Old dog syndrome can look alarming, but thankfully it’s usually not as devastating as it appears. Integrative veterinarian Dr. Julie Buzby explains the signs, diagnosis, treatment, and outlook for old dog syndrome to help dog parents navigate this condition with their senior dogs.
“My dog was completely fine last night, and now this morning he can barely even stand up. He wouldn’t touch his breakfast either. I think he’s had a stroke,” a heartbroken dog mom told me through her tears.
Indeed, Murray, a sweet 14-year-old Pit Bull mixed breed dog, had seen better days. He was definitely conscious and fully aware. However, he was lying on the exam room floor with his head tilted dramatically to the left and his eyes darting wildly back and forth. He was panting heavily, clearly anxious and uncomfortable.
My assistant and I helped my patient to his feet. The senior dog had an uncoordinated, stumbling gait, and walked in circles before falling back down.
I explained to my client that although her sweet dog’s symptoms are commonly associated with strokes in people, true strokes in dogs are actually quite rare. Instead, it appeared that Murray likely had old dog syndrome.
What is old dog syndrome?
Old dog syndrome, also know as old dog vestibular syndrome, is a condition where the dog exhibits a sudden loss of balance and coordination due to a malfunction of the vestibular system. Composed of an intricate network of nervous system structures in the inner ear and brain, the vestibular system is responsible for balance and spatial orientation (i.e. where our bodies are in relation to the ground). So when it doesn’t work properly, the dog will experience severe vertigo.
Yet another name for old dog syndrome is idiopathic vestibular disease in dogs. This particular name includes the word “idiopathic,” which means we don’t know what causes it. However, the good news is that old dog syndrome usually improves in a matter of days with supportive treatment.
As an important aside, middle or inner ear infections, brain tumors in dogs, or brain inflammation can wreak havoc on the vestibular system too. But old dog syndrome is the most common cause of symptoms due to a vestibular system malfunction.
What are the symptoms of old dog syndrome?
Signs of old dog syndrome can develop very suddenly—often literally overnight. Symptoms may include:
- Head tilt—Your dog may be holding his or her head cocked to one side.
- Circling—Often dogs will circle in one direction.
- Rapid eye movements—Called nystagmus, this involuntary rapid repetitive side-to-side (or occasionally up and down or rotational) eye movement occurs while the dog is awake. It almost looks like your dog’s eyes are twitching back and forth.
- Lack of coordination (a dog who is wobbly and off balance)—Your dog’s world is spinning due to the vestibular system malfunction so he or she will have trouble standing and walking normally.
- Leaning or falling to one side—The dog’s whole body might tilt one way, or every time you try to help him or her stand up, your dog might fall to the same side.
- Trouble standing—Sometimes your dog will be standing with legs spread wide in an attempt to stay balanced, or the dog may even be completely unable to stand unassisted.
- Dog keeps licking his or her lips or drooling—Lip licking and drooling are both signs of nausea. Essentially your dog is motion sick due to the vestibular system malfunction.
- Vomiting—Sometimes dogs experience enough motion sickness that they will vomit.
- Unwilling to eat or drink—Not only are dogs dealing with nausea, but the ataxia, or loss of coordination, can make it physically difficult to eat and drink.
- Restlessness and panting—Vestibular signs can be very distressing for dogs, so you may notice signs of anxiety like increased panting or restlessness.
These signs simply indicate that something is wrong with the vestibular system. However, by themselves, they don’t point to a particular condition being the culprit.
Who gets old dog syndrome?
As the name would imply, we see this syndrome more often in senior dogs. There are not any known breed predispositions.
How is old dog syndrome diagnosed?
Since there is no known cause for idiopathic old dog vestibular disease, there is no specific test that can diagnose it. This means your vet will try to rule out the other causes of vestibular symptoms using some of the tests described below. If he or she doesn’t find an obvious cause after taking a medical history, performing a physical exam, and running diagnostics, then most likely your dog has old dog syndrome.
Otoscopic exam
This test involves visualizing the external ear canal and tympanic membrane (i.e. ear drum) with an otoscope. Your vet will be looking for signs of infection or inflammation such as discharge, redness, or changes in the appearance of the ear drum.
