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.


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 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. :-)

Submitted by Grace | July 28 2013 |

My rescued poodle-schnauzer (we think) is going through this. Head tilt, cannot get up, cries when she tries to stand. From observing her I think the crying is more from disorientation than from pain. We aren't sure how old she is, but I know she is, as the vet said, old enough to collect social security. Sudden onset of symptoms, doesn't want to eat or drink much at all. No nystagmus, but she has cataracts and has had them for the last two years that we have had her. She also has hearing loss, also has always had that. We have just adapted our home to her needs. It seems like now her "sniffer" isn't working well. I've been doing research on this disorder, and she seems to fit the hallmarks. We are feeding and watering with a syringe, hoping to keep her hydrated. She still has good urinary out put, and when she needs to pee is when she attempts to stand and gets frustrated. I know it's good that she hasn't given up attempting to go out to pee. I am a paramedic, and have done the things I would do for a bedfast human; linens changed, positions changed, massage to help with soreness. Hydration, food as tolerated... I am looking for any other advice to help my Sophie. We love her ridiculously, even though we have only had her for two years. I knew when I rescued her that she would be with us for a relatively short time, but we have tried to care for her needs as best we could. Would ginger tea help with the nausea? She's breathing normally for the most part, heart rate steady, no tenting of the skin that would lead me to suspect severe dehydration. She does "shiver" at times, cries when she attempts to get up (but truly, it doesn't sound like her "mom, this hurts" cry), and isn't interested in much other than being loved on when we are down on the floor with her. Euthanasia is a LAST resort. With a human patient I can ask what hurts, or feels bad, and I know how to help. I am completely at a loss. Any advice is appreciated. Thank you in advance!

Submitted by Amanda | July 29 2013 |

My 8-year-old boxer developed these symptoms on Thursday, took anti-nausea meds and we took her home to hand water and wait-and-see. On Friday she had fluid draining from her ear (vet had checked for infections and seen none). She seemed to brighten over the weekend, still staggering, but going outside to pee. On Monday I took her back to the vet because she was still not drinking unaided and to check the ear. The vet kept her in to flush out and start anti-biotics for her ear, and to give her 24-hours of intravenous fluids. She passed away on Monday evening, apparently after a seizure. 2nd guessing whether I missed something. She had her annual exam and vaccinations a week prior to this and was taking other meds for a leaky bladder and swollen gums. So sad right now.

Submitted by Bill | August 2 2013 |

My 13 year old german shepard mix has exhibited most of the symptoms you describe for vestibular problems but the episodes have been very short, lasting about 5 minutes or less, and I have only observed about four total episodes during the past year. During the episodes, she seems very disoriented and seems to turn or fall in one direction when she tries to stand up or walk. I usually just make her lie on the ground so she doesn't move around until the episode passes. After a few minutes, she is totally normal again and it may be two or three months until the next episode. She is in overall excellent health otherwise although she is showing signs of arthritis. Does this sound like old dog disease?

Submitted by Vicson | August 14 2013 |

Our 13 yr old pit bull is experiencing this disease now, symptoms started on Monday 8/12, we brought him into Emergency Vet office. He got IV fluids, anti nausea and predinose and the doc told us we would see improvement within a few days. It's now Wed, and he is not any better. I am really worried. All the info I read says, it will just go away. I am doubtful. But I do tend to worry more than others. It is so hard to see your animal out of control. Any and all info is appreciated. Anxious Atlas

Submitted by shannonb | August 14 2013 |

My dog has had 3 episodes in the past 4 weeks. Head tilt, nystagmus, unsteady gate. Her symptoms are lasting less then 24 hours though. The vet said everythong points to vestibular disease except the frequency. Between episodes she is a perfectly normal 13 year old. She is still quite active with minimal arthritis. Has anyone ever seen this kindof frequency before? He did say it may be a tumor but didn't seem to be presenting that way. Also he did not do blood work, should I get some done? If so what? Please help, I am feeling very helpless right now.

Submitted by Laraine | August 16 2013 |

My thirteen year old Shih Tzu is just recovering from vestibular syndrome. He's drinking but hasn't eaten if four days. I've tried hand feeding him but he's not interested. He does go to his bowl so I know he's hungry. His eyes have stopped twitching and his stance and gait are improving. How long can he go without eating?

