When the world is spinning. Recognizing Vestibular Syndrome in your pet.

Many times I have seen a client bring in their beloved pet to the hospital terrified that they have suffered from a stroke. They are stumbling, seem disoriented, often can’t walk. While a stroke can definitely occur in a pet, another very common problem, Vestibular Syndrome , is often the culprit. This is very fortunate for the pet as this disease is usually self limiting and carries a much better prognosis than a stroke.

So what is Vestibular syndrome?

Vestibular syndrome is very similar to vertigo in people. Problems with the inner ear or central nervous system can result in dysfunction of the vestibular apparatus. The vestibular apparatus is responsible for your pet’s balance and spatial awareness. Disturbances of this apparatus can cause nausea, inability to stand up, circling to one side, a head tilt and abnormal eye movements. Basically a roller coaster ride gone very bad.

There are two types of vestibular syndrome, peripheral or central. Peripheral disease is much more common and occurs within the inner ear, not the central nervous system. Common causes of peripheral disease include:

  • Chronic/recurrent middle and inner ear infection
  • Idiopathic geriatric vestibular disease
  • Trauma to the eardrum
  • Head trauma
  • Polyps
  • Hypothyroidism
  • Medications
  • Ear infections are far and away the most common cause of vestibular syndrome in a young dog, whereas older dogs commonly have an idiopathic form of the syndrome in which we don’t exactly know the underlying cause
  • Central disease is seen much less often. Common causes are
  • Inflammatory disease (encephalitis)
  • Infection
  • Trauma
  • Bleeding in the brain
  • Cancer

What are the clinical signs of Vestibular syndrome?

  • Dizziness and loss of balance. They are often stumbling, falling over and unable to right themselves
  • Nausea and vomiting due to motion sickness/vertigo
  • Head tilt to one side. The muscles of the head are affected and the pet will usually tilt their head to the side of the problem  Nystagmus- This is an abnormal movement of the eyes. You can see them move quickly side to side, up and down, and even in a circular pattern

These signs often occur very suddenly and can be very dramatic which can be quite frightening for clients.

How is vestibular syndrome diagnosed?

Vestibular syndrome is diagnosed based on physical exam. Additional diagnostics, such as bloodwork, cytology and advanced imaging (CT scan or MRI) are used to determine the underlying reason for the vestibular syndrome.

How is my pet treated for Vestibular syndrome?

Once the underlying cause has been identified, treatment usually results in improvement of the clinical signs. Antibiotics are used for ear infections, thyroid supplementation, Immunosuppressants and anti-inflammatory medications for other diseases.

Initially, the most important treatment is supportive care. Often these pets can become dehydrated due to vomiting and lack of intake because of nausea. They are often given SQ or IV fluids to help correct the dehydration. Anti-nausea medication is used to treat underlying nausea. These can be given in the hospital as well as sent home with the pet.

Also supportive care at home is very important. Pets need to be confined until the clinical signs improve/resolve to prevent them from hurting themselves. They also often need support to be able to walk outside to use the bathroom.

The good news is, the large majority of causes of vestibular syndrome, particularly peripheral, are easily treatable and the pet usually makes an uneventful recovery. Clinical signs can resolve in as little as 48-72 hours. Sometimes there may be a residual head tilt, but they can adjust to this with little to no problem.

 

If you ever have any concerns regarding your pet, it is always best to consult with your veterinarian. I am always available for questions! 

Alisha Spivey, DVM  a.spivey@uvhvets.com