The otoscopic exam is important because inner or middle ear infections (i.e. otitis in dogs) can also cause vestibular signs. But you should know that it cannot evaluate all of the middle ear or any of the inner ear.
Ear cytology or culture
If your vet suspects your dog could have an ear infection based on the otoscopic exam, he or she may collect material from the ear and examine it under the microscope for bacteria or yeast. Your vet may also send the material to a diagnostic lab for a culture and sensitivity test.
This will identify the type of bacteria present and the best antibiotics for treatment. Sometimes your dog may be anesthetized so your vet can collect samples from the middle ear, which lies behind the eardrum.
Imaging
Diagnostic imaging of ear disease in the dog can be quite helpful in some cases. Your vet may decide to take an X-ray to help evaluate the bony portion of the middle ear. Or he or she may refer you to a veterinary specialist near you, usually a veterinary neurologist, for advanced imaging such as a CT or MRI. These types of imaging are useful for detecting brain tumors, brain inflammation, or changes to the middle and inner ear.
Blood work
Your vet may recommend blood tests for dogs to screen for hypothyroidism in dogs, tick-borne diseases in dogs, or other conditions that can also cause vestibular symptoms. Especially in older dogs, these tests can often uncover issues not detectable on physical exam. And they can help give a picture of the dog’s overall health.
How is old dog syndrome treated?
Regardless of the underlying cause, one of the main goals of treatment is to offer supportive care while the dog is acutely symptomatic. Your vet may prescribe anti-nausea medications like Cerenia for dogs or meclizine for dogs to help with the motion sickness. Sometimes dogs are too severely affected to eat or drink on their own. In those cases, your vet may give IV fluids for a bit to combat dehydration.
The good news is that the majority of these cases respond well to outpatient care at home. Time, TLC, and figuring out how to feed a dog with vestibular disease can go a long way. Only very severe cases require hospitalization.
In addition to supportive care, it is important to address the underlying reason for the vestibular signs. For example, this may involve thyroid hormone supplementation for hypothyroidism, specific treatments for tick-borne diseases, or control of seizures in dogs related to brain tumors or brain inflammation.
If an inner ear infection is the cause of the signs, your vet will prescribe a long course of an antibiotic or antifungal for your dog based on the results of the cytology and/or culture. Affected dogs typically start to improve in one to two weeks, but may relapse if they stop taking the medications early. Thus, it is important that your dog takes all of the prescribed medication. My five tips for dogs who won’t take pills may be helpful if your dog is resistant to taking pills.
What is the outlook for old dog syndrome?
I am always a bit relieved when I diagnose a dog with old dog syndrome. Although the clinical signs are quite dramatic, the condition is not life-threatening and is self-limiting. This means that it resolves on its own, usually fairly quickly. Additionally, the symptoms are usually non-progressive, meaning they don’t get worse.
How long does old dog syndrome last?
Often, the first 24 to 48 hours after signs start are the hardest for your dog (and you too). Most of the more severe signs such as poor coordination and loss of balance typically show improvement within 72 hours. But some of the other signs can take several weeks to completely resolve. Occasionally, the head tilt never fully goes away. The residual head tilt is not cause for concern, and does not impact a dog’s quality of life.
If your dog is not improving as expected, don’t hesitate to reach out to your vet. Sometimes your dog just needs a bit more time. But in other cases, a lack of improvement may mean it is time to do advanced diagnostics to ensure that a brain tumor, brain inflammation, or other conditions are not the real culprit.
What happened to my 14-year-old senior dog patient?
Outside of his neurological signs, Murray’s physical exam was great. My senior patient didn’t have any evidence of ear infections. His blood work showed mildly high liver enzymes in dogs, but that wasn’t new. We’d been monitoring those values for a few months, and they were unlikely to be related to his current issues.
I talked to my client about what we were seeing and what I thought was most likely going on. Murray’s diagnostic tests didn’t show an obvious cause. And he was an older dog with a sudden onset of symptoms related to the vestibular system. This meant the most likely diagnosis was old dog syndrome.
We discussed going to a veterinary neurologist for further evaluation. But my client decided to start with a “wait and see” approach for now. My veterinary team and I gave my patient some subcutaneous fluids for dogs and some anti-nausea medication. Then Murray’s mom took him home and kept him in a safe enclosed location where he couldn’t hurt himself falling down.
