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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,
President, Maybeck Animal Hospital

Article updated 8/18/2012

53 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:

      What ended up happening? Did she get better?

    • lareina says:

      can this be caused by vaccinations? Vaccinated ten days ago and symptoms began shortly after and increasingly got worse.

      • Hhac says:

        Lareina, what vaccines did you animal receive prior to this condition? Canine or Feline?

      • Kate says:

        Hi, My dog got either vestibualr disease or stroke after vaccinations. If over vaccinating can cause neurological issues, then they could also cause vestibular disease or a stroke.

    • Anne B Gwydir says:

      I had a dog who developed this at 14 and lived to be 18. She did improve a bit. She could walk enjoyed her food etc so I wanted to hold off euthanising her. She was a bit wobbly and carried her head at an angle but she was happy and otherwise healthy.

  2. 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!

    • Joanna says:

      hi Lori, yes I can relate to your situations as well. it was super scary to see my dog acting this way (she is 13 y.o border collie). the first episode happened at 3am on Thursday and now its Saturday and she still have periods she is back to normal but then few hours later she is back to square one – unable to walk, limping falling, panting, jerky eye movements.. did your dog that the same periods of time that was okay for few hours and then back to being sick again? I’m worried sick. Thanks ! ps. is your dog better now?

      • Marlene says:

        I wondered how your dog came out. Our 13 year old border collie started with this a week and a half ago. She was great in about 3 days (even playing), then it started all over again. The vet said there is just usually a slow progression to the better and now I am worried about a tumor. Her balance is now better, but she is not eating well (some table food – will not touch her dog food) and she seems very tired. Very unlike her. Except for hip dysplasia she has been a healthy dog.She has been given antibiotic in case of an inner ear infection (no signs of other ear problems) and an anti-nausea medicine.

  3. 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.)

  4. 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.

  5. Ali says:

    My almost 11 year old black lab/border collie mix is currently suffering from vestibular. We’re going on 3 weeks now. Vertigo, nausea and eye shakes took about 7 days to leave. Anti nausea meds really helped in the beginning because he wouldn’t touch food or water. I finally used a turkey baster to get some water in him on about day 4. That worked well. He’s eating dog food and drinking on his own now and goes outside to do his business. He’s still very unsteady walking and still has the head tilt. Vet said these are the last symptoms to go. He’s on a 10 day oral antibiotic as well as a topical ear drop, which we had to change yesterday because it didn’t seem to be getting rid of the brown gunk in his ear. He’s been prone to ear infections all his life. I am praying he’ll make a full recovery, but at 3 weeks I thought he’d be better by now. It’s a strange ailment where the severity seems to wax and wane. One day I’ll think his balance is way better and then the next he’s all unsteady again. So heartbreaking to watch. 🙁

    • Steve says:

      You are so right about it being heartbreaking. My Border Collie (Bandit) has had this disease now for 1 week. Still has the head tilt but compared to a few days ago at least now he can walk but not perfectly. He is acting more like himself by bringing a toy to me when I come home :)So it seems as if there is a light at the end of the tunnel. All I can say to all the owners is keep the faith stay positive and keep praising your buddy and pet and hold him to reassure him that all will be fine. It goes a long way for both of you.

    • Melanie says:

      Did your dog ever recover completely? We are on week 3 with our 15 year old shihtzu and he is doing the same thing. He’s eating on his own, using the bathroom but still has the head tilt and is unsteady, some days his balance is better than others.

  6. Angie says:

    My 16 yr old Mini Schnauzer just had a head tilt at first. I looked it up online and found info about vestibular, but I took her to the vet just to rule out an ear infection. After 2 days on anti nausea meds, she started twisting to one side. She has been eating and drinking fine from the start, but is hesitant about going down the stairs. She seemed quite a bit better last week, but then over the weekend got worse again. It has been 3 weeks and she is better than at her worse, but worse than when it was first diagnosed. I’m going to start tracking how good or bad her days are to see if I can get a sense of how bad it is. I just don’t know what to do.

  7. Robyn Landers says:

    My 9 year old Chihuahua was diagnosed with this on Saturday. Today I called the vet to ask what I should expect with this disease and they told me this is the way my dog will be for the rest of his life. Can any of you tell me what your vet did for you and how long did it last?

    • Kate says:

      It should not last forever. The head tilt might, but my vet said that aside from that, they usually expect a full recovery. It just takes a very long time and varies for every animal. My cat is still working through her unsteadiness and balance issues two months after diagnosis. My vet said that is normal. If they’re showing any improvement, that is positive. Just might take a while.

      • Beverly A Bean says:

        my cat is 8 wks old, and she has the head tilt, and equilibrian off, my vet told me to keep him in a cage from his brother, but i put him in a bathroom instead. I feel bad, He is eating good etc. and I am thinking of letting him out. what do you think?

  8. Sam says:

    It is important to protect cats and dogs

  9. Website says:

    Vestibular Syndrome is very common these days.