Submitted by Jean S | August 16 2013 |

My 15 year old Cocker Spaniel developed Vestibular Disease. I came home from work one weekend and my boyfriend was in the yard with her. When I went to check on her, her head was tilted to the left, she tried to stand but would fall. I thought for sure that she had a stroke. I was devastated watching my baby struggle to walk. I took her to the vet the next day, by then she was able to stand and walk a few steps with out falling. Today is the 6th day, she is walking almost normal, shes goes up steps but is afraid to go down them and she is still experiencing the head tilt. She eats and drinks normally. She didnt have any problem eating or drinking on the 1st day it happened. In the process of the doctor diagnosing her, we found out that she might have Cushing's Disease and the dr is running blood work to confirm. I just wanted to share my story because when I first saw Sparkie in her condition, I was very upset. Hopefully, this puts some parents at ease. If your dog is experiencing Vestibular Disease they can still live a normal functional life =)

Submitted by Katie | September 1 2013 |

My dog was a german shepherd/border collie. I got her when she was 8 weeks old. She lived until she was 17 1/2 years old. I first experienced this was she was 12 yrs. old. My Vet said she had a TIA, which is similar to a mini stroke. He gave her a shot consisting of corticosteroid, thiamine and B-6. By the next day she was fine. I went on-line constantly to get more info about TIA's. It was probably 1 1/2 years later, when I stumbled across the "old dog syndrome". There was very little info available about this syndrome at that time.
Thank you so much for this article. I hate thinking of all the poor dogs that were put to sleep only because their owners did not know that if given just a few days their dogs would come out of it and be back to normal.... Very heart-breaking.
As I mentioned earlier, my (smart, wonderful, loving, happy) dog lived until last month. She was 17 1/2 years old. She did have a couple more episodes of this syndrome. During her last year of life, her balance was a bit unsteady at times. Maybe it was just old age catching up to her. I sure do miss her. My little shadow.....Forever in my heart...
To those that have medium to larger dogs. The best thing you can do to help them live a long healthy life is to: WALK/RUN everyday. 15-30 minutes is NOT enough. Repeat. 15-30 min is NOT enough exercise.
Also, ask vet for blood test every couple years when their young. Every 1-2 years when they're older. At my request, my vet would do a CBC (complete blood count), heartworm test and thyroid test every year after age 12. Luckily I had a healthy dog. I hope all of you do too...

Submitted by Mike | September 4 2013 |

My wife and I have a 13 year old Nova Scotia Duck Tolling Retriever that we have had since shortly after we got together. About a month ago he had an episode of vestibular disease, the symptoms were as outlined above. Our vet treated with prednisone and Dramamine. But he had already showed signs of recovery within about 30 minutes of the episode. By late that night he was fine. Well, the other night he was laying next to us on the floor and started crying. I got him up and sure enough he was having another episode. It only lasted about 30 minutes and later that night he was fine again. I took him to the vet and she recommended blood work and x-rays. This will likely run $500 plus. At this point, I am inclined to wait and see if he continues to have them. My questions are: Does the fact that he has had more than one of these episodes indicate anything? and secondly, am I making the right call to wait a bit longer? Could it be that he will just keep having them, recover quickly, and be fine? It's obviously concerning not knowing what is causing this.

