“I think my dog has just had a stroke” is a not uncommon comment we get when a senior dog suddenly collapses. While there are a number of diseases that can lead to collapse, vestibular disease has a very particular presentation that makes it easier to diagnose. This, and the fact that many dogs will go on to recover from the event, makes it a good topic for owners to know about.

Head tilt to the dog’s left side.

The vestibular system is the part of the nervous system that deals with balance. When it doesn’t function properly, the pet feels like the world is turning, or that their brain can’t tell them which way is up. Most of the time, only one side is affected. What you end up seeing is an animal that has a head tilt which is sometimes quite severe, and may be staggering or just plain collapsed and struggling to get up. Sometimes there is vomiting as well. When the attack first happens, a rhythmic movement of the eyes is usually present. This is called nystagmus.

Vestibular disease can happen at any time during a pet’s life when those nervous structures are irritated or damaged. Middle ear infections, drug reactions, head traumas, and even some parasites can be associated with vestibular syndrome. What distinguishes this type is:

• Older dogs. I often find that these dogs are older than 13 years.

• Sudden onset. One minute they are fine, and the next, they can’t walk. Hence the ‘stroke’ similarity for the owner.

• No associative cause is found. We rule out all the usual causes with diagnostic tests.

• It does not progress after the attack. So, the worse it gets is that first day.

• Most pets improve over the following weeks, with the most dramatic improvement in the first week or so. Some pets are left with a residual head tilt. Rarely, the disease will come back, sometimes affecting the opposite side. It is important to understand that while most dogs recover from this, these older patients often have other problems that can complicate their recovery.

The cause of this type of vestibular disease is unknown. For this reason it is also called as idiopathic vestibular disease. Treatment is all about supporting your pet through the episode. Anti-nausea medication may be necessary to improve appetite, especially in the early stages. Pain relief should be considered for the arthritic pet that is now falling, or scrabbling to gain their footing. Providing support to help them get outside and mats for slippery floors indoors are essential. Thankfully, this is a condition that most dogs will recover from.

Here is a video of a patient with nystagmus.