By the next day, my 14-year-old patient was doing better. He was still a little dizzy and uncoordinated, but his nystagmus had resolved, and he was eating and drinking again. Two weeks later you’d never know anything had ever happened!
Dogs affected by old dog syndrome are unlikely to have a recurrence (only 17.6% had a recurrence in the 12 months following diagnosis in one study), and this held true for Murray.
Hope for dogs with old dog syndrome
I always love being able to give good news to the parents of old dogs who fear something catastrophic is happening. It’s one of the few times I get to feel like a bit of a magician as a veterinarian!
The initial onset of old dog syndrome appears very scary. But, the high likelihood of rapid improvement can be a beacon of hope in the darkness. If your dog has been diagnosed with old dog syndrome, don’t lose heart. In most cases, better days are on the horizon.
Has your dog been diagnosed with old dog syndrome?
Please comment below with your dog’s story.
our 15-year-old lab was diagnosed with old dog, vestibular disease, 10 days ago. We were out of town when it happened and for four days he was throwing up and had diarrhea.. both those have cleared up since we have them back. His head tilt has improved greatly, and he is just a little bit wobbly. However, he struggles to stand up from lying down on our hardwood floor or tile floor. We cannot get him to go up and down the stairs unless he’s carried. I’ve tried using a harness, but he fought me on that. Any suggestions?
Hi Karyn,
I am sorry your senior guy is struggling with the symptoms of vestibular disease. It sounds like you are doing everything you can, this may just take some time. Do you think traction is an issue? Do you have hardwood or slick floors? You could try using yoga mats in the areas he frequents the most and I encourage you to look into our ToeGrips! Also here is a link to another article that may have some new information: 10 Tips and Exercises for Dogs with Vestibular Disease
Hoping things will start to improve and praying your sweet boy can make a full recovery. Best wishes and keep up the good work!
Our almost 14 year old Australian Shepherd is almost back to 100% after experiencing this about 2 and a half weeks ago. She now, though, has started peeing in our basement on the carpet. She is really very healthy apart for some noticeable getting older symptoms like barking way more often than she used to. She still wakes me up at night or early morning if she needs to go out (as recent as last night). Then just now she came up from downstairs (I forgot to close the gate) when I was here the whole time, and when she had just been out about an hour previously. I went to check, and sure enough she peed. Could this somehow be related to Vestibular Syndrome, even though she hadn’t peed inside for the first 2 weeks? My husband has been out of town for a week, so wonder if it’s just behavioral.
Hi Deanna,
I am sorry your senior girl is exhibiting these unwanted urination behaviors. While a behavioral cause is possible, I would want to rule out a medical cause first. Having your vet do a thorough exam and checking for a UTI would be a good start. Also, this could be early signs of dementia/canine cognitive dysfunction. Here is a link to another article with more information: Signs of Dementia in Dogs: Stages, Symptoms & Treatment
Hoping for answers and praying there is an easy solution.
I have pup with this . He is 17 year old Jack Russell mix . He is diabetic which really complicates things . My vet out of town so had to use another vet . Trying to keep watch on his blood sugar insulin is as needed at the present . He won’t eat but is drinking. I am worried sick but encouraged by your article I will keep on pushing and trusting if he and I can hold on maybe he will be better soon . Many prayers and much hope now.
Dear Anne,
I am sorry your senior guy is dealing with these worrisome issues. I hope he can keep fighting and will be praying for healing. Wishing you strength and comfort as you navigate this difficult path.
My 16 year old Parsons Russell Terrier, Jack, who has had Addison’s Disease for more years than I can count (on Prednisone 1/2 tablet every other day plus shot of Precorten V every month) came down with Old Dog Syndrome a week ago. My wonderful vet diagnosed it immediately, kept him for a few hours, then I picked him up. He’s been eating well and drinking water, still goes in circles but walks on his own, when he shakes his head unfortunately he falls. He’s doing pretty well although he is peeing all over the house. He was on prednisone for 5 days straight then back to his normal every other day. Is it normal with this Syndrome for a dog to pee and not give any notice that he needs to go outside? I’m washing throw rugs every day and need to get my bedroom carpet cleaned when he’s done peeing… I’m 72 and trying to support him and be in good spirits although this peeing is frustrating me – my vet is on vacation for another week. I take him outside every few hours and he does pee and poop, then comes in and within an hour he’s peeing in the house. Will this go away? Thanks for your input!
