Written by Dr. Carley Giovanella and Kate Lawrence of GCVS
Charlie is 13 year old Labrador Retriever who still acted like a puppy in many ways, despite the grey creeping into the fur around his muzzle. So when Charlie’s owners came home from work one day to find him unable to stand without falling over, unable to walk in a straight line, and holding his head tilted to the side, they thought he had had a stroke. They rushed him to a veterinarian and were diagnosed with idiopathic vestibular disease (an “idiopathic” disease is a disease or condition that has no known cause). Vestibular disease is a common neurological problem that often affects older pets, can appear suddenly, and can be very scary. Thankfully, in many cases, vestibular disease is treatable and the affected pet does recover!
The vestibular system is in charge of maintaining normal balance. It includes inner ear as well as parts of the brainstem and cerebellum. To a patient affected by vestibular disease, it seems as though the world won’t stop spinning. Dizziness, nausea or vomiting, circling, falling, a tilted head, and a condition called nystagmus (the eyes move back and forth or up and down uncontrollably) are all associated with vestibular disease. These symptoms can be associated with identifiable medical problems, such as inner ear infections, inflammatory diseases, and tumors, so it is important to have your pet checked by a veterinarian as soon as you see any symptoms appear. Idiopathic vestibular disease is often seen in older dogs, as in Charlie’s case, with a sudden onset of symptoms, and is actually referred to as “old dog vestibular syndrome” by many veterinarians. It is not due to an infection , inflammation, or tumor, and is self-limiting.
When dealing with a possible diagnosis of vestibular disease, a thorough exam by a veterinary neurologist is recommended. A veterinary neurologist will be able to determine if the symptoms are being caused by a tumor, ear infection, inflammatory disease, etc, or if the vestibular disease is idiopathic in origin. Diagnostic tools such as an MRI or CT, or testing the patient’s cerebrospinal fluid may also assist the neurologist in the diagnosis.
If the diagnosis is “old dog vestibular syndrome”, as it was for Charlie, the treatment is generally supportive care, medication to help with dizziness, and/or anti-nausea medication. It is very important for patients who are affected by vestibular disease be kept away from potentially hazardous situations. Dogs who are going through the recovery process for this condition should be kept away from bodies of water, like pools, lakes and rivers, as their uncoordination may cause them to fall in and not be able to get out. Similarly, they should be restricted from access to furniture and kept away from stairs – there are many patients who have been seriously injured through a fall down the stairs or off of the couch while trying to recover from their vestibular symptoms.
In many cases, patients who are affected by idiopathic “old dog vestibular syndrome” recover over a relatively short period of time. Some patients will retain a milder form of their symptoms, such as a head tilt, but this typically does not affect their overall quality of life. There are situations where vestibular disease can be more serious and even debilitating for the patient, without seeing any resolution of the symptoms, but these severe cases are uncommon. Some senior pets who have experienced one vestibular episode are at a higher risk for a repeated vestibular episode, so pet owners should be aware of the possibility of repeated recurrence with this disease in some cases.
If your senior pet experiences a vestibular episode, check with your family veterinarian right away and see if a consultation with veterinary neurologist is right for you and your pet!