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Shea Cox
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Idiopathic or “Old Dog” Vestibular Disease

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.

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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.

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Submitted by Mary | March 12 2013 |

Thank you so much for your comments..it is reassuring. Our Arly just out of nowhere started getting sick 2 nights ago, vomiting and very unsteady on his feet. He is 14 years old, weighs around 100 pounds. Getting him outside yesterday was tough, today nearly impossible. When we got up his eyes were darting side to side and he was tilting his head. He does seem quite comfy if he's just allowed to lie quietly on the floor. Our vet said hand feed small amounts of rice and chicken which he is happy to eat and hasn't thrown up again, and as you say we are bringing the water to him. We got him when he was almost 2, and the first owners had terrorized him! so he will never pee or poo inside, I swear he would hold it til he burst! Between the 2 of us we get him out there, but your ideas with the towels is a good one! I'm sending good thoughts for you and your dog your way!

Submitted by Gary | February 8 2013 |

We are on day 6 with our 180 lb English mastiff....yeah it's tough haha. Besides having Vestibular he also has cushings disease and high blood pressure so it's meds 3 times a day on top of this. His little sister (140lb mastiff) has stage 5 lymphoma....she just made it a year and is still ticking thanks to Ohio State vet clinic. They are wonderful!!! So it has been a handful not only the last year but especially the last week. Just letting you all know this so you know it's not that bad if you just have one smaller dog with this disease. If you think you have it tough, I'll let you dog sit for us one day lol

When walking or attempting to walk,I have to keep my hands on him at all times or he falls over head first. He tries to walk fast so it's tough. Initially I wrap a towell around him to go down the stairs then I switch and either stay close and try to get him to take slow steps or I get being and steer/balance him like a jet ski by grabbing both rear hips. The "jet ski" method seems to work the best so far. Some days it's near impossible to get him to eat food so I switch to cookies and cream protein shakes. At least his way I know he is getting his nutritients. Trying 6-7 different types of food sometimes works too. Chicken nuggets, post bran cereal, yogurt, dog treats broken up, and again protein shakes although not the best food for a dog,seem to be the best option at the moment.

Our vet said he has central vestibular possibly from a blood clot so we give him one baby aspirin a day for that. We also have heard Dramamine or cerena can help with motion sickness. If your dog is really excited or upset a Benadryl can put them in a better mood to rest. If you have tile floors try to put mats down everywhere, rubber ones are the best. Lots of light is also helpful. Also he likes to bury his head whe resting so I put a few pillows on his bed too. Hopefully he gets better soon because it's quite a load emotionally and financially between him and his sister. walking him to pee in 30 degree weather at 5:30 am and again in the evening is one of the most stressful moments in my life but I love them both to death so giving up is not an option. :-)

Submitted by Babe's best friend | February 9 2013 |

Babe (Baby Ticka) is on her tenth day now. It was so bad on the onset that she couldn't walk, eat, drink. We went to a different vet in another small town near by because we no longer trusted the local vet. The new vet diagnosed it right away and prescribed 10, 20 mg prednisone pills. Babe is a Chessie and weighs 94 pounds, she is a big girl. Later that day she began eating a small amount of peanut butter bread and animal crackers and would also drink but she had to be hand fed and the water dish brought to her. By the end of the second day she was able to sit up. We have been by her 24 hours a day. The most difficult part was that we couldn't carry her outside to tinkle so we devised a system where my husband would pick her front up and I would act like a bench for her, propping the front up while massaging her belly, naturally with about 100 towels to absorb the tinkle. One of the scarry parts was her trying to walk so we had to be right by her to grab her to make sure she didn't hit her head. On the third day we used a fleece vest of Paul's (men's large)to put on her with the zipper on her back. The chest size (42) was perfect for her chest and the waist was large enough to be able to gather the vest in the back to use as a handle to stabilize her and enable her to go outside to do her business. On the fourth day she was able to walk on her own; however, she is still a little unstable in the morning and evening. Well,on the third day we then switched to chicken and then chicken with a small amount of her food and now she is on a regular diet and can go outside to tinkle and do her bombs but she is still somewhat unstable but compared to ten days ago she is 100 times better. It is exhausting for her so I still spend all night sleeping by her and taking her out as soon as she needs to go and doing hundreds of loads of towels and throws. She is my little princess and she is getting better. It would be nicer if there wasn't so much snow outside and if it were warmer. So, Babe isn't totally back to her old self i.e. taking a slipper, glove or taking my towel from the bathroom and demanding that we chase her for them, but, she is on the last day of her pills which make her very thirsty and causes her to go out every hour. I am praying, as I have been from the start, that by the end of next week she will be back to normal, normal for a Chessie anyway. Don't give up, it may take longer than five days, wait on her hand and paw and give her kisses on her face.
Rose

Submitted by debbie | April 18 2013 |

my dog got hit by a car, rushed to the vet she got hit monday, she have head trauma,she cant stand she dont eat her head tilt to one side, she dont drink water or nothing, her eyes go everywhere rolling in her head, side to side, and i am worry sick, i dont know what to do she is a chihuahua dog, any advised please will help me. thank you