Hi Kimberly,
I am sorry your senior pup experienced this difficult condition. I am glad your vet was able to catch it quickly and get treatment started right away. The increased urination is probably due to the increased prednisone dosage. If this is the case, it should resolve on its own after the dosage is decreased again and the body has some time to adjust. In the meantime, maybe you could use male wraps or diapers to keep your cleaning stress to a minimum. Hoping your boy is feeling better and praying he can make a full recovery. Best wishes and good luck!
Our 13 yr. old pomeranian just collapsed last Wed. and she started doing circles and crying. We thought she had a stroke, but the next day the Vet said she has “Old Dog Syndrome” The vet gave us a aspirin mix which we were to give her every 24 hours and gabapentin to be given every 12 hours. Our dog still stumbles on and off for days, but seemed to be ok with eating, drinking and sleeping. Today which is 5 days later she started again by collapsing and has been going around and around in circles and banging into walls for hours today. Our vet is out of town and my husband and I don’t think it’s fair to allow our pom to suffer like this. I made an appt. to have her put down tomorrow unless we have a miracle before tomorrow.
Dear Pamela,
My heart aches for you with this very difficult situation you had to endure. I am not sure how things turned out, but if you had to say goodbye, I hope her passing was smooth and peaceful. Praying for comfort and healing for everyone involved. Bless you. ♥
My 11 black lab came down with this in early December when on a Saturday late morning he started stumbling around and couldn’t stay upright. He was able to still get up but he was very uncoordinated and unstable with heavy panting and drooling. By later that night he was already starting to move around better and by Monday you wouldn’t have known anything happened. We brought him to the Vet and he said it was hard to say what it was because all his symptoms subsided but was guessing he may have had a seizure.
Fast forward to the next Saturday night and it happened all over again. This time his symptoms were a bit more pronounced with the head tilt and instability. I took him to the vet the follow week but again his symptoms had improved greatly by that point. The Doctor said it’s possible it could be an inner ear infection or IVD but not much he could do other than clean out his ears and give me a 5 day supply of ear drops. We gave him the full bottle of drops and in a few days he was again back to normal but the head tilt stuck around.
The other day he again became very unstable and uncoordinated all of sudden. My son was able to get him up and all very unsteadily but he was able to urinate outside and walk around but kept laying down. When he got here m back inside and laid down he started vomiting then drooling and panting. We were able to get him up and he moved to the living room. He has now not wanted to get up and move other than crawling short distances. He also over the night urinated twice where he was laying.
We are confused and uncertain what to do at this point.
Hi Nick,
I am sorry your senior guy has been struggling with these episodes of neurological issues. While they do sound like Old Dog Syndrome, it has me a bit concerned that you have seen so many episodes in such a short period of time. Of course, without examining your dog myself, I can’t make specific conclusions. But I am suspicious there could be something else contributing to this situation. It might be good to think about a referral to a neurologist. I would want to rule out the possibility of a brain tumor or other serious issue. Also, if you can catch this strange behavior on video, it could be a huge help to your veterinarian. Especially since your boy always recovers so quickly and there are no symptoms to see at the time of his visits. I am sorry I can’t be of more help. Hoping you can find the answers you need to ensure your boy remains happy and healthy for many years to come. Best wishes and bless you both.
Hello,
My 14 years old golden retriever has the same thing.
She was super fine on thursday morning but then. started trembling, sort of collapsed (not able to hold her back legs), peed, pooped and vomited consequently thursday mid day.
I took her to vet.
The major diognose was nystagmus in her eyes and not able to stand.
Her conscious was also blurry.
Her blood werk was almost super healthy considering her age.
She the had xray. All good.
We had mri for brain and vertebra.
No tumors. But disc problems in c5-6-7.
This might explain the legs but not the nystagmus. as a result our vet said this is an idiopathic vertibral disease.
The applied iv, steroids and dramamine. As well as diuretics.
On Saturday, this morning she’s much better.
