Vestibular Disease in Dogs

Written by Carley Deery • 2025 Scholar

History

Harlie, a thirteen year old, spayed female Labrador Retriever presented to Iowa Veterinary Specialties for increased respiratory effort and inability to walk. She fell over at around 3 pm but appeared to be fine after. By around 10 pm she was restless, swaying her head from side to side, and falling over. Harlie has a history of laryngeal paralysis and is on pain medications and joint supplements for arthritis.

Physical Exam & Diagnostics

Physical exam findings include dental disease, mild and symmetrical muscle loss, as well as moderate stridor on inspiration. On her neurological exam, Harlie was alert and responsive, had a head tilt to the right and was circling to the right, had an abnormal horizontal nystagmus to the left, had absent proprioception placement in the hind limbs, and was unable to elicit patellar reflexes. Bloodwork was ran including a complete blood count, electrolyte and chemistry panels, T4, glucose, lactate, total protein, and packed cell volume. There were no significant findings within the bloodwork.

Diagnosis

Harlie was diagnosed with vestibular disease. The left nystagmus, circling and head tilt to the right, as well as the leaning and lack of balance suggest an issue with the vestibular system. It was not determined whether Harlie’s vestibular disease was of central or peripheral, however,
the proprioceptive deficits noted in the hind limbs as well as the circling behavior are commonly seen in central vestibular disease. Diagnostic imaging such as MRI or CT could be used to determine the origin of the lesion.

What is Vestibular Disease?

The vestibular system is responsible for orienting animals within their environment. It maintains posture and balance in relation to body movement. When this sensory system is impaired, there is a miscommunication between the body and brain about the body’s position in space. Signs of a diseased vestibular system are lack of coordination, walking in circles and a head tilt, abnormal nystagmus, and even motion sickness.

There are two types of vestibular disease differentiated by their origin. Central vestibular disease is caused by a lesion within the brain, brainstem, or cerebellum. Peripheral vestibular disease is associated with dysfunction of any other component of the vestibular system. The signs and symptoms of central and peripheral vestibular disease are similar and clinical presentation can aid in diagnosis. A vertical nystagmus, proprioceptive deficits, as well as abnormalities with other cranial nerves can help indicate a central lesion. A peripheral lesion can often be seen in conjunction with old age or even ear infections, due to the vestibular organ’s location deep within the inner ear.

Photo courtesy of Charlotte Animal Referral & Emergency

Treatment

Upon presentation at Iowa Veterinary Specialties, Harlie was started on phylyte intravenous fluids at a rate of 56 mL/hour for hydration, 0.8 mL of 10 mg/mL butorphanol IV for pain relief, and 2.7 mL of 10 mg/mL cerenia to help with nausea. During her hospitalization she was switched to oral medications including 30 mg/mL entyce for appetite stimulation, meclizine 25 mg for nausea, and her normal dose of carprofen 100 mg for pain management. Following about 48 hours of supportive care, Harlie was not showing significant improvement and was referred to Blue Pearl to consult with a neurologist. Supportive care was continued and diagnostic imaging was declined according to an update sent from Blue Pearl. Unfortunately Harlie continued to not show any improvement and her family elected for humane euthanasia.

Sources

  • Brooks, Wendy. “Vestibular Disease in Dogs and Cats.” VIN, Veterinary Partner, 26 Aug. 2024, veterinarypartner.vin.com/default.aspx?pid=19239&id=4951444.
  • De Decker, Steven. “Vestibular Dysfunction - Central or Peripheral? .”VIN, Veterinary Information Network, 2016, www.vin.com/apputil/content/defaultadv1.aspx?pId=19840&catId=105891&id=8249864.
  • Platt, Simon R. “Mastering Vestibular Disease in Dogs and Cats: All That You Need to Know.” Veterinary Information Network, New York Vet, Nov. 2019, www.vin.com/members/cms/project/defaultadv1.aspx?pid=23658&catId=&id=9319986&said=&meta=&authorid=&preview=.
  • “Vestibular Disease in Dogs.” PDSA, PDSA Veterinary Services, Jan. 2021, www.pdsa.org.uk/pet-help-and-advice/pet-health-hub/conditions/vestibular-disease-in-dogs.
  • “Vestibular Disease.” Charlotte Animal Referral and Emergency, CARE, 15 Jan. 2021, carecharlotte.com/blog/vestibular-disease-in-dogs-and-cats/.

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