Shea Cox
Print|Email|Text Size: ||
Idiopathic or “Old Dog” Vestibular Disease
Vestibular signs in dogs are often incorrectly referred to as a stroke

A fairly common reason for a veterinary visit is the concern that an older dog has had a stroke, when he suddenly starts walking like a drunken sailor with his head tilted. I know of other cases, where these sorts of symptoms are assumed to be a brain tumor and the dog is euthanized—maybe unnecessarily. (The condition plays a role in the new Hallmark movie, Duke.)

Well, I want to shed some light on a much more common and less concerning cause of these and other disturbing signs, something known as idiopathic vestibular disease, in case it is something you ever experience with your own geriatric dog.

Idiopathic (meaning unknown cause, think: idiot) vestibular disease is a syndrome that looks really, really bad, but usually gets better all on its own with little or no treatment.

The vestibular system
The vestibular system is composed of portions of the brain and ear and is responsible for maintaining a sense of balance. When something goes wrong with this system, it’s like being drunk on a rocky boat. Dogs with idiopathic vestibular disease have some combination of the following signs:

These videos show a dog with mild, but very typical, vestibular signs and another dog with more severe signs.

Now for the caveat: These clinical signs are unfortunately not unique, or diagnostic for, idiopathic vestibular disease and other things can cause this same presentation. These can include (yes) a brain tumor, an inner ear infection, inflammatory disease or sudden bleeds into the brain—to name a few. But with that being said, when the symptoms seemingly appear out of nowhere in an older dog, I always recommend a “wait-and-see approach,” treating symptomatically and supportively, as there is a good chance of improvement.

Wait-and-see approach
For a dog showing the above signs, I first discuss the possible causes. Next, I recommend blood work and a blood pressure check to make sure there is no “obvious” disease. I discuss the availability of an MRI to evaluate the inner ear and brain. Although an MRI allows for the best evaluation of disease, it is often not pursued due to cost (about $1,500 here in the Bay Area).

I examine both ear canals, and if an infection is suspected, I discuss antibiotic therapy, as inner ear disease is one of the possible causes of vestibular signs. The inner ear (pictured below) is something you cannot see during an exam because the eardrum obscures the view to the inner ear. The eardrum is like a closed door that sits in front of the middle and inner ear. However, if there is a nasty looking outer ear and an inflamed eardrum, there is a chance that inner ear disease could be present as well.

If the dog’s clinical signs are so severe that they cannot walk, I then recommend supportive care with IV fluids and injectable anti-nausea medications. Urinary catheters are sometimes placed for hygienic reasons. If clinical signs are mild, pets can often be managed at home with over-the-counter meclizine (for the feelings of “motion sickness” they experience). We also provide instructions for general nursing care as well as how to protect from falls.

The conversation ends with discussing a very loose rule of thumb: If there is gradual or complete improvement within 72 hours, it is likely idiopathic vestibular disease and additional diagnostic testing is not necessary. If there is no improvement or progression of signs, it is likely something much more serious, such as a tumor, and an MRI would be recommended to reach a definitive diagnosis. With idiopathic vestibular disease, marked improvement is usually evident in this time frame, with the pet returning to normal in 7 to 14 days (although in some dogs, a head tilt will still persist).

It should also be noted that this is not a painful condition, and my recommendations stem from the fact that euthanasia is a permanent decision, so why not wait and see, giving time a chance? There is a high likelihood that improvement will be seen and the difficult decision of euthanasia can always be made at a later date if there is no improvement or if there is a change in your pet’s quality of life. I feel there is reason to hold out hope and be cautiously optimistic, as idiopathic vestibular disease is the most common form of vestibular disease in dogs. It is the direction I would take if it were my own boy experiencing this.

Please note: There are times, however, when a physical exam points undeniably to a brain tumor, but these neurological exam findings are beyond the scope of discussion, so feel free to ask me any questions.


Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.

CommentsPost a Comment
Please note comments are moderated. After being approved your comment will appear below.
Submitted by Shea Cox DVM | June 7 2012 |

Hi Cath~ First off, let me relay my heartfelt sympathies for your loss. I don't think there are many things more difficult than that experience. And secondly, it sounds like the difficult decision of helping her pass peacefully was the right one, as heart wrenching as it is to make. I mentioned in the blog, "There are times, however, when a physical exam points undeniably to a brain tumor, but these neurological exam findings are beyond the scope of discussion." I bring this up because it sounds like she had such an underlying problem. The way you described her return of clinical signs, the progression of her signs, and especially the knuckling of her right paw under her, all point to a tumor in her brain. And I want you to know that I am not saying these things to ease your heart- I, myself, would have made the exact same decision as you based on what you have shared. You did not let her down in the least- you were by her side, sharing your love for her, and letting her pass in as peaceful a way as possible. I hope this helps in some small way. In understanding, Shea Cox.

