Vestibular Syndrome

What is vestibular syndrome?

Vestibular syndrome, or old dog (geriatric) vestibular disease, is often incorrectly termed 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 the dog rolls over and over.

What is the vestibular apparatus?

The vestibular apparatus is concerned with maintaining the balanced posture of the individual. Components involve the structures of the inner ear, i.e. semi-circular canals, with nerve connections to that part of the brain known as the medulla oblongata.

Are some breeds more prone to vestibular syndrome than others?

There appears to be no breed predilection although the condition does appear to occur more in medium and large sized dogs. Both mixed breed and pedigree dogs can be affected but most affected animals are more than eight years old, hence the alternative terms geriatric vestibular syndrome or old dog vestibular disease.

Does the condition get worse?

The condition is usually very rapid in onset and can occur in a matter of hours. However 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 but trauma or stress can sometimes play a part.  

What are the signs?

The characteristic signs are loss of balance, leaning to one side, head tilt and rapid eye movements. Occasionally with other similar diseases there will be incoordination and/or some paralysis which indicates that the condition is also affecting the brain stem. Occasionally the dog may vomit just before the onset of the other signs. Inflammation of the external or middle ear may accompany the disease and sometimes may be coincidental.

"The characteristic signs are loss of balance, leaning to one side, head tilt and rapid eye movements."

Treatment

Since the condition is almost entirely confined to elderly animals and the cause unknown, treatment is basically supportive. Rehydration and maintenance of fluid balance by means of intravenous fluid is often required, particularly if vomiting has occurred. Sedation may occasionally 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 by your veterinarian depending on the circumstances.

Prognosis

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