As usual, different types of diseases usually show up in groups of 3.  In the last few weeks, I have seen 3 cases of “Old Dog Vestibular Disease”.  Prior to that, I think I had seen one case in the last year.  I thought it would be useful to go over some signs of this disease.

Basically, vestibular disease is like a sudden attack of vertigo.  The vestibular nerve is the nerve that is responsible for balance.  It runs near the inner ear, which is why middle or inner ear infections can affect balance.  I can’t ask a dog, but I assume that they feel similar to a human who has vertigo:  dizzy.  What owners usually report is that their old dog is suddenly uncoordinated or falling over.  Their head may tilt to one side.  They may also have nystagmus, which is a horizontal movement of the eyes.  Some dogs feel so dizzy that they can’t eat or drink.

How do we know if this is vestibular disease and not something else?  One clue is if the rest of the physical exam is normal.  I usually at least check a blood panel to be sure there is not an issue with one of the internal organs.  I also often check xrays.  This helps us rule out any kind of cancers.  If all of those things are normal, then I usually treat symptomatically with some motion sickness medication.  If the dog isn’t able to eat or drink, we may give them IV fluids until they can eat on their own. 

What causes Old Dog (or Idiopathic) Vestibular Disease?  No one really knows.  Some suspect a virus, but that wouldn’t change our treatment.   Why should you see your vet if your dog is having these symptoms?  Like I said, ear infections can cause similar signs.  Also, other issues with the nerves or brain can cause incoordination and head tilt.  It is important to make sure that one of those other things isn’t going on so that we’re actually treating the real issue. 

The good news is that most dogs recover from this condition.  Many get back to 100% normal.  Some may have some residual signs.  One of our patients has a little bit of a permanent head tilt after his vestibular episode.  Once the room stops spinning, they can get back to life as usual.