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Dog vestibular syndrome

The vestibular system is the organ of balance. It consists of a part housed in the inner ear and a part located in the brain. It constantly tells the dog where the top is and how his head is oriented. When this system goes wrong, the dog su...

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Definition Signs Causes Diagnosis Treatment Prevention Complications When to see a vet Prognosis FAQ Sources Affected species

What is it?

When this system goes wrong, the dog suddenly loses balance: he tilts his head, staggers, falls, his eyes move on their own and he has the impression that everything is spinning, which makes him nauseous.

The picture is very impressive and often reminds us of a stroke. In older dogs, however, it is most often a form without an identified cause, from which recovery is generally good.

Commonly observed signs

These signs are neither exhaustive nor specific. Only a veterinarian can establish a diagnosis.

Related signs — each one links to its page:

Head tilted Staggering gait Vomiting Loss of appetite Reduction Lying animal that does not get up

Head permanently tilted to one side.

Loss of balance: the dog staggers, moves in a circle, leans against walls, falls, sometimes rolls over itself.

Eyes that move on their own, in small, rapid, rhythmic jerks.

Nausea: salivation, vomiting, refusal to eat and drink.

Immobility, lying dog who no longer dares to get up because the movement makes him sick.

Disorientation, anxiety, moaning.

When the ear is involved: ear pain, discharge, bad smell, sometimes paralysis on one side of the face with drooping eyelid and hanging lip.

The signs generally appear very quickly, within a few hours.

Certain signs should alert you more: marked weakness of the limbs, change in behavior, deep drowsiness. They point to more serious brain damage.

When to consult without delay

This list does not replace veterinary advice. It gathers situations that justify a prompt consultation.

Causes and risk factors

In older dogs, the most common cause remains unknown: we speak of idiopathic or geriatric vestibular syndrome. It occurs suddenly, without any underlying disease found, and most often resolves within a few days to a few weeks.

An infection or inflammation of the middle and inner ear, often as a result of poorly controlled chronic otitis, is the other major cause.

Rarer causes: ear polyp or tumor, brain tumor, vascular accident, inflammation of the nervous system, head trauma, adverse effect of certain medications toxic to the inner ear, hypothyroidism.

The veterinarian first seeks to know whether the damage concerns the inner ear or the brain: the prognosis and treatment depend entirely on this.

Advanced age for the form without identified cause.

Chronic or recurrent ear infections, especially in dogs with lop-eared or narrow ear canals.

History of aggressive ear cleaning or foreign body in the ear.

Use of certain medications known to be toxic to the inner ear, particularly applied in an ear with a pierced eardrum: hence the importance of never putting a product in the ear that is not prescribed for this dog.

Untreated hypothyroidism.

Diagnosis and care

Diagnosis is the veterinarian's responsibility, based on clinical examination and laboratory tests. Care is decided case by case.

The veterinarian begins with a neurological examination: he determines whether the signs come from the inner ear or the brain, which changes everything for the future.

He carefully examines both ears with an otoscope and checks the condition of the eardrums.

A blood test, with measurement of thyroid hormones if necessary, looks for a general illness.

Blood pressure is often measured in older dogs.

If there is any doubt about brain damage, or if the signs do not improve as expected, magnetic resonance imaging or a CT scan of the head is offered, supplemented if necessary by an analysis of the fluid surrounding the brain.

A swab of the ear for analysis and culture guides treatment when an infection is involved.

Treatment

Treatment depends on the cause.

In the form without identified cause of the elderly dog, the treatment is supportive: medication against nausea and motion sickness prescribed by the veterinarian, infusion if the dog no longer drinks, calm and secure environment.

Arrange the house: non-slip mats, space without stairs or sharp corners, cushions around the bed, bowls within reach, help with moving with a towel placed under the stomach.

When a middle or inner ear infection is the cause, prolonged antibiotic and anti-inflammatory treatment is prescribed by the veterinarian, sometimes supplemented by ear surgery.

A polyp or a tumor requires specific treatment determined after imaging.

Never put ear products in your dog's ear without a prescription: some are dangerous for the inner ear if the eardrum is punctured.

If pain accompanies the picture, only painkillers prescribed by the veterinarian are suitable: human anti-inflammatories such as ibuprofen, aspirin or paracetamol are toxic for dogs.

Treatment depends on the cause and the animal's condition: it must be determined by a veterinarian. No self-medication.

Prevention

Treat ear infections correctly and to the end, and have the ears of dogs prone to recurrence checked.

Clean the ears with a suitable product prescribed or recommended by the veterinarian, without ever pushing any object into the ear canal.

Never use a product intended for another animal or purchased without advice in the ear.

Have an ear infection that persists or comes back checked: this is the main gateway to damage to the inner ear.

Monitor the thyroid in affected dogs.

There is no prevention of the form without identified cause in elderly dogs.

Possible complications

Dehydration and weight loss when nausea prevents the dog from eating and drinking.

Injuries related to falls, especially on stairs.

Head tilt which persists for several months, or even permanently, even though the dog is walking normally again.

Extension of an infection from the inner ear to the coverings of the brain: this is a serious development.

Facial paralysis and dryness of the eye on the affected side, requiring eye care.

Recurrence, possible particularly in the form of elderly dogs.

When to see a veterinarian

Your dog tilts his head, staggers or turns in circles: consult the same day.

His eyes move on their own in rapid twitches.

He has been vomiting, hasn't eaten or drunk for several hours.

He is no longer able to get up or rolls over: consult urgently.

He is drowsy, disoriented, or has weakness in his limbs: these signs point to brain damage and require immediate treatment.

His ear smells bad, runs or is painful.

His condition does not improve in the following few days: the diagnosis must be re-evaluated.

Prognosis

In the form without an identified cause in older dogs, the prognosis is generally good: improvement often begins within a few days and walking returns to normal within two to three weeks. A slightly tilted head can remain for a long time without bothering the dog.

When an ear infection is involved, the prognosis is good if treatment is complete and long enough.

Brain damage, tumors or vascular accidents, have a much more reserved prognosis, which depends on the lesion.

The first challenge is therefore to clarify the origin of the signs rather than immediately concluding that they have a benign form.

Frequently asked questions

My elderly dog tilts his head and falls: has he had a stroke?

This is the impression it gives, but in older dogs the most common cause is a vestibular syndrome with no identified cause, from which recovery is generally good. Only a veterinary examination can make the difference with brain damage, hence the importance of consulting quickly.

How long does this last?

In older dogs, improvement often begins after a few days and walking returns to normal in two to three weeks. A slight tilt of the head may persist without consequence.

My dog is no longer eating, what should I do?

Nausea is at the forefront the first few days. The veterinarian prescribes treatment for motion sickness and vomiting, and can put in an IV if the dog becomes dehydrated. Do not force him to eat or move him more than necessary, movement makes the feeling of dizziness worse.

Is this linked to his recurrent ear infections?

This is a possible and common cause: a middle ear infection can affect the inner ear. This is why the veterinarian always examines the ears and eardrums when there is a balance disorder.