Has your old dog suddenly started to stumble and act drunk, developed a head tilt or can’t even get up? They may have old dog vestibular disease. In dogs this can come on very quickly and the symptoms can appear very dramatic like a stroke.Read about the symptoms, treatment and recovery time now! There are some weird and scary behaviors your dog can display that come from canine vestibular disease. If your dog has a dizzy spell or can't stand or walk, take it seriously, but don't freak out. They may just be having inner ear trouble. Read this post to learn about vestibular disease in dogs, its symptoms and trea
Vestibular Disease in Dogs: the ESSENTIAL guide
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Do you have an older dog who has suddenly started to stumble and act drunk?
Do they have a head tilt and are their eyes flicking all over the place?
If you’ve answered “yes” then there is a real chance they are suffering from a condition known as vestibular disease.
This condition can come on very quickly without and warning, and the symptoms can appear very dramatic. In fact, many dog owners believe that their dog has suffered from a catastrophic stroke.
Thankfully, for the vast majority of individuals, with the correct treatment and support the prognosis for a full recovery is actually very good.
What Is Vestibular Disease?
To understand what your dog is going through, we need to understand to the disease process and parts of the body that have been affected.
Vestibular disease is a disorder of balance and equilibrium. At least one part of the vestibular system is not working properly.
The vestibular system is the group of structures and nerves that are responsible for balance. The vestibular apparatus, part of the inner ear, picks up movement and orientation, information which is then relayed to the brainstem via the vestibular nerve.
As well as balance, the vestibular system also helps with the control of posture and keeping the body (and head) horizontal or at least know which way up is!
Think of vestibular disease being a little like doggy vertigo and you’ll have a good idea about why your dog is showing the symptoms they are.
With this in mind, the symptoms of vestibular disease in dogs relate to a loss of balance and not knowing which way is up.
The severity of the disease your dog is suffering from will impact the number and severity of the symptoms they suffer from.
Symptoms of Vestibular Disease in Dogs
Not all dogs will experience every symptom, however, the most common symptoms of vestibular disease in dogs are:
Head tilted to one side
Flicking eyes – most often from side to side (nystagmus)
Wobbly and unsteady on feet (ataxia)
Falling or leaning to one side
Legs spread in a wide stance
Drooling + vomiting
Walking in circles
Inability to stand
Other symptoms may also be present, depending on the underlying cause of a dog’s vestibular disease. These other signs though can be thought of as relating to that underlying disease process, rather than a direct result of their vestibular disease.
It is the three core symptoms of a head tilt, nystagmus, and ataxia that allow a tentative initial diagnosis of vestibular disease to be made.
A head tilt alone is certainly not enough as this can be seen as a result of other common conditions, such as an external ear infection, a foreign body in the ear (such as a grass awn), and dental disease or tooth root abscess.
As previously mentioned, severity can also be highly variable.
Some dogs may only develop a slight head tilt, holding one side of their head lower than the other just a fraction, with nystagmus and wobbliness that only lasts for a very short time.
Other dogs will have their head tilted at almost 90 degrees to normal.
The degree of wobbliness, or ataxia, can also vary considerably. It might just be a subtle stumble or dragging of a leg that you notice in your dog. At the other end of the spectrum, they may be completely unable to stand.
For those that can still get around, you may notice their legs spread to give a wide base in an attempt to remain upright. Leaning against solid objects while standing, like walls and furniture, along with a general reluctance to move are other strategies your dog may employ to prevent falling and rolling over.
Walking in circles that are always in the same direction (clockwise or anticlockwise) is yet another sign that all is not well within your dog’s nervous system.
The consequences of a dog wobbling and rolling all over the place, not knowing which way is up, and feeling like the ground is shaking under their feet, is the common occurrence of nausea and vomiting.
It’s like your dog is suffering from vertigo with an added bout of motion sickness!
What Causes Vestibular Disease in Dogs
The name vestibular disease gives the impression that this is a single disease. In fact, I prefer to think of it as a syndrome – a collection of symptoms that are given a collective name.
The reason for this is that there are many different causes that may result in a dog suffering vestibular disease, and it is important that the correct diagnosis is made so that the best treatment can be given.
Some of these vestibular causes will affect mainly young dogs, others just old dogs. Some causes are very rare and others much more common. Some come on out of nowhere, while others will graduate progress in their severity.
All of these are clues that can be used to try and determine exactly what your dog is suffering from, and what the best plan going forward is.
Major Causes of Dog Vestibular Disease
Otitis media interna
Inflammatory diseases of the nerves/brain (such as meningoencephalitis and granulomatous meningoencephalitis)
Thromboembolism (blood clot)
High blood pressure
Drug toxicity (high dose metronidazole and aminoglycosides specifically)
That’s a long list and one that has also been simplified. A blood clot, for example, can be the result of a number of different diseases in its own right, including sepsis (infection), hyperadrenocorticism aka Cushing’s disease (a hormone abnormality), and different body cancers.
Thankfully, the vast majority of old dogs that develop vestibular disease are suffering from the idiopathic form. Idiopathic simply means we don’t yet know why it happens or what the cause is.
That said, this cause is so common that the condition is also known as old-dog vestibular disease.
This disease can affect all old dogs, of any breed and any gender. It can also affect cats but this is very rare.
