What is vestibular disease?
The vestibular system is responsible for maintaining normal balance. It 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. It is also referred to as canine geriatric vestibular syndrome and canine idiopathic vestibular syndrome.
What are the clinical signs of vestibular disease?
Most dogs present with the sudden onset of loss of balance, disorientation, head tilt, and irregular jerking eye movements called nystagmus. Many dogs will become reluctant to stand or walk. Most dogs will lean or fall in the direction of their head tilt.
What causes vestibular disease?
Causes of vestibular disease include middle or inner ear infections, drugs that are toxic to the ear, trauma or injury, tumors, and hypothyroidism. When no specific diagnosis is found, the condition will be 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.
How is vestibular disease diagnosed?
Diagnosis is based on medical history, clinical signs, and the results of blood and urine tests. In some cases, diagnostic testing will include radiographs 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 tumors or other abnormalities. Brainstem auditory evoked response (BAER) testing may also be performed in some patients.
How is vestibular disease treated?
Treatment is directed at the underlying cause, if one can be identified. In severe cases, supportive therapy such as intravenous fluids and hospitalization may be required until the dog can eat and walk on his own. If the dog is seriously disoriented or ataxic (stumbling, unable to stand or walk), he may be given sedatives to help him relax. Drugs that help combat nausea or motion sickness such as dimenhydrinate may be beneficial. Antibiotics may be used in cases suspected of having middle or inner ear infections. Corticosteroids are not recommended in older dogs, especially in cases where fluid intake may be low.
What is the prognosis for a dog diagnosed with vestibular disease?
Many dogs begin to improve within 72 hours. The head tilt and stumbling often improve over a seven to ten day period. Most patients are completely recovered within two to three weeks. If the patient fails to improve or worsens, then a more severe underlying disorder should be suspected and advanced diagnostic testing should be pursued.
Based on material written by Ernest Ward, DVM. and modified with permission from Lifelearn Inc.
© Copyright 2005 Lifelearn Inc.