As i was searching on internet, i come across this page, read your article and all the comments. So relieved to see all the positive outcomes, hoping that she can get pass this as well.
Hi Yasemin,
I am sorry your senior girl is experiencing the symptoms of vestibular disease. What a blessing your vet was able to get a diagnosis rather quickly and your girl seems to be responding well to treatment. Thank you for sharing your experience with our readers. Praying for a complete recovery and many happy days ahead. Best wishes to you both!
Our 12-13 year-old `beagle (he’s a rescue so we have no way of knowing his exact age) was diagnosed with this. Same exact symptoms as described in your example. He improved after a course of ea medication and meds for nausea and vertigo. Three weeks later, he is definitely better but wanders around a lot and pants whenever he isn’t sleeping. He still stumbles and splays his legs when standing on wood floors. Otherwise he’s eating, drinking, and going for short walks (temps where we live are 90’s-100’s right now.).He also seems to have one eye that is not seeing very clearly. Do you think we should follow up with our vet the lingering symptoms (panting and pacing)?
Hi Julie,
I’m sorry to hear that your pup had old dog syndrome, but I’m glad to hear that he has made some improvements. I do think that it would be worth following up with your vet to ensure that there isn’t a different underlying cause for the panting and pacing. ToeGrips may also help him to get a better grip on the wooden floor while he is recovering. If you think you would like to try them and have any questions about sizing or application, please don’t hesitate to reach out to my amazing customer support team! I hope that he is continuing on the road to recovery and that you found some answers about his lingering symptoms.
So grateful to find and be encouraged by reading all this. Thank you all and I pray it’s what I’m enduring and not the end… . I have not phoned a vet as I’m in a war zone and cannot travel yet. Jet collapsed about a month ago and fell on the floor and rolled over. I stabilized him he then didn’t want to eat or drink and took him to vet thinking it was a dreaded visit as obviously only want to do the best for my treasured companion. I was told he’s good take him home and give start giving him wet food. Everything resolved…
My Jack Russel is almost 18 ! weakening heart but tough playful and remarkable !!!
The past 2 days he has vomited yellow bile and barely eaten and only a little water.
Today he was / is unbelievably wobbly and his back legs sliding and not interested in food and only a little water which I was so grateful he drank this afternoon. He is sitting in a strange way and looking at wall…. and then becomes normal again. Hrs very lethargic and tired and to help him move to urinate I either carry him outside and I have also put towels down so he doesn’t slide and forces himself to walk. He’s determined but barely eating and only a little water.
He seems to have lost a lot of his hearing overnight and I’m hoping and praying what I’m reading in this thread is all it is. as he’s been with me for almost 18 years which is the biggest blessing in my life. The sudden sliding and symptoms today have been alarming but as we all know,,, dogs feel our emotions so am being as comforting and helpful and loving as I can and haven’t left his side.
I pray he drinks more with no more bile and obviously nausea and that his body stabilizes. Thank you all for encouraging me with this post I found while googling.
It’s Friday and wiill find a way in the current war zone I’m in to get him to a vet on Sunday if PG he’s still with me 😢🙏🏻 but hoping after reading this all will resolve on its own
Thank you all again with my heart and soul
Dear Debra-Lee,
My heart aches for you with this difficult situation you are in with your senior pup. I am sorry the current conditions are preventing you from getting your dog immediate care. I pray he was able to recover and stabilize and is still by your side. Feel free to leave an update if you have a chance. Bless you both. ♥
My 11 year old dog has just been diagnosed this. She was fine in the morning but at lunch time, she couldn’t stand, and when I helped her up, she kept moving to the right, and then collapsing. The vet said it was either a tumour, stroke or epilepsy but never told me that there is one condition where she would get better in time. They recommended seeing a neurolgist, so the next day, when she was no better, I traveled to see one. He said he needed to rule out everything. Cost me a fortune to find out its old dogs syndrome. I picked her up the next day and she was a little better (3rd day) but having 3 legs means she’s still wobbly and falling a few times. It’s day 5 now. I just wish our local vet had mentioned it, and we need to spread the word about it, as so many would not be able to afford the tests and MRI, and may put their dogs to sleep too soon…
Hi Emma,
I am sorry you had to go through so much to get a diagnosis for your senior girl. What a blessing it is nothing serious and you are already seeing some improvement. Thank you for sharing your story with our readers. I am certain this will be the exact thing someone else needs to hear to offer hope in a difficult situation. Wishing you and your sweet girl many happy days ahead!