Submitted by Diane Kerner | September 9 2013 |

My 13 year old lab-shepherd mix recently had this. It is amazing to me that we had never heard of it, given how horrifying an experience it is to watch you pet and think they're dying. At times, Reese looked possessed: upside down, her back arched, head upside down, legs flailing in the air. OMG it is so heart wrenching. That was a setback around day five. The original attack was the head tilt, eye movement, stumbling, circling, whining, and she was so panicked, as were we. Thankfully, we learned she wasn't dying and had something curable. whew! It's a long road, though. It takes a tag team of at least two because you really can't be out of reach in case she tries to stand up and walk (she will fall) - and that's around the clock. If you're lone with her, you can't go take a shower or be in another room. I was awakened by her panting a couple times each night and got up to give her water. She would only eat baby food from a spoon around day two. it was a week before she was able to reach around to clean herself and took her first normally beloved biscuit - her first hard food, fed by hand in small pieces. It's so nice to see her do ordinary things like lick her feet. We have stairs coming in and out of the house, and that is a problem, as she must be carried into the yard to relieve herself and take a little walk (using a sling, of course, but gradually just needed spotting). Anyway, carrying her can send her back into a spin, as can repositioning her if she lands half in/out of her bed. We learned to give her fair warning, verbally and tactilely before moving her. We learned she'd take almond butter, masticated baguette, organic broth, soft ginger cookies (good for nausea)... we just kept trying everything. I also had a bowl of water with a slice of fresh ginger and a couple of mint leaves in it. both good for nausea. I'd add a syringe-full to her water and she liked it fine. I also sprayed chamomile mixed with distilled water around her beds for calmness. just breathing the steam from chamomile tea can be calming. And she would eagerly take the Bach Rescue Remedy in pastille form (kinda like a gummi bear), which is for anxiety. Since she is on antibiotics for ear infection, I got her to take a little coconut yogurt, though I don't know that dogs stomachs need the same bacterial help that humans do. Still, it was more food she would eat. I'd say it will be around two weeks before we'll be able to leave her alone in the house again. I really feel like starting a support group or awareness campaign about this disease. reading all these posts, it is such a scary thing for all involved and it seems none of us had a clue this could happen to our pets. Good luck to all of you!

Submitted by Kathleen Barker | September 10 2013 |

I took my 11 year old Maltese/Dashund mix, Ralphie to the emergency vet on Sunday night & they diagnosed with nystamus. I've been giving him anti-nausea medication (they gave him a shot for nausea & iv fluids) but 3 days later, he has started to vomit again & hasn't eaten in 4 days...we have limited funds but make too much to qualify for a grant. Is there anything you can recommend? I want to stop the meds but haven't yet. I'm just so worried about him. It's my hubby & I & our two four legged children. I helped Ralphie's mother birth him. After reading your article, I have more hope. Thank you for writing it.

Submitted by Chris Massey | September 11 2013 |

I am so glad I found this forum/blog. We too are going through this - our 13 yr old Malamute presented with severe symptoms out of nowhere 72 hours ago. She seemed to get worse over the next 12 hours. 24 hours later the nystagmus stopped so i guess that's the progress you want to see as a sign that she might recover. We are now at 72 hours and she still can't stand, even refuses to try but is eating and drinking fine when hand fed. It is beyond heartbreaking to see her in so much distress- any forced movement sees her flailing around as she doesn't know which way is up. I can only assume any movement causes such a head spin. We are naturally starting to question our wisdom of keeping her going but reading this site gives me hope and the will to carry on. I spend every minute by her side and it's so exhausting. I am sure she is not in pain but must be so stressed out.

Submitted by jane | September 11 2013 |

5 days ago, the 8 yrs old pomeranian suddenly tilt her head to the left and panting heavily. Bought her to the vet, but was not told that it might be a vestibular disease. However she does have a mild ear infection on the left ear. What bother me is the X ray result shown her neck bone had curve shape.

Can someone tell me is it normal?

Also my dog tends to pant more anxiously at night only, usually after she wake up from her sleep.

Need some advise please. Thanks

Btw she only treated with antibiotics and ear drop for ear infection.

Submitted by Rcahel Bishop | September 12 2013 |

Very reassuring to read, BEFORE an expensive vet visit! Thank you! Hoping my 'Old Pup' will be with me for a while yet!

Submitted by Marcia | September 18 2013 |

We are having our second episode of this in our now 18.5 year old poodle/spitz mix...Gritz, the Mighty Boo Bear. Last time - 3 years ago - it took a very determined vet and 12 days to start to recover. This time, neither our trusted and tenacious vet, nor we are convinced there will be recovery. We are giving it some time - but not as much as 3 years ago. He has been a valiant little warrior - and a delight for all these years. We hope our 21yr marriage will survive not having him as part of it. Sad but ready.

