Vestibular Disease

14th Jan, 2020


Photo credit: Mariaan Browne

Written by Dr Mirjam van der Wel  

You come home from work and suddenly find your dog off balance, with its head to the side, walking in circles. He doesn’t seem excited to see you. Understandably you panic. This looks BAD. Has Fluffy had a stroke? Has he been poisoned? Has he developed a brain tumour?

Any of these conditions are possible, but if you have an older dog it’s likely that your dog is suffering from idiopathic vestibular disease (“idiopathic” means that the condition arises spontaneously, without any apparent or known cause) – also known as “old-dog vestibular syndrome”.

And, fortunately, this is a condition that usually has a positive outcome.

Balancing act

Your vestibular system is situated in your inner ear and brain. Its job is to maintain balance by coordinating the position of the head, limbs and eyes. Dogs are the same.

A dog with vestibular disease will tilt its head and be off-balance. Some dogs will walk around in circles looking a bit “drunk”, while others may fall over and be unable to get up. The dog may have a very distinctive eye flick called a “nystagmus”. The dog is likely to feel dizzy and nauseous and probably doesn’t want to eat.

The above symptoms can be caused by a number of conditions, including a stroke, poisoning, trauma, brain tumours, low thyroid hormone and an inner ear infection.

To the vet

Your vet will take a thorough history, examine your dog and possibly run some additional blood tests and maybe an x-ray if they think it’s related to a middle ear infection. Because we’re looking at possible problems inside the dog’s head, further imaging can include MRI and CT scans.

But before you panic and think that this is going to be out of your budget, please note that it’s very common to adopt a more conservative approach. The basic veterinary exam can make the diagnosis of idiopathic vestibular disease very likely, and you and your vet will monitor Fluffy for the next few days.  

Is there a treatment?

In severe cases Fluffy may need to be hospitalised for intravenous fluid treatment if he doesn’t want to eat, but, more often than not, Fluffy can recover at home.

He’ll likely be prescribed meds to help with the nausea, and you may have to adjust some things in his surroundings to make injury less likely as he regains his balance.

There’s a good chance that Fluffy will be back to normal within a matter of days/weeks.

Yes, sometimes the head tilt can remain, but it won’t affect Fluffy’s quality of life, and although initially the symptoms of idiopathic/old-dog vestibular syndrome can be very scary, the outcome is generally positive!