Submitted by Jane | February 12 2013 |

Hi,
My dog was diagnosed with Vestibular Disease last Monday, after he collapsed. Vet did find some signs of ear infection, and we have been fighting ear and yeast infection in one of his ears for years, it would keep coming back few months after being treated. He spent 2 days in the hospital, and went from not being able to lift his head up to walking around the house (still rocking from side to side) and being more confortable outside when on the leash, in just 5 days. Just when I thought that he was on the road to recovery, he had a seizure last night. I spoke with his vet and he told me that there is a possibility of brain tumor, but he still suggested to increase his dose of steroids and see if he continues to get seizures. My dog had hard time falling asleep last night, he was breathing heavily, getting up, shaking his head, so i do understand that he is experiencing discomfort. What i want to find out is - are seizures common during Vestibular Disease recovery or should i outrule everything else, and succumb to the fact that it is brain tumor? If it is the brain tumor, then how brutal can it get for him? I would hate putting him through pain, if he is experiencing it, but at the same time i dont want to give up just because it became challenging. He has always been a healthy dog, and has been in excellent mood for the past 2 days, even after the seizure, trying to move around a lot, playing with his toys, etc. But i must mention - he is 12.5 years old labrador retriever.

Submitted by Jane | February 12 2013 |

Hi,
My dog was diagnosed with Vestibular Disease last Monday, after he collapsed. Vet did find some signs of ear infection, and we have been fighting ear and yeast infection in one of his ears for years, it would keep coming back few months after being treated. He spent 2 days in the hospital, and went from not being able to lift his head up to walking around the house (still rocking from side to side) and being more confortable outside when on the leash, in just 5 days. Just when I thought that he was on the road to recovery, he had a seizure last night. I spoke with his vet and he told me that there is a possibility of brain tumor, but he still suggested to increase his dose of steroids and see if he continues to get seizures. My dog had hard time falling asleep last night, he was breathing heavily, getting up, shaking his head, so i do understand that he is experiencing discomfort. What i want to find out is - are seizures common during Vestibular Disease recovery or should i outrule everything else, and succumb to the fact that it is brain tumor? If it is the brain tumor, then how brutal can it get for him? I would hate putting him through pain, if he is experiencing it, but at the same time i dont want to give up just because it became challenging. He has always been a healthy dog, and has been in excellent mood for the past 2 days, even after the seizure, trying to move around a lot, playing with his toys, etc. But i must mention - he is 12.5 years old labrador retriever.

Submitted by Andy and Cheryl | February 17 2013 |

Our 15-yr old female pug has had 5, 1-hour vestibular episodes, she is wobbly afterwards but fully recovers in a few hours after some weakening of back legs when eyes stop rolling, etc. This is happening every 5 or 6 days for past month. This is not what we read elsewhere? Anyone know how serious it is...Vet doesnt know but confirmed Vestibular event, did blood work only found some kidney malfunction.MRI, $3000, too much for us. Any insight???????????

Submitted by Debby | February 23 2013 |

Ask your vet about Gabapentin...it's done wonders for my dog. He weighs about 50 lbs and is on 300 mg twice a day.

Submitted by Robin | February 28 2013 |

I wonder if this might not be some sort of seizure disorder? I would keep a log...day, time, place, circumstances. I had an older pup diagnosed as a probable brain tumor. Listed to a jerk of a vet and we saw specialists, put her through the trauma of a spinal tap, mri etc and nothing was conclusive (aside from the expense!). Got fed up with the vet who ignored me and my updates, found a new vet who listened, heard the story (in our case it was that she almost always had the seizure in the AM, BUT on the nights when she had a snack before we went to bed, it didn't seem to happen) Vet grabbed a text book to confirm what she was thinking, and she turned out to be able to confirm via blood work it was being caused by an insulinoma, an insulin secreting tumor of the pancreas. Surgery was too risky, so we treated her medically, and that included smaller meals throughout the day. Seizures still happened but more days without than with.

Submitted by Hannah | February 21 2013 |

Our rescue dog, Toby, also had this in January 2013. We are unsure of his breed (possibly labrador cross beagle?) or age (the vets put him in double figures so he is an older dog). He started off by staggering a little and then his legs wouldn't hold him up. He was also very sick and his eyes kept fluttering and moving like he was in a sci-fi film. It happened fairly quickly - over an hour or so - and we were convinced this was the end and we were going to lose him.

We took him straight to the emergency vet who gave him a shot to stop him vomiting. The vet explained Toby's condition was not unusual in older dogs and he had a good chance of making a full recovery. We watched him like a hawk for the next 72 hours, and he slowly seemed to regain his balance and started eating again. He was very tired and slept a lot, but the eye twitch had stopped and he was no longer vomiting.

Toby is now fit and well after 6 weeks, although his head is slightly tilted to the side. He also seems to have lost some strength overall and is perhaps a little lobsided. He needs to have his food cut up into small pieces as the episode seems to have affected his ability to eat large bites. His apetite came back fully after 3 weeks and he was starving!

We are aware that the condition may strike again and consequently he is being treated like royalty. But to anyone else out there who is going through the same thing, have hope as we really thought he wouldn't get better.

Submitted by Debby | February 23 2013 |

My 14 year old border collie mix has Old Dog Vestibular Syndrome. He was on Gabapentin for another problem. We upped the dosage to 300 mg twice a day, and a little extra when necessary, he was normal again within hours! He had the more severe form of ODVS. Couldn't even stand up without falling over. Gabapentin...ASK YOUR VET about it! It's not expensive...I pay about $30 a month for 100 300 mg capsules. And the pill pockets are a God send! I hope your doggies get better. No need for this to be a death sentence!

