If your dog is suddenly leaning to one side and can’t seem to right his or her head or walk, your dog needs to see a veterinarian immediately. Several disorders can cause this presentation, including idiopathic vestibular disease. The Meowing Vet provides pet owners with a speedy summary of this disorder, which dogs are more prone to it, and how it is managed by your vet.

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Often called “old dog vestibular syndrome,” canine idiopathic vestibular disease (or vestibular neuritis) is a condition of sudden onset most commonly affecting geriatric dogs over the age of 12 years. The vestibular system controls balance and coordination. Disease of or damage to the vestibular system (such as with idiopathic vestibular syndrome) leads to loss of balance and vertigo, resulting in falling or rolling behavior and a wide-based stance in an attempt to remain upright. Dogs with this condition also have a head tilt to one side, have horizontally “twitching” eyes (known as nystagmus), and are very nauseous and may vomit due to extreme dizziness.

The vestibular system may suffer either a central lesion (involving the brain) or peripheral lesion (involving the inner ear). Idiopathic vestibular syndrome results from a peripheral problem: disruption of the inner ear or vestibulocochlear nerve running between the ear and brain. The cause of idiopathic vestibular syndrome is unknown (hence, use of the word “idiopathic”) and is diagnosed when another cause for the clinical signs cannot be determined.

Look-alikes (a.k.a. differentials) of canine idiopathic vestibular syndrome that must be excluded by your veterinarian include the following:

• inner ear infections
• aural tumors
• hypothyroidism
• congenital vestibular disease (such as in Doberman puppies)
• brain disorders resulting in similar central lesions that affect the vestibular system, including:
  • brain tumors
  • meningoencephalitis
  • conditions which result in a cerebrovascular accident, or stroke, such as hypertension (high blood pressure) which can be secondary to:
    • heart disease
    • diabetes mellitus
    • kidney disease
    • hyperadrenocorticism (Cushing’s disease)

During the bout of your dog’s illness, anti-nausea medications such as maropitant (Cerenia®) or meclizine should be administered. Aside from supportive care, no other treatment is generally required. Fortunately, dogs with idiopathic vestibular disease tend to spontaneously improve significantly within two weeks. However, the head tilt may remain permanently. On occasion, the vestibular disease may recur.

– Maranda Elswick, DVM

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This article originally appeared as a post on The Meowing Vet’s Instagram profile, @themeowingvet (January 17, 2018).