Submitted by J | June 8 2012 |

Hi Cath, My story mirrors yours very cloesely, except I still have my 14 year od Belgian sheep dog with me.10 months ago she develpoed vestibular syndrome. very severly. I too layed next to her side for 5 days. She could not stand on her own. She peed where she layed too. I gently cleaned her as well. I had to feed her water thru a syringe, and made a slurry of food home cooked meats, organ meats, probiotics, electrolytes. I was certain she would not recover, but never lost hope. it was touch & go. Slowly she recovered, but still has a head tilt and wants to spin/walk. I don't mind these changes. I'm just greatful that I still have her. I'm writing to express that you absoluty did everything within your power to help her. I don't believe in a wait and see approach. I've found much success with homeopathy. I used gelsinium, traumeel, pusattlia remedies. for the inflamation & nausea. i firmly believe that these helped speed her recovery. after all if inflamation causes this symdrome, why not try to alleviate it? Ive also discovered slippery elm bark helps with nausea and upset stomach along with ginger. I continue to use homeopathic remedies for her other health concerns. I know the pain of the loss of a beloved pet is devasting. I just lost my 19 yer old Cat, 3 weeks later our 10 month old kitten snuck out and was hit by a car. they lay to rest in my back yard. Our Dear Belgian is clearly morning their loss, I wish I could find a remedy to help ease the devasting loss of those so dear to us. maybe just knowing that others share in your loss and that you are not alone helps?

Submitted by Anonymous | December 1 2012 |

I have an almost 5 years old St. Bernard. In the Past few days he has been having trouble with his motions, bad stomach. Today when we woke up we got to see his shit in the house (which never happens), turns out he is not able to move much and has been shivering/shaking(not out of cold) with long breaths with constant trembling. He is not able to lift his body, and can't be taken to the Vet as he is huge to carry... I'm really worried, thinking either he has got a stroke or may be paralysis. Any suggestions as to what actually is going on with him?

Submitted by jackie hannum | February 26 2014 |

id be worried about bloat, with a big dog, if he seems
uncomfortable, or paces you must get him to
vet stat!! is his stomach distented? seem bigger
than normal? if so get to hospital please

Submitted by Anonymous | June 11 2012 |

We are going thorugh this with our Cocker Max. We have him on Antibo.and Pred. we are seeing improvement, but still have to lift him and some times he gets going and out side to do his business,he stands for a while and eats and drinks out of his bowl and some times on a plate easer. Our vet did not metion Old Dog Sbyndrome. We are going to watch for about a week or two. I guess if his bad days are more than his good it is time. A tough dicissoion to make. So sorry for your loss, all dogs go to heaven, and we meet them later.

Submitted by Anonymous | June 19 2012 |

I want to cry as I am going through this right now. My shihtzu is 17 and it is hard to watch her. I aboutt has only been 24 hours since she started antibiotics for this Ivd. Do you think i should give her more time before deciding about euthenasia?

Submitted by Scott | July 25 2012 |

Cath, first as a many pet owner, doing this for other reasons, understand your pain.

My mixed dog, Arfy, been told by vet 7.5 years ago when saving him from the adopted brought back twice reason for the "shot". He is something Akita. Others have said "some wolf". I don't know either was but we love him. Friday will be three weeks since he woke us up, as many, thinking seizure or stroke. 1100 later, diagnosed hour away vet ER. Immediately said IVD. Never heard of it he was 70% and in the last 36, seems to have regressed back to a week ago. Putting our precious daily joys down comes to our mind, we are scared, we are too close to be objective.

I am not sure how long this will take, as long as I can see that smile, that tail wag, the vet continues to assure us, we will, as you had to make the awful choice of thinking of your baby, I will make that decision. I do not think you were and us either, what is best for our pets, just harder to make this tough decision.

I am a 53 yr old man, not to macho to admit I cried reading your story.


Submitted by Paula | December 12 2012 |

Dear Cath,
I am so sorry for your experience and am full of tears! I had to respond to let you know that as my beloved shihtzu is now going through this if not for the vet telling me to wait it out, I would have put her down. The signs alone had me panic stricken since it seemed like a stroke and so unlike Cricket's normal behavior. She is 16 and the best friend anyone could ever want or need and I couldn't tell what was happening but didn't want her in pain. I depended on the vet to guide us. Honestly, I was way too emotional to make any decision since I thought she was dying and was devasted. Even people in the vets office were devasted when they saw her and tried to be comforting to us.

Again, I am so sorry for your pain but understand how the decision was made. Your little lady is now in Heaven and having a ball without despair. You will see her again! Blessings to you Cath.

Submitted by Tamara Miner | May 26 2013 |

Dear Cath-
It takes a lot of LOVE to let go. Think about the wonderful time (forever) in eternal summerland you have gifted your dog with. She will be waiting for you!

Submitted by Senga Thorpe | June 8 2012 |

Hi, my 13+yr old had to be rushed to the vets on New Years day 1012. the vet i saw suggested a stroke. the condition got worse when we got back home and eventually Clova was completly of her legs. My own vet came to see her two days later. i asked him what was the diff to tis 'stroke' and vestibulars. he told me this IS vestibulars. and also that it is one of the few occassions that he goes out to a house to pts a pet and then advised wait and see. my bitch had the VD severly and after a week my vet said we need to have a think now what we do. i told him i wanted to wait and see for longer as with each day there was slight improvement. the most distressing was my bitch being unable to stand and toilet, she would store it for about 17hrs, get v stressed, puffing and panting then the floods came. after two weeks she was up on her wobbly legs. i know i may not have her much longer as she now has Laryngyal paralasis, but i have had extra time and appreciate that time. Clova celbrated her 14th birthday 7 wks ago!