Submitted by Donna | February 24 2013 |

I came across your article as I was searching for information about canine stroke symptoms and recovery. Its thought that our 7 year old blue heeler had a stroke 3 days ago. She's lost her vision in her left eye. She has limited use with her left feet (legs work well other than the wrist down so she walks heavy footed in order to place her foot pad on the ground instead of landing on her toes)She gets around pretty good compared to when it just happened.
My question is, do dogs with this condition regain their eyesite? Is there any supplement, medication or rehab we could try to help this? thank you so much for this article, it gives hope.
Donna

Submitted by Robin | February 28 2013 |

One of my pups appeared to have a stroke many years ago, which led to my doing much reading. She recovered. I remember reading about someone in England...and that the conclusion was rest and quiet, less stimulation, lots of love, helped the process along.

I knew someone whose dog had stayed with me...a wonderful lab. When he had, what appeared to be a stroke, his "father" wasted no time and had no patience for nursing him back to health. It was one of the saddest moments of my life for he made a decision to put him to sleep without supporting or helping him for any time.

as long as you have love, you have hope:-) and we're keeping you in our prayers and thoughts here in Cleveland!

Submitted by Joe G | February 27 2013 |

My dog Stubby has presented much like Lo's (feb 5) dog. He is a Boston Terrier about 11 years old. I originally noticed the red eye and corresponding loss of muscle mass behind it- looked like his head had been stove in. Turned out to be a corneal ulcer. The e-vet suggested that it might be result of a tumor.

Took him to a small animal ophthalmologist and was told he had the corneal ulcer and something akin to 'bell's palsy' for dogs. Besides the ulcer due to dry eye and lack of blinking, he had a droop on one side of his mouth. (all on left side). We have been treating the corneal ulcer with antibiotics and ointment. Ulcer has improved since december. Last visit may be mar 4th.

We are now treating the eye with a neomycin ointment- for about a month. Last weekend Stubby lost control of legs, has head tilt and circles. His normal vet says vestibular disease. We checked outer ears.

I am wondering if the topical Neomycin might be affecting Stubby. I noticed that some articles suggest it but don't know if that would be due to topical use in eye. Any thoughts? I will also ask my ophthalmologist. Thanks!

Submitted by Cat | March 2 2013 |

Found this article and it has helped tremendously. Tallie is a mini wirehair doxie - He woke me up at 3am, vomiting profusely. He seemed thirstly, drank water and vomited some more. He also seemed unsteady on his feet. He has a history of epileptic seizures, very infrequent - 1 to 2 per year, usually when stressed, and recovers very quickly. He is lethargic, disinterested in the other dogs, food or any thing. I took him to the vet this morning, they gave fluid, anit nausea injections (famotidine and cerenia)and checked blood pressure. Later this afternoon, I noticed the rapid eye movement and he continued to sleep. I tempted him with a little broth from some canned chicken and he took that and went back to sleep. I have a call in to the Vet to find out if there's anything else I should be doing to help him feel better - I wondered about an antiinflammatory

Submitted by Anonymous | March 10 2013 |

My dog was diognost with vestibular disease
My vet and I are treating it as iner ear infection since
She had Ben treated for one but we thought it cleared
Up but we think it went deeper / behind where you can't
See it with a scope ? , she is on Prednisone , doxycycline
, meclzine , started decrease prednisone she started
To shiver , up dosage back for a few days , I'm concerned
About infection and swelling ?

Submitted by Mama Wolf | March 14 2013 |

My fifteen year old German Shepherd has this in a severe form. Good news is that, after a full two weeks of not walking, she is walking now. Although she is still extremely lopsided and her walk is tentative, she can manage from one room to the next. Her first panicky fear has subsided and although she seems puzzled by her inability to run and jump she is no longer freaked out by it. It took longer than I expected but dhe is recovering. Good luck to anyone else who has a dog with idiopathic vestibular disease.

Submitted by Anonymous | March 14 2013 |

My dog was diagnosed with this on Monday night. It was so sudden and was so scary, we thought for sure it was the end. The ER vet diagnosed her with this and we are in the wait and watch stage. I have a question to people out there... My dog can't move at all, other than holding her head up for awhile and wagging her tail. We are doing everything for her (and she's not a tiny dog). For those of you whose dog was unable to stand or move at all, how long did it take until they tried to make the first attempt to stand/walk? I'm really worried that she hasn't shown a whole lot of improvement thus far, other than being able to hold her head up.

Submitted by Anonymous | March 19 2013 |

I feel your pain and anxiety...and I hope that things have improved by now.
My dog was three days before he tried to stand...he was placed on iv fluids and stayed at the vets for almost five days. I was there with him as much as they would let me be.
Its a hard disease to watch...I hope things are better for you and your furry friend

Submitted by Kevin | March 21 2013 |

Our dog Peebody is a 12 yo German Shepard mix that can't stand up, vomited, and seems to be disengaged. He can lift his head, but can't turn over or stand. He doesn't have the head tilt or eye symptoms. Is this ODV or something more serious?

Submitted by Kristi | April 2 2013 |

Our 14.5 yr old Golden fell into our pond (with the help of his 3yr old nephew galloping by) and that's when this IVD hit.

He couldn't walk at all the next day and I too thought this was the end for him.

Then the next day, he started getting up very wobbly but walking again.