The next most common cause is an underlying middle ear infection. Thankfully, this also carries a very good prognosis providing an accurate diagnosis is made and the correct treatment is given.
More on this further down the page.
Vestibular disease vs stroke in old dogs
We are all aware of the signs of stroke in people and the devastating effect that a stroke can have. It is pretty common for worried owners to believe that their old dog has suffered a similar catastrophic stroke.
It used to be thought that dogs didn’t actually get strokes in the true sense of the word. With MRI scans now being available we know that this isn’t true and they actually can suffer from a stroke, also known as a cerebrovascular accident (CVA).
While they can be due to a bleed within the brain, most are actually due to a blood vessel becoming blocked, either due to a blood clot or other form of embolism, cutting off the blood supply to part of the brain.
Very often, a dog who suffers a stroke will be suffering from a condition that makes blood clot development more likely, such as Cushing’s disease, cancer, or heart disease.
Unfortunately, the signs of stroke and those of idiopathic vestibular disease can be identical. In fact, a blood clot or bleed on the brain is one of the potential causes of vestibular disease.
History, examination, and testing though may very well give a clue as to which is the more likely diagnosis.
In reality, true strokes are much less common in dogs and the prognosis for vestibular disease is normally much much better than that of stroke in people.
How Vestibular Disease Is Diagnosed
Because vestibular disease can be caused by a large number of different underlying conditions that need very different treatments and carry hugely varying prognosis, a number of tests may be needed to reach a specific diagnosis as to the cause of a dog’s vestibular disease.
Central or Peripheral Vestibular Disease
The first step is to try to determine whether the cause is central or peripheral. Central vestibular disease causes being those that originate in the brainstem, and peripheral causes being diseases affecting the vestibular nerve where is level the brain to it’s receptors in the middle ear.
The reason this is so important is that, by and large, peripheral vestibular disease carries an excellent prognosis for recovery compared to some (but not all) central causes.
The presence of central vestibular disease also justifies the use of more expensive and invasive diagnostic testing in the form of an MRI scan, CSF tap (sampling the fluid that surrounds the brain via a long needle), or both.
Unfortunately, it is not always possible to make the distinction between central and peripheral vestibular disease in dogs based on presentation and physical examination alone. A lot of the time further testing is needed, and yes, this may mean an MRI and CSF tap.
Certain symptoms are only present if a central cause of a dog’s vestibular disease is the underlying problem. These are:
Altered mentation that is inappropriately low over and above what you would expect based on the severity of clinical signs. This is clearly very subjective. But if a dog is very dull and non-responsive despite only seeming to have a relatively “mild” case of vestibular disease, then a central cause would be expected.
Ipsilateral proprioceptive deficits, which means a dog is not placing their paws as they should on the same side as their head tilt.
Multiple cranial nerve deficits distant to the vestibular system, meaning that other nerves of the head and neck are also showing signs of dysfunction. This might present as a vision disorder or problems with swallowing for example.
Vertical nystagmus, which is when the eyes are flicking up and down. It is important that this is not confused with rotational nystagmus that can appear as the eyes moving in a narrow oval rather than truly round.
The difficulty with relying on these vestibular symptoms to determine that a problem within the brain is present is that their absence does not mean a peripheral cause is the underlying issue.
If a central symptom is present then a central cause is highly likely. The absence of a central symptom means that either a central or peripheral cause could be present
The final symptom that can help determine where the lesion is located is the presence of Horner’s Syndrome.
Horner’s syndrome is a relatively common neurological disorder that is caused by a dysfunction of the sympathetic nerves of the eyes and surrounding facial muscles. These nerves run through the middle ear and so the presence of Horner’s syndrome means that a central vestibular cause can be virtually eliminated from the list of likely causes.
Symptoms of Horner’s disease include:
Drooping of the upper eyelid (ptosis)
A small pupil (miosis)
A sunken appearance to the eye (enophthalmos)
A prominent third eyelid
Your Dog’s History
Along with the symptoms found on a thorough clinical examination, your veterinarian will also use the history of your dog’s health that you provide them with to put together a working list as to the most likely diagnosis and the most appropriate tests needed to reach a firm conclusion.
A dog who was previously completely healthy before a very sudden onset of vestibular disease is more likely to be suffering from idiopathic vestibular disease or vascular rather than a brain tumor for example.
A young puppy is most likely suffering from a congenital problem, and a young adult with trauma or middle ear infection rather than idiopathic vestibular disease.
If you have been giving your dog any medication then your vet needs to know. Have they gradually become less enthusiastic about exercising? What has their thirst and appetite been like? Have they seemed not to be themselves recently?
Your vet will use all of the clues they can gather from asking you detailed questions to help piece together this challenging jigsaw puzzle.
The next step is diagnostic testing to help confirm the suspected diagnosis or narrow the list of suspected causes.
This might be as simple as using an otoscope to check your dog’s ears for signs of an external ear infection, the presence of which will increase the likelihood of a middle ear infection (although really, every dog should have a thorough ear exam).
Your dog’s blood pressure may be checked if hypertension is suspected.
Blood testing is likely to be ordered to look for signs of organ disease, clues that inflammation or cancer could be present, or an indication that a hormone abnormality is an issue. The level of thyroid hormone (T4) is also often tested as a matter of routine, although it is important to note that any non-thyroidal disease can reduce T4 levels if present for some time.