Submitted by Don | June 18 2012 |

My 13 year old german shepard/chow mix had an episode last night right after he ate. Eyes darting, drooling, some whining, unable to stand, falling over to one side when we did help him up. We thought he must be having a seizure or stroke so we took him right to the emergency room. Once there, the staff evaluated him and thought that he has vestibular disease. His symptoms vanished as quickly as they had come. When we left the clinic he was able to walk on his own and even climb into the car with very little difficulty. 3 hours later he was still fine, no eye movement, no listing to one side. The clinic had given us meclizine to give to him. I gave him a pill, brought him into the bedroom, and we went to sleep. About 1 am he started vomiting every hour on the hour until 5 am and his eye movement returned. It has been 16 hours since then and his eyes are still moving on their own. He can stand up on his own but not very well, his head leans to the right quite a bit, he will take food and water from his bowl if I hold it under his nose. He still wags his tail and smiles at me when I come in the room so I know he feels pretty good. I just wish his eyes would stop! Any suggestions would be greatly appreciated.

Submitted by Shea Cox DVM | June 21 2012 |

Hi Don~ I'm so sorry to hear about your baby :( It is tough to have to go through these experiences... by now, I would expect him to be getting slowly better. The difficult thing with these signs, is that every pet can present differently, take completely different paths towards improvement or decline, and can have any one of many underlying causes going on that all give you the same clinical picture. For example, sudden onset of signs, rapid improvement, and then return of signs again can indicate a small bleed in the brain; but on the other side, it could also mean simple exacerbation of vestibular disease. At this time, the focus is mainly on comfort measures, safety, and nursing care. You can give Meclizine 25 mg once daily for several days in a row without harm. Keeping him in a darkened, low stimulus room can help with the spinning (and subsequent vomiting). It can take a while for the nystagmus (eye movement) to resolve, but that is usually one of the first things to go away. I'd be concerned if this is still present, and if so, you should follow up with his vet. I am glad to hear his tail is wagging and he is happy... it is emotionally frustrating to have to 'wait and see' what progresses or improves, and I wish you both the best. Keep us posted.

Submitted by Zeke's Mom | July 7 2012 |

Last September, my 6 year old sheltie/Australian Shepherd mix began barking episodes ..for 10 mins, two to three times a day..In October, after medicating, my Vet Said she believed, based on her educated intuition and 30 years experience, that Little Zeke has a brain tumour...( I must include here that he developed a paralysis(partial) on right legs when he was 2 years old...acupuncture reduced the severity but he has limping with clubbing sometimes in the right front leg.).Vet believes the old injury and these barking episodes may be related...Now, eight months later, he is on a cocktail of supplements, pheno and prednisone(every other day)..but he still barks..and it's an anxious bark, staring at nothing...The curious part is that the bark episodes (142 times in 30 mins -sometimes only 10 barks) are within an hour to one and half hours of eating..the other thing, is that if I stroke him, pet him, barks stop! If I stop, he resumes this mindless barking.. I tried for one month an experiment recommended by vet, of NOT touching him at all..the barks continued..so rather that leave him in what appears to be a fearful state, I stroke him, to calm him. At 6 years(when it began) is he a senior dog ? I must note here that he is although a little subdued still has a good life for about 70% of his days...Anyhelp out there ?

Submitted by Anonymous | September 8 2012 |

My approximately 11 year old dog started the barking episodes in the last few months, usually after eating. I really didn't relate that to anything, and didn't mention it to the vet. when I took her this past week. She started the head tilt and stumbling on Sunday so I took her to the vet. Her eyes were moving rapidly to the side, so he concluded that she had vestibular disease. He seemed to think it was not ear-related, but now I wonder. She is blind, but has been able to sniff her way around. Now she just runs into everything, and I have to carry her outside. He seemed to think she would get over this in 3 days to 2 weeks, but I really wonder.

Have you learned anything else about your dog? I hate seeing my dog like this. She sleeps much of the time, but I would like to know if she is in pain or just frustrated because her balance is very unstable.

Submitted by Scott | July 25 2012 |

Dr. Cox,

I came here to ask, cried my eyes out about Cath's decision

Arfy, male, 9 years. Bam, 3 am wake up, he is left, stiff, certainly trying to understand it himself. First thoughts as many, seizure or stroke. He was so bad, it could have been seen as a broken back. Freaked, rushed to vet ER hour away, first look, check, then eyes and immediately said vestibular disease, explained it using the human vertigo times ten.

Arfys improvement has been much slower. Starting last week, he could manage drunk, left side tilt, everything crashes and leans left.. Up until late Monday night, he was even able to sorta take his position to poop, with some stumbling. Continues to pee with a four legs down stand pee. Noticeable Tuesday, he went south a bit. Instead of running somewhat straight with a left lean, he really started floating to the left, so bad, makes a half moon if you will trying to get right, as he is flowing 10 yards to then head a bit straight.

