Vestibular Syndrome is dizziness caused by a failure of the vestibular system – the organs involved with the sense of balance. The vestibular system consists of part of the inner ear called the semi-circular canals and regions of the brain that process the sense of balance. Usually only one side stops working, so the dog loses its sense of which way up it should be.

The dog appears dizzy or drunk and if it can stand it will tend to walk in circles and fall over to one side. Many dogs are unable to stand and will lie on one side only. The eyes tend to flick from side to side, moving slowly in one direction and flicking quickly back. They will often pant and may vomit. If able to stand, the head will often be tilted to one side.

Vestibular syndrome can be caused by an infection in the middle ear that spreads to affect the inner ear. In these cases, there is often pain in one of the ears and head shaking may have been present for some time previously.

The cause is unknown In most cases of vestibular syndrome. This is known as Idiopathic Vestibular Syndrome. This occurs in older dogs and is often referred to as a “stroke” to help people understand what has happened to their dog, although the cause is not the same as a stroke in humans – there is no blood clot or bleed to cause it. Factors that seem to be related to incidence of this problem include general anaesthetics, heart disease, poor circulation and very hot weather. These are all factors that can affect the blood flow in the brain and all indications are that the cause is a disruption of the blood flow to part of the brain. There are similarities with Meniere’s Disease in humans. It is possible for a blow to the head to cause vestibular syndrome, but this is rare.

Provided that only the vestibular system is affected, the prognosis is usually very good for a full recovery. However, in some cases, other parts of the brain can be affected at the same time. Generally, if the dog is able to recognise its owner and is at least partly aware of what is going on, it will recover eventually.

If an underlying cause is suspected, then treatment must be given for that. A middle ear infection will require antibiotics and anti-inflammatory drugs. No drugs have definitely been proven to help dogs recover from Idiopathic Vestibular Syndrome. An injection of steroid soon after it occurs has been proven to help many brain injuries, so it is possible this will speed recovery. Otherwise drugs that help to improve the blood flow to the brain are often given, such as Vivitonin or Fitergol, particularly if the dog has other evidence of poor circulation.

Treatment is aimed at making the dog more comfortable.  Drugs may be given to prevent vomiting and if the dog is unable to settle, tranquillisers will help. In the early stages it is best for the dog to rest quietly lying down. They may require help taking food and drink until they regain some stability. Once they start to feel better in themselves, particularly after the eyes have stopped flickering, it is useful for them to try and get around. When they first start moving around again, they will be unstable and fall often. To help them through this phase it is best to protect them from falling on hard floors/objects and to loop a towel under the body when they walk to help them. They should not have access to stairs without help. Lifting them off the floor at this stage is often distressing – they learn to use the floor as a reference for their balance. Walking around at this stage will speed their recovery – it is largely a learning process, so practice helps.

Most dogs will make a reasonable recovery within 2 weeks of the problem starting. In many cases, it seems that the damage does not repair, but rather the brain learns to cope with the change in the sense of balance. The dog is often left with a head tilt, usually worse than when the problem first started, but will be able to get around normally. Many people contemplate euthanasia when a vestibular attack occurs. However, if the dog is otherwise in good health and aware of the people around them, the prognosis is good, although it takes a little time. If, however, the dog is already suffering with poor health or seems to have suffered damage to other parts of the brain also, euthansia may be the kindest option.

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Canine Vestibular Disease

One day our 15 year old dog became disoriented, unbalanced and appeared to be confused. He was leaning toward one side, shaking his head, going around in circles, etc. We thought he may have had a stroke and took him to the emergency animal clinic. Instead of stroke it turned out he was suffering from Canine Vestibular Disease—also known as “old dog vestibular syndrome.”

Vestibular means a problem with the connections between inner/middle ear and brain causing ataxia. Dogs with ataxia stand with their limbs braced, they walk with difficulty and have a “drunk” type of motion because they have lost their sense of balance. When the vestibular nerve, which travels from the inner ear to the brain, malfunctions. It disrupts the animal’s sense of balance and orientation.

It is important to find out where the vestibular abnormality is located. The disturbance can be peripheral, meaning it is located outside the brain, or central, located inside the brain. The distinction between the two is subtle and is best diagnosed by a veterinary neurologist. The peripheral disturbance is the most common and least serious.

It has been suggested that there is a correlation between old dog vestibular syndrome and hypothyroidism so blood work should be done to rule out this problem.

The ears should be thoroughly examined because the same symptoms can result from a severe ear mite infection. Also certain types of antibiotics such as streptomycin and gentomicin can cause vestibular syndrome.

This syndrome is not a life threatening condition, nor should it even be called old dog vestibular syndrome because young dogs have also contracted it. However, in most cases old dogs are seen by veterinarians with this condition more often.

Time is a major factor in old dog vestibular syndrome. Recovery time depends on the afflicted dog. Eventually the animal teaches itself to compensate and overcome old dog vestibular. Rest and quiet are required during this recovery time, and it’s important to keep the dog in a well lighted room. If possible, avoid carrying the dog, or, if this is unavoidable, lift the dog slowly and smoothly and hold the pads of it’s feet while airborne. Lifting and moving it through the air disrupts the dog’s sense of orientation. Keeping the dog’s feet firmly on the ground with it’s eyes on the horizon helps regain it’s balance. This condition is sometimes misdiagnosed and dogs who could have recovered have been euthanized because the condition appears so severe. It is important to note that there are no warning signs, which may lead to the conclusion that it is a stroke. Fortunately most dogs will be spared this affliction. However, if your dog does contract this disease, it is comforting to know that it is not fatal and recovery is merely a matter of patience and tender loving care. Please note that a serious inner/middle ear infection—which can occur without the customary smelly ear—has the same severe and frightening symptoms. An infection can usually be cured with antibiotics and the dogs have a complete recovery. Drugs that might be used to treat old dog vestibular syndrome include Cholodin Tabs and Winstrol V. As always, check with your vet.