I think it's because he overheard us preparing ourselves for his demise! Kind of like the scene in Monty Python ... "I feel Happy! I want to go for a walk!" .... the Bring out Yer Dead scene. :-)

Anyway, took him in for a check and vet gave me that long explanation of what he has.

If he isn't in pain and he can still walk with steriods, then I'm happy.

He's lived almost 15 years and can still bark at the goats. This is good enough for me.

Peace.

Submitted by Anonymous NOLA | April 9 2013 |

This is a bit long but:

Our dog suffered from a very severe version of this on Friday. She is an Australian Shepherd / Collie mix. We had no idea what was going on, but she began to throw up all over herself and then soiled her self repeatedly. She would not stand up or drink anything. I really got scared when I noticed her rapid side to side movement of her eyes and up and down motion of her "eyebrows". It was if her computer was malfunctioning. She was incapacitated to the point where we had to roll her up in a towel like a dead body to carry her to the vet. I thought for sure that this was the end and was preparing myself accordingly. Our vet immediately recognized it a IVD and started to work on her. They set her up with an IV to keep her hydrated and began her on antibiotics designed for this sort of thing. The vet kept her over night to watch. When we went the next morning to the vet, they said we should visit with her for a bit to see if we would be able to deal the challenges of taking her out, feeding, cleaning up after her and such. I had already read about cleaning up the mess, but she already had incontinence issues beforehand. So this was not a huge shocker. When the vet brought her out, she looked a little better. She could not quite walk on her own, but could get around with a little bit of assistance. We decided to take her home and care for her ourselves. We were instructed to discontinue her incontinence and arthritis meds temporarily as to not react with her new meds. Later that evening on the day after the improvements continued. We still had to carry her a bit, but she was able to stand on her own as long as it was not a slick surface. The next morning the eye movements subsided substantially and were hard to even detect, But the eyebrows continued to move up and down at opposite times. When we tried to help her walk, she would move faster than us, but then fall occasionally. Sunday night, we were having dinner and she got up on her own and walked over to sit by us as she would normally. This was huge and showed her personality was intact. On Monday (yesterday, the vet prescribed some steroids to help her out and I imagine they aren't hurting her arthritis either, especially in lieu of the absence of the arthritis meds. She now can walk up stairs with slight assistance and as I write this just ran at the front door to bark at the sound of the mailman putting mail in our box. It's good to have her back and I am amazed by the improvements in just a few short days. I feel truly blessed that it was diagnosed correctly and the meds and care have worked so well. I know it won't always be like that for others, but just know that it can get much better.

Submitted by Chris | April 10 2013 |

Thank goodness for sites like this.. I was at a complete loss when I got home and my 140 lb 13 year old Great Pyrenees was displaying these exact symptoms. I am by myself, and have no way of getting him to a vet (in fact, the last time he was to a vet was for his 8 week shots, I have treated him with honey, epsom salts, the occasional panalog for ear infections, until the only vet that would give it to me without having to take him in is no longer working). Over the years he has had 2 face fulls of porcupine quills, throat opened from ear to ear from a tangle with a wolf, a severe infection on his shoulder from a wound, nose slashed by god knows what.. and at 13 years old, he still acts basically like a puppy, rolling over for belly scratches, jumping with joy when we are going for a walk, etc....

so, when I came home today and saw him, I was terrified that he had suffered a stroke. I was prepared to call someone to end his suffering until I came across this information. Thank You!!! I have food and water near him, although he won't take any, and i have been comforting him and massaging him to keep him calm. He doesn't seem to be in any pain, just afraid and disoriented, unable to move well, and his eyes are doing the side to side and eyebrows up and down. Will be doing lots of TLC, will try the dramamine, and tons of hugs, kisses and massages. Thank you all for your input... before I read this information I was beside myself with grief, although i do understand that 13 years is an incredible life for a giant breed... he has been the best friend ever...

Submitted by Anonymous | April 12 2013 |

Thanks very much for the reassuring info.

Do many pet owners experience such a situation and just "wait-and-see"? Without consulting, visiting the vet?

I wish I had known how to search for ODVS/D (Snyndrome/Disease) yesterday morning!.. I came home about 2 mins. after my daughter found our 13 y.o. male shepherd mix, OLAF, lying on the floor next to his bed. Olaf had urinated and defecated in his bed. One of our other dogs, Lila, heard Olaf whining and started barking. Our daughter thus found Olaf in this state... he couldn't get up. Fortunately I came home just after...not that I knew what was going on..

Previously I had a 12 y.o german shepherd who developed degenerative myleinoapathy (sp?) rear-end paralyzation-- also known as German Shepherd Dog(GSD) disease, so, I knew the "towel sling" method for moving her.... We took Olaf outside his head was tilted left, whole body leaning left on the ground... he could not get up, or stand when we tried to get him standing... he would try to move-- going to the left (trying to circle). We know he has hip dysplasia and arthritis... so I figured this WAS IT... the big one!!! A stroke.

I called the vets, they said bring him in.... had to leave him there since we didn't have an appt and they were of course booked... but "his" vet was in, so I knew she would tend to him ASAP. She did. By the time I had gotten back home she was calling to tell me she thought it was ODVS/D. She explained ODV and what they would do for him.

He received Dexamethasone IV, with Sucralfate to take home for stomach protection from ulcers (and I suppose to help protect the liver/kidneys as well).

