Vestibular disease affects both dogs and cats, and when it happens, it can look very scary. The important thing to remember is that although the symptoms of vestibular disease look very similar to stroke, these are entirely different conditions altogether.
Unlike stroke, which is caused by an interruption of blood flow to the brain, vestibular disease is caused by a malfunction in the mechanisms of the inner ear. Although stroke can cause permanent damage to the brain, vestibular disease does not.
Vestibular disease is essentially a sudden disturbance of balance. It’s very common in cats, and in dogs it’s often referred to as “old dog vestibular syndrome”. Although it’s more often found in older dogs and cats, all ages can be affected.
But to really understand how vestibular disease affects the body, it’s important to know how the vestibular system works.
The Vital Vestibular System
Our body’s vestibular system is responsible for maintaining normal balance and keeping us in an upright position without falling over. According to Cornell University’s College of Veterinary Medicine, the vestibular system is made up of 2 parts: the vestibular apparatus (located deep within the inner ear), and a second component located in the medulla, an area of the brain located at the base of the skull.
Inside the vestibular apparatus are fluid-filled canals filled with specialized nerve cells and receptors. These receptors are connected to nerves that lead directly to the medulla. As our heads change position, the fluid in these canals shifts and sends signals to the brain, which registers the position of our heads relative to gravity. This tells our brains whether we are motionless or moving, and if so, in what direction.
Just like us, dogs and cats maintain their sense of balance because the vestibular system is able to adjust for changes in position. Whenever an animal turns, signals are sent from his brain to the muscles on one side of his body telling them to make adjustments – and it’s this communication that prevents him from tipping over.
What Causes Vestibular Disease?
Vestibular disease can result from a variety of factors:
- Inflammation of the vestibular nerve located in the inner ear
- Middle ear infections (caused by bacteria or ear mites)
- Head trauma or injury to the ear
- Underactive thyroid gland (hypothyroidism)
- Adverse reaction to certain types of antibiotics (including streptomycin, gentamicin, or metronidazole) or ear flushes containing chlorhexidine (an over-the-counter antiseptic)
- Genetic or inherited factors
- Thiamin (Vitamin B1) deficiency
- Polyps (small growths) or cysts in the middle ear
- Brain tumors
However, most cases of vestibular disease are considered “idiopathic”, which means that no identifiable cause is ever found.
Interestingly, in the northeastern United States, there seem to be more cases of vestibular disease in cats in July and August, which suggests there could also be an environmental cause. I witnessed this when I was in veterinary practice in Ohio – we saw more vestibular disease in cats during the summertime than during any other time of year.
Symptoms of Vestibular Disease
Vestibular disease symptoms tend to come on very suddenly. They can include:
- Head tilt
- Dizziness
- Loss of balance and falling over to one side (usually in the direction of the head tilt)
- Disorientation
- Ataxia (lack of coordination – stumbling, staggering, wobbling)
- Standing with legs apart in a wide stance
- Head shaking
- Nausea
- Vomiting
- Rolling on the floor or walking in circles
- Inability to stand
- Repetitive, involuntary drifting eye movements (“nystagmus”)
- Reluctance to eat and drink
- Anxiety
- Panting
- Avoidance of people or other pets
You can see what nystagmus looks like in the video below:
Diagnosis
It’s important to differentiate between vestibular disease, stroke, and brain tumor, as they can all cause similar symptoms. A veterinarian will usually diagnose vestibular disease based on symptoms, blood and urine tests, and an examination of the ears. Stroke and brain tumor can be definitively ruled out with the use of magnetic resonance imaging (MRI), or computed tomography (CT) scans.
If symptoms do not begin to resolve in a few days, the veterinarian may recommend a visit to a veterinary neurologist for a spinal tap.
Treatment For Vestibular Disease
If vestibular disease symptoms have a known cause (such as hypothyroidism, injury, or infection), specific treatment will be started to help resolve that particular condition. However, if no other cause is found and the case is considered idiopathic, unfortunately the only effective treatment is time and supportive care.
