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Vestibular Syndrome

Vestibular syndrome in dogs and cats can be a frightening event for owners, given the set of clinical signs that typically present when their pet is affected by this disease. For the owner or even young veterinarian that has little experience with canine and feline vestibular syndrome, it can often be mistaken for a poisoning, siezure, or stroke. In some cases of vestibular syndrome, there is an identifiable underlying cause, but in most cases, it is never really understood what set the disease off. When we are not certain of the pathogenesis of a disease process, we tag it with the term, ideopathic, hence the name of the disease, ideopathic vestibular syndrome. To understand the disease and its implications, it if first very important to understand the vestibular system, its functions, and the organs involved.

The vestibular system accomplishes three tasks. First, it contributes to an individualís sense of equilibrium in relation to the force of gravity and thus adds to the subjective sense motion and spatial orientation. Second, inputs coming from the vestibular system convey information to the body ís muscles and posture. Third, while head and body are in motion, the vestibular system controls eye movements so that images remain steady and in focus. This is called the vestibular-ocular reflex.

These tasks are accomplished through the mechnoreceptors of the three semicircular canals housed within the inner ear, the utricle and the saccule. Like the neighboring auditory system, each canal has hair cells that detect minute changes in fluid displacement, but unlike the auditory system, the utricle and the saccule send information to the brain regarding linear acceleration and head tilt. Likewise, there is a canal that detects head movement in the eye position, and there is yet another semicircular canal that detects motion from moving your head from shoulder to shoulder. These hair cells called stereocilia are located within the crista that is in each semicircular The ultimate carrier of signals from all of these aforementioned organs to the brain, is the vestibular nerve. The vestibular nerve ends at a nerve bundle within the brain stem called the vestibular center. Disease of any part of this system leads to disfunctions in balance, spatial orientation, and overall equillibrium.

As previously mentioned, by far the most common cause for vestibular syndrome remains unknown or ideopathic. However, since the canals and sensitive organs of the inner ear are the sensory input for the vestibular system, inner ear infections are a known cause for vestibular syndrome in dogs and cats, and is therefore a primary rule out when presented with a canine or feline patient showing vestibular signs. The least common cause for canine and feline vestibular syndrome is a tumor on or near the vestibular center of the brain stem.

Vestibular syndrome occurs most commonly in middle to senior age dogs and cats. Clinical signs a dog or cat will likely display in an acute vestibular event are: head tilt, circling, falling, and jerking of the eyes from side to side (nystagmus). The head tilt, circling, and falling are all directed toward the same side, which tells us which side of the body the respective vestibular system is affected. There is also associated vomiting and anorexia.

Once vestibular syndrome is recognized, the veterinarian must throughly examine the ear of the affected side to rule out inner ear infection as a potential cause. If the ear is found to be severely infected, then treatment of the infection must be addressed. The vestibular signs should gradually begin to resolve once the infection is under control.

If the ear is found to be free of infection, then it must be assumed that the vestibular syndrome is ideopathic in origin, or there is cancer. Since cancer of the vestibular system is quite rare, I only revisit that possibility if the patient does not resolve.

Ideopathic vestibular syndrome cannot be treated. However, the course of disease is such that it presents acutely, then gradually resolves on its own over 7 – 30 days. There is no way to speed this recovery process, but during this time the patient needs to tbe supported by antinausea and dizziness medication, and fluids (if the patient is so bad the it cannot eat). In majority of cases, the vestibular signs completely resolve, but with others some remnants of disease never go away. For example, some dogs and cats will keep a mild head tilt and occasionally cirlce, but for the most part, quality of life is good. If the condition does not resolve, then MRI or CT scan should be performed to rule out tumor (s).

Dogs and cats that have recovered from ideopathic vestibular syndrome usually do not ever have it again, but a minority of cases experience relapses. Unfortunately, there is no way to prevent relapses.

Roger L. Welton, DVM
Founder and Chief Editor, Web-DVM.net
President, Maybeck Animal Hospital

Article updated 8/18/2012

21 thoughts on “Vestibular Syndrome

  1. Phyllis Tweed says:

    My 14 year old dog developed symptoms of vestibular disease 9 days ago. She has been in vets since. On antibiotics etc. little change – unable to get up by herself, needs assistance to walk, being hand fed, though drinking on her own. Should we persevere for a while longer? Grateful for any advice.

