Vestibular disease in old dogs can look very scary. A senior dog appears to go from perfectly healthy to completely off kilter in a moment, usually with no warning signs. Integrative veterinarian Dr. Julie Buzby shares her experience diagnosing old dog vestibular disease, and how dramatic symptoms don’t always mean a devastating prognosis.
Working as a veterinarian, my days are full of ups and downs—sometimes even in back-to-back appointments. My passion for working with senior dogs means I deal with a lot of very serious health conditions in my patients.
Sometimes, however, dramatic clinical signs are not necessarily an indication of a severe underlying problem. This was the case for one of my very first patients, Lola. She was the first dog I diagnosed with old dog vestibular disease when I was a newly-minted veterinarian 25+ years ago.
Meet Lola: A senior dog with old dog vestibular disease
Lola, a 13-year-old Blue Heeler, arrived at my clinic with very serious symptoms. She was lovingly cradled in her dad’s arms with her head tilted distinctively. Her eyes were rapidly scrolling back and forth over and over again, like something you’d see in a Looney Tunes character.
Lola’s parents explained the events of the past few days and how suddenly Lola’s symptoms had developed with no apparent explanation. Now she could hardly stand up without falling to one side. At 13, they feared that their sick dog would not be going home with them that day.
I gently scooped Lola from her dad’s arms and performed a physical examination and then a neurologic examination. Despite initial fears that this appointment would end in euthanasia, I then knew I could offer Lola’s parents a glimmer of hope.
A surprising prognosis
Although we still needed to do some diagnostic testing to rule out more serious conditions, I was able to offer Lola’s parents some hope that their senior dog would recover with minimal long term effects and possibly none.
Lola was suffering from a common canine condition known as “old dog” vestibular disease, also called idiopathic vestibular disease. Idiopathic simply means the disease’s origin is unknown—we really don’t know for sure why it happens. The key part of the syndrome’s long name is the word “vestibular.”
What is the vestibular system?
“Vestibular” refers to the vestibular system—a complex network of structures located in the dog’s inner ear. The vestibular system perceives the body’s orientation with respect to the earth’s gravitational field and facilitates normal movement. The brain, eyes, and body use the information gathered by the vestibular apparatus to maintain proper posture and balance.
What are the symptoms of old dog vestibular disease?
Because the vestibular system is in charge of balance, dogs with vestibular disease often experience dizziness and have difficulty walking in a straight line. If you’re thinking “that sounds a lot like vertigo in humans,” you’re on the right track. Old dog vestibular disease can be likened to vertigo in humans, and symptoms of doggy vertigo are similar to symptoms of vertigo found in people.
In dogs, classic clinical signs of vestibular disease include:
- Abnormal posture, especially standing with legs spread wide
- Head tilt
- Impaired coordination
- Loss of balance
- Rapid eye movement when awake, called nystagmus
What causes vestibular disease in old dogs?
By definition, the word “idiopathic” means we don’t truly know what causes old dog vestibular syndrome.
As an aside, some other conditions can affect the vestibular system and clinical signs for these conditions are similar to those of vestibular disease. These conditions can include:
- Ear infections
- Hypothyroidism in dogs
- Trauma
- Tumors
- Tickborne diseases
- Toxin or drug side effects
What dogs are at risk for vestibular disease?
Idiopathic vestibular disease can happen in dogs of any breed, size, or gender. It is most common in senior dogs, and occurs more frequently in German Shepherds and Doberman Pinschers.
Can vestibular disease be prevented?
As the exact cause of idiopathic vestibular disease is unknown, we don’t have an effective way of preventing it. Old dogs develop this condition seemingly randomly, out of nowhere. The best thing you can do for your senior dog is to be aware of his or her overall health and notice any changes so they can be addressed quickly.
How is old dog vestibular disease diagnosed?
At your dog’s veterinary appointment, your veterinarian most likely will give your dog a thorough physical and neurologic examination, evaluate your dog’s medical history, and have routine bloodwork checked. This is usually enough to make a diagnosis of exclusion, meaning the veterinarian has ruled out other causes of the symptoms and is left with a diagnosis of canine idiopathic vestibular disease.
