyst. If a cancerous tumor is present, chemotherapy and/or radiation may be recommended.
Prognosis for dogs with vestibular disease
The prognosis for dogs with idiopathic vestibular disease is excellent, with most dogs making a full recovery within days to months. For dogs with other causes of vestibular dysfunction, the prognosis depends on how well this condition can be treated. For example, hypothyroidism and ear infections are easily treated with medication, but dogs with strokes, tumors, or severe trauma have worse outcomes.
How to prevent vestibular diseases
Unfortunately, there is no sure way to prevent vestibular problems in dogs. If your dog is prone to ear infections, cleaning their ears regularly with a vet-approved cleaner can help prevent ear infections from developing. Annual or semi-annual veterinary exams and laboratory tests can help your veterinarian detect subtle changes in your dog’s health before your dog develops a vestibular disorder.
If you notice signs of vestibular disease in your dog, don’t wait for it to go away. Take your dog to the vet as soon as possible. The sooner the underlying cause (if any) is found, the sooner your dog can receive proper treatment.