Reading what you posted here, I think the MRI or CT are in order. Money is not the object, my kids cost me more and I love my dogs more. ;) I read you say tumor possible in the brain. If this, I assume a qualified radiologist report would be clear enough to know operate or not operate?

Thank you Dr. Cox

Submitted by Shea Cox DVM | July 25 2012 |

Hi Scott~ I hope I am replying at a time where this still helps (I'm sorry, but I am not alerted as to when a new comment is made, otherwise I would have replied sooner)... First off, please let me offer my heartfelt empathy for the difficult situation your family is experiencing. The next step would be to consult a neurologist, who would perform advanced imaging; the neurologist and radiologist would then evaluate the images to see if a tumor or other problem is present. The neurologist generally oversees the MRI/CT while the pet is anesthetized, and from there, it can be determined which modality would work best based on the images that are interpreted by the radiologist. So, yes, moving forward with a neurologist consult and advanced imaging would be the next steps. I hope this helps answer your question, and again, my thoughts are with you and Arfy.

Submitted by Anonymous | July 30 2012 |

With the exception of 'vomiting', my 19+ y/o mix breed dog has all the symptoms, at first, I thought he was unable to walk due to hip dysplasia[even tho I make sure he takes a glucosamine tablet daily]. When he defecated inside due to inability to walk down one step, I panicked, we have a vet appt first thing tomorrow, hopefully[& prayerfully] it will be something simple like vestibular disease...please send response.
Thank you for being there, I'll keep you posted

Submitted by Shea Cox DVM | August 29 2012 |

Hi Anonymous~ I hope your appointment turned out well; I am just seeing this response now but sending thoughts that you had a happy outcome. Please do keep us posted.

Submitted by Susan | August 17 2012 |

Our 7 yr old shih tzh, Lexi, first got the vestibular symptoms on June 30th. Shd had
the head tilt and could hardly walk but never got sick. The vet prescribed antibiotics and
prednisone and she got back to normal within a few days. About 3 weeks later, the same symptoms
Re-occurred. Antibiotics again for a month....gets better and now about 3-4 weeks later, head tilt iz bCk.
She is able to get around, use the bathroom, eat, etc but seems tired. We thought we are dealing w/ vestibular disease but now we are being referred to. Neurologist cor an MRI. Lexi keeps shaking her head and scratching at her ears like they are bothering her. Dont mind paying for mri but shouldnt a
blood rest reveal if we are dealing w/ something else other than vestibular? Coulx this re-occurrence be a brain tumor ?

Submitted by Shea Cox DVM | August 29 2012 |

Hi Susan~ an MRI is the best way to evaluate what is going on from what you describe, and it will help "cut to the chase" so to speak. An MRI can help evaluate for inner ear disease (that you cannot see on an exam) as well as any problems with the brain tissue. With that said, a blood test will be part of the work up (not just the MRI).

Contrary to popular understanding, a blood test can not tell you if you are "dealing with something else." I often hear people say that "the blood test didn't reveal any cancer," when in fact, there are not any specific blood tests for cancer screening (like in people, such as a prostate cancer screen).

What a blood test can tell you, is general organ function; i.e., the kidneys and liver are healthy, the electrolytes are normal, etc.

To further illustrate the "frustration" of a single test, if you see an increase in white blood cell levels, that doesn't necessarily mean an infection like you would think... i can also mean inflammation, certain types of cancer (again, NOT a diagnosis for cancer or screening, but a piece of a big, big puzzle), or sometimes even stress.

Unfortunately, there are very few diseases in medicine (human or animals) where one test gives you an answer. Oftentimes, the more important thing a single test can reveal, is, what it is NOT going on.

When I am explaining the need for various diagnostics to a pet parent, I use the analogy of a literal puzzle, and each diagnostic gives us one piece of the puzzle. The more "pieces" of the puzzle we can lay down on the table, the clear the picture (diagnosis) becomes.

I hope this helps! Good wishes to Lexi and your family.

Submitted by Anonymous | September 13 2012 |

My dog has a very similar thing at the moment! Did you get any further investigations?
I notice they are about a monthly occurrence? Out of interest, this doesn't coincide with flea treatments does it?
My Frenchie has had this hind leg lameness 3 times now 2of which were just after the flea treatment. My vet told me it would not be the cause at all.
So would be interest to find out how your pup is doing now and if you found the cause?

Submitted by Jo carroll | August 9 2013 |

Hi Shea,
My very fit 17 yr old Welsh Collie awoke yesterday with bi lateral nystagmus, head tilt, urinery incontinence overnight and was very unsteady. She is mildly epileptic, suffering from focal fits for the past 12 years and having a full Grand Mal fit about 6 weeks ago. She had two further Grand Mal fits yesterday afternoon lasting only 5-10 seconds in total. Overnight she has slept soundly by my side with no further fits.
Today her nystagmus has reduced, her gait is stronger, steadier and she is walking in strait lines. She is sill swerving but it's so much better than yesterday. She still has head tilt but has eaten and drank water, wags her tail from recognition when we are near her and seems settled.
If a dog is already epileptic could the past two fits have come from that or does it I'll indicate a probable brain tumour? She has improved so much in 24 hrs- would she have done if she h a brain tumour? My vet, I can tell, thinks we are delaying the euthanasure selfishly, but I do not think she is in pain and she seems happy and content albeit obviously very dizzy. We have meds today to help h wih her sea sickness symptoms. Can you advise? Could he fits be a red
herring and could she have vestibular disease and also have fits from her epilepsy? Could h epilepsy have caused vestibular disease?
Many thanks and great site!