When I went to get him 6 hours later Olaf PULLLED me out of the office vs. being carried IN by a Tech earlier--he weighs 80 lbs.
Olaf ate dinner, "used the bathroom" on his own, and is amazingly beter today.... Still wobbly.. but then I had been attributing the wobbliness to his arthritis...!

In hindsight, of course, I am wondering if I could have saved $200 (he had some radiographs & EKG, his heart beat was irregular, possible murmur....) had I know it would pass...

Peace of mind often comes with a price tag so, it' all GOOD. Praise God, He loves and cares for ALL His creatures.

Submitted by Anonymous | April 13 2013 |

My dog is with vet now . The vet called me and said it could be vestibular disease. My dog is a 5y old westie.
About ten days ago, he did not want to jump on my bed anymore, had dry nose, but only vomited once. I did not notice shifted eyes. 2-3 days ago, he started to show tilt head when walking, but never falling down. Does this sounds like VD?

Submitted by DCW | April 19 2013 |

10 days ago my dog (8 years old) woke up we went to let her out as usual. But as she made her way to the door she stumbled around as if she were drunk. She became very scared and tried to run back to us. As she did this, she fell violently (very tough to watch). We immediately grabbed her and called the vet. Her eyes were very very dispondent and she was shaking. At first we thought it was a leg injury but as we checked all of her legs, there didnt seem to be any pain. We then thought it was a stroke. It is worth noting that she had jogged 2 miles the night before and appeared to be in perfect health prior to this...

To make a long story short, she was not doing very well. The 1st vet (emergency vet- not our regular vet) was very thorough, but couldn't really diagnose her. He told us to keep an eye on her. For two days we had to physically carry her outside. She appeared miserable, stumbled severely and was extremely morose. Each day her eyes began to twitch more and more. With some research, I was pretty confident it was vestibular disease - which I had never heard of.

Our regular vet confirmed that on the 3rd day, but she showed zero signs of improvement for the first 4 days. It was a really hard time. Not only to see her that way, but also to care for her. My wife and I both took a day off work because she could not be trusted to be left alone. She would go to get up and fall violently. If you are dog people, as you obviously are if you are reading this, you know how hard it is to watch your dog suffer. The symptoms of vestibular are brutal, and although you are told it is not that serious- it is nearly impossible to believe that (especially when you see no improvement).

And then out of nowhere, she woke up one day (day 6) and was 10 times better. The eye movement had vanished. She was still a little wobbly, but was improving by the minute. We used treats to have her walk back and forth (pseudo physical therapy if you will). This helped alot!!! By that night, she was back to being 75%...

Today it has been 10 days and she is now nearly back to normal. God has blessed us with our dog back again, and we couldn't be more thankful. She still has a bit of a head tilt, but it doesn't effect her at all. She wags, plays, and begs to be taken on walks. I just wanted to post this as a way to give hope to all those who may be experiencing this. I came across a lot of scary information online when this first happened to my dog and I wanted to post a success story. Vestibular looks horrible... It is scary and overwhelming. But there is hope! God Bless

Submitted by Cheryl | May 15 2013 |

Thanks so much for your helpful comments regarding vestibular disease. Our 12 year old bichon frise came down with it and like you, we were petrified. As we brought her to the vet's office, we both thought that this was it and we were so sad. Our vet, an older gentleman, diagnosed the condition immediately and told us to give her an adult size dosage of dramamine(she is 17 lbs), and that otherwise, there was nothing he could do for her. He said that we were to call him daily for an update on her condition and that she would make the most progress within the first week. Like you, I stayed home with her and felt like I did when my daughter was an infant and totally helpless. The poor thing couldn't even shake her head without a face plant and fell over when trying to go to the bathroom. Miraculously, she made improvements daily and seems to be left only with the head tilt. We hope she doesn't get a reoccurrence and are so happy she is herself again.
Your comments in those early days were so comforting!
Thanks, Cheryl

Submitted by Tracy | July 30 2013 |

Thank you for this encouraging message. Mollie, 14 and a half border collie, started with these horrific symptoms on Saturday evening. My husband was away and I called him back early because I really thought we were loosing her. This is day 3 and this morning she got up and followed me out to the yard, slow but determined. She is not eating which is a worry but is taking water. It has been exhausting nursing her night and day and there is piles of washing as she has a few mishaps. She seems shattered after her trip to the yard and hasn't moved since. I am not giving up hope. We go back to the vet tonight for a check up. Less than a week ago she came to the lake with us and paddled while we fed the ducks so its not like she was an old dog who couldn't enjoy her life. Thanks again and pray for my Mollie please.

Submitted by Annie | April 26 2013 |

Our 14 year old Golden experienced this about 8 months ago. all the classic symptoms. Our vet followed your treatment to the letter. It did scare us watching him like this and we were frightened.

He has a few lingering things now, hearing is not great but then he's 15 next month, trips a bit and can be a bit unsteady but on the whole he is his old self, happy, friendly dog with much more life to come !

Submitted by Julie | December 1 2013 |

I was encourage by this article about 6 months ago when my 14 yr old Shepard mix went through this & fully recovered.....but am now faced with the exact same symptoms presenting in him again. Has anyone in this thread had this happen more than once? And is it more or less severe? Any thoughts would help as I am just as devastated seeing him like this as I was the first time.