This means that low T4 levels will need to be followed up with additional testing, but normal levels will exclude hypothyroidism.
If middle ear disease is suspected then x-rays (or a CT scan) can be used to confirm the diagnosis. Of course, if a severe external ear canal infection is present, or a perforation of your dog’s eardrum (tympanic membrane) can be seen then your vet may not need this further imaging.
When it comes to idiopathic vestibular disease, there are no tests that will confirm this diagnosis. After all, idiopathic means “relating to or denoting any disease or condition which arises spontaneously or for which the cause is unknown”.
If the clinical picture fits then a tentative diagnosis of idiopathic vestibular disease is likely to be made. This includes:
Very sudden onset with no preceding symptoms
No symptoms consistent with vestibular disease
No indication of other disease on examination or with routine blood testing (which are often run on every patient “just in case”)
The disease does not become more severe after a peak of 24-48 hours
MRI and CSF Tap
When to take your dog to a neurologist for an MRI scan or CSF tap is one of the most common concerns owners of dogs with vestibular disease have.
After all, these are expensive tests. They are also tests that may mean your dog has to travel a significant distance to access, or may simply not be an option because of your geographical location.
My take on this question is that an MRI scan and neurologist’s input is valuable if:
Any of the symptoms that indicate a central cause are present
All testing draws a blank in a younger dog (i.e. not a senior)
An older dog that has previously been suspected to have idiopathic disease is not improving as expected
Any dog where the response to treatment is not as expected meaning that the diagnosis needs to be re-evaluated
An owner wants everything possible to be done
Vestibular Disease Treatment
Clearly, the best treatment for any dog with vestibular disease will vary based on the underlying disease process causing the syndrome, along with the severity of their disease and presence of any other conditions..
A dog with an underactive thyroid will need thyroid hormone supplementation. A dog with a middle ear infection will need a 6-8 week course of antibiotics.
This disease-specific treatment however will also need to be supplemented with treatment that is going to be appropriate for every dog with vestibular disease.
Giving your dog time to recover is, in my experience, one of the most important “treatments” that you can give your dog.
Vestibular disease, especially idiopathic or old dog vestibular disease, comes on so quickly and can look so severe that it is only natural for an owner to consider that euthanasia is the only realistic (and kind) option open to them.
The reality however is that the prognosis is generally excellent. Something I discuss later in this article.
This is not a disease that your dog will recover from in a matter of days, although for some dogs this can be the case. Give your dog the time they need to recover and there is a real chance that they will remain a part of your family for many months or years to come.
Your dog’s world is spinning and they don’t know which way is up.
No wonder then that nausea and vomiting are common consequences to vestibular disease.
Not only does this make a dog feel terrible, it also stops them eating. And given that recovery can take many days or weeks, the consequences of a reduced food intake can be significant.
Anti-nausea medication, such as maropitant, metoclopramide, or ondansetron (the most appropriate for your dog will be decided by your veterinarian) are commonly prescribed to limit the impact of this common complicating factor to any dog’s recovery.
Many dogs that are more seriously affected by vestibular disease are not only unwilling to eat, but are also not able to maintain their hydration levels without additional support.
In the early stages, this most likely involved the administration of intravenous fluids in the hospital setting. Later on, a dog who is eating may just need to be fed a wet diet or have additional water added to their food to ensure that dehydration does not become the cause of a setback.
The Nursing Team
It is in the hospital too that the nurse and technician team can really make a difference. In many ways your dog’s recovery will be more reliant on their care than that of your veterinarian.
It is a real team effort, and nursing these sick dogs is something that the veterinary support staff truly excel in.
Once nausea is controlled, coaxing a dog to eat can still be a real challenge. The importance of providing adequate nutrition being that the recovery and rehabilitation period for your dog will be less.
Regular turning to prevent pressure sores is vital in those dogs who are unable to move around by themselves, along with the provision of clean, dry, supportive bedding.
Taking a dog out to toilet regularly is also important, along with changing any soiled bedding and cleaning your pet should an accident occur.
It shouldn’t be underestimated either the comfort and support that the team brings to their patients. Suffering from vestibular disease is an anxious time for dog and owner alike, and providing a stress-free experience can really help to alleviate the anxiety your dog experiences in the hospital environment.
Physio and Massage
With muscles, it’s really a case of use it or lose it. This means that for a dog who is either unable to get up and move at all, or one who is reluctant to move because of mobility issues, physiotherapy and massage can make a real difference to both comfort and recovery.
Lack of use can cause muscles to become stiff. As can a constant head tilt or circling activity. Gentle massage and using warm wheat packs can help to ease this tension and improve comfort.
Physiotherapy can, in it’s most basic form, help prevent joints from seizing up and becoming stiff. This can be as simple as gently flexing and extending the main leg joints a couple of times every day.
For a dog who is recovering well, physiotherapy with a qualified practitioner can help ensure that muscle mass is maintained and movement optimized. You can find out more about physiotherapy in the article “ The Importance of Physiotherapy for Your Dog ” where I interview a fantastic physiotherapist who shares all her experience and expertise.
Anti Inflammatory Medication
This one’s a bit more tricky.