Submitted by Nick Abbott | November 6 2013 |

Graham, In my experiance 3 out of 3 is not a coincidence , may be just that the connection has not yet been made

Submitted by Anonymous | August 22 2012 |

Hi Dr. Cox,

Do you see dogs who have repeat episodes of IVD?
I have a 15+ year old german-shepard mix who I adopted 3 years ago. She had her first "episode" 2 1/2 years ago and presented with classic signs of IVD (head tilt, falling, nystagmus, etc.) the only odd thing is she recovered within 2 hours. Same thing happened 3 months later, then 6 months later, etc. She has always recovered within hours and has no symptoms in between episodes.
My vet started her on asprin and plavix (maybe she is having strokes?). Now, 7 months later, she's having an episode that has been going on for 2 days (again, classic signs of vestibular) but this time for a longer duration.

Any thoughts? Brain tumor? (would symptoms dissapear in between episodes for such long periods of time?). Focal seizures? Odd version of IVD?

Thank you for your comments,

Submitted by Shea Cox DVM | August 29 2012 |

Hi Anonymous~ Yes, dogs can have repeated episodes of vestibular disease, and I have seen dogs that recover quickly (just as you experienced). Some reports state that these rapidly presenting and resolving episodes are due to sudden bleeds in the brain but the jury is still out as far as a definitive answer for this. This may be why your vet prescribed the aspirin/plavix.

A brain tumor (unfortunately) has to be considered due to the recurrence of the signs and her age, breed. And to answer your question, yes, symptoms can disappear between episodes. An MRI is the only way to tell what it happening.

I hope this helps, please keep us posted. My thoughts are with you; it's hard on the heart to see our babies go through this. And, as an aside, my hat goes off to you for opening your home to an older dog! Those that adopt geriatric pups have a special place in my heart :)

Submitted by Melissa | September 12 2012 |

Hello Dr. Cox,

About a month ago my 8 yr old shitzu Myles was in a car accident one week before we were scheduled to fly back to the US from living overseas for 2 yrs. I fortunately did not witness it but was on site of the accident just as it had happened. Surprisingly, he survived the accident and the vets went above and beyond to save him. We quickly realized he'd been hit in the head but the swelling went down fast enough that the vets believed there was a very good chance for a full recovery. But they had to remove both eyes as they were causing him more harm than good. He's flown home last weekend and seems to be perking up. But what we are left with is not just blindness but a very considerable head tilt. He stands up from time to time as if to try and get from point A to B but only ends up walking in circles. I really don't know what to do. I've not taken him to our vet here because I just want to give him some time to just be home for a while to just rest. He's eating well (his jaw was broken but seems to be healing fine). He always waits to be put outside to use the restroom. He certainly responds positively to our voices and touch. We've had a little tail wagging and barking at the door. Just no improvement on the walking. Do you think there is any chance he might someday be able to get around? I know, loaded question. Just thought in case you had ever known of a dog in this situation. Blind and with the head tilt is a tough combination. Any words of wisdom would be appreciated. Thanks.

Submitted by theresa | September 14 2012 |

Dr Cox I have a chihuahua, the vet thinks he is 12 years old. Two weeks ago he woke me with a yelp at 5am. He had his head turned to his left. We thought he had a crick in his neck. He has walking eating peeing pooping like always but had the head tilt. We thought he had a stroke. He got better then a week later had to take him to the vet because he would bark and it sounded like a painful bark it did not sound like his usual bark. I thought his ear was painful or itchy because when I would rub his ear he would push it down on my hand. The vet gave him clavamox for 1 week and said he has an ear infection very deep down. Also gave him a shot dexamethasone. Other than the head tilt you wouldn't have known anything was wrong with him. But 2 days later all he wants to do is eat and sleep. But now he gets up and will step backwards 2 or 3 steps and lay back down. He knows where he wants to go but has lost some ability to get there sometimes. If he thinks he is going to get some food he always manages to get there but it is hard for him. About a year ago I think he made have had a seizure because for about 10 minutes he was laying down head up but shaking not responding to my voice. It hasn't happened again to my knowledge. Does this sound like vestibular disease to you and if so will he have setbacks? I have read a lot on this but every dog is different. He has not vomited or does not have the eye movements. He does squat to pee. Your opinion means a lot to me sounds like you know a lot on the subject. We are leaning on putting him down as we don't have money for xrays and mri. We love him like our child but dont want him to suffer. Do you have any suggestions on what I can expect if it is a tumor. Thank you

Submitted by Ashley | October 16 2012 |

I too have a chihuahua and my dog is having identical issues. I'm freaking out looking for answers. Have you figured anything out since posting this? Any info helps! Thank you!