Submitted by kathleen whelehan | April 29 2013 |

My pug has a head tilt. Hard time breathing. He has been to the vet and given
Meds. Gets better for awhile then comes back. I took him finally to a specialized hospital. He was going to have a egd but he had reaction to meds . His eyes were rolling. I took him home
He doesn't move alot because of breathing. This started about four months ago with ear infection. He also
has coughing which makes breathing worse. Is this vestibular disease? No other symptoms. Still eats. Goes out to do business. Also the cough is like choking. Any info would be appreciated. Thank you

Submitted by kathleen whelehan | April 29 2013 |

My pug has a head tilt. Hard time breathing. He has been to the vet and given
Meds. Gets better for awhile then comes back. I took him finally to a specialized hospital. He was going to have a egd but he had reaction to meds . His eyes were rolling. I took him home
He doesn't move alot because of breathing. This started about four months ago with ear infection. He also
has coughing which makes breathing worse. Is this vestibular disease? No other symptoms. Still eats. Goes out to do business. Also the cough is like choking. Any info would be appreciated. Thank you

Submitted by Plear | May 2 2013 |

Thank you so much for this article.

My Belgian Shepherd/Chow mix just threw up ALL of her dinner. She is drooling slightly and her nose is watering a bit. She couldn't walk for a while, seemed neurological, stroke-like? Her eyes were moving up and down, although not all that quickly. She did NOT have a head tilt and she was NOT walking in circles. She seemed like she didn't want to walk. She has improved drastically already, in about 1 hour, and is now asleep.

Does anyone know what may have happened?

Submitted by Sherry Reitmyer | May 6 2013 |

I have been reading so many of the comments and now have a better understanding as to what to expect. Our little Audri (a mini Dachshund) was diagnosed over this past weekend. She was absolutely fine on Friday night running around and begging for food. When I woke up to take her out in the morning she was a totally different girl. Her balance was off, she was stumbling, her eyes were shifting back and forth, and she had her head tilting. I took her out to go potty and she imediately vomited but was able to go to the bathroom. I just knew that she had a stroke and scared to death. We took her to the vet and the doctor diagnosed her with Vestibular Desease and gave her three shots for inflamation, nausea, and an antibiotic. She also gave us Valium for her to take for 3 days to hopefully break the signal? Anyway, she has had issues with wetting where she sleeps and she isn't eating very well. She does drink water so that is one thing that we are not worried about. I am concerned about her eating; she has always been a very enthusiastic eater and hungry all the time. I have found that she will eat softer foods like lima beans and wet dog food other than her beloved kibbles. She doesn't seem to be able to chew the kibble and spits them out. It has been only two days and I don't know if she is truly showing signs of improvement or if it is my wishful thinking. She is 15 years old and up to this point has been very healthy except for being deaf and having normal elderly dog problems. How long should we wait to see if she can recover? I know this is a question that you will say is not easy to answer but I am so concerned that we will make a decision too soon or one that doesn't need to be made at all. I am willing to take care of her for as long as it takes but on the other hand I don't want to prolong anything that is making her have pain or discomfort. She looks so confused and scared all the time and it breaks our hearts. I thought she showed signs of some improvement yesterday but this morning she seems to be where she was on the first day. Hopefully I am wrong. Is there anything thing more we can do for her at this point?

Submitted by brit | May 18 2013 |

my 14yo BC/JRT was dx with Vestibular Syndrome this March. She slowly recuperated but within the last month her right front foot 9same side as her head tilt) has become more shaky and knuckles under easily. I may be wrong but seems to be getting worse. Otherwise she is ok although not her original happy/perky self. Appetite is good. Any thoughts re her foot? I am concerned about this as I can no longer take her for walkies due to her having scraped the nails down to the quick :( Thanks for any help.

Submitted by Scott | May 19 2013 |

Hi Dr. Cox,

My dog Samantha is a 9ish year old Corgi/Beagle. Up until this morning her health was perfectly fine, and she woke up at 4am with the exact symptoms listed plus vomiting. I took her to the vet and they said it is likely this is what she has. Since her 4am spells she's walking better, she drank some water, and I was even able to get her to eat a slice of bread (in pieces out of my hand). Are these all pretty good signs that she's on the road to recovery? They recommended a blood test and a chest x-ray which she will be getting tomorrow (she's due for shots anyway).

Any thoughts would be appreciated. Really sad to see a perfectly healthy dog who loved to run, fetch, go on walks, and play get nailed with something so quickly.

Scott

Submitted by Hayley Adlam | May 23 2013 |

I'm gutted after reading this as I think my dog could of been mis-diagnosed! At 13 years old she displayed these exact symptoms and straight away with no real examination we were told she'd had a stroke! For 2 years she was prescribed vivitonin to thin her blood but we could never understand why she kept having repeated episodes! She had bad teeth, and after getting an abscess on her tooth was told she needed it removing, (wonder now if this caused an ear infection too), anyway we went ahead with the op only to get a phonecall hours later stating that the vet had removed 14 teeth which was a shock as it was originally meant to be one!! He was worried about the amount of blood our dog was losing to which I stated I had done research and was concerned the vivitonin drug she was on (blood thinner ) could be the cause of this! My baby didn't make it through the night as she lost so much blood and the vet tried to blame us for going to see her after the op and getting her overexcited hence making her bleed more!!!!??? After reading this I have a horrible feeling her death was in vain !! It's been 10 years since she passed but never a day goes by that I don't think she was diagnosed or treated properlyand wonder what if!!???