In severe cases, if the dog or cat is extremely disoriented, sedatives and anti-nausea medication can be administered. If the patient can’t hold down food or water, he or she may need to be hospitalized for a few days so intravenous (IV) fluids can be given.
Vestibular disease in dogs and cats is usually best treated at home, where they will be less stressed. Keeping them in a quiet place, and as comfortable and still as possible, goes a long way in the recovery process.
If your dog or cat is diagnosed with vestibular disease, you can also help assist in their recovery by:
- Giving them time and space. Vestibular disease is not life-threatening, so although the symptoms may be upsetting, they will often start resolving on their own within a few days.
- Keeping your own stress to a minimum. Since pets are sensitive to the moods of others, keeping your own stress level low will keep your pet from being startled or upset.
- Providing good lighting. This enables your pet to better use visual cues to determine proprioception (where his body is positioned in space).
- Creating proprioceptive support. You can do this by taking a long, thick blanket, rolling it up jellyroll-style, and snuggling it around your pet in a C-shape to provide something for him to press his body against.
- Not carrying your pet around. Since touch sensors in your pet’s paws need to be activated by touching the ground, carrying your pet can make him feel more dizzy and disoriented. Instead, help him learn to walk steadily again by putting your hands on both sides of his body as he walks.
Most patients recover from vestibular disease on their own in about 2-3 weeks, and in most cases, it never comes back. The head tilt is usually the last symptom to resolve, but occasionally it may not fully go away. However, this will not interfere with the dog or cat’s quality of life.
The Mystery of Vestibular Disease
A healthy vestibular system is vital to well-being, for us as well as for our dogs and cats. Without it, we wouldn’t be able to recognize where we are in space, maintain our balance, have good vision, or walk without falling over.
When the vestibular system malfunctions, it can be both frightening and frustrating, especially if there doesn’t appear to be any cause. But the good news is, vestibular disease in dogs and cats usually resolves just as suddenly as it appeared, with no lasting permanent damage. However, if your pet begins to exhibit any of the symptoms of vestibular disease, always take him to your veterinarian to rule out other potentially more serious causes.
Have you ever had a dog or cat with vestibular disease? Please tell us about it in the comments below!
My cat Chessie (14 years old) had an attack of vertigo July 1, 2017. Thank God I happen to be close by. She rolled around on our deck and I was able to get her inside our house. I did think she had a seizure. Rushed to our vet and he diagnosed her with Vertigo. She received a shot for nausea, I’VE fluids for 2 days and a shot for infection. There was no evidence of ear infection. Brought her home yesterday (from Sat. – Mon.) in hospital.
I have to figure out the best way to get some fluids and food in her. Will try the dropper method with chicken broth and same can food.
I hope, that she will recover and be back to her old self.
Hi Elke! Yes, vertigo/vestibular disease can look like seizures, so you definitelyl did the right thing getting Chessie to the vet. If you’re having trouble getting fluids into her, you can always bring her to the vet for them to give some quick subcutaneous (“Sub-Q”) fluids under her skin. It only takes a few minutes and she can go right home afterwards. Luckily, most cases of vestibular disease resolve on their own with no after-effects, so I’m hoping Chessie recovers quickly!
After I tried using a suringe, he kept spitting food back out due to his tongue staying to the side, I got a squeeze bottle with a long tip ( empty hair dye bottle) never used of course, that worked pretty good. But now just a few days later, he’s back to eating, drinking, running, licking, going to the potty box, climbing, just not totally stable yet to go out without a leash, so we have
hope! And I hope for u too!