Steroids (in the form of prednisone or prednisolone) are often given to dogs suffering from vestibular disease, especially idiopathic or old dog vestibular disease, with the aim of reducing any inflammation of the nerves. Steroids may also help improve recovery in dogs with a middle ear infection so long as given alongside an appropriate antibiotic.
Whether they really make any difference is up for debate, and they do come with the risk of side-effects.
Instead of steroids, some dogs may be given a non-steroidal anti-inflammatory drug (or NSAID) which is both a painkiller and anti-inflammatory.
Because arthritis is so common in older dogs, it may be that this is more appropriate to ensure that your dog remains comfortable. That said, other pain-killing medication may be more appropriate for your dog if it is needed at all. Vestibular disease in itself is not a painful condition but rolling, stumbling, and falling will increase the chance of injury.
It is worth noting here that steroids and NSAIDs must never be given together.
Let’s face it, vestibular disease is stressful enough as a dog owner. Just imaging how anxious a time it can be for your dog.
Adding an anti-anxiety medication to their care plan may make all the difference to their wellbeing, especially for those dogs for whom recovering is taking a long time.
Options to consider include the supplement Zylkene (which you can find here on Chewy – these are affiliate links), CBD oil or chews (head here to read all about CBD oil and dogs ), or the pheromone Adaptil .
If your dog’s anxiety is particularly bad then it is also worth consulting with your vet to see if any pharmaceuticals would be a better option.
A Note on Other Diseases
One important consideration when it comes to diagnosing and treating vestibular disease is that, because the vast majority of individuals are older, there is highly likely to be one or more diseases already present.
It is also possible to incorrectly diagnose your dog with vestibular disease if you are relying on a google search rather than a veterinarian.
Arthritis, for example, affects 4 out of 5 older dogs. An arthritis flare up can cause stumbling and tripping which a dog owner could confuse with some of the signs of vestibular disease.
Equally, an older dog suffering from vestibular disease is more likely to stumble or fall and the presence of arthritis makes it much more likely that they will hurt themselves. Hence the potential need for additional painkillers.
If your dog does have arthritis then you should check out my free arthritis mini-course .
A slipped disc can also be confused with vestibular disease because of the tripping, stumbling, and even circling that can result.
Canine cognitive dysfunction, also known as senility or dementia in dogs , is a massively under-recognized disease and one that could significantly impact your dog’s recovery. At the very least it may increase their anxiety levels.
Dental disease, organ failure, hormone abnormalities. the list goes on, and all these need to be factored into your dog’s treatment plan should they be complicating factors in your dog’s individual circumstances.
Home care tips for your dog
Let’s jump into my 5 home-care tips for treating old dog vestibular disease:
Avoid skin damage
Maintain hydration and food intake
Work with your vet
Home treatment tip number one is to help your old dog avoid injuries. When they’re disorientated and stumbling around, it’s very easy for them to become injured. To prevent this from happening, we can do a number of things.
Stop your dog lying down or having access to areas with slippery floors. This could be tiles, linoleum, bare wood, whatever. One way to get around this if that is all you have in your house is to put a rug or runner down in the area your dog likes to be. It’s important though to make sure that the underside has a non-slip grippy surface so it’s not sliding around when your dog walks on it. If that happens it could make injury even more likely. Just keeping them on carpeted areas to make sure that they’re not going to slip and fall over is clearly a simple solution if available.
A non-slip floor will also help them get extra purchased when they’re trying to stand up. This in something a lot of seniors can struggle with at the best of times, especially it their arthritis (something that’s really common in senior dogs), but will be even more of a struggle while they’re a little bit unsteady on their legs.
If your dog is really unsteady than actually helping and supporting them can make a huge difference. What you can do is actually put a harness on your dog to help with this. While some harnesses are appropriate for keeping on all the time, others are better just to slip on when you’re going to take your dog out to go to the toilet. For example I really liked the ones by Julius K9 which are very robust and have an excellent handle (as well as coming in all sizes and colors!).
You can help your dog get to their feet in the first place and then continue to hold this handle to help support them while they’re getting outside and while going to the toilets as well.
For those old dogs that are really struggling with mobility, as well as having that handle on the harness you can sling a towel or sheet under the tummy just in front of your dog’s back legs to provide just a little bit of extra support and stability. This is manageable with one person but having a second pair of hands will definitely help, especially if you have a larger dog!
Avoid skin damage
Next up is to prevent pressure sores and urine or fecal scolding. So often, a dog who is suffering from vestibular disease spends a lot of time lying in a single spot. They’re sleeping a lot, they really not wanting to move, and this can be a perfect recipe for developing pressure sores. These can then be quite challenging to treat in some cases and will simply add to your dogs distress.
The other skin problem is getting really sore, inflamed skin around their back-end and back legs. A dog who is struggling to move freely will often have accidents, they’re wetting themselves and the urine is sitting next to the skin.
There are simple ways to help prevent both of these skin problems in dogs with vestibular disease.
In the first case we should try and encourage our dogs to get around and move a little bit more, within reason. We don’t want to force them to do more than they are able to do, or if they get upset by being encouraged to move.
If a dog is not moving then rotating them from side to side every few hours is important. Also making sure that they’ve got really nice soft, comfortable bedding is vital as well. A memory foam bed is perfect for this and is an ideal bed for any older dog to take pressure off painful joints. They even come with waterproof covers to make clean-up super simple.This will massively reduce any pressure build up over the bony bits out seniors often have.