  10. Shiloh says:

    This type of disease is so common in Dogs and Cats.

  11. Finding a good vet is important says:

    A thorough vet exam and even an xray by a radiologist (they are trained specifically on how to read and interpret xrays far better than most regular vets) will help determine if there is an inner ear disease as it can be seen. There is an invasive surgery that can help but it is involved- worht it if you are willling to do that. For mild cases dramamine -the 24 hour kind which is metriclizine- and cerrenia help.

  12. Kate says:

    My ten year old cat developed symptoms of a vestibular condition in March 2017. She had been walking peculiarly–her back leg(s) or hip(s) were not functioning properly. Then all of a sudden she was unable to walk, extremely disoriented, eyes moving rapidly back and forth, no appetite. The vet came and said it was likely a vestibular condition. He checked her outer ear and did not see anything worrisome, but said it could be inner ear or some other infection, so he gave her a prescription for a 28 day dose of antibiotics. He also gave her a fluid injection in case she didn’t start eating and drinking soon.

    Within the next couple of days, she was able to stand and walk–but very weak, and with a lot of difficulty and very unsteadily. She ate very little voluntarily, likely due to the dizziness and the side effects of the antibiotic. She lost an enormous amount of weight, despite our force-feeding her.

    Then, all of a sudden, she started eating and drinking on her own. She was still incredibly tippy and unsteady, but she was undeniably improved. She continued to show signs of improvement–she is now able to go up and down stairs (though we haven’t let her up to the second level of the house yet because we’re not sure she would be able to go down more than a few at a time).

    It is now May 21, almost exactly two months since she first displayed vestibular syndrome symptoms. She is now back to her normal weight of about ten pounds. She goes outside–only supervised now–previously she was a confident, happy indoor/outdoor cat. She has a litter box for the first time in her adult life. She eats and drinks normally. She has returned to asking for canned food. She is playful. She jumps onto the sofa to access her favorite spring spot–the windowsill–but she has a lot of trouble getting off the sofa and benefits from assistance.

    She still has a head tilt, which we knew may be permanent. She still circles a little (nothing compared to what it used to be). She still is a bit unsteady and appears weighted to the left. But she is able to walk in a straight line. She does get a little agitated or nervous if she is outside too long–even though we are never far–and doesn’t stray beyond a very small area. She is able to jump into and out of boxes, but she’s just not quite as steady about it.

    She’s obviously not back to her pre-vestibular condition self, but she is dramatically improved. I hope she will continue to get better. It worries me that she becomes so nervous outside–a place that used to be her kingdom. Overall, her quality of life seems fine. She seems content, certainly not in pain, and as close to herself as she’s been in two months.

    Vestibular conditions are scary for sure. I was a little relieved to see another commenter say that her cat had the symptoms from July-September because it looks like that’s the trajectory of recovery my cat is on. Much longer than some others.

  13. julie says:

    my dog was diagnosed two weeks ago, seems really good sometimes and other times really bad. just wondering if it can come and go..he is very hesitant about going down stairs.

  14. Amanda says:

    My 1 & 1/2 year old lab/collie mix is displaying the same symptoms of this disorder… it possible for one this young to get it?

  15. Jenn says:

    My kitten had the onset of this on Monday morning, vomitting, unable to walk and loss of balance, bobble head and flickering eyes. She’s gotten a lot better in the few days. Vet ran bloodwork and everything came back normal. Tuesday she came home and was fine, Wed she had an episode that lasted about an hour and a half. Thursday no episodes and this morning Friday she had one that lasted 5minutes. A little head bob and nystygmus with the eyes. I’m hopeful that this is clearing up as the symptoms were not as bad as they were on Monday morning. Vet gave her a steroid shot as well. She’s been eating, drinking and playing normally. I’m hoping that someone can tell me that she will be okay in a few days as she is my baby and I want to avoid a CT scan if possible.

    • My kitten is 9 mo. old, and she has vestibular disease, and i am told to keep him away from his brother and it breaks my heart. My kitten just has the head tilt, and a little off balance, and she is eating and drinking good. He is getting medication (orbifloxacin), glad to get some comments here, as I don’t feel to be as now I know it can get better.

  16. Lori M says:

    My 13-1/2 year old Boston Terrier looked like she was having a stroke on the morning of July 4. We took her to the ER vet- who diagnosed her with Canine Geriatric Vestibular disease. She had all the classic symptoms. We had her on Meclizine for the dizziness and another drug for the nausea. She has very slowly improved but is still walking tilted and cannot go up and down the stairs (inside the house). Our vet mentioned having a ct scan but for $2-$3K we opted to not do that and to see how she does. The vet put her on steroids about a week ago – thinking she may have a brain lesion – but we’re not too certain of that. She has improved alot since that first day 7 weeks ago and we’ve kind of come to the conclusion this may be her new ‘normal’. My daughter also suffers from vestibular disease and some of the same situations that make her dizzy make our dog dizzy…like small tight spaces and dark areas. So, we will continue to do what we can to give her a happy life and if that means carrying her up and down the steps and using pet gates we will. Just a mention that if we take her outside to the park she runs and sniffs just like she always did…just a little more tilted 🙂