Old dog vestibular disease vs. stroke
The most common concern that my clients share with me when their dogs develop vestibular disease is this, “I think my dog had a stroke.” Indeed, with sudden onset of a head tilt, nystagmus, and lack of coordination, the comparison we could reasonably draw to human conditions is signs of a stroke.
Fortunately, strokes are much less common in dogs than in people. Age of onset of these signs is also significant, as canine strokes tend to happen in younger adult dogs. In a senior dog presenting with these clinical signs, idiopathic vestibular disease is much more likely than stroke.
How is vestibular disease treated?
The treatment for canine vestibular disease includes inpatient or outpatient supportive care for the symptoms, lots of TLC, and sometimes alternative treatments like acupuncture for dogs. I also make sure to prescribe anti-nausea medication (like Meclizine for dogs), even in dogs who are not vomiting. That unrelenting dizziness can cause debilitating nausea. (Having personally experienced a period of such dizzying vertigo that I couldn’t safely stand up, I’ve developed new sympathy for dogs with vestibular disease.)
It’s important to note that idiopathic vestibular disease affects the peripheral vestibular system (inner ear) and not the central system (brain stem). Because of this, you shouldn’t see mental dullness or generalized weakness. If those are present, your veterinarian will likely be thinking about other causes for your dog’s clinical signs.
I expect my patients with old dog vestibular disease to maintain their overall strength and mentation even though their balance and equilibrium are terribly out of whack.
Home remedies for vestibular disease
If your veterinarian has diagnosed your dog with vestibular disease, you may be wondering what you can do at home for your dear dog. In addition to following your veterinarian’s treatment plan, you can make sure your canine companion is comfortable and safe. Here are several things to consider:
- Make sure you have soft, padded bedding for your dog to relax on.
- Keep your dog away from potential hazards like stairs or swimming pools.
- Some dogs with vestibular disease can have a hard time eating or drinking and may need their food bowls brought to them or even hand fed. (Need more tips? Check out my article on how to feed a dog with vestibular disease.)
- Using a sling or towel under your dog’s abdomen when he or she walks can prevent falling.
- Certain physical therapy exercises for dogs with vestibular disease may also help.
Additionally, dogs with vestibular disease have trouble rising and are unsteady on their feet. Our company’s signature product, Dr. Buzby’s ToeGrips® dog nail grips, can improve traction on slippery floors for these dogs and may also provide increased proprioceptive stimulus—improving the dog’s overall stability through neural pathways to the brain.
What is the prognosis for vestibular disease in dogs?
Fortunately, despite the dramatic clinical signs, canine idiopathic vestibular disease has an excellent prognosis—prospect of recovery. This non-painful condition is usually self-limiting, meaning it will resolve on its own—generally within one to two weeks. In fact, improvement of symptoms within the first 72 hours also helps confirm the veterinarian’s diagnosis.
In many cases the head tilt (a classic sign of old dog vestibular disease) does not go away. But this does not negatively impact a dog’s quality of life. Also, dogs who have recovered from idiopathic vestibular syndrome do not typically experience it again.
Old dog vestibular disease does not impact a dog’s lifespan, and patients go on to live out the rest of their days as if this scary episode never happened.
As a veterinarian, I often half-joke with my clients that the whole ordeal takes years off the parents’ lives though!
Lola’s happy recovery from vestibular disease
To this day, Lola holds a special place in my heart. She was the high point of my first year as a veterinarian.
Don’t get me wrong. I was sad to see Lola and her owners endure a few tough days, but the outcome was far better than my clients’ initial expectations.
A few days after her initial examination, Lola strolled out of our hospital, tail happily wagging. A slight (and endearing, if truth be told) head tilt was all that remained as a reminder of her bout with vestibular disease. Lola and her family went on to share many, many more happy and healthy days together.
Knowledge is power
If your older dog experiences symptoms like Lola’s, get to the vet as soon as possible, but proceed with hope. Odds are, your dog can rebound and recover from what can be a dizzying, but not devastating, disease.
Has your dog experienced canine vestibular disease?
Share your story with us!
Also, otoliths in the ear as another possible cause? Is there a version of the Epley maneuver for dogs?