Submitted by Doug | May 24 2013 |

My 12yo Lab/Husky mix presented last Saturday (5/18) with sudden onset vomiting, loss of bladder control, nystagmus, head tilt and loss of balance. Not being a vet, we were of course immediately concerned about the possibility of stroke. We took her to the pet hospital and the vet there was convinced that it was IVD based on the nystagmus in combination with other symptoms. Blood work showed slight dehydration but no other concerns. She was given a subq injection for nausea and put on Cerenia ... my regular vet also recommended meclazine 25mg 1/day, which we have added.
In a prior comment, I noticed that one of the vets here had said that it is rare loss of for bowel control to present as a symptom of IVD. That does not preclude co-morbidity with another condition, of course, but the correlation in time (sudden onset of all symptoms within about 10 minutes)suggests a causal relationship.
Of greater concern to us is the fact that as of today, the 6th day after onset, the dog refuses to stand or attempt to even sit up, and food intake was 0 until day 4; the first two days she refused water as well even when squirted in her mouth with a syringe. Today food intake is only about 1/3 of normal. Head tilt is still present, nystagmus seemed to stop about day 4.
My dog has been afraid to stand; when we lifted her to a "sit" position, while she was able to hold her own weight, she began to tremble violently as if in extreme fear.
Today, day 6, she remains prone on the floor in the same spot where we brought her home last Saturday evening. She has urinated, but has not had a bowel movement since last Saturday. She refuses to walk or stand ... and she literally has not moved more than about 12 inches from her initial position 6 days ago. She does hold her head up now and drinks from a bowl hand-held in front of her, and she has began eating when hand-fed.
We looked into her ears and found them both to be extremely dirty. We were able to clean the left one but the right ear seems sensitive and the dog does not want us to clean it ... suggestive of an infection.
SO, as I understand it, the possibilities are:
-IVD
-Brain Tumor
-Brain Bleed
-Ear Infection
If there are others, please enlighten me.
We can't afford an MRI for the dog, and the persistence of symptoms are concerning, however, given the lack of food and water intake ... I am not sure that we should expect a lot more in recovery progress yet.
BTW, we do believe she is adequately hydrated now .. her skin is elastic when we pinch it ... it returns to shape and does not "tent" after pinching it.
Progress is very slow, compared to what my reading has led me to expect.
I have two questions:
(a) given the ear sensitivity, does it make sense to go ahead and treat with antibiotics for a possible ear infection? It seems that the downside consequence is only that there might be no infection and no improvement. But given that we can't pursue an MRI, this seems like a reasonable approach.
(b) should we expect more progress by this time, or am I unnecessarily concerned given her history since onset?

Thanks for your comments.

Submitted by Scott | May 27 2013 |

Samantha Update: It's been one week since the onset of the symptoms and she's doing great! After about 48 hours she started eating a little bit of sliced turkey, 72 hours she was eating sliced turkey mixed with some dog food. She's now back to eating most of her 2 meals a day. She hasn't vomited since day 1 and her eyes got back to normal around day 4. The wobbling/punch drunk behavior subsided around day 5. Her head tilt is better every day, she's almost there. She started going upstairs around day 5. Interestingly, she doesn't seem to have the confidence to go down the stairs yet. She chased her ball once today (first time since the disease occurred). It's clear her personality is coming back. She was on Meclizine twice a day and finished her last people yesterday. Pretty good progress in 1 week!

Submitted by chris | May 28 2013 |

my 13 year old jack russell just had an episode this past friday night and i witnessed it myself and had to hold him for a while and was so hard to watch.Took him to vet today and they said just like this article that with time he will get better to wait it out and monitor him for the next 10 days or so.Thanks for the article and info!really needed this for peace of mind!

Submitted by James | June 2 2013 |

Idiopathic vestibular disease. Our lab Lexi (13 yrs) is healthy and happy but she has had two bouts with IVD before we were advised of a helpful solution. If it happens in our presence we were advised to hold her gently, talk to her and rub her. In two cases since we were able to stop the syndrome completely in less than a minute with no effects whatsoever except for some excessive panting for a few minutes afterwards.

Submitted by Scott | June 4 2013 |

Samantha Update #3: It's been 2 weeks since she came down with IVD and she is doing great! Up and down the stairs, much more active, eating like a pig, personality has returned... Still not playing as much as she was prior to the disease but every day is improvement. I would put her at 90% recovered. So happy to see her get back to being herself!

Submitted by Angie | June 13 2013 |

I believe I am going through this right now with my dog. She is 11 years old and I have had her since she was 8 weeks old. I discovered it when I went to let her out of her kennel on my lunch. It was by far the scariest thing I have ever seen. She was flipping backwards because she couldn't get her balance. Unfortunately, I have had to carry her up and down the stairs and outside to go to the bathroom and am hand feeding her. The vet said it is probably this but there is still a chance that it is a brain tumor. The last couple days have been very sad and difficult. Just hoping it truly is this condition. She brings such joy to my life and thinking of being without her is unbearable.