Submitted by Stacey | September 24 2012 |

Hi Dr. Cox,
Thank you for the great article. I was so frightened when my dog displayed the symptoms described in your article. My Vet suspected Vestibular disease, which I had never heard of. I immediately did some research online and thankfully came upon your article. It put my mind at ease to see that in all likelihood, this is what my dog has. One thing I have not seen discussed in your article or any of the comments is the absence of an appetite. My dog has never been a ravenous eater, but usually eats both breakfast and dinner. It's been six days since she's had the symptoms of Vestibular disease and she has still not eaten on her own. She spent two days at the hospital receiving IV fluids. Since then, it has been three days in which I've had to force feed her. I am mixing Pedialyte with baby food from a jar and squirting it into her mouth. She'll eat about two small jars a day but only if I force her. She has no interest in dry dog food, wet dog food, beef, chicken, etc. I managed to get her to eat a few small scraps of chicken last night but that's all. She seems to be keeping the food I manage to get in her down. But I'm very concerned that she won't eat on her own. Is this to be expected?

Thank you!

Submitted by Cara | October 2 2012 |

Hello, our 14 year old Golden Retriever was diagnosed with Vestibular Disease yesterday afternoon. We brought her home from the vet and she hasn't been able to walk since. Her back legs stick straight out and when we try to assist her to stand or go outside, her front legs shoot out and she "faceplants" into the ground. She is on antiobiotics and drops for an ear infection and an anti-nausea medicine. Is the absolute lack of use of her legs a common symptom of vestibular disease? Most sites/info. lists staggering, trouble walking, circling, etc. but NOT the complete inability to use legs.

Thank you

Submitted by Anonymous | October 3 2012 |

Hi Cara,

I'm not an expert, but my dog (a 15 year old german sheperd mix) had very similar symptoms (inability to use her legs, doing faceplants, etc.) Her symptoms went on for almost 5 days before she started making any improvement. Now, 4 weeks later, she's doing MUCH better. Have you tried using a towel as a sling to hold her legs up? If you put the towel towards her midsection it might help keep her back legs up and prevent faceplants.
My dog was struggling so much that she partially tore her cranial cruciate ligament (canine version of an ACL).. have you checked to see if her knees are swollen at all?
My thoughts are with you!

Submitted by Rich | October 22 2012 |

Our 14 year old dog couldn't stand at all without assistance. It's normal. Not to worry. Comfort and containment are the most important things. You want to limit movement. It might take a week before you see any real improvement, but I'm happy to report that, after 3.5 weeks, our dog is back to 100% herself. Hang in there.

Submitted by retired in nyc | October 5 2012 |

i hope this helps future folks that visit here. our 16 year old "baby" got this last week, after a night at the animal hospital and one night at our vets office, 5 doctors agreed it was idiotpathic vestibular, we came home with him. we bought a playpen at target . he is 34 pounds. it said it can hold 30 . but is looks like it could go up to 50 pounds. this way it restricts his movements. we couldnt get him to eat , but he is drinking from his bowl if we lift it up to him. after trying everything to get him to eat including baby food via a syringe , we had sucess with slices of baloney and american cheese( ripped into small pieces) and putting/shoving into his mouth. he looks like he is on thmend. everytime he got up or fussed in the playpen we carried him outside ASAP and he was urinating every few hours. as a safe guard we bought huge wee wee pads and put them on top of the comforter which is on top of the play pen matteress. i hope this helps. needless to say we thought when he sudeenly got this we thought he was a goner and we were hysterical. lots of kisses seems to help too !

Submitted by Debbie | October 6 2012 |

My dog is 14 yrs old and has signs of vestibular she has the head tilt,leans to the left and is having a hard time holding her pee.Her 1st bout was back in Dec.and she got better over a couple of months. Now she has had another episode in Sept.and is having a hard time. She also has cushings which is making her pee alot. She is eating again after a week of hardly eating anything. Now she eats soft food and noodles and some cheese.Some days are better than others but I think she has more than vestibular.From what I have read vestibular gets better over time.I think she might have a small tumor. She is still able to walk and go out on her own. But it's hard to watch her wobble around and go in circles. She does not seem to be in pain she does not whine or make any noises.I'm not going to put her down until she tells me or shows me she can't function with a quality of life. Anyone else have the same issues with an elderly dog? Thanks

Submitted by Anonymous | October 9 2012 |

My 13 yr old Shepherd/Boxer mix started the head tilt thing a few days ago. Yesterday she peed either when sleeping or because she got startled when the phone rang. Tonight she got herself downstairs by pretty much falling down. She does not have barking episodes and she seems to be eating, no vomiting. She is 70 lbs. She has always been a nibbler, not a gobbler, and she usually eats when we eat. We put a baby gate to keep her from coming upstairs tonight. She is walking in circles and stumbling, and I've noticed nystagmus. I'm so worried. But she does not seem to be in any pain. What can I do for her?