    • Shirl says:

      My female 7year old cat went through this since July 26th. It’s now Sept. 16th and she finally looks better. I HIGHLY RECOMMEND the following: steroid prednisone to reduce inflammation, an antibiotic in case there is infection and ACCUPUNCTURE treatments. The accupuncture treatments that my vet did on my girl made her MUCH better. She has had 4 treatments – once a week with two treatments after that spaced a couple weeks apart each. If you can find a vet to do the accupuncture, do it.

    • Coleen Schaefer says:

      Our 13 year old lab could not get up Sunday when we returner from an overnight trip. On Monday she was still wobbly but a tiny bit better. She gets stressed by the vet so we were going to wait until the weekend to decide if we needed to put her down. I found another blog and give her a dramamine each morning and she is getting better. Able to go in and out of doggy door. She has had numerous ear infections over the years and this may be the cause. We are letting her enjoy herself vs putting her through vet visit and potential meds. One day at a time

    • Ellen B says:

      How is your dog today. I just read your post while I was trying to find info about my 15 year old cat who while being treated for ear infection became totally unbalanced as soon as she was given ear drops. It has been 10 days and she still cannot stand or walk. Thank goodness she is eating and drinking well. What have you decided to do with your dog. Any improvement?

    • Jan Liberto says:

      Phyllis and Shirl,
      I just found your stories. I wish I would have found this sooner.
      I cured my 5-yr old male Golden Retriever of Vestibular disease with Ginko Biloba. It required, for his weight (60mg per 60 lbs of body weight), 120mg/day 3X/day.
      I opened the capsules and sprinkled it on his food.

      The disease was completely resolved in a few months. He had all the symptoms, head tilt, no appetite, falling down.

      Now he suffers with what I think is sebborhea. I think it may be a side effect of the vestibular disease. I know for a fact, it is not a side effect of the Ginko Biloba.

      I am giving him “Ultra Oil” in his food, brushing the flakes from his skin twice a day, trying some Tee Tree oil directly on his skin and coconut oil on his skin. They both need to be organic.
      I just started this regimen, so I can’t mention any results or time frames for it being resolved at this time.

      • TXLPC says:

        I have a 14 yo blind Cocker Spaniel with the same diagnosis.Blind since 2. He adapted well to his blindness. The vet tried him on prednisone but it caused intestinal problems.Sometimes he eats on his own sometimes not. He is getting his personality back but the head tilt is still bad and he can hardly walk. Where is this info spoken about above

    • Jen says:

      Phyllis-
      What ended up happening? Did she get better?

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  3. Lori Maloney says:

    My 10 year old Belgian Mal had this event last week. Rushed her to the vet hospital thinking stroke or seizure. Vet diagnosed vestibular syndrome. She had a couple of mild relapses over the next 24 hours. We helped her stand and used a strap under her belly so she could walk to relieve herself. She would not eat much at first but after 3 days she is almost back to normal, She has a slight weakness in her hind legs and seems a little confused at times when going for her daily walk. It will take me longer to recover from the scare!

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  6. Joanne says:

    My 12 year old lab had an episode last fall. She was considerably better the next day but wasn’t eating well so eventually I took her to the vet who gave her steroids and antibiotics. The steroids really helped her appetite. Her balance gradually improved over a few weeks and she made a complete recovery. A couple of weeks ago she had another episode, but it was a bit different. She threw up once but since then has been eating though I have to coax her with a little cat food or boiled egg on her dog chow. Her balance is gradually improving again. I would urge anybody whose pet has this problem to be patient and get the vet to prescribe steroids if they are not eating. It really looks bad but a full recovery is possible with patience. (Both times my dog had eaten something unidentified off the ground before I could stop her so I wonder whether that could have been a factor.)

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  12. Katelynn says:

    I adopted my little cairn terrier a little over 2 years ago, don’t know anything about her past just know she is around 12-15 years old the vet has guessed. A week ago I thought she had a seizure but they said it was vestibular. I took her to another vet the day after and they put her on prednisone. The day after she had her episode she was wanting to get up and eat and drink. She just could stand up on her legs or sit-up without falling. But after starting her on the prednisone I felt like she got worse and we stopped it. She’s had 2 visits after that and it’s in between vestibular and a brain tumor as well as kidney failure. We are doing at home IV fluids and she is on antibiotics and meclizine. She still drinks eats and pees. But each day she is more and more tired. We don’t know what else to do and would hate to put her down when she is still trying and showing no signs of pain. Please give any tips that can help.

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