Dog - Vestibular Syndrome

What is vestibular syndrome?

Vestibular syndrome, or geriatric vestibular disease, is often incorrectly referred to as a 'stroke'.

The characteristic signs are loss of balance, leaning to one side, head tilt and rapid eye movements (nystagmus).  Sometimes the loss of balance is so severe that the dog rolls over repeatedly.

What is the vestibular apparatus?

The vestibular apparatus is concerned with maintaining balance.  It involves the inner ear, i.e. semi-circular canals and the nerve connections to the brain.

Are some breeds more prone to vestibular syndrome than others?

There appears to be no breed predisposition, although the condition does occur more in medium and large sized dogs.  Both mongrel and pedigree dogs can be affected.  Most affected animals are more than 8-10 years old, hence the alternative name geriatric vestibular syndrome.

Does the condition get worse?

The condition is usually rapid in onset and can occur in a matter of hours.  Once established it is non-progressive (i.e. it does not get any worse).  Frequently it will rapidly improve.

What causes the condition?

The cause is unknown.  Trauma and stress are thought to play a part.

What are the signs?

The characteristic signs are loss of balance, leaning to one side, head tilt and rapid eye movements (nystagmus).  Occasionally there is lack of coordination and/or paralysis which indicates that the condition is also affecting the brain stem.  The dog may vomit just before the onset of the other signs.  Inflammation of the external or middle ear may also occur.

Treatment

Since the condition is almost entirely confined to elderly animals and the cause is unknown, treatment is basically supportive.  Rehydration and maintenance of fluid balance usually requires intravenous infusions (a drip), particularly if vomiting occurs.  Sedation may be required for dogs with severe disorientation together with the use of anti-emetic drugs such as those used to combat motion sickness.  Antibiotics and/or corticosteroids may also be prescribed depending on the circumstances.

Prognosis

Despite the severity of the initial signs, for the majority of cases the prognosis is good.  Within 48-72 hours many cases show improvement.  If the brain stem is involved or if the condition is complicated with infection from the middle ear, improvement may take much longer.