Submitted by Anonymous | October 10 2012 |

I had a 14 yr old Lab who all the sudden last week could not steady herself on her left hind leg. The following day, both hind legs were so weak she could not stand or walk on her own. I took her to the vet immediately and she was put on steroids to treat a possible disk issue. We discussed that there could be other causes, but we'd have to run costly MRI scans , so we opted to try steroids first. Two days later, she could not use her front left leg either. We had to completely support her if she needed to move or go outside. She also did not appear to be able to walk straight when guided, on her harnesses ) and would run into things. The following day ( we were heading into vet later that day) she had a seizure. Vets said it was most likely brain tumor or strokes. We put her to sleep after the seizure (she had two smaller seizures within the hour of the first big one.) It seemed whatever was happening to her was progressing, which seems different than the other posts I've read on this topic. I hope we made the right decision. It absolseutly broke my heart. She was my first baby before my children and brought joy to my heart each day.

Submitted by Karen | October 30 2012 |

I understand where you are coming from. I just put my 14 year old Lab down, my heart is breaking. I am now wondering if I did the right thing. His back legs collapsed, and was having that back and forth motion with his eyes. I wish I would of know about this disease ahead of time. The doctor mentioned it, but said if it was her dog she would put him down. Sometimes I don't think the vet. knows everything. I am just sick about it. Feeling like I made the wrong decision. Now there is nothing I can do about it. I had him cremated. I just feel sick all day long after reading deeper into this disease. So please everyone, don't make the mistake I did. I just didn't want him to suffer.

Submitted by BeareKucyGabby | December 6 2012 |

Our prayers are with you, you made the right choice at the time,so sorry to hear about your lost..your story is making me tear.Up this is a horrific time to watch. Each pet reacts differently some cases are very servere, they can also have a brain tumor or irrversable
symptoms..You did what was best at the time,we
came very close..Treatment can be expensive..Please do not beat yoursel up.. 14 years, just remember what you did to have the 14 years. Now go out to the SPCA and get another friend when you are ready.. Again my heart goes out to you nothing compares to the love you received.. memories are treasures for the heart. Hang in there.. hugs zx

Submitted by Sandra | October 14 2012 |

My 12 year old Springer Spaniel has developed a head tilt. At first his head just twisted to the left and he was walking squint. Then recently he has been very unsteady on his legs an then randomly collapses. He lies on his side looking really confused about why he keeps falling down. It's as though his brains wanting to do something but his legs just don't want to. We have the vets on Wesnesday. He walks around a lot unsettled and takes a while to lie himself down. At night he wanders around slightly whining then settles for a while then gets back up it's really heart breaking to see him in this way and the cost of MRI scans is just so out of reach. This page has been very helpful though I hope we can fix him

Submitted by Anonymous | November 10 2012 |

we are on day 19 of our vestibular syndrome for our 12 year old springer spaniel. We were there when the onset occurred.. watching tv in the living room. He threw up 3 times (very forthy) and eyes darting back and forth.. and shaking.

He is slowly getting back to normal. I did not take him to the emergency vet..I called them and they said it usually resolves it self. My vet said.. lots of TLC and PATIENCE!!

hope yours gets better also..

Submitted by Aida D | October 19 2012 |

Hello....I have a 17 yr old Lhasa Apso.She has had her second stroke this week. The first was 2-3 mo ago. I took her to the vet the first time around and he said because she issue such an old.dog its probally a tumor in her brain to just make her as comfortable as possible. She seems to be recovering from this second stoke but what she is doing now that is different from the first time is heavy panting as she walks around anxiously. Why is that? Is there anything I.should do? All her symptoms are exactly what is listed. Except for the vomiting. She is blind, partially deaf, and her Are legs are very bad. I pick her up and bring her outside to. HOWEVER she is still alive and kicking. At what point should it be determined that her quality of life is gone and I should put her down? Is she suffering mentally? Please help! God bless...thank-you!

Submitted by Nick Abbott | November 6 2013 |

AidaD my heart bleeds for you, My dearest friend a 14 year ol Staffy, has been going downhill for over a year now, swellings on both hocks, kept falling over at regular intervals, 7 to 14 days, unsteady on his legs, but he was coping. In the last few months he has started to drink a lot more water than usual, I think, and he , whilst always being very vocal, has started to bark loudly for minutes at a time. This morning he staggered whilst trying to get down stairs to go out for his morning ablutions. I had to carry him downstairs. He was not right, eyes rapidly moving left to right , all the symptoms mentioned apart from the vomiting unless I did not see him. His appetite is not there anymore, UNHEARD OF, he usually could eat for England. I am not very good with emotional pain and was certain that this was it, and I was certainly going to loose him , BUT I just felt that whilst frightened and confused, he was not in any pain. I then found this thread, I am so glad I did as if I have to nurse him 24/7 for weeks, I will as long as I feel that he is not suffering unduly, in no pain, and reassurable with love and attention and encouragement. I am sure I am not being selfish, I love my boy more than you could know, but I am sure that letting time take it's course is the right thing for him at this moment. I think I will know, and i'm sure that you will also, when the time comes to say good bye, your heart knows, you just have to trust your heart, so sad, it's a bitch, I've got it coming very soon but thanks to reading the information here, I truly believe I have had a short reprieve.
Love,compassion and my very best to you and your Lhasa hope she is still ok

