FAQ: Our old dog suddenly became dazed and confused, staggering around the house, losing his balance, and wandering in circles. Our veterinarian diagnosed his problem as vestibular disease. What causes this disease and how serious is it?
Idiopathic Vestibular Disease (IVD) is a disorder of the organs of balance (vestibular apparatus), situated in the middle ears. Their function is to maintain equilibrium (balance) by coordinating movements of the head with the eyes, trunk and limbs. Failure of this system results in a tilting of the head, abnormal body posture, loss of equilibrium, abnormal eye movements and incoordination as the body tries to compensate. Vomiting occurs because the loss of balance and incoordination, in a sense, make the patient “sea sick” or nauseous.
There are many causes of vestibular disease. Degenerative processes of the body, inflammation, cancer, trauma and poisons are some of the known causes. Most commonly, the disease can be related to an inflammation of the organs of balance due to an ear infection. However, in some cases, the cause is simply not known. In these situations, the disease is termed “Idiopathic Vestibular Syndrome”. The term “Idiopathic” means that veterinarians do not know why this disease occurs.
When IVD affects middle-aged or older dogs, which it commonly does, it is called “Geriatric” or “Senile” Vestibular Syndrome. It can also occur in cats at any age, and it occurs most often in the summer and early fall (75% between June and September).
When it occurs, IVD is usually sudden in onset and often incapacitating. The pet usually has a loss of balance, disorientation, unsteadiness and a pronounced head tilt. The degree of head tilt can vary considerably and there are usually involuntary rapid movements of the eyes. There may also be a tendency for the animal to walk around in a circle in one direction. Some animals will be listless, refuse to eat, pant and be nauseated.
At this point, many owners often think that their dog or cat has had a “stroke” or a fatal brain hemorrhage and suspect the worst. In some cases, pet owners have mistakenly euthanized their pet, thinking that their pet’s prognosis is poor and the situation hopeless. Nothing could be further from the truth. Pets with IVD, although confused and anxious at times, are not in pain and there is no reason for euthanasia. Relapses usually do not occur.
In fact, there is no treatment for this disease nor does any appear to be necessary since all patients appear to recover on their own. In some cases, a slight head tilt may be the only clinical sign that persists. Supportive therapy, if required, generally consists of preventing self-injury and ensuring adequate nutrition. Should your dog shows signs of this disorder, contact your veterinarian to confirm that this is the problem with your pet.
Here is a story by one of our members concerning her experience with Vestibular Disease
The vestibular system is the neurological system which controls balance by holding the head and body in a relative position to gravity and space. It is located in the inner ear and connects to the brain. Canine vestibular syndrome is also referred to as “old dog vestibular syndrome” and “geriatric vestibular syndrome” since it commonly occurs in older dogs with an average age of 12 – 13 years.
The most common causes of vestibular syndrome are due to a middle ear infection, a brain lesion or it can simply be idiopathic, which means that there is no known cause.
The symptoms, which come on very suddenly, include:
- Ataxia (stumbling and staggering)
- Motion sickness
- Nystagmus (rhythmic movement of the eyes)
- Circling and falling to one side
- Head tilt where one ear is held lower than the other
These symptoms gradually disappear within two weeks, and most dogs fully recover. Some dogs may retain a slight head tilt, which does not seem to bother them, and they live the rest of their lives quite happily. Since there is no cure for this syndrome, the most important thing is to help the dog during the recovery period.
Well, my vet was right about the getting worse part. Alex’s condition quickly got worse until he could no longer stand and his eyes began to dart back and forth. I fixed up his bed where I could keep watch over him at all times. I spent the entire days of Sunday, Monday and Tuesday never leaving his side. Because he could not get up to eliminate, I placed urinary pads under him, and each time he urinated, I gently rolled him over to the other side, cleaned his soiled coat, replaced the pad and repositioned him on his opposite side. I’m sure it must have been quite scary to be rolled over while already trying to cope with dizziness, but he cooperated without a struggle.
After 12 years together, I guess our trust in each other was implicit. Periodically, I would lift up his head and shoulders, propping him up with my body while I directed his head to his water and food bowls. Surprisingly, though Alex was immobilized, he was still thirsty and hungry as usual, although it was quite the trick to keep his head steady enough to find the water or food in his bowl! After meals, I watched for the tell-tail (no pun intended!) lifting of his tail after a meal to alert me that he was having a bowel movement, and I quickly whisked it away. At night, I put down cushions and slept next to him, touching him so that he would know I was there. He seemed very comforted by that and rested peacefully through the nights.
Finally on Tuesday afternoon, Alex began showing signs of wanting to get up! After much steadying, he was able to stand, and we practiced taking some wobbly steps around the room. After making some ramps to get him down the two sets of small steps to get outside, we finally made the attempt to go outside. I think he was as excited as I was to finally be able to urinate outside!! We walked around a bit with me on the left awkwardly trying to keep him from walking in circles, while trying to keep up with his quick forward steps!
Remember how you felt as a child when you spun around in circles and then tried to walk? Well, that was Alex, with me trying to keep him steady-quite the sight for my neighbors, I’m sure! By Wednesday, Alex was recovered enough for me to go back to work. He retained his head tilt for another week or so and then that eventually disappeared too. I could not believe that my “old man” was able to recover from such a debilitating condition with absolutely no side effects! And he lived happily for another 2 years!
The important message to remember in this article is that stroke, or vascular disease, is very uncommon in pets. So please, do not wrongly assume that your dog has had a stroke and needs to cross the Rainbow Bridge. See your vet. While canine vestibular syndrome is very debilitating, it is a short-lived syndrome which, with a few days of compassionate nursing, can result in many more years of enjoyment with your best friend.