Hi Lis,
I am so glad you brought this up! Honestly, I had to do some research and there really isn’t much out there. But I did find a research article that was published back in 2014 on exactly this topic. Here is a link to the article on PubMed: https://pubmed.ncbi.nlm.nih.gov/25103883/
My 14 year old Shiatzu-Chi Wawa mix starting losing her balance. At first I thought she had a hind leg problem. At the beginning she vomited but only twice. Since then she’s been wobbly and has fallen a few times. She’s got a history of ear issues, we often have to clean her ears.. She has a head tilt and her eyes move quickly sometimes. I think she’s getting better. but she favoring her one side.
I suspect the root cause is an ear infection although your article says that old dog syndrome has unknown causes. Any advice ? Should I take her to the vet, do you think she might need antibiotics ? Thanks for your help, you have excellent information.
Hi Reno,
I understand your concern over these neurological symptoms your dog is displaying. I definitely think you should have your vet do an exam. If there is an ear infection, it needs to be addressed. Since I have not personally examined your dog, I can’t make specific conclusions. But I am suspicious there could be something else going on here. You mentioned her eyes move quickly sometimes. This could be a condition called nystagmus. Your vet will probably want to rule out the possibility of other more serious conditions, such as a brain tumor, before proceeding with treatment for vestibular disease. I hope you can find the answers you need to make sure your sweet girl is feeling her best. Wishing you both the best for many happy days ahead.
Thank you for sharing your knowledge and experiences. My 17-year-old chihuahua is suddenly displaying movement very much like this but only when outside in daylight. Before or after the sun goes down, walking outside is normal. Could this be vestibular? Thank you.
Hi Amy,
I am not sure I have ever heard of a case quite like you are describing. It is very puzzling to me that the symptoms are only present in daylight. It definitely seems to be something neurologic in nature. I highly recommend you have your senior pup examined by your vet.
My dog Sadie was diagnosed with this two weeks ago. She has gotten worse since then, but luckily she is still eating and drinking water on her own. I’ve covered the floors with non slip rugs so she doesn’t fall while walking. It is now heart breaking just getting her on and off the bed because she is so scared. She freaks out if I try to pick her up (50 lbs). Sleeping on the floor isn’t an option in her opinion!
It’s interesting that another reader mentioned a spleen issue. Sadie had to haver hers removed in August because there was a mass that had ruptured. Despite the opinion that 75% of these are cancer, her’s was not. My poor baby, she’s been through so much this year.
Thank you for the website!
Hi Kimber,
I am sorry Sadie is struggling with the symptoms of vestibular disease. It sounds like you are doing a good job of trying to keep her comfortable while you wait for the side effects to diminish. Here are two links to other articles with more information on this topic:
1. 10 Tips and Exercises for Dogs with Vestibular Disease
2. How to Feed A Dog With Vestibular Disease: A Comprehensive Guide
I know you said she is eating and drinking well on her own but figured there is no such thing as too much information and advice when it comes to this disease. What a blessing her splenic tumor was benign! I am hopeful that given more time Sadie will be able to make a full recovery. Wishing you both the best and feel free to leave an update if you have a chance.
Thank you and bless you for what you do as not only a veterinarian, but also a caring person. I’m going through this with my 12-year old poi (mix) dog, but unfortunately it’s been over four weeks now, and I’m still looking for glimmers of hope for her (Lili). Everything sounds so classic, other than the longevity of it, and no nystagmus, plus she’s still eating and drinking, with great assistance. She has no other signs of an infection, like fever or even pain, at least in my interpretation. I am a people doctor, so of course, I’m watching every sign to try to figure more out. I did take her to ER vet almost 2 weeks ago, they did. Fluids and dexamethasone, then outpatient prednisone taper, which she’s finishing up, but no improvement. I have a notion to ask about meclizine for sure, and possible antibiotics for inner ear infection (even though 2 vets have looked and said otoscopic exam is normal). Figured those couldn’t hurt?? Any other advice? Thank you so much!
Hi Doede,
I am sorry I am just now seeing this comment. I hope you saw my reply to your other post from a few days ago. Were you able to have Lili rechecked by your vet? Did you find out if there is a veterinary neurologist on your island? I am hoping your sweet girl is making some improvements. Feel free to leave an update if you have a chance.
Hi Dr. Buzby, Three weeks ago my 12 year old dog Ben was diagnosed with idiopathic vestibular disease and after x-rays and an ultrasound of his abdomen they also found a 6 inch tumor on his spleen. They recommended surgery but I was unsure if that would be too much for his age and onset of vestibular disease. Do you have an opinion on this?
