Idiopathic Vestibular Disease

A dog with pet insurance is treated for Idiopathic Vestibular Disease.

By: Dr. Fiona Caldwell
For Pets Best Insurance

Idiopathic vestibular disease is a pet health condition that can initially be terrifying to any pet owner. Imagine one day your older dog is fine, then the next she is falling down to one side, sometimes even rolling because she can’t keep her balance and her eyes are jerking back and forth.

Owners often fear the worst, thinking that their pet can’t possibly recover from such a horrible disease. We often think of it like a ‘stroke’, which can cause one sided symptoms in people, but the disease is actually very different, and when appropriately diagnosed, generally has a much better outcome. And if you have Pet insurance through a company like Pets Best Insurance, you can rest easy knowing 80% of the vet bill will be reimbursed to you.

The vestibular apparatus controls our sense of balance. It allows us to orient our bodies in relation to our world. If the floor were tilted, you could lean to compensate for this and still maintain your balance. There is a left and a right side which each gathers information from our world to transmits this to the brain. If all of a sudden one side isn’t working anymore, this one sided information wreaks havoc on the brain, which thinks its world is spinning or lopsided. The patient will tilt their head, jerk their eyes or fall to one side, thinking their world is off balance.

Part of the vestibular system is located in the middle ear, and the vestibular nerve exits from a specific location on the brainstem. The three most common reasons for vestibular disease include an ear infection, a brain lesion and idiopathic, meaning nobody knows exactly why it occurred. Clinical signs of vestibular disease include ataxia, or incoordination, head tilting or turning to one side, and nystagmus, or jerky eye movements. Patients will often feel intense dizziness or even vertigo, which can lead to motion sickness and nausea, thus many animals will vomit as well.

Vestibular disease is often mistakenly referred to as a ‘stroke.’ A stroke is a vascular accident that cuts off blood flow to a certain portion of the brain. While this is a rare cause of vestibular disease, generally this isn’t a true stroke, as there has been no vascular accident in most cases.

A central brain lesion causing vestibular disease can be a very serious, and often pets won’t recover well from this. Advanced imagining, such as MRI or CT scan is often needed to diagnose exactly where the brain has been affected, how serious it is, and whether it can be treated. Although these diagnostic tools can be expensive, many pet insurance companies will cover them. Ear infection causing vestibular disease has a much more favorable prognosis, treating the ear infection generally leads to recovery. Idiopathic vestibular disease, or “old dog vestibular disease” is the most common vestibular disease seen in cats and dogs. Interestingly, cats in the northeast united states are most likely to get this disease in the late summer and early fall.

It is important to immediately take your pet to the veterinarian if he or she is having symptoms of this disease so that it can be determined if there is central lesion, or an ear infection. Since this disease affects almost exclusively older pets, it is a good idea to have screening blood work performed to ensure there are no other underlying diseases. Once idiopathic disease is confirmed, treatment generally involves controlling nausea and letting the disease take its course. Usually there is noticeable improvement in balance within 72 hours. Most pets are nearly normal within weeks.

There will be intensive nursing care in the beginning, as your pet will have trouble going outside to potty and getting to the food dish. It is important to protect them from stairs or slippery surfaces where the pet could potentially harm themselves. It is also equally important to challenge them too! They have to re-learn to use their bodies. Provide sure footing, like carpet or grass and encourage them to try to get around. After recovery, most pets can return to their normal lifestyles.

While this disease is frightening and terrifying in the beginning, your veterinarian can help assure you that idiopathic vestibular disease carries a great prognosis. It’s one of the few diseases where you really can relax and know that things will improve and your pet will get better.


  • Noah Rosmarin

    Our family cat was diagnosed with vestibular disease about 4 months ago. After it did not heal during the normal time period, she had surgery at Tufts Vet Hospital in January where a significant amount of fluid was removed. While she is eating much better and has shown a little improvement, she is still having balance problems, seems disoriented and no longer plays like she used to. The vet said to try motion sickness pills, but this made things worse.

  • Vestibular Diease in Dogs and Cats.

    Our dog, a lab and greyhound mix, has been afflicted with this malady for the second time about 1.5 years after the first.
    The first time it was entirely debilitating and he became a quadraplegic zombie. He could not stand or drink or eat for about 24 hours. He was unresponsive and his eyes would dart back and forth continuously and unconsciously. After that period and a shot of steroids from the Vet he slowly recovered. We used a harness to hold him up to go to the bathroom. We fed him rice and broth to keep him hydrated. We stayed with him day and night to make sure he was comfortable and safe. Eventually the symptoms subsided and we got our friend back. He continued to show reduced symptoms for months.
    A few days ago he started to walk erratically and stumble a bit more than usual.
    He is 15 years old after all. Then he kind of fell into a wall which was similar to his former state, but not total. We quickly got him to the vet for a steroid shot the same day.
    He did get worse but not to the point of total collapse like before.
    We just needed to watch him more often and help him down the porch stairs as he was unsteady and fell every now and then. But he could eat, drink, and eliminate as normal with a little help to keep him upright and steady.
    He is now recovering and is back to maybe 70% normal. I can take him for short walks (10 min). I expect him to be around 90% in a week or so.
    I am also giving him a baby aspirin at the vet’s recommendation.
    He looks better every day.
    The main reason I wanted to post this is to let people know that the steroid shot, while not a cure, seems to have helped shorten and lessen the period of disability. I have not seen this mentioned before on the internet and maybe it can be useful to others where the cause of the vestibular disease is not known (idiopathic). Our vet ruled out ear infection and we have not scanned for brain lesions, but those are pretty rare, I guess.

  • Rebecca P

    I appreciate these posts. My cat has been at the emergency hospital for almost 48 hours now with no improvement. He is also essentially a quadraplegic. He is receiving antibiotics (in case it is an ear infection) and steroids. I have been told that the steroids can almost work “miracles” in these cases, so I am hoping that will be the case. He is only about 6 years old.

  • I really appreciate this as well, my cat, Harley, who is 4 years old is now at almost 3 weeks of this disease. The first 3 days were terrible, we had to force feed her and hydrate her with an IV. She is now not falling over – as much, still falls over several times a day. Sometimes she eats good, sometimes she doesn’t but she is drinking water now. She will not jump up on anything as she fell off so many times, hoping that she gets that back. She still does not play like she used to but she is much better and I hope she recovers 100% soon!


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