My poor little Scout was diagnosed with Peripheral Vestibular Disease 2 weeks ago. He had an ear infection and the typical symptoms. My vet assured me he would recover and all would be back to normal within a week. Well that did not happen. In fact his symptoms became progressively worse. I took him to a neurologist and had an MRI, spinal, blood work done. All came back relatively normal. Nothing indicating something serious. Scout is 9.5 years old which is kind of on the young side for this disease and he did not improve as expected. The neurologist sent us home with nothing to do but wait it out. Two days after the MRI, Scout became so unstable with his head tilted severely, and rapid eye movement again. He can not walk at all now. This is so very scary and sad to watch. I brought him to another neurologist and left him at the hospital for 24 hour care. After some more research, and because I prepare his food and have for a while, I asked that he be given B1 shots. They also started him on steroids. So now, I’m waiting and praying he starts to recover. The new Dr thinks he may have a form of encephalitis. He told us sometimes it does not show up in an MRI or spinal. So, this disease is not cut and dry…not all dogs get better quickly or at all.
I am so very sorry to hear about Scout…neurological illnesses can be so frustrating and heartbreaking to watch. 🙁 Was the diagnosis definitely encephalitis? (It sounds like it may not be true vestibular disease, although VD doesn’t always look the same in all animals). How is he doing now? Is there any improvement on the steroids?
Scout has been home 4 days. He is on steroids and antibiotics. I started him on vitamins and omega 3 as well. Just today I noticed some improvement in his ataxia. He seems a little more steady on his feet. Prior to today, very slight movements would cause him to go into an erratic spin where his neck and body would go in separate directions. Today I have not seen that and he seems to have more control. His head is still tilted. The neurologist told me the head tilt may last 4 months and not fully go away. The dr thinks scout had a virus that led to an immune response attacking the nerve in his middle ear. He had a cough prior to all of this starting that went away 2 days prior to the vestibular attack. Time will tell.
My dog, a golden retriever, developed VD three days ago. Her head is tilted pretty far to the right. I was wondering if this is really uncomfortable for her and causing muscles in her back to become strained. Is there any kind of neck brace for dogs with VD, or would a brace cause more harm than good? I would appreciate any feedback.
My Lily had a vestibular crisis the day before Thanksgiving. We took her to emergency vet an hour away. I initially thought the attack was a seizure which she has had before. The seizures started immediately after Lily took a horrific tumble down 16 wooden steps. That happened on August 8 2021.
A visit to the vet revealed that Lily had/has hyperthyroidism. So, poor Lily… Hyperthyroidism, seizures, now vestibular system crisis. No testing has been done outside of blood work.
Outside of medication for nausea, Lily was not given any other intervention. I have been giving her intensive care since Thanksgiving. At this time she is eating, drinking and using her liter box… I am grateful for the progress but worry about possible ear infection. Yes, I am in touch with my vet whom is a compassionate and caring. Since it is SO traumatic for kitty to travel, etc. I am choosing to continue in home care.
Someone mentioned there is an antibiotic that can be administered by 1 shot/ week and that would not interfere with Lily’s GI system which would be important at this time. Lily has lost weight since that dreadful vestibular system disruption. Thank you….
Hi Patricia, I’m so sorry to hear about the challenges Lily is experiencing. 🙁 Since the vestibular disease, hyperthyroidism, and seizures are not infections, she would not need an antibiotic unless there is definitely a diagnosed inner ear infection going on. With the multiple issues she’s having, personally I would not recommend giving her any type of an antibiotic (which can be hard on the body) unless you have a confirmed infection. Vestibular disease will usually clear on its own. But your vet would be the best person to ask, as he/she would be able to recommend the correct antibiotic for an inner ear infection if one is suspected.
Regarding the antibiotic that the person you spoke to mentioned, I’m not aware of one that is given once per week, but your vet would know. There is another antibiotic called Convenia that is given by injection once and stays in the body for 14-65 days, but it is usually used for post-surgical procedures and skin conditions, and it carries a fair amount of risk. I wrote about Convenia in another post titled “Why These Veterinary Miracle Drugs May Not Be The Best Option For Your Pet”. You can read about it here: https://www.goodpetparent.com/2017/06/09/veterinary-miracle-drugs/
I’m glad to hear that Lily is improving, and hopefully she will continue to get better! Please keep me posted on her progress!