Submitted by Francis | October 19 2012 |

My dog Tiny just passed away yesteday she was almost 14 and she was a chihuahua. The vet said she had Vestibular Disease. She jumped off the couch 8 days ago and didnt move i thought she broke her leg when i picked her up her body just went limp and her head turned to the side. I rushed her to the vet and they diagnosed her. They put her on medications but nothing changed. She never walked again or could even sit up. you had to do everything for her even hold her over the bowl to drink water and hold her up to pee and sometimes she would pee on you or in her bed and only ate a very small portion the first couple days after that she would not eat anything.Then you had to try and use a syringe and queeze it in her mouth. She started to act like she was not swallowing so i was scared that she would get choaked. Even though she could not do anything she really did not make any noise except a couple times during the week she yelped out.She would pee but never had a bowel movement the whole eight days, and the last day and a half she stopped urinating. Did not act like she was in pain. Yesterday my mom tried to feed her and about an hour after she tried she was dead. I am wondering if trying to feed her with the syringe could have caused her to dye sooner. I asked my mom how much did she feed here and she said hardly nothing because she wouldnt swallow. My question is that normal for a dog of her age with Vest Dis to have those symptoms? Could it have been because she had been with out food for so long. The last two days she would not even drink any water had to use a syringe for that. I know it had to be her time but just wished I could have done more for her. I am so heartbroken.I wished i knew exactly what caused her to dye.She didnt bounce back like they said she would and so I was not sure if it was Actually Vest Dis. Thanks

Submitted by Rich | October 22 2012 |

This doesn't sound like IVD. Our dog or 14 years just went through it 3 weeks ago, and she's back to 100%. She couldn't stand on her own or eat from a bowl. She had to be carried outside (and she's 70 lbs), and had to be hand fed. We even had to cup water in our hands to make her drink, but she wanted to drink quite a bit. Dogs can live without food for a while, but can't live without water very long. Dehydration can cause greater weakness and account for the lack of urination toward the end. Syringes of water probably isn't enough to live on. I'm very sorry for your loss.

Submitted by Cath | January 3 2013 |

Hello, I am so sorry for your loss. It is possible that there was an underlying cause to the vest disease. Sadly I lost my gorgeous girl to this too. Have a look at my post in early June. Cath

Submitted by sandra | October 21 2012 |

our boy is 11yrs old am staff and has a history of sezing, he takes 1 every 6 months, usually one in summer and one around christmas, but last night was diff. he was fine ,he went out to pee ran around ,was fine, came in ,after a good while my daughter hallerd for me he was sezing, but idont think so. hes quivering,left side isnt worken well and holding head low,dosent want water,hes the same this morn,i know it could be a stroke or v diesease, but is ther any thing i can do right now, its sunday his doc is closed and the emergancy hosp. is far, scary,and expensive which i dont care about money but i have not a dime right now, i have payed over 10,000 in the last yr for his docs.never nothen serious,so they said.im so scared for him.

Submitted by jemom | October 22 2012 |

Our 15 and half year old pointer mix got vestibular 3 weeks ago. For those of you out there whose dogs just got it, hang in there. Confine, hand feed, take out outside a lot, give them light at night, all of these things I learned from others online and they worked. It is an up and down process and I lost hope a lot but was not willing to give up on my sweet pup. 3 weeks later, she is pretty much back to normal. I am grateful to my vet who said to give it time.

Submitted by Andrea Llewellyn | October 28 2012 |

My 13 year old German Shepherd Dog had an episode of Vestibular on Wednesday, Oct 24th. I was sure it time time to make that decision that we all dread. However my vet said to give him some time. I am happy to say that today he is once again eating and has taken two short walks I. The woods. He seemed to enjoy them very much. He is still far from normal, but I am seeing little glimpses of him more and more. :)

Submitted by Simon | November 9 2012 |

Hi, i'm not too sure if this has happened to my dog this morning. I was upstairs and heard him bark then the kids shouted for help saying he had slid over on the floor. I came down to find him laying on his side, he didn't seem in any pain so i just held him close and got him onto a cushion. I did notice he was tilting his head but once he had lay for a few minuets he seemed ok. Still a little wobbly on his right front leg but he did manage to go out for a very short walk about an hour later.
He is 14 years old, a Jack Russel Cross and very prone to ear problems (i think he is pretty much deaf, only hearing high pitch sounds).
I haven't spoken to the vet yet as i'm sort of hoping it was a one off thing.
4 hours later and having slept most of the day (pretty normal for him) he has eaten but just seems a bit slowed down.
Any feedback on if I should worry would be very welcome.

Submitted by Munya | November 11 2012 |

hey doc i have an 8 month old pitbull puppy n has recently been diagnosed of tick bone disease but three dayz latter after treatment its now showing symptoms of the v-disease but it been 24 hrs n no improvement what should i do please help am freking out.thanx in advance


More in Shea Cox:
Arthritis in Senior Dogs
Legislative Alert
Bromethalin: not all blue-green rodenticides are the same
Hops Can Be Lethal to Dogs
Moist Dermatitis in Dogs—Hot Spots
Cracked, Broken or Torn Nails
Hyperadrenocorticism or Cushing's Disease in Dogs:
ASPCA Poison Control Center