Submitted by anonymous | September 19 2013 |

This also happened to my 14 year old American Eskimo last month. She used to have seizures but had not had one in over 5 years and this was definetly different. I took her to the vet the follwoing morning because I thought she had a stroke. My vet said she thought she did too but to take a wait and see approach without alot of tests considering her age. I started doing research on the internet and came across idiopathic vestibular disease. She had another episode last week which was worse than the first. She was acting like herself when all of a sudden she vomited, all four of her legs collapsed and she rolled over 7 times. After about 10 minutes she was much better. She now walks with a slight head tilt and sometimes falls when she's walking but that is improving. One thing I want to mention to anyone that has a dog dealing with this is to get baby gates to block stairways. That way you'll have peace of mind knowing they won't get hurt falling down the stairs if you aren't home.

Submitted by kristin | September 19 2013 |

My nearly 13 year old American Pitbull terrier recently had surgery to address Laryngeal paralysis - prior to this surgery he was showing minimal signs of weakness in his back end - and increased sensitivity to the "spot" on his neck that causes most dogs to crescent themselves or involuntarily move their back leg as if to scratch. Other than that - none of the signs of vestibular disease were present. Post surgery - he was treated with Cerenia to avoid nasueousnes which could cause him to aspirate - and there was evidence of a slight lean to the right. on day 11 (post op) the lean became severe - he is leaning all his weight to the right, tilting his head to the right - but there is no sign of the eye movement noted in all the descriptions ive read about the condition. My vet determined that he likely has either the central or idiopathic vestibular disease - we put him back on the cerenia and predensone to treat any potential immflamation that may be in the brain. He has been on these meds for 2 days now and i am not seeing any improvement. the thought is that if this condition was present pre-surgery - that the anesthesia could have exacerbated it - ear infection was ruled out. Based on my description - what would you recommend ? He is eating well, drinking is difficult but we are managing to assist him by bringing his water dish to him - but walking is becoming increasingly difficult as he seems unable to stay on his feet for very long- he is putting all his weight on the right side. He has a harness and we are helping him get around by supporting him - and i am going to purchase a "sling support" as well - I do not want to give up on him and reading your notes about how this disease can correct itself has given me hope - but i am unsure if the meds he is on will actually help him recover. there is always the possibility of a tumor - but at this time (after a very expensive surgery) the $2000 MRI is just not in budget - especially if it would only tell me that the end is eminent. I want to give this as much time as is reasonable given his current quality of life. Any thoughts would be greatly appreciated.
thank you

Submitted by dee | September 24 2013 |

my four year old dog started with the head tilt. the vet found nothing wrong treated with antiobodics and she had gotten better. The head tilt was gone and she was back to herself. I came home from work on friday and she is now blind in both eyes. we see a neuroligist today and very afraid. I was told about vestibular but she is young. I guess i am hoping for answers. I tried to tell my vet I think something is wrong. Her ears were always clean but was told ear infection, or vestibuler, I read on that and usually happens in older dogs. On her check up I told vet her pupils looked big but was told her eys were fine. two days later she was blind.

Submitted by Brianne | September 25 2013 |

Thank you for this article. Our dog started showing symptoms this morning and I freaked right out; he's a geriatric dog with arthritis, recently started on cuprofen. I thought that he was either having a reaction to the new drug or a stroke. I called our vet and she let us come over for a walk in. She diagnosed vestibular syndrome within three minutes (she pulled down her pathology book and read through the information with me, and I was finally able to relax when I saw "often reported as stroke by owners" and that it usually resolves without treatment within 72 hours ). I went home feeling worlds better.

Submitted by Catherine | September 30 2013 |

My mini wirehair doxie developed vestibular disease, after treatment he returned to normal except that he has become deaf. He's thirteen and basically healthy. He used to be able to hear jelly fall on a cracker and now we have to shout to get his attention.

Submitted by pb | October 7 2013 |

my old buddy is now experiencing his third incident this year (first one - full recovery same day with steroids 1/13 second one took 4 days 5/13 This event- worst- cannot bear weight at all. At what point do I say enough is enough?
He's 15 and was a champion out door warrior. Tracking moose in Wyoming wilderness; backcountry ski trip partner, marathon runner etc.

Submitted by Rachelle | October 7 2013 |

My older CAT had this. My vet told me to euthenize him. Thankfully I didn't. I put him in a cage and started him on heavy antibiotics. He is doing great and that was several years ago. His eyes still dart back and forth though.