  17. Morgan Hinsee says:

    So sorry to hear of everyone’s fur babies problems. Everyone’s post is heartbreaking and I hope all see a light at the end 🙂 My Siamese cat age 13, with front left leg amputation last year due to osteosarcoma is also suffering from the same. Came on suddenly today and as gotten really bad as the day went on. Took Bubba to the vet and like so many others got all the tests as well as a chest X-ray to rulel out matastasized cancer. It was blue pearl vet and 10 pm so was only sent home with the antibiotics. Was reading that Dramamine helps and I have the human pills. Should I crush up quarter of the pill for Bubba to help? The vet sujested my left over bupamorphin (pain killer) left from the amputation as a sedative but that seems wrong and wouldn’t it be expired? It’s so hard to watch my baby like this. He normally has the most sweetest disposition and is a lap kitty but he is so agitated and angry. I feel like he is suffering and I didn’t get the best advice from the late night vet. Suggestions would be greatly appreciated. Thanks

  18. david says:

    well my cat was 19 years old and came down with this little over a week ago. He was eating and overdrinking quite a bit, and it seems his kidneys may have been waning. He was relieving himself a bit more often then normal. Falling down, couldnt climb the stairs and a day full of vomiting clear liquid.Would not eat or drink. Went to the vet and got a ringer bag. didnt seem to help. noticed he did not sleep all night and he was hunched over on his pillow, as if in pain. He cried a good bit, which he has never done.Walking incessantly in circles.He was an outdoor cat most of his life and I felt that 19 years was a good long life. I put him down and now for a week, am regretting that decision.I was very upset believing he was in pain.He also had minor tremors for a few months now in his head.
    Wish I had found this site before making that decision…………
    In any case, I know he couldnt live forever, but yes a very difficult decision to make and I didnt want him to suffer.

    • Jean Woody says:

      My 10 year old Cat, Mr Fletcher, seems to have same symptoms. Can’t stand or walk…very alert and beautiful eyes still smiling. I’m not going to put him down until I’m convinced he’s not going to get better….will have the $2,500 MRI maybe!

  19. amanda hoyles says:

    My 10 year old cat has had two episodes of vestibular disease in the past 3 weeks. We only saw the end of the 1st episode as we had been out and came home to find Ginga on the floor in front of the sofa staring, at first I thought she had brought a mouse in from outside and it was under the chair but when I called her and she went to come to me she couldn’t walk properly. She was very wobbly but after an initial hello she went to the front door and pawed it to be let out, I let her out and she went into the garden right outside and had a wee, I took this to be a good sign as she knew she wanted to go out and she knew she wanted to wee. However we were far from happy with the loss of balance so We took her to the vet about half an hour later and she was quite a bit better, the vet checked her over and did a number of things with her feet and limbs to check out her balance, she got a dose of antibiotic and a shot of anti-inflammatory drug. We have two other cats, one is her sister and the other an adoptee we took on, both of these were fine.
    We were due to go away for 12 days a couple of days later and she was still a bit wobbly the next day so I decided I wouldn’t be going anywhere. I went out with her whenever she went out for about the next 5 days but she didn’t have any more symptoms at all for about 3 weeks and then she had a full episode in front of my partner and I. It scared the crap out of me and I thought she was having a fit/seizure/stroke. She had been sick and it wasn’t her food so she had been out somewhere stealing food, she was hyperventilating,her eyes were darting from side to side, she was circling until we stopped her by holding her still, her head was swaying back and forth and she seemed out of it. We held her and stroked her, and talked to her repeatedly and when she eventually seemed a little calmer and her breathing had eased a bit we took her and put her on her favorite chair where she generally sleeps, she calmed down a lot and I decided I would sit up with her overnight, I took the sheepskin she sleeps on off the chair and put it on the floor and put her on it and made the chair so she couldn’t jump up and injure herself, she settled down on the skin beside me and after about half an hour she got up and wobbled out into the hall and had some food and a drink then she walked back in went around the side of the couch, jumped up on the arm and ran across the back to sit on the windowsill. She was due at the vets two days later for some routine jabs, we had taken a video of her eye movements and head swaying to show the vet, the vet said she felt it was unlikely to be caused by an ear infection or tumor as the symptoms were unlikely to have completely disappeared and then reappeared the way that they had and that it was almost certainly idiopathic vestibular disease and to just watch her. If she has another attack we are going to take her for a full set of bloods and if she vomits we may well take that to be tested too. She has been absolutely and utterly fine since she jumped up on the sofa to sit in the window and that was about 3 hours after the 2nd episode began. Tiny bit worried as no other pet owners seem to have the symptoms go so quickly but am fairly confident that it is vestibular disease and not something else. She’s currently snoring her head off on her favourite seat …

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