As well as keeping the bedding soft, keeping it as clean and dry as possible is clearly of huge importance. If your dog does have an accident then change it straight away. Also bathing them and drying them well is key to prevent urine scald.
If though you do find that your dog is developing urine scald, you need to clean and dry your dog well and then use a barrier cream like Sudacrem to help protect the skin from further damage. Clipping the fur can help with this and bandaging the tail is also a good way to help keep a dog clean.
Eating and drinking
It’s obviously important that they stay hydrated. It’s also important, if we can, to try and ensure that they’re getting enough calories on-board. The body is in a recovery mode and they’re going to need their calories.
When it comes to encouraging them to drink, we can put ice cubes in the water bowl. You can also put unflavored ice cubes in, or just flavoring. So that could be low salt stock cubes, you really want to avoid anything with a high salt content. Or you could boil up some chicken or vegetables and use that broth to add flavor to the water.
We also need to offer this water to them regularly. Remember, your dog might not be wanting to get up. They might be really reluctant even to reach not very far to try and get to that water. So just taking it to them and then to encourage them to drink is vital.
As far as feeding goes, start by choosing something that you know your dog likes, something strong tasting or strong smelling food. You can also hand feed it, so have your dog either lick it off your finger or take it out of your hand and again offering it to your dog, taking it to your dog because they might be hungry, but they might again be really reluctant to get up and actually go to their food bowl.
Tip number four is to try and prevent anxiety. It can be a very anxious time for your dog. They’re not understanding why they’re struggling, why they’re stumbling around, why they can’t get up. Remember too that for your dog with vestibular disease the world seems to be spinning!
Reducing anxiety starts with simply spend time with your dog. Be there to reassure them. You don’t have to spend all your time stroking or patting them obviously, but just your presence being there, talking to them in a gentle voice will reassurance can make a big difference.
Next, if your dog is able, consider using some kind of food treat or food toy.
So that could be a kong, it could be a licki pad, it could be a food puzzles. Now obviously if a dog is badly affected then they’re not going to be able to benefit from these more challenging situations. That said, it could definitely be good mental stimulation for those dogs that aren’t too badly affected or who are well on their way to recovery.
Finally, if your dog is getting anxious then consider anti-anxiety supplements or medication. That could be something like the supplement Zylkene. It could be Adaptyl, or dog appeasing pheromone, that comes in a color form or as a plugin diffuser.
You could also consider something a lot of people are recommending at the moment, CBD oil. Now cbd oil isn’t the be all and end all. There’s a lot that we don’t know about it. But if it’s something you’re looking into make sure you check out my guide to the evidence behind CBD oil in dogs, and with any form of supplement of medication consult your vet.
Work with your vet
You need to be sure that your dog does have idiopathic vestibular disease or old dog vestibular disease. There are a number of other conditions that can cause very similar symptoms. As an extreme it could be a brain tumor so you definitely want to make sure that you’re treating your dog for the right thing.
Your dog may also need other medications. For example, if they are feeling really nauseous or vomiting they might need treatment to stop that so that they then feel like eating and drinking.
It may also be that your dog has other conditions that need to be addressed or they are already under treatment for. It’s important that you work with your vet to make sure that you’re able to give the appropriate treatment that your dog needs for all their conditions.
You need to have a chat about what’s important to your dog. Both from a vestibular disease point of view, but also what’s going on with that general health and you know, being older adults frequently, there are other things going on.
And then finally, if your dog really is severely affected, if you’re struggling, then the veterinary hospital might definitely be the best place for them. You know there’ll be looked after by a team of nurses or techs who are fantastic at caring for patients in situations like old dogs with vestibular disease. Your dog may need intravenous fluids to stop them being dehydrated. They may need other care and attention.
Hospitalization is definitely something to consider if you’re struggling, even if your vet is happy for you to try and look after your dog at home. You need to be honest with yourself about whether it is something you’ll be able to cope with. Looking after any dog with reduced mobility is challenging, even more so if your dog is big and heavy. Sometimes the veterinary hospital is the best place for them.
Prognosis and recovery time
As you might have guessed by now, the actual prognosis for dogs suffering from vestibular disease is generally really good. Most will go on to make a full recovery. Some will be left with a permanent head tilt but they will otherwise adapt really well and be able to live a full, happy life.
It is important that we give our pets enough time to recover. It is all too easy to see a dog that seems to be suffering from really severe, upsetting symptoms and make the irreversible decision to euthanize.
We need to give them time. The general course of disease is that the symptoms are at their worst 24-48 hours after they start. Some dogs will then recover as rapidly as the disease started. For others the recovery time will be longer, instead taking more like 7-10 days before a significant improvement is seen and 2-3 weeks before they are back to normal in the case of idiopathic disease.
If your dog’s disease is progressing differently and the suspicion is that diagnosis should be re-evaluated. It may be correct but there is no harm in reassessment and confirmation.
This might mean repeating some tests, running new ones, and even referral to a neurologist for assessment alongside advanced brain imaging with an MRI scan. This might be out of reach for you but it would certainly offer your dog the best chance of an alternative diagnosis and successful treatment.