Hi Rina,
I am sorry your senior guy is dealing with the effects of Vestibular disease and now has been diagnosed with a splenic tumor. Once a splenic mass has been found, I usually recommend surgery to remove the spleen even if other medical issues are present. The problem with splenic masses is they will eventually rupture. Even if the mass is benign, the risk of rupture and a potentially fatal bleeding event is high. Here is a link to another article with more information: Splenic Masses in Dogs: Types, Diagnosis, Treatment, and Prognosis
I hope you can find the answers you need to make the best choice for you and Ben. Praying for a positive outcome.
Our big shepherd mix had his first vestibular episode when he was about 9 years old, and it was terrifying. He woke us in the middle of the night – frantic, panting, stumbling, urinated in the house – all of this thoroughly out of character. He was walking with a lilt in circles, head tilted, stumbling sideways. He did drink some water and even accepted a favorite treat once we got him a bit settled, but he was still clearly “freaked out”. I was fortunate to find a blog that described another dog’s very similar episode, and that’s how I learned about idiopathic vestibular syndrome. As our poor guy calmed down a bit more, we decided to wait until morning to call our veterinarian. By 9 AM, he was doing notably better, and the vet agreed we should just keep monitoring and giving lots of TLC (of course, all this occurred on the weekend!). It was a quick and full recovery for our dog but he did eventually have another episode, maybe 8-12 months later, and it’s happened more as he’s gotten older. Each episode is similar but varies in severity and length; the last took closer to two weeks to subside fully. He now has that little head tilt pretty much all the time (and yes, it is endearing!), but there can be many months between episodes. It’s scary in the moment and may require supportive care but it’s a gift to know that the prognosis is actually quite good. Thank you for sharing this information; I wish I’d had it before that first experience and I’ve told everyone I know about what we learned in case they experience it with their beloved dogs.
Hi Chrissy,
Thank you so much for sharing your experience with our readers. This may be exactly what someone else needs to see while in a similar situation. I am glad that your big boy is doing well and has been able to overcome all his scary vestibular episodes thus far. I hope he continues to find joy in life and has many happy days ahead. Best wishes and bless you both!
Hi doctor I read a lot of the good articles you wrote for a second there I thought my dog may have that old dog syndrome vascular or something either way the more I read I’m not too sure I have a chihuahua it’s 16 years old and it recently started the shaking like tremors that would last a couple seconds sometimes the tremors would make her fall down but she would get right back up and snap out of it I took her to the vet thinking it was seizures and they said no I ran all the test possible the doctor just said the dogs getting old now my dog is not eating I put seven different types of dishes in front of it and it might take a nibble it is drinking water but the dog is hungry and I can tell it’s hungry and keeps looking for food but when I give him food he won’t eat it or puts it in his mouth and spits it back out I’m in so much pain and tears watching my dog wither away please help..
Hi Israel,
I am sorry your little guy is struggling, and I understand your heartache with not knowing how to help. Since I have not examined your dog myself, it is hard to make specific conclusions and suggestions. It might be a good idea to get a referral to a veterinary internal medicine specialist. They have access to testing and treatments that may not be available in general practice. Also, if it seems like your sweet boy may be nearing the end of his life, it might be helpful to contact a veterinarian that practices hospice and palliative care. I hope you can find the answers you need to restore your dog’s quality of life. Wishing you the best as you navigate this uncertain path ahead.
It happened to my black lab Sebastian few weeks ago. It was Sunday morning and he just stumbled on the kitchen floor. I helped him get up and he couldn’t walk without falling. We took him to the emergency vet. The vet took his blood and came back ok,except his liver is a little elevated. The vet prescribed meds for the liver,he was also prescribed meclizine for dizziness and also pain meds.. I bought a Carelift to help him when he go outside to potty,he can walk in the house by himself,but still wobbly. I also noticed that his tail is always tucked in between his legs,and also I felt like he has no control of his back legs sometimes.
