Vestibular Disease in Dogs
Vestibular disease is a general term for anything abnormal affecting the vestibular portion of the central nervous system. This includes the inner ear, middle ear, and part of the brain. The vestibular system is responsible for a sense of balance and spatial awareness. Vestibular disease can affect dogs of any age, breed, or size. There are many causes of vestibular disease in dogs, so keep reading to learn more!
Signs of Vestibular Disease in Dogs
Dogs with vestibular disease can have dramatic symptoms that can be very concerning. These include:
- Head tilt to one side
- Rolling or leaning to one side
- Vomiting and/or drooling
- Ataxia (walking abnormally)
- Falling to one side
- Circling in one direction
- Nystagmus (eyes are moving repeatedly from side to side, up and down, or in circles)
- Head swaying from side to side
Causes of Vestibular Symptoms in Dogs
There are many potential causes of vestibular disease in dogs, including:
- Inner ear infection*
- Middle ear infection*
- Idiopathic or Old Dog Vestibular Disease*
- Inflammation in the central nervous system
- Congenital malformations (birth defects)
- Secretory otitis media (not an infection, but too much waxy material building up in the ear)
- Thiamine deficiency
*The most common causes are inner or middle ear infections and idiopathic vestibular disease, often called “Old dog vestibular disease”.
How can my vet determine the cause of these symptoms?
A complete physical exam and blood work, including thyroid testing, is a good place to start. Your vet will want to check your dog’s reflexes, determine the type of nystagmus and direction the eyes are moving, see if any other nerves around the face are affected, and look deep into your dog’s ear canal to see if the eardrum appears abnormal.
Advanced imaging of the skull and brain may be needed to look for signs of infarction (stroke), assess the inner and middle ear, look for any signs of cancer, and any inflammatory changes. Both a CT and MRI may be needed since the CT scan is best for bones and the MRI is best for soft tissues like the brain.
A spinal tap may be needed to look for signs of infection and inflammation in the fluid along the spine and central nervous system.
In older dogs, you can often wait and watch for 2-3 days. If this is “old dog vestibular disease” the symptoms tend to improve within 48-72 hours but may take weeks to fully resolve. If the symptoms are not improving or seem to worsen, additional testing is needed.
Treatment for Vestibular Disease in Dogs
The treatment will be directed at the underlying cause.
Inner and middle ear infections may require surgery or flushing under anesthesia, followed by oral medications to treat the infection. If the eardrum appears abnormal or ruptured, a myringotomy can be done. This procedure involves directing a sterile needle into the middle ear and discharge or fluid is obtained for testing to look for inflammation and infectious agents.
Hypothyroid dogs can start thyroid supplement pills. Often, this will resolve the vestibular disease.
If cancer is found, chemotherapy and radiation therapy can be discussed. Surgery may also be indicated.
If an inflammatory condition is diagnosed, steroids are often the necessary treatment.
Symptomatic treatment often involves anti-nausea medications, motion sickness reducers (the eyes are spinning or moving and it makes your dog feel like they’re on a moving boat!), anti-anxiety medications if needed, and support to get them to eat and drink.
You will also need to support your dog and help them get outside to potty and help stabilize them so they can posture to urinate and defecate. Some dogs may not be able to stand on their own and may urinate and defecate on themselves while they’re laying down. Have potty pads and diapers available. Be sure to check on your pup often to clean them, offer food and water, and give them comfort and encouragement.
Keep only small volumes of water available at a time and refill often. You don’t want your dog to roll into the full water bowl and not be able to get up and possibly drown. Securing water and food bowls to the kennel or holding up the bowls for your pup to eat and drink from are often needed while the vestibular symptoms are at their worst.
Be sure to rotate the sides your dog is laying on to prevent pressure sores from forming. Have a soft padded area to lay on, like a washable bed or blankets. Clean and dry the coat and skin thoroughly if they spill water or have a urinary accident to deter infections from forming.
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