The most common symptom to remain is a head tilt, and this may remain a constant feature. Even in this case, our dogs are amazing at adapting and will be able to run and exercise without a problem and with no impact on their quality of life.
In my personal experience, most dogs will show significant improvement after only a few days and will recover fully.
Buddy and Dan’s Story
A friend of mine, Dan from the Youtube channel Parent Pacifier, had his family dog go through an episode of old dog vestibular disease. Along with his family, he went through a lot of worry and uncertainty and I’m really grateful to him for sharing his story with you here:
Full Transcript →
“Hi, I’m Dan from the parent pacifier YouTube channel and I want to thank Dr Alex for having me on Our Pets Health to talk to you about the story of my dog Buddy and his bout with vestibular syndrome, also known as old dog syndrome or doggy vertigo.
On a Sunday morning in February 2018, my dog Bud was with my parents and he started to fall down a little bit. He’s 13 years old, cavalier cocker spaniel and he’s had some knee problems, so we assumed that it was probably a knee issue. Our normal vet was closed so we took them to another one that we’ve been to before and they gave him a shot because he looked completely normal of course at that time.
So then fast forward a couple of hours in that day and he started tripping again. He started falling down, his head was a little tilted and he didn’t look like himself. He was having a hard time. That night he had fallen asleep on the couch, like he normally does, and about an hour into being asleep, he got up, jumped off the couch and then fell down and could not get up.
You could tell he was really disoriented. He was looking all over the place when you called him. He really couldn’t tell where you were calling him from. His legs were completely stiff and he urinated himself.
We knew we needed to take him to the vet. So we called the closest vet that was 24 hours, also another one that we don’t normally use. Immediately the veterinarian knew it was vertigo, that is was vestibular syndrome.
And it made so much sense because he looked like he was seasick. He just was stiff with those paws trying to hold on to anything that would keep him still, and his head was tilted. And actually you could see it with his eyes. The vet had showed us that his eyes would jump up and then slowly come down, jump up and slowly come down. And that was happening throughout this time. And so they had to keep him overnight that night and we would hear the next day how he had progressed.
Well that Monday around 2:00 PM, we heard back that nothing had happening and he was actually still exactly the same. So we decided to let them keep him overnight another night.
That Tuesday afternoon again, no progress, still exactly the same, laying down, not getting up.
And that’s where the vet said, “well, you know, he’s 13, he’s, he’s lived a good life, but we’ll have to at some point make a decision on what we’re going to do” because it was getting really expensive to keep him overnight there. We also had to have him in an IV drip because he wasn’t eating. So it was a difficult situation to be in.
So we’re trying to think through what that family decision would be on that Wednesday. But around noon I was doing some research because I really wasn’t ready to give up and found an article or a blog that had talked about another person who had the same experience. They had a dog very similar to buddy and around 13 years old and had vestibular syndrome and was in it for like four days. But on the fifth day the dog got up.
They were ready to go to a neurologist and all those are things that we just don’t have the money for, to take him to a neurologist to find out potentially what could it be causing the problem. This is anything from an earache all the way up to cancer on the brain. And at 13, what are we going to do? Have surgery and spent all this money when he might not make it through.
So I was looking at it and thinking maybe just one more night, right? One more night if we need to. I’m not ready to jump on that decision but we had to make it as a family.
But at 2:00 PM we got the call from the vet that he actually stood up and that was awesome. We really wanted to hear that. So we went to the vet that night to go see how he was and we were able to make our decision. He was walking around and moving. His head was still tilted. He still looked a little disoriented, but he was up and walking around, which was a huge difference from where he was Sunday night and throughout the beginning of the week.
So we decided to take him home and he actually ate at home. He didn’t want to eat at the vet, he refused to take anything even from our hands at the vet’s office. But the second we were back home, he was eating. He actually ate some chicken right away. It took only a couple of days and he was pretty much back to normal and now he doesn’t even look like he has had to deal with that vestibular disease.
It was really encouraging to read what others had been through so I hope that this can encourage you if you’re currently dealing with vestibular syndrome or vertigo with your dog. I’d love to have conversations with you in the comments below.
That’s our story and here he is today, a 13, almost 14 years old, and normal and healthy. It was rough because it looked really bad but ultimately he was able to come out of it and we’re glad we didn’t make any other final decisions that week.”
If you have an old dog and are wondering what else you need to think about to make sure they are looked after as well as possible – so that they stay happy, comfortable and actively engaged in family life – then make sure you also check out this article all about caring for senior dogs.
Canine Vestibular Disease: An Overview
There are some weird and scary behaviors your dog can display that come from canine vestibular disease. If your dog has a dizzy spell or can’t stand or walk, take it seriously, but don’t freak out. They may just be having inner ear trouble. Read this post to learn about vestibular disease in dogs, its symptoms and treatment.
Canine Vestibular Disease: An Overview
Canine vestibular disease is a problem with the inner ear that impacts the dog’s balance.
Vestibular comes from the word vestibule, a hallway or anteroom. This is a very descriptive name for the complex parts of the ear. There is a whole vestibular system in dogs, and humans, that is located in the brain and the inner and middle ear. This very delicate system detects subtle changes in atmosphere and the dog’s body and has a powerful impact on their balance.
