Old Dog Vestibular Disease

Old Dog Vestibular Disease

This post is intended to be a dog owner’s guide to old dog vestibular disease.

Imagine your old dog suddenly becoming wobbly and walking unsteadily, her head tilted, her eyes flicking back and forth, and she looks totally disoriented.

What would you think has happened to her?

A stroke?

Possibly… but it could also be an episode of old dog vestibular disease.

What is Vestibular Disease?

Before answering this question, let’s talk a bit about vestibular system or apparatus.

The canine vestibular apparatus is an organ responsible for balance. It consists of two components.

One component (the peripheral component) has sensors and is located in the middle and inner ear. The other (the central component) is the “control center” located in the brain.

The purpose of the vestibular system is to synchronize eye movements and maintain posture, balance, and coordination.

Vestibular disease occurs when there is a problem in either component (peripheral or central) of the vestibular apparatus.

When that happens, the dog does not know where he is spatially, where to put his feet, and how to maintain balance and a steady gait.

Vestibular disease in dogs usually occurs very suddenly, without any prior warning.

Old dogs are more prone to this problem. That’s why sometimes vestibular disease is also called “old dog vestibular disease” or “old dog syndrome”. Despite the name, vestibular disease can also occur in young dogs.

Symptoms of Old Dog Vestibular Disease

Typically, the dog feels very dizzy, which can cause him to drool, feel nauseous, and vomit. Because of that, he may not want to eat or even drink.

He is disoriented and lacks coordination, so he can stumble and fall down easily.

His head is titled to one side, and has rapid irregular back-and-forth eye movements (nystagmus).

As you can imagine, this can be very scary both for the dog and the dog parents! Some dog parents may think that their dog has just had a stroke, which shares a lot of similar symptoms.

That’s why it is very important to get the dog to the vet to rule that out.

What Causes Old Dog Vestibular Disease?

Peripheral vestibular disease can be caused by many things.

The most common cause is “idiopathic vestibular syndrome”, meaning vestibular disease with unknown cause! This tends to occur in older dogs. Symptoms usually peak in 24-48 hours, and gradually improve on the 3rd or 4th day.

If your older dog suddenly shows some of the above symptoms, but improves rather rapidly (in a matter of days) without any treatment, then there is a high chance that he has had an episode of idiopathic vestibular syndrome.

For peripheral vestibular disease that is not “idiopathic”, possible causes include:

  • Chronic or recurrent middle or inner ear infections
  • Perforation of the ear drum caused by vigorous ear cleaning
  • Head trauma
  • Hypothyroidism
  • Certain antibiotics (such as gentamycin, tobramycin)

Central vestibular disease is less common but is a more serious condition. It can be caused by something more nasty such as brain tumors, infections (due to bacteria, fungus, or protozoa), head trauma with brain hemorrhage.

Diagnosis and Treatment of Vestibular Disease

When old dog vestibular disease does happen to your dog, you need to get him to the vets asap so that they can figure out which area (inner ear or brain) is causing the problem.

There are a few clues though to distinguish between peripheral and central vestibular disease:

If the eyes are flicking up and down rather than side to side, usually the problem is in the brain.

Also, if the dog has diminished mental awareness (e.g. depression, decreased consciousness), and if he has real difficulties placing his limbs and positioning his feet correctly on the ground, then chances are the brain is affected.

If the dog has a weakened jaw, and/or head tremor, then it’s likely to be central vestibular disease.

Of course, a definitive diagnosis can only be made by the vet after a thorough physical examination, blood and urine tests, and otic (ear) exam. Sometimes, CT scan or MRI is required.

The vet usually will diagnose the dog as having idiopathic vestibular disease if:

  • The dog is older
  • The problem happens suddenly
  • The vet cannot find any underlying cause, and
  • The symptoms go away in a matter days or a couple of week

If an underlying cause is found, then treatment will be directed at the cause.

If no underlying cause is found, then treatment usually includes supportive care. For example, anti-nausea drugs will be given to help with motion sickness. If the dog is really stressed, some sedatives may be given.

Home Care

How can you help if your older dog has just had an episode of idiopathic vestibular disease?

Make Sure Your Dog Eats and Drinks

The first thing to do is to make sure that he drinks enough water to stay hydrated. If he doesn’t want to drink water, try giving him some homemade chicken broth (no salt). The taste may entice him to drink. At the same time, he can get some nutrients from the broth as well.

Very often, the dog is too dizzy and nauseous to eat, especially if the food is hard and dry like kibbles. Sometimes, after an episode of vestibular disease, some dogs may have weakened jaws, or jaws that become painful when opened.

Try soaking the kibbles in warm water to make them softer and easier to eat (the food will have more aroma as well). You may need to hand feed the dog in the first few days.

If that doesn’t work, make some real yummy food for him. For example, get some ground chicken or turkey and cook it with rice. Add some fresh or powdered ginger to the mix. Ginger has anti-nausea properties and can help settle the dog’s stomach.

Help Your Old Dog Relax

If the dog is stressed out and cannot relax, try using Bach Rescue Remedy. Put a few drops in his drinking water and let