Idiopathic Vestibular Disease

D E F I N I T I O N

The vestibular system is responsible for maintaining normal balance. The dog’s vestibular system has central components located in the brain, and peripheral components located in the inner and middle ear.

Vestibular disease refers to a sudden, non-progressive disturbance of balance. It is more common in older dogs.

The criteria for diagnosing Canine Idiopathic Vestibular syndrome are: older dog – usually 12 – 14 years old, sudden onset of peripheral vestibular signs, no detectable cause such as an ear infection, ototoxicity, trauma, hypothyroidism, or infectious disease, and signs resolve over several weeks (Fitzpatrick Referrals, 2024).

C A U S E S

Causes of vestibular disease include middle or inner ear infections, drugs that are toxic to the ear, trauma or injury, tumours, and Hypothyroidism.

When no specific cause is found, the condition is called Idiopathic Vestibular syndrome. These cases are distinguished by the sudden onset of clinical signs and the subsequent rapid improvement with little, if any, medical intervention.

Diagnosis is based on medical history, clinical signs, and the results of blood and urine tests. In some cases, diagnostic testing might include blood pressure measurement, or radiographs (X-rays) of the head to assess the appearance of the middle and inner ears and the Tympanic Bullae.

Occasionally, magnetic resonance imaging (MRI) or computed tomography (CT) scans will be performed to look for tumours or other abnormalities (Barnes et al., 2024).

S Y M P T O M S

Most dogs present with the sudden onset of:

• Loss of balance
• Disorientation
• Head tilt, often with leaning or falling in the direction of their head tilt
• Irregular jerking eye movements called nystagmus
• Reluctant to stand or walk

 The clinical signs associated with vestibular disease are often most severe during the first 24 to 48 hours. Many dogs begin to improve within 72 hours.

The head tilt and stumbling often improve over a seven to 10-day period. Most dogs are completely recovered within two to three weeks, although some will have residual symptoms such as a head tilt or mild ‘wobbling’ for life.

If the dog fails to improve or worsens, then a more severe underlying disorder should be suspected, and advanced diagnostic testing should be pursued. A referral to a veterinary neurologist may be advised.