Submitted by Kristine | June 24 2013 |

My 10 year old golden retriever started showing signs of this a fe months ago. She has head tilt, trouble laying down, and sometimes falls over. It's very scary but she always returns to normal with a week. When she is having an episode she hangs her head in a downward sideways position and we have to feed her by hand

Submitted by Nancy | June 27 2013 |

Hi Dr. Cox, not sure if you're still monitoring the comments here, but if you are I have a question. My older (found her and not sure of her age) mini dachshund is in chronic renal failure. We've been battling it for two years. She went into crisis and was hospitalized two months ago. Since then, she has had mild vestibular symptoms. She doesn't have many of the symptoms I'm reading about here; no nystagmus, circling, vomiting or head tilt. Her front end - head and front limbs - get very wobbly and uncontrollably shakey for several moments at a time. She has knuckled on one of either of her front paws very occasionally. She's eating and drinking well and gets subcu fluids daily. She coughs after drinking. I wouldn't say she's dizzy, but she does want to see where she's going if being carried and will sit up suddenly if I move her kennel. She has hypertension and is on meds. We saw a neurologist, but can't do an MRI because of the anesthesia risk to her compromised little system. I first noticed a slight head wobble, for one second, back in January. In March, she had a ruptured disk that healed well with strict crate rest. Her current symptoms respond somewhat to Meclazine. She's had a couple of courses of Clavamox and one of Clyndimycin recently. I'm wondering if you'd like to hazard a guess at what the cause of her vestibular symptoms might be. Thanks.

Submitted by Anonymous | July 1 2013 |

This happened to my family's 14 year old dog last night and we were really nervous. At first we just thought it was just her arthritis but then we were worried and thought it was a stroke or seizure. We rushed her to the emergency vet and found out about this disease. We all hadn't heard of it before but the vet told us that it was like the dog had just gotten off a crazy roller coaster. Our dog had to still stay overnight and we took to our vet the next morning. Since my dad is an emergency physician and used to be a vet assistant, my mother used to be a nurse and most my family knows a decent amount about medicine and such we were able to take her home since she would be more comfortable there. She can't eat or drink very well so right now she still has her IV in and has some fluids. My whole family is relived that she is okay. I wanted to thank you for writing this because its important that more people know about this because I have heard of people losing their pets when they could save them. Thanks again! her arthritis but then we were worried and thought it was a stroke or seizure. We rushed her to the emergency vet and found out about this disease. We all hadn't heard of it before but the vet told us that it was like the dog had just gotten off a crazy roller coaster. Our dog had to still stay overnight and we took to our vet the next morning. Since my dad is an emergency physician and used to be a vet assistant, my mother used to be a nurse and most my family knows a decent amount about medicine and such we were able to take her home since she would be more comfortable there. She can't eat or drink very well so right now she still has her IV in and has some fluids. My whole family is relived that she is okay. I wanted to thank you for writing this because its important that more people know about this because I have heard of people losing their pets when they could save them. Thanks again!

Submitted by madhuka | July 4 2013 |

hi, my 14 year old pom girl was acting strange for the past two weeks, like she was walking in circles,panting,and she looked very disturbed. unfortunately i was able to show her to the vet only on the 3rd day since he was out of town and he knew her medical history very well. gradually she showed an improvement after the medication but yesterday suddenly she started breathing heavily,eyes were popping out and did not respond to me at all. i rushed her to the vet and he gave a drip and some other medication and said that her temperature was 103.7. she didnt even move but looked as if she was leaving me. i was so devastated and didnt want her to leave me. she didnt sleep the whole night and wanted me to be with her. i slept next to her and took her to the vet again this morning. he said that it might be vestibular disease but he was having doubts since my girls tummy was swollen, and she was having alot of ticks lately mostly in her ears which was uncontrollable despite all the effort and medication done to her. im really confused at the moment if it is vestibular disease or tick fever. if it is either of them does she stand a chance to recover since she is old. she cannot stand by her own,eat or drink. i have to help her to even urinate. it doesnt matter i will take care of her even if i have to stay awake 24/7 with her.please advice me what i should do. after reading some of the comments i feel that i should give her some time too recover.is that what i should do.thank you.

Submitted by michelle caley | July 6 2013 |

lab mix DX with IVD 5 days ago. Given Prednisone and Cephalexin. 7 bouts of vomiting day 2-3. Antinausea med given. Vomiting stopped. Walking better. Head tilt better. Dog sleeping a lot. I think she's wore out from all the vet trips this week. No defecation in 4-5 days. Took Daisey to Michigan State University (MSU) last night for lack of defecation. Abdominal x-rays show soft stool with some dark blood there. No constipation. I was told she will defecate soon. She may be having difficulty squatting to be able to defecate. Very tired this morning and doesn't want to go outside. No defecation yet. Thinking of trying a towel underneath back end to help walk and squat. Concerned about how long she can go without defecation and what I should do next. If you have any suggestions, I would appreciate any help you can give.

Submitted by Stacy | July 16 2013 |

My lab presented all the symptoms except the eye rolling (falling over, vomiting and voiding)suddenly one night. We decided to wait till the next day since getting her to the ER vet would have been a problem. The vet came to my house and gave a shot for nausea and inflamATION. No antibotics as he said they do not help. A week later still falls from head shake but back to regular dog food and a partial walk outside. She no longer has the desire to be outside. But comes to the treat bowl for one. Still unsteady but what a difference time makes with this.

Submitted by Anonymous | July 26 2013 |

A very good and informative article about the subject!!! My former dog got this disease at 12 years. Accute onset with her falling over to the right, came into comalike state and she was opistotonic. I was sure she was going to die there and then. But - after diazepam an fluids iv she woke up again, and within 24 hours she was back on her feet. Fully recovered by one week. She lived happily for almost three years after this incident. :-)

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