Hi Maria,
I am glad you were able to get Sebastian to the ER quickly to get treatment started. Vestibular disease can take a long time to resolve and sometimes it does not completely go away. If you have any concerns about your boy’s recovery or how things are progressing, I highly recommend you talk to your vet and possibly have Sebastian rechecked. You may even want to schedule a consult with a veterinary neurologist. I hope you can find the help your sweet boy needs to help restore his quality of life. Best wishes to you both!
My dog Sadie, who is 14, is currently going thru this. Started night before last, heard her fumbling around the wooden floor, which is hard enough for her, but this was even worse. Head kept tilting to the right, and vomit everywhere. Of course, I thought she had a stroke, but checked on the internet for stroke symptoms and Vestibular came up. Took her to a Vet on call yesterday morning and he confirmed. It is awful to watch. I am giving her water thru a straw because she can not keep her head still to drink out of a bowl. All I have done is cry. She is my grand dog but has lived with me for a year. Today is day 2 and no sign of improvement. She just sleeps. We will see what happens, but all of your stories have given me encourage meant. Thank you..
Hi Tracey,
My heart goes out to you and Sadie during this most difficult time. I know how worrisome it can be to watch a beloved dog struggle and feel like you are already doing everything you can to help. Fortunately, most dogs with vestibular disease do improve and return to more normal function. I recommend you talk to your vet about your concerns. There are medications that they could prescribe to help with the dizziness and nausea that it causes. I will also attach some links to other articles that may offer new information. I pray Sadie’s healing process is fast and that you can find some comfort for your heart as well. I wish you both the best and, if you have time, keep us updated on Sadie’s progress.
1. 10 Tips and Exercises for Dogs with Vestibular Disease
2. How to Feed A Dog With Vestibular Disease: A Comprehensive Guide
We heard Miss Molly, our 14 year old Labradoodle, slipping and stumbling across the floor in the middle of the night, unable to keep her hind legs from spreading apart. I lay on the floor with her all night to comfort her until we were able to rush her to the vet in the morning. We were both in tears as we took her to the waiting room, fearing that her time had finally come: a stroke, dysplasia, a neurological disorder.
What a relief as soon as I hear the vet say the words “Inner ear infection–vertigo”. My wife has bouts of positional vertigo, so we both knew the diagnosis fit perfectly. The instability, uncontrolled rapid eye movements. The infection is clearing up slower than anticipated, but hopefully we can pick up our precious girl tomorrow.
We understand it could take several weeks for her equilibrium to be restored, and our slippery floors were a concern even before this happened. We are going to pick up some Toe Grips from a vet in Chattanooga. From an engineering standpoint, they seem like an almost perfect solution for an elderly dog. I never like bootie-type footwear on my dogs, as it greatly affects their gate. That would not be good for a dog trying to get her ambulation back to normal. I will write back after we have a chance to try them, but I have good reason to think they will help her!
Hi Chuck,
Thanks for sharing Miss Molly’s story with us. I am so glad that it ended up being vestibular disease rather than any of the more devastating possibilities. I hope that she is able to come home with you tomorrow too. As your wife can attest to, vertigo is no fun for anyone, dog or human. Eating can sometimes be a concern for dogs with vestibular disease to, so you might find this article helpful: How to Feed A Dog With Vestibular Disease: A Comprehensive Guide
I am excited that you are going to try ToeGrips for her! I think they have a great potential to help her gain much needed traction and I am looking forward to hearing how they work for her. If you have any issues or questions, please don’t hesitate to reach out to our customer support team. They are wonderful individuals and dedicated to helping people and their pups.
If Miss Molly is dragging or scuffing her toes on the ground, you may need to affix the ToeGrips with superglue to keep them from getting tugged off. I explain how and why to do this in my video How to apply ToeGrips with glue.
I hope that Miss Molly is home with you soon and that the ToeGrips are helpful for her! ❤
A few years ago, while walking our 15 yr old English Cocker on a leash, she fell off a dock at the lake. We immediately grabbed her by her collar and pulled her out. But, suddenly she could only walk in circles. I called our vet and raced there with our Betsy, thinking for sure she had a stroke caused by us pulling her out of the water. He noticed her flickering eyes and immediately diagnosed Vestibular Syndrome, something I had never heard of. I made a harness for her and would walk her around outside, as it helped her walk a straight path instead of in circles. It took a few weeks for her to recover, but she did. We were able to love her for another year!
Hello!
