Sunday, March 3, 2024

Unsteady as she goes: canine idiopathic vestibular disease

It’s not unusual for me to get a text or phone call any hour of the day from families-of-record if their pet is presenting with symptoms that are concerning, or behavior is at all unlike them. (Because we know that a change in behavior is in itself a symptom, right? Of course!) My families know they can get in touch anytime in these situations, and though I can’t diagnose their pet, I can definitely assess the situation and give good guidance on next steps and what to expect if and when their primary vet or an emergency vet needs to be involved. And if I’m able, I’m happy to come by to assess what’s happening and offer support. 

And this weekend, one of those calls came in. 

A very unnerved guardian detailed what they’d just witnessed in their very active and happy senior dog with a sound medical history: sudden onset of stumbling about/staggering/lack of coordination (ataxia), vomiting once, and a little confused. Definitely alarming, was my initial thought, though with my professional training to assess, experience and employing the principle of Occam’s Razor—the simplest explanation is usually the best one—I had a solid basis to work from. Also, I don’t panic. That’s unhelpful. 

The possibility of a stroke crossed my mind, or them having come into contact with a toxin. Other things too, but all of that was far less likely than what I felt was probably going on. 

Upon arriving just a few minutes later to assess things, I could see what the guardian was talking about. Though improved, and possessing otherwise normal vital signs, the pooch was still mildly unable to reliably coordinate their movements, and a little drooly (indicating nausea). They also had a telltale symptom that rounded out what I was expecting to see: though their pupils were equal in size, their eyeballs were moving back and forth like ping pong balls, a symptom called nystagmus

“I feel pretty confident based on what you’ve told me about what the past few days have looked like—rather ordinary— and what I see, is that they are experiencing an issue with their vestibular system,” I explained. 

“I’ve seen this before in senior dogs. Though it’s typically idiopathic, not life-threatening and resolves in a short time, I can’t say for sure that’s the case. A vet would need to do a proper assessment, diagnostics and history to rule out other possibilities.” 

The guardian agreed with my advisement to have them assessed immediately as a precaution, and so off to a local emergency veterinary hospital we went. (And of course, said pooch was 90% improved, by this point!) With otherwise normal vital signs assessed, the verdict from the veterinary team a short time later was what I’d expected: canine idiopathic vestibular disease.

Sometimes referred to as Old Dog Vestibular Disease (wince with me here) since it’s more common in senior and geriatric dogs, canine idiopathic vestibular disease is a diagnosis that can feel understandably scary upon its swift onset and presentation. No one likes seeing their pet wobbly, vomiting, sometimes struggling to stand. Stemming from an issue in the middle ear rather than the brain, it’s not known why it happens. 

The good news is that it tends to resolve quickly without intervention aside from any necessary supportive care, usually within weeks with no lingering problems. Below are things that are very helpful in managing the symptoms:

  • Maintaining a safe environment indoors, especially blocking off access to stairs, is essential of course, as is close supervision outdoors. Consider nightlights for the overnight hours to help the pet navigate with more ease.

  • Providing easy access to resources of food, water and places to rest/sleep. 

  • For pets that are having difficulty in relieving themselves due to the wobbliness, I find that having them wear a harness is super-helpful. That way, you can help stabilize them as they are trying to urinate or defecate.

  • If a pet is finding it too difficult to hold a position long enough to urinate or defecate even with assistance, they may develop issues with keeping themselves clean. It’s sensible to tend to their hygiene needs regularly and be watchful for urine scalding, matting and soiling. All of these impact the integrity of their skin and their overall well-being. 

  • Supportive care, like medication to assuage nausea can be helpful for those pets that need it. Your veterinarian will likely send this home with you as a precaution. If your pet is having a hard time being upright long enough to drink water, consult your veterinarian straightaway so that they can decide on a plan to assist with hydration. 

At last check in this afternoon, I’m happy to report that said pooch is in fine form, and their guardian, relieved. 

For more on canine idiopathic vestibular disease and other vestibular disorders, click here. 

With over 20 years of experience in pet care and the past 9 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at

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