Vestibular Syndrome

What is vestibular syndrome?

The vestibular system includes the inner ear and associated nerves, and a centralized location in the lower brain. A healthy vestibular system keeps a dog balanced, and coordinates their head and eye movement. Vestibular syndrome interferes with a dog’s balance and coordination. The majority of vestibular syndrome cases in dogs have an unknown cause (i.e., idiopathic), or result from a middle or inner ear infection. Other possible underlying causes include medication reactions, trauma, hypothyroidism, polyps or tumors, infectious or inflammatory disease, vascular accident, or a brain tumor.   

What are common vestibular syndrome signs in dogs?

Early signs include:

• Head tilt
• Difficulty standing
• Drunken gait (i.e., ataxia)
• Abnormal eye movements (i.e., nystagmus)

Intermediate to advanced signs include: 

• Circling
• Falling over
• Agitation
• Facial drooping
• Nausea and vomiting
• Inability to rise

How is vestibular syndrome managed in dogs?  

Vestibular syndrome management in dogs depends on the identification and treatment of any underlying cause. Idiopathic vestibular syndrome is a diagnosis of exclusion, and treatment focuses on supportive care, including hydration and nutrition, and medications to reduce motion sickness, nausea, and anxiety. For an ear infection, appropriate antibiotic or antifungal medications are needed, and surgery may be recommended to flush out the infection. The less common causes of vestibular syndrome require specific treatments. Discussing a personalized management plan with your veterinarian is important for the best outcome for your dog.

What is the prognosis for dogs with vestibular syndrome?

The prognosis in dogs depends on the cause of vestibular syndrome. Idiopathic disease can show improvement in a few days and complete resolution in three weeks, but a head tilt may persist. A middle ear infection can require eight weeks of treatment to fully resolve. Brain lesions or tumors have a poorer prognosis.

Management tips for dogs with vestibular syndrome    

At-home needs include:

• Easy access to food and water, and a quiet sleeping area
• Consistency with prescribed medications or supplements
• Ramps, modified surfaces for increased traction, or mobility aids, if needed
• Confining your dog to a safe space to prevent injury
• Avoiding abrupt changes that may startle your dog
• Monitoring appetite, drinking, urination, defecation, and ambulation

For end-of-life care:

• Try to keep your dog safe and comfortable
• Ensure adequate nutrition and hydration
• Monitor for pain or discomfort
• Evaluate your dog’s quality of life with our scoring tool
• Track progression of their health with our calendar

In a crisis situation:

Contact your veterinarian immediately if your dog stops eating, has uncontrollable vomiting, is overly agitated, collapses, or vocalizes in pain.

Before your dog‘s condition becomes unmanageable, or they begin losing their quality of life, beginning end-of-life care discussions is vital. Learn more about pet hospice, in-home euthanasia, and our teleadvice service, or contact a Lap of Love veterinarian in your area, so you can feel fully prepared for this difficult time.