Have you ever been dizzy or had a stopped-up ear? You couldn’t move normally, or even stand or sit normally if it was bad enough. You felt weird and nauseated, maybe even anxious and irritable. This same thing happens to your dog. With dogs, it impacts their balance and the rhythm of their paws.
Canine vestibular disease is more likely to impact older dogs because things just don’t work like they used to anymore, but it can impact dogs of any age.
It is not dangerous in itself. The causes, such as an infection, may be dangerous. The biggest threat to your dog with canine vestibular disease is injury as they are likely to hurt themselves. While you don’t want to overly alarm yourself, you should always take symptoms of this disease very seriously and get the dog emergency care because these symptoms are shared by very serious diseases and immediate diagnosis is needed. Also, even though vestibular disease is not dangerous, you need to know how to care for them to keep them calm and safe and ensure that they eat and drink normally.
Canine idiopathic vestibular syndrome
Vestibular problems can be caused by infections, toxins, or other factors influencing the ear. Many times, there is no identifiable cause of the vestibular problem, the dog just clearly has it. This is known as canine idiopathic vestibular syndrome and it is quite common, particularly in older dogs. If your dog has vestibular disease, rather than another condition causing a vestibular problem, the dog will probably be diagnosed with canine idiopathic vestibular syndrome.
Vestibular disease in puppies
While it’s most common in older dogs, vestibular disease in young dogs is possible and it can even be a congenital thing with puppies. It is very rare in puppies, only appearing online in scattered scientific cases.
Always take a dog to the vet for symptoms of vestibular disease to rule out other diseases and to learn how to care for your dog.
Vestibular episode in dogs
Thankfully, vestibular disease, the idiopathic kind that isn’t caused by another factor, is mainly episodic. The dog has acute symptoms for a while and then the problem corrects itself. The downside is that it will likely come back. Some dogs never fully recover, keeping a slight head tilt or always being slightly unstable. Allowances may have to be made for them to remain safe and active and there may be some things they can’t do anymore. The latter is more common in older dogs.
Vestibular disease caused by another factor should go away when the factor is addressed.
Symptoms of vestibular disease in dogs
Symptoms of canine vestibular disease include:
590 people per month search for dog vestibular disease panting. If your dog is experiencing noteworthy panting while suffering these other symptoms, it is probably from their anxiety. You should include it in your description of the symptoms for the vet, just so they have a perfectly clear image of the dog’s case. It is not a direct symptom of the disease but can accompany it because of the stress the disease causes.
Symptoms of vestibular disease will have rapid onset. There isn’t any warning and there is no gradual progression, they’ll just suddenly act like they’re going haywire. They may wake up one morning that way, suddenly act crazy, or get increasingly unstable over a matter of a few hours.
These symptoms sound really scary. So try not to freak out. You don’t want to make the dog more upset than they probably already are or put yourself through excessive stress.
That being said, you should still always get them emergency care because these symptoms are shared with dangerous diseases. It probably isn’t the dangerous disease, but you need to be sure because they require immediate treatment. You also need to know how to care for your dog properly to keep them safe, calm, and healthy.
Causes of vestibular disease in dogs
Most vestibular disease is the idiopathic kind where the cause is never identified. Their poor vestibular system just doesn’t want to act right.
Causes of canine vestibular disease include:
- toxins that impact the ear
The connection is unclear, but experts report that it seems to be more common for larger dogs to have vestibular problems.
While there is no evidence that they can cause vestibular disease, allergies impacting nasal function may bring about or exacerbate a vestibular episode. Barometric changes while traveling or during weather events may also bring about or exacerbate an episode.
Diagnosing vestibular disease in dogs
The vet will need to hear both your account of symptoms and the dog’s history.
Three questions need to be answered:
- Has the dog ingested or breathed a toxic or potentially toxic substance? This may be a food, a cleaning product, a chemical, a human medication, a cosmetic, or something the dog is allergic to.
- Has the dog had an accident, been in a fight, or suffered a known injury in the preceding 24 hours? They may have trauma.
- Has the dog been somewhere unusual where they may have encountered an allergen, a toxin, or a venomous animal?
They may ask you other questions to rule out symptoms or potential events that may indicate another disease like a tumor or stroke.
The vet will observe the dog for symptoms and check their ears for signs of inflammation. While the vet is checking their ear, they may get stressed. Try to calm them by speaking to them in soft, loving tones and maybe even petting them soothingly.
They will probably lift the dog’s paw and flip it over to see if the dog can turn their paw back to its normal position. Inability to do this is an indicator of stroke.
They can run blood tests and other tests to detect infections or other diseases. MRIs and other tests for problems in the brain may be run, but the vet may wait to see if the vestibular disease can clear itself up before moving on to this step. It depends on how likely one or the other seems.
Treatments for vestibular disease in dogs
If the vestibular symptoms are caused by an underlying factor or disease, then that will be treated and the symptoms should go away. While the dog is being treated, you will probably have to follow some of the advice below to manage their symptoms.
If the dog has idiopathic canine vestibular disease and they can’t eat or drink or are dehydrated from vomiting, they will be kept at the vet’s office to be fed and hydrated until they can eat and drink on their own.
