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FAQ:
Our old dog suddenly became dazed and confused, staggering around the house,
losing his balance, and wandering in circles. Our veterinarian diagnosed his
problem as vestibular disease. What causes this disease and how serious is it?
Idiopathic Vestibular Disease" (IVD) is a disorder of the organs of balance
(vestibular apparatus), situated in the middle ears. Their function is to
maintain equilibrium (balance) by coordinating movements of the head with the
eyes, trunk and limbs. Failure of this system results in a tilting of the
head, abnormal body posture, loss of equilibrium, abnormal eye movements and
incoordination as the body tries to compensate. Vomiting occurs because the
loss of balance and incoordination, in a sense, make the patient "sea sick" or
nauseous.
There
are many causes of vestibular disease. Degenerative processes of the body,
inflammation, cancer, trauma and poisons are some of the known causes. Most
commonly, the disease can be related to an inflammation of the organs of balance
due to an ear infection. However, in some cases, the cause is simply not
known. In these situations, the disease is termed "Idiopathic Vestibular
Syndrome". The term "Idiopathic" means that veterinarians do not know why this
disease occurs..
When
IVD affects middle-aged or older dogs , which it commonly does, it is called
"Geriatric" or "Senile" Vestibular Syndrome. It can also occur in cats at any
age, and it occurs most often in the summer and early fall (75% between June and
September).
When it
occurs, IVD is usually sudden in onset and often incapacitating. The pet
usually has a loss of balance, disorientation, unsteadiness and a pronounced
head tilt. The degree of head tilt can vary considerably and there are usually
involuntary rapid movements of the eyes. There may also be a tendency for the
animal to walk around in a circle in one direction. Some animals will be
listless, refuse to eat, pant and be nauseated.
At this
point, many owners often think that their dog or cat has had a "stroke" or a
fatal brain hemorage and suspect the worst. In some cases, pet owners have
mistakenly euthanized their pets, thinking that their pet's prognosis is poor
and the situation hopeless. Nothing could be further from the truth. Pets with
IVD, although confused and anxious at times, are not in pain and there is no
reason for euthanasia. Relapses usually do not occur.
In
fact, there is no treatment for this disease nor does any appear to be necessary
since all patients appear to recover on their own. In some cases, a slight head
tilt may be the only clinical sign that persists. Supportive therapy, if
required, generally consists of preventing self-injury and ensuring adequate
nutrition. Should your dog shows signs of this disorder, contact your
veterinarian to confirm that this is the problem with your pet.
Here is a story by one of our
members concerning her experience with Vestibular Disease
NO,
stop! It's not a stroke!
By Christine Jackman
 One Saturday morning, I noticed that Alex was having trouble walking. In fact,
he was staggering around like he was drunk. I immediately thought "stroke!"
After all, Alex was 12 years old and I felt that each additional day with him
was a gift. I immediately called my vet and we headed straight there. I can
remember supporting him with my body on his left side as we walked up the ramp
to the vet's door because he wanted to "fall to the left." I waited in the
waiting room not wanting to face the fact that this may be my last time with my
best friend. After a brief examination, my vet told me that Alex had canine
vestibular syndrome, and she warned me that it was going to get worse before it
got better. She sent me home with some antibiotics in case of an infection and
some medication to help with the increasing dizziness, or sea-sickness, which
was going to soon set in...
The vestibular system is the neurological system which controls balance by
holding the head and body in a relative position to gravity and space. It is
located in the inner ear and connects to the brain. Canine vestibular syndrome
is also referred to as "old dog vestibular syndrome" and "geriatric vestibular
syndrome" since it commonly occurs in older dogs with an average age of 12 - 13
years.
The most common causes of vestibular syndrome are due to a middle ear infection,
a brain lesion or it can simply be idiopathic, which means that there is no
known cause.
The symptoms, which come on very suddenly, include:
- Ataxia (stumbling and staggering)
- Motion sickness
- Nystagmus (rhythmic movement of the eyes)
- Circling and falling to one side
- Head tilt where one ear is held lower than the other
These symptoms gradually disappear within two weeks, and most dogs fully
recover. Some dogs may retain a slight head tilt, which does not seem to bother
them, and they live the rest of their lives quite happily. Since there is no
cure for this syndrome, the most important thing is to help the dog during the
recovery period.
Well, my vet was right about the getting worse part. Alex's condition quickly
got worse until he could no longer stand and his eyes began to dart back and
forth. I fixed up his bed where I could keep watch over him at all times. I
spent the entire days of Sunday, Monday and Tuesday never leaving his side.
Because he could not get up to eliminate, I placed urinary pads under him, and
each time he urinated, I gently rolled him over to the other side, cleaned his
soiled coat, replaced the pad and repositioned him on his opposite side. I'm
sure it must have been quite scary to be rolled over while already trying to
cope with dizziness, but he cooperated without a struggle.
After 12 years together, I guess our trust in each other was implicit.
Periodically, I would lift up his head and shoulders, propping him up with my
body while I directed his head to his water and food bowls. Surprisingly,
though Alex was immobilized, he was still thirsty and hungry as usual, although
it was quite the trick to keep his head steady enough to find the water or food
in his bowl! After meals, I watched for the tell-tail (no pun intended!)
lifting of his tail after a meal to alert me that he was having a bowel
movement, and I quickly whisked it away. At night, I put down cushions and
slept next to him, touching him so that he would know I was there-he seemed very
comforted by that and rested peacefully through the nights.
Finally on Tuesday afternoon, Alex began
showing signs of wanting to get up! After much steadying, he was able to stand,
and we practiced taking some wobbly steps around the room. After making some
ramps to get him down the two sets of small steps to get outside, we finally
made the attempt to go outside. I think he was as excited as I was to finally
be able to urinate outside!! We walked around a bit with me on the left
awkwardly trying to keep him from walking in circles, while trying to keep up
with his quick forward steps!
Remember how you felt as a child when you spun around in circles and then tried
to walk? Well, that was Alex, with me trying to keep him steady-quite the sight
for my neighbors, I'm sure! By Wednesday, Alex was recovered enough for me to
go back to work. He retained his head tilt for another week or so and then that
eventually disappeared too. I could not believe that my "old man" was able to
recover from such a debilitating condition with absolutely no side effects! And
he lived happily for another 2 years!
The important message to remember in this article is that stroke, or vascular
disease, is very uncommon in pets. So please, do not wrongly assume that your
dog has had a stroke and needs to cross the Rainbow Bridge. See your vet.
While canine vestibular syndrome is very debilitating, it is a short-lived
syndrome which, with a few days of compassionate nursing, can result in many
more years of enjoyment with your best friend.
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