Idiopathic Vestibular Syndrome in Dogs

The dog's vestibular system tells them where its body is, helps with balance, and coordinates head and eye movements. Vestibular disease is any abnormality of that system. Idiopathic Vestibular Syndrome is a common form of vestibular disease in older dogs, of unknown cause. It's not a life threatening disease, and often resolves itself. Idiopathic vestibular disease is more common in large breed dogs and most typically affects older dogs, those in the 8 plus age range, although middle aged dogs can be affected.

Dogs with this syndrome will present with a sudden loss of balance, sometimes falling over to one side, or an inability to stand. They'll have a head tilt, usually to the affected side, and they'll demonstrate rapid sideways eye movements (known as nystagmus). Most of these dogs won't be able to eat, or drink without help, or won't want to because they feel nauseous, like motion sickness. The syndrome can often be confused with a stroke or a seizure.  Diagnosis is largely based on history and clinical signs.  Sometimes diagnostic tests such as blood chemistry and complete blood count, xrays, or occasionally magnetic resonance imaging (MRI) will be done to rule out other more serious causes.

Treatment for Idiopathic Vestibular Disease is primarily supportive. In a severe episode, a dog with idiopathic vestibular disease may need to be hospitalized for supportive care, placed on intravenous fluids, and given drugs to control vomiting. Steroids or other anti-inflammatory drugs may be used. A medication that can improve blood flow to the brain may also be dispensed. If an ear infection is suspected, the dog may be put on antibiotics. Usually the animal is able to be treated at home. Often it is necessary to hand feed and water your dog for the first couple of days.  Help getting up to go outside for toileting is also often necessary.

Symptoms like loss of balance and rapid eye movements begin to improve within 72 hours. Vomiting stops and appetite returns. The head tilt can be slower to improve, with some dogs having a slight tilt the rest of their life. Most dogs with this disease are back to normal within two to three weeks. Sometimes, under stress, dogs will have a mild recurrence, but repeated episodes are really unusual. If the dog doesn't recover, or continues to have episodes, your veterinarian will recommend further diagnostics.