Thanks for sharing your dog’s story. Seeing her fall in the water, pulling her out and then having the vestibular signs start must have been such a scary experience for everyone but I’m so glad that day had a happy ending. It is fantastic that she recovered so well and that you were able to love her for another wonderful year.?
This happened in July to my older standard poodle. So scared . Didn’t know anything . He has recovered. Took about 4 weeks. He definitely needed help w walking and stairs. (Got a harness to help him up and down). At this point in time, my neighbors are amazed at how well he is doing.
Hello Lynn, Thanks for sharing your dog’s story. It can definitely be very distressing to watch your sweet dog go through a vestibular disease episode, especially before you know what is going on. The harness was a great idea and I am so happy to hear that he is amazing everyone with his progress.
My 14 year old birder collie had this a year ago. She was fine the night before but when I got up the next morning, she had gotten sick in several places and was in the closet. She could not walk and would fall over when she tried to get up. I rushed her to the emergency vet and they told me that she probably had a brain tumor and referred me back to my regular vet.. When I took her to my regular vet, they told me that they were going to treat her for old dog syndrome and if she wasn’t better by end of week, we would know that the brain tumor diagnosis was probably correct. I was told to bring her in if she got worse. It was a very long week and she finally started getting better by the end of the week. It took about 2 weeks for her to completely recover. She still has a slight head tilt today. I was told that she would have it from now on. Until this happened, I didn’t know anything about old dog syndrome. I never heard of it. It was really scary and especially hard for the dog. I’m so glad that she recovered and hope that she never gets it again.
Thanks for sharing your dog’s story, Sunny. I’m so glad she recovered well and I hope you get to enjoy many more good days together!
My 2.5 year old lab is currently on her second round of idiopathic vestibular disease after just a couple months…she made almost a full recovery last time after she walked the green mile to the vet. However, this round does seem to be different both times when it started it looked as if she was following a fly around with her head shifting right to left ….and this time she does not have the eye movement of back and fourth but the wondering head is more intense this round. I love her so much it makes me nauseous thinking what she is going through…not once but now again ?thank you soo much for putting this website up I am constantly looking for advice!
Hi Tiffany, Thanks for sharing your lab’s story and for the kind words. I’m so glad that the post was helpful to you and I hope your dog recovers well from this episode too! As you gathered from the article and your own experience, this condition can be heart wrenching to watch but thankfully usually has a happy ending. If you have any concerns about how she is recovering, don’t hesitate to reach out to your veterinarian.
My client just put her dog down because of this.
That is so sad, Amy. It’s always so hard to say goodbye.
My old rat terrier, Brandy, suffered from this shortly after being given Bravecto. The medicine helped and she was only left with a little extra white around the eyes.
I had experienced it a couple years before Brandy when I woke up one morning and couldn’t walk a straight line. I wasn’t really dizzy but was unable to walk straight. I ran into doorways instead of through it. Then, it got where I couldn’t see because my eyes wouldn’t focus. I went to the doctor at that point and she gave me some Valium and physical therapy. The physical therapy helped a lot and I used it for the recurring vertigo that happened over the next 18 months occasionally
Hi Kris, thanks for sharing your personal story. Yikes, I’m glad you are recovered. As I mentioned in the article, I know that vertigo is no fun! I’m also so glad that Brandy has made a (near) full recovery! Bless you both!
This happened to my 17 y.o. chihuahua, and I brought her at 2am to an emergency vet. They were clueless, and it was found with blood tests she also had kidney disease. I could hear them laughing at her in the back lab as she staggered around like a drunken sailor. They came out and asked me if she could have gotten into drugs, pot. No! She was euthanized that night, because they told me it was irreversible, and I couldn’t stand seeing her so distressed. I wish more vets knew about this. I might have had at least one more precious year with her.
Oh, Diane, your story breaks my heart. I’m so very sorry for your loss. ?
Thank you, Dr. Buzby, for this informative story about Lola. I can see why this experience stayed with you as a young vet. This story was well written and easy to understand, and you are right that knowledge is power. Senior dogs hold our hearts in their paws, so anytime we can be aware of how conditions like these may present is very helpful.
Thanks for your encouraging words, Pat. I appreciate your comment more than you could know. Many blessings to you and your crew! ❤️