Submitted by Millie Brown | October 7 2013 |

Millie is a sixteen and a half year old Lhasa Apsos and just recovering from Vestibular Syndrome. She had all the symtoms and after the bloods came back OK the Vet said it was probably the VS. As we had never heard
of it before such a relief to find something that appeared like the worst case scenario, ie stroke, tumour
was only temporary.

Submitted by jlaass | October 14 2013 |

Dr. Cox,

Popper was 10 years old when she experienced a seizure just after Christmas of 2012. Since it was the holiday break from school, two of our daughters were able to sit with her, petting and comforting her. She recovered (eyes stopped moving rapidly side to side, balance improved, appetite returned, head tilt went away) to resume normal functions though she still has a loss of balance in her hind legs, circles often, and lost her bark. She had a minor episode a few months later, but now nearly 1 year later she is still full of a positive spirit and life. I've noticed that taking her to the park to run on grass vs the asphalt jungle of Tucson, AZ is great for her to exercise without experiencing the jarring effects of a hard surface. The jaunts in the park are very therapeutic for her as she runs past physical exhaustion and returns home with a big smile on her face to a very good night of rest.

Thank you for the very informative article.



Submitted by Connie Wilkinson | October 16 2013 |

our 12 yr old shepard /golden retriever mix Had a Spell two weeks ago On Oct 2 2013 we rushed him to the ER Vet and he was diagnosed with acute idiopathic canine geriatric vestibular syndrome , Buddy is 126 lbs and it has been a very Rough Two Weeks to recovery , but he is making progress everyday ,vet gave him antibiotics , pills for his dizziness, and tramadol for his pain because he could not walk or get up for the first week , the second week we were walking him around the house and out to do his business with lots of help and yesterday he got up by him self and this am he was walking around the yard still a little staggering so we will keep helping as long as we need too , but all in all so glad we waited it out because it was very scary to witness and we thought it was the end but he proved us wrong and I'm so glad we still have our Buddy he has been an amazing patient we hand fed him chicken and rice with chicken noodle soup poured over it had to hold his water bowl for him to drink , had to do daily and nitely baths if he had an accident , he was such a trooper through it all , LOve our Best Friend so don't lose hope !

Submitted by Lisa Jessop | October 17 2013 |

Our 6 yr old golden was diagnosed with vestibular disease. I thought for sure it was a stroke or a snakebite. Our vet was spot on but precautious.Thank goodness for the web. I was able to get information that kept us going. After 1 week of antibiotics and anti nausea medication he showed major tail wagging. I thought for sure we would have to put him down. Sharing is the key. Also YouTube videos

Submitted by Julie B | November 7 2013 |

Our 6 year old Golden started with these symptoms a couple of weeks ago. He was given antibiotics and since then his nystagmus has stopped, the slackness in his jaw has gone, he's smiling again and he's now back to his usual boisterous self. However, he's still got a lazy left eye and his head is still tilted. He goes back for his fourth visit to the vet tomorrow, but they're now recommending an MRI because he's still tilted. He's insured, so this isn't a problem at all but it's now got me worried in case it's something more serious, just after I'd calmed down a bit because he seemed to be responding so well to the treatment. Can anyone offer reassurance?

Submitted by Sharon Johnso | October 18 2013 |

Thank you so much for this information. My Chesapeake Bay Retriever is right in the middle of week two of this problem. For a while, I, too, thought she was tired of her 16 years and ready to call it quits, but she is progressing slowly. Scary presentation but it gets better and we are so lucky to still have her.

Submitted by linda miller | October 18 2013 |

this morning 10/18/2013 noticed my dog Chance 15/half year old dog, head hanging to the side eyes rolling like a drunk person, my first thought is omg he has had a stroke, called the vet. crying I told them I believe Im going to put him down..saying my goodbyes on the way to vet.after I got him there they soon after seeing him said he has the old dog vestibular disease.. he has inter ear infection.. waiting now for next few weeks..they think he will recovery just fine. but looking at him, makes me wonder if he will recover..feeding him by hand and holding drinking bowl to drink , carrying him to his potty pad to do his business..love my dog and do not want to see him suffer..but he is not crying.so praying for recovery!!