My 17 yar old Lab had sudden onset of symptoms on a Saturday evening. I thought he was having a stroke. Hr had the dizziness and inability to stand without splaying his legs. His eyes were OK. He looked directly at me and held contact. I could not find a vet within a 2 hour drive so I just waited. About 4 hours later, he seemed better. The next day he was normal. On Monday I called his vet. They said I should monitor him but I didn’t need to bring him in. I was somewhat upset but agreed. About 2 weeks passed and again on a Saturday evening symptoms came on suddenly. He vomited several times… a snotty foamy vomitus. Since it only lasted a few hours previously, I waited it out. It lasted longer this time. I took him to the vet on Monday and he was diagnosed as having Old Dog Syndrome (or a brain tumor). Vet said probably the former. He has not had a recurrence but I’ve read up to be sure it is a real thing. Hope this is the last of it.
Hi Peggy,
I am glad your senior guy is back to normal and his symptoms have all resolved. Thank you for sharing your experience with us. I hope these vestibular episodes are now a thing of the past and your sweet boy can happily live in peace. Best wishes to you!
Our dog Suzie who is 14 woke up with this. It is indeed very scary when your first encounter it but after we knew what it was we could deal with the issues. She’s only had maybe two episodes where she couldn’t really walk. There are meds for it that help. It does not get worse from what I have read.
Hi Ann,
Thanks for sharing Suzie’s story. I’m glad that although she had some scary looking episodes of Old Dog Syndrome, you have figured out how to help and support her through it. I hope she is able to continue to live her best life for years to come.
What kind of meds did they give you? I have a 10 year old golden retriever in great health from what I thought and the suddenly started having all the symptoms of the old dog syndrome. I thought she was having a stroke so I took her to an animal urgent care. The vet told me she probably had a stroke or has a tumor in her brain. They gave me a steroid and something for the nausea. She improved within a couple of days and seemed like she was good as new. This was over a month ago. And today she seems to be going through the same thing again suddenly. I’m at a loss for what to give her to help her.
Hi Stephanie,
I am sorry your senior girl is dealing with these worrisome symptoms again. While a stroke or brain tumor are still possible, dogs can also experience vestibular disease more than once. I would recommend you contact your vet and see if they are willing to prescribe another round of medication or if they want to do a follow up exam. It may be time to think about scheduling a consultation with a veterinary neurologist. I am hopeful you will find some answers and can ensure your sweet girl remains happy and healthy for many days to come. Best wishes to you both.
I’ve always wondered if my 13 year-old Wheaton Terrier was misdiagnosed in 2007. His symptoms came on very suddenly overnight on Monday, and on Tuesday morning he could only walk in circles. I thought he must have had a stroke, and called our vet. She advised a “wait and see” protocol. Meanwhile poor Sam needed help doing his business, and ate and drank very little. There was no abnormal eye movement, although at the time I didn’t know about vestibular disease, so wouldn’t have been looking (but surely it’s something I would have noticed?) By Thursday I was not feeling optimistic—he wasn’t getting better. We were due to travel overseas the follow Monday for a conference, but I would gladly have stayed home if there were any chance he’d recover. Our vet came to our house on Friday morning and said that if it were her dog, there was no question as to what she would do. So we let him go. But when she gave him the tranquilizer at the beginning of the procedure, Sam tried to rise and looked at me as if to say: “no, it’s not time!”.
So I’ll never know. And I suppose I had to trust our vet. But vestibular disease wasn’t so well recognized 15 years ago, and I will always wonder if she missed it. And I’ll never forget the look in his eyes.
Hi Joanna,
What a difficult experience. I’m so sorry for the loss of your dog and the guilt you still carry. It is true that we will never know for sure what Sam’s official diagnosis was, but it sounds like you and the vet worked together to make the decision that you both thought was best for Sam given the information you had in front of you. And in the end that is what matters. It is so easy to be consumed with the “what ifs”, but I hope that in time you will be able to find peace with Sam’s final days and the decision to let him go. ❤