Vestibular Disease in Dogs
The vestibular system is responsible for maintaining normal balance. The vestibular system has central components located in the brain, and peripheral components located in the inner and middle ear.
What is vestibular disease?
Vestibular disease refers to a sudden, non-progressive disturbance of balance. It is more common in older dogs. It is also referred to as old dog vestibular syndrome and canine idiopathic vestibular syndrome.
What are the clinical signs of vestibular disease?
Most dogs present with the sudden onset of loss of balance, disorientation, head tilt, and irregular jerking eye movements called nystagmus. Many dogs will become reluctant to stand or walk. Most dogs will lean or fall in the direction of their head tilt.
What causes vestibular disease?
Causes of vestibular disease include middle or inner ear infections, drugs that are toxic to the ear, trauma or injury, tumors, and hypothyroidism. When no specific cause is found, the condition is called idiopathic vestibular syndrome. These cases are distinguished by the sudden onset of clinical signs and the subsequent rapid improvement with little, if any, medical intervention. Causes of vestibular disease include an ear infection, perforated eardrum, hypothyroidism, trauma, tumors or possibly as a side effect of antibiotics. When no specific cause is found, the condition is called idiopathic vestibular disease.
Some dog breeds are known to be more prone to developing vestibular disease, including German shepherds and Doberman pinschers. While this condition is commonly seen in older dogs, younger dogs can also suffer from vestibular disease.
How Veterinarians Diagnose Vestibular Disease in Dogs
To diagnose vestibular disease, your vet will want to know your dog’s medical history including current medications, the start and progression of symptoms, and any current illnesses or conditions.
At the hospital, a physical exam will determine if your dog is showing signs of vestibular disease. If vestibular disease is confirmed, a neurological exam determines if it is a central dysfunction (tumor or polyp) or a peripheral dysfunction (ear infection).
Based on the findings of the neurological exam, your vet will determine the most appropriate test. Tests may include:
- Ear cytology: A sample of debris from the ear canal is collected which identifies if yeast, bacteria, mites (or a combination) is causing an ear infection. Not all ear infections extend past the ear drum into the inner ear. Based on symptoms, the physical exam, and test results, your veterinarian can determine if an ear infection is the likely cause of the vestibular disease.
- Complete blood count: Confirms or denies other systemic infections or blood-related abnormalities like anemia that may also cause stumbling similar to vestibular disease.
- Internal organ function or biochemistry test: Although it cannot determine cancer or tumor location, this test can suggest if further cancer or other organ dysfunction testing is needed.
- Urinalysis: Results, in conjunction with other tests, identify if an underlying condition may be the cause of the vestibular disease.
- Advanced imaging: X-rays (radiographs) or CT (computed tomography) scans confirm the suspicion of polyps or tumors.
What are common symptoms of vestibular disease in dogs?
- Pronounced Head Tilt
- Staggering or Stumbling
- Nausea and Vomiting
- Lack of coordination
- Continuous circling in one direction
- Standing with legs spread wide
- Unwillingness to eat or drink
- Loss of balance / falling over
- Rapid eye movement while awake
- Choosing to sleep on hard surfaces
If your dog shows any of signs listed above call your vet for advice, as these symptoms could indicate a more serious condition. Therefore, communication with your vet over these symptoms is essential.
Based upon your dog’s medical history and overall health, your vet may suggest bringing your dog in for an examination or waiting to see if the symptoms begin to improve within a few days.
Treatment for Vestibular Disease in Dogs
While vestibular disease may cause your dog some mild discomfort, motion sickness and a lack of coordination, the good news is that the condition it isn’t painful or dangerous and will likely clear-up on its own without treatment within a few weeks.
That said, it is important to monitor your dog’s symptoms carefully. If you notice that your pup’s condition begins to worsen after the initial 48 hours, contact your vet to book an examination for your pet. Your vet will examine your dog for signs of more serious conditions, and to assess your pup’s overall health.
If your dog is experiencing nausea or vomiting related to vestibular disease, your vet may prescribe an anti-nausea medication to help relieve these symptoms. Dog’s experiencing difficulties drinking due to dizziness caused by vestibular disease may require treatment with IV fluids to avoid dehydration.
The bottom line is that the main treatment for canine idiopathic vestibular disease is patiently waiting while your dog recovers.
Since vestibular disease in dogs is caused by an underlying condition, your vet will treat the dog’s underlying condition first, and then control the effects of vestibular disease with supportive care.
Supportive care for vestibular disease is based on each dog’s symptoms and may include:
- Anti-nausea medication to decrease vomiting and help with motion sickness.
- Topical skin care for pets that cannot walk or hold themselves in position for normal urination and defecation, to prevent urine scald, bed sores, and skin infections.
- Oral antibiotics for treatment of bacterial infections.
- IV (intravenous) fluids, as needed.
- Sedatives to promote relaxation and reduce anxiety.
Recovery and Management of Vestibular Disease in Dogs
Overall, the prognosis of vestibular disease in dogs is good if the underlying cause can be resolved.
Most dogs that are diagnosed with vestibular disease start to improve within one week, and often return to normalcy within three weeks. Some, however, may develop a permanent head tilt or may have continued episodes of ataxia. During recovery at home, it is important to provide a calm and quiet environment free of potential dangers such as pools, stairs, or items that may cause injury.
A recurrence of vestibular disease is possible, but uncommon. A head tilt or mild ataxia may linger, even when other symptoms are resolved. However, neither symptom is life-threatening, and dogs can go on to live a normal life.
When your dog’s vestibular disease is caused by an ear infection, resolution of the ear infection usually results in resolution of the vestibular disease. When the cause of vestibular disease is unknown, symptoms usually resolve completely within three weeks.
In severe cases—or cases where the underlying cause cannot be resolved—like tumors or polyps that cannot be removed, supportive care at the hospital is needed until your dog can eat, walk, and eliminate on its own.
BY-DR. UDAY KUMAR, CANINE SPECIALIST, PATNA