If they can eat and drink, they will be sent home. Time is the best cure for an episode of idiopathic canine vestibular disease. but that doesn’t mean your dog just has to suffer and there is nothing you can do. The vet will probably send them home with anti-nausea medication and maybe something for dizziness and/or a sedative if they are too unstable or too stressed. You will also want to protect the dog by making the home as safe as you can for them to move around in and to keep them off furniture and not let them use stairs by themselves. You may need to carry them outside to go to the bathroom or give them potty pads. Placing their food and water near where they are staying will make it easier and safer for them to make use of it.
Corticosteroids have been prescribed in the past, but it is not a popular treatment at this time because the scientific evidence shows little indication that it really helps.
We mentioned making the home safe. You will also want to keep them as stress-free as possible. Love them, if they don’t want to hide. If they do want to be alone, provide them a good place to do so. You might keep them in the crate a lot, if they like their crate, so they feel secure. Provide as many of the things they are used to as possible, like their favorite toys and blankets. Try to eliminate or minimize stressors like the doorbell, visitors, changes in the home, etc.
Don’t be surprised if they are jumpy or even irritable. Having your balance messed up is like losing one of your senses, this makes the animal feel frightened and they may act out.
Recovery time for vestibular disease in dogs
Dogs with idiopathic canine vestibular disease should see some relief in as little as 72 hours, but it is not surprising if it takes anywhere from a few days to 30 days for the episode to resolve completely. With some dogs, usually older ones, some residual effect may be permanent.
Should you keep dogs with vestibular disease away from other pets and children?
Vestibular disease is not contagious, so they can’t give it to another pet or you, but whether they can be around other pets or children depends on how well they can still fend for themselves. They may accidentally hurt a small pet or child or be hurt by another pet or child if they can’t get around normally. Irritability may also make them unsafe to be around other pets and children. You can help them maintain some sense of normalcy by letting them spend time with the rest of their family, but only with supervision.
If you have multiple pets in the house displaying similar symptoms, they were likely all exposed to something like a toxin. Or you’re unlucky enough to have multiple pets with vestibular disease and an allergen or storm is wreaking havoc on them all at once.
Dog not recovering from vestibular disease
If your dog doesn’t show marked improvement in a few days to a week, the vet will probably tell you how long to expect. Call the vet back up for advice. The problem may not be vestibular disease.
If the dog has improved but is not 100% after a month, call the vet back up. You should ask if they need to see the dog again.
Remember that unless the problem was caused by another factor, the dog will probably suffer from vestibular episodes again. How often and how severe they will be is unknown and depends on too many factors, but as long as you know that is the cause of the problem, you can just focus on making your dog comfortable and safe while they recuperate. It is not a sign that your dog was not treated properly or didn’t recover because they have another episode. It’s just the nature of the illness.
How CBD Oil May Help with Canine Vestibular Disease
CBD oil shows promise and gains a lot of attention for potentially helping with a vast array of pet ailments.
CBD oil may help in a vestibular episode in dogs by:
- easing nausea
- alleviating stress
- providing a sedative effect
- soothing pain from an injury reducing inflammation from an injury
- soothing bed sores
- preventing and killing infections
- easing the side effects of medications they need
The most dangerous aspect of a vestibular episode in dogs is the risk of them not being able to eat or drink. Vets may prescribe anti-nausea medication to help with this, but if you weren’t given one or the dog can’t take it, CBD oil may serve the same purpose.
If you’ve ever had inner ear troubles, you can understand why your dog gets anxious during a vestibular episode. If not, imagine being dizzy, perhaps so dizzy you can’t stand or even sit, for days or weeks on end. Your dog can’t do what they normally do and feels completely disoriented. This is frightening to them as they can’t take care of themselves. CBD oil is commonly used to address anxiety in humans and pets.
Vets sometimes prescribe sedatives to help with the anxiety and make the dog more relaxed so they are less likely to want to run around and potentially hurt themselves. if you weren’t given one or the dog can’t take it, you might try CBD oil in its place. Just make sure you give them an amount intended to relax the dog. Different doses can give them a subtle energy boost instead.
Should the dog injure themselves, CBD oil can be given orally or topically to potentially reduce pain and inflammation.
If the dog lays down too much because they can’t get around normally, they may get bed sores. These are painful and dangerous because they may get infected. A topical CBD balm might soothe the pain, reduce inflammation, and serve as a barrier to prevent infection. If the sore is already infected, CBD oil shows promise at killing infections. Should the dog not be able to take antibiotics, CBD oil could be used in their place as long as you watch for signs that it isn’t working and get immediate medical help should that happen.
While CBD oil hasn’t been studied and tested long enough to gain FDA approval, it is exciting scientists with all of the ailments it shows promise at addressing. Scientists have discovered that humans and many animals have an endocannabinoid system that creates and uses its own cannabinoids to maintain the body’s homeostasis. External cannabinoids like cannabidiol in CBD oil interact in the body much like its own cannabinoids, addressing deficiencies or providing a boost.
CBD oil for pets is available as:
- oil tinctures
- extract concentrates
- crunchy treats
- soft treats
- topical balms
Innovations from Innovet
We create scientifically-backed natural and eco-friendly products to address pet problems. If you’re dealing with a vestibular attack in dogs, you might be interested in our CBD oil tinctures, treats, capsules, and balm.
If you encounter a pet-related problem or pet ailment that no traditional or alternative method addresses, let us know. We love to innovate for pets and pet owners.