Submitted by linda miller | October 18 2013 |

this morning 10/18/2013 noticed my dog Chance 15/half year old dog, head hanging to the side eyes rolling like a drunk person, my first thought is omg he has had a stroke, called the vet. crying I told them I believe Im going to put him down..saying my goodbyes on the way to vet.after I got him there they soon after seeing him said he has the old dog vestibular disease.. he has inter ear infection.. waiting now for next few weeks..they think he will recovery just fine. but looking at him, makes me wonder if he will recover..feeding him by hand and holding drinking bowl to drink , carrying him to his potty pad to do his business..love my dog and do not want to see him suffer..but he is not crying.so praying for recovery!!

Submitted by Lisa Robinson | October 23 2013 |

I have a 16yr old papillon dog, otherwise healthy but just getting old she is now going blind with cataracts. I had her teeth cleaned 3 months ago in the past week I put her out for a wee in the morning and saw her take a couple of steps very wobbly and fall over sideways...this was sooo scary...this was last friday...now she is like she is drunk, wont eat or drink having to syringe food and water into her now, she is weak..standing with head down also going in circles. I am thinking vestibular maybe eyes are not twitching though...she cannot concentrate and is in a daze it is heartbreaking to watch has no appetite now...absolutely heartbreaking...all bloods were normal kidneys good and liver and no diabetes...looks like she has had a stroke.

Submitted by Becky | October 25 2013 |

BigDog is a kind, gentle, 13 year old rescue. He has been having significant arthritis issues and some imbalance. He has been going through his normal fall bout of allergies, only it seems worse this year. For the last 24 hours, it's like his hind end has "caved" in. Unable to walk for more than a couple of steps, and can't support himself in the rear. No bowel or urinary issues as far as incontinence. No rapid eye movement. He's on metacam and tramadol for the arthritis, and benedryl for the allergies (steroids have not worked well this time around). My husband is devastated...... but we've adopted a wait and see approach as I had another dog go through this same thing, recovered and lived for four years after........... however, I'm still not sure I'm doing the right thing by the dog despite the fact he seems in no pain... confused by his inabilities but not in pain........

Submitted by Elva Fig | October 25 2013 |

Yesterday, my pug Mimi on her 12th birthday suddenly woke up am hours with heavy breath and complete disorientation, eyes were darting all over, head/body tilted and inability to stand. ER vet visit revealed that they suspect Vestibular Disease. She has had a long history of ear infections and currently has a mild infection. Veterinarian suggested to wait and see if it clears up with treatment of the ear infection. She has drastically improved on her own within a few hours, I'm too concerned to just wait to see if it does not occur again. My sisters 13yr old pug recently and suddenly passed away with symptoms almost exactly the same. Going to see a specialist and possibility a neurologist as well.

This article has been tremendously helpful and so have the numerous posts of animal companions.

Submitted by Margie Thompson | October 26 2013 |

Our 8-yr-old Beagle, Dudley, experienced a stroke-like episode 2 wks ago. We suspected it was a resurfacing of degenerative disc -- a condition for which he was diagnosed and then underwent surgery for at the Veterinary Teaching Hospital, MSU, in 2010. We were pretty sure it was his time to go, but then our vet suggested we hold off, as she suspected peripheral vestibular disease. She is currently treating him with dexameth., IM every other day, and also treated him with antibiotic ear drops, which seemed to do wonders for his ears. As of today, he has the same symptoms, but a dramatic decrease. There's always a chance, too, with his history that this is central vestibular disease. We're keeping our fingers crossed and saying our prayers that he improves and doesn't relapse. He's such a good dog, and we love him. Thanks for the informative article, Dr. Cox. It re-inforces what our vet (another MSU VTH Grad...we call her Dr. Sparty...)is telling us.

Submitted by Joanie Rogers | October 26 2013 |

I am currently going through this with my 12 yo Doodle (Dox/Poodle). She didn't start vomittiing right away but now she can't keep water down. Symptoms started about 18 hours ago, vomitting about 15 hours ago. She seems to be very thirsty. The emergency vet started her on meclazine. Any suggestions?

Submitted by Cleo | October 26 2013 |

Hi .. I'm not sure if you are still receiving comments on this. We just got back from the ER with our 12 year old dog tonight with this diagnosis, vestibular disease. We've had her since her rescue from an abandoned apartment at 3 months old. For the last 3 years she's been prone to ear infections but nothing this severe and the ER vet explained this was an inner ear thing. Her back legs bottomed out, she was shaking, vomiting and unable to stand. She's 60 pounds and a Chow mix so at times, a little hard to handle but I'm so glad she let me pick her up and get her in the car. It's something how adrenaline gives you that superpower strength when you need it! She's was given a shot of antibiotics and a shot for the nausea. She'll be on a 2 week course of Baytril, Cerenia for nausea and Meclizine for dizziness. She's sleeping now but favoring her right side, tilting her head. She drank a lot of water since coming home which I'm hoping is a good sign. It was suggested we wrap a towel underneath her as a hammock to help her get around which is actually what I needed to do to get her out of the car tonight.

She has an aggressive temperament and I had to muzzle her before going into the ER. It breaks my heart doing that but I know it's for everyone's best interest including hers. Thankfully though she let the ER vet and techs do what needed to be done and allowed the tech to carry her out to the car afterwards. It's hard taking her to the vet without sedating her and at her age, we're reluctant to do that and many a vet in the area is reluctant to take us on as clients. We've been through 4 I think. Sigh.

Any other advice as to what we should do aside from the meds and keeping her indoors and off steps would be greatly appreciated!

Submitted by Kristal F | October 28 2013 |

We have a 17 yr old Shiba Inu whose episode started at 9:30am yesterday morning. We were certain that this was the end until we read your article. We were dreading the trip to the vet as we were certain they would tell us to euthanize him due to his age. We are going to wait and see if his symptons get better as he will take water if you drip it into his mouth, but is unable to get up to eat, drink or go to the bathroom. We are keeping him calm and warm and making sure he knows we are with him. He is deaf, so we are stroking his side and neck. After doing some research, we realized that he is not in pain, he's not whining or yelping, which relieves us, but is there certain cases where they never recover?

Submitted by Laura | October 30 2013 |

Thank you for this great information, very informative! I am with a rescue that takes many older dogs. We have experienced this condition with several dogs over the years, the latest being an older cattle dog mix who just started showing symptoms last night which is how I found your post. She will be going to the vet this morning, but this information helped put my mind at ease, no matter how many times I see Vestibular Disease, it is always scary. I shared this post on our rescue's Facebook page, it is great information for all dog parents and I always hope it will help someone decide to give a dog the benefit of the doubt and some time before deciding to euthanize. Thank you!

Submitted by Ruby | November 12 2013 |

As a retired medical doctor who has fostered about 70 dogs in the last 25 years, about 1/3 of whom were seniors, I was surprised to not see a mention of vertical or rotary nystagmus as diagnostic signs. The first old dog of mine who developed Ideopathic Vestibular disease was a 15 year old 80 LB lab-golden mix named Sadie. Sadie suddenly fell over in the yard and looked like she was having seizures. I noticed her nystagmus but did not know at the time it was a diagnostic sign. I rushed Sadie to the vet and he diagnosed the vestibular disease. It took over a month to resolve. Anti-nausea meds and massage helped her maintain her composure and appetite long enough to recover.

Since Sadie developed it, I've had 4 other elderly dogs develop this. I've had 9 dogs live to be 15 or older. Most were fosters who never found homes. This is less of a problem now, but I started living with 4-8 dogs at a time in the late 1980's. Mandatory spay/neuter and rescue have made a huge positive benefit.

4 more old dogs living with me have developed this disease. About 1 out of 3 of the elderly dogs who have lived with me have developed this, usually only a mild case. The nystagmus can be hard to catch as it is sometimes quite transient. For two of my dogs, only I saw the nystgmus; it was never present when the VMD examined my pups.

One thing I have noticed in human medicine over the last 40 years is that doctors are becoming less proficient in physical examinations. There is so much more scientific information to learn and the time with each patient has been drastically reduced by through the monopoly practices of the for-profit insurance companies. (Insurance is the only industry specifically exempted from federal anti-trust laws. This occurred in 1946 with the McCarran Ferguson Act.)

I am wondering if the same thing is happening with veterinarians--do they have less time and are they becoming less proficient with physical exams?


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