Sunday, May 27, 2012

Vestibular Syndrome in Dogs - Jennifer Hawthorne

Vestibular Syndrome in Dogs
by Dr. Jennifer Hawthorne

Vestibular disease refers to a disorder involving the vestibular apparatus of the inner ear and brain.  It involves the 8th cranial nerve.  The vestibular apparatus helps maintain balance and orientation.  A condition commonly seen in older dogs is something often referred to as “geriatric vestibular syndrome” or idiopathic vestibular syndrome.  It is similar to vertigo in people.  Some people will also refer to it as a “stroke,” but it is not really the same as a stroke in humans.  Sometimes there are other underlying reasons such as an inner ear infection or a problem within the brain.  Often, however, it simply happens for no known reason.

Symptoms usually come about suddenly in an older pet.  Signs include:
  • Head tilt to one side
  • Falling over to one side
  • Completely unable to stand or walk
  • Rapid eye movements in a certain direction (nystagmus)
  • Nausea/ vomiting
    Circling in one direction
Pets may show several or a few of these symptoms.  Usually it is very disturbing for a pet owner to suddenly find their pet in this state and they often rush them into the veterinary clinic.  Evaluation of your pet will include a good physical exam to start with to determine whether your pet has an ear infection or not.

There are certain signs that may sometimes point to a more serious problem. Vestibular disease is usually lumped into two categories:  peripheral and central.  Geriatric vestibular disease is typically peripheral with symptoms as above.  Central vestibular disease is more serious with other signs.  These include nystagmus in a vertical direction,  loss of conscious proprioception (proper placing of feet) and change in mental status.  Other cranial nerves are involved and there may be a problem within the brain.  Typically with geriatric vestibular syndrome the nystagmus is horizontal or rotary, the pet maintains normal proprioception and normal mentation.  Further tests are usually needed to rule out a central problem including bloodwork and advanced imaging of the brain (MRI, CT).

There is no real treatment for geriatric vestibular syndrome, but that does not mean that the pet is doomed.  Many pets can recover with some time.  Often they will start to recover in a few days, up to 2 weeks.  Some medications can be used to try to alleviate symptoms.  These include meclizine, which is a motion sickness medication, and prednisone, a steroid/ anti-inflammatory.  Many times symptoms will resolve, although some animals will have residual side effects such as a head tilt that remains.  If a pet is not recovering it may be a sign of a central problem.  Sometimes owners cannot bear to see their pet in that state and worry that they will suffer while waiting for it to resolve.  Other factors such as the pet’s age and overall health come into play as well.  Worry that the pet will harm itself falling is often another concern.  The pet should be kept confined in a safe place while trying to recover.  If the symptoms are too severe some owners will elect euthanasia.  This is a decision that should be discussed with your veterinarian.  

Blog by:
Jennifer Hawthorne, DVM
Lap of Love Veterinary Hospice and In-Home Euthanasia

Dr. Jennifer helps families in the Mecklenburg, Cabarrus and Iredell counties including Charlotte, Concord, Kannapolis, Huntersville, Mooresville and more. Click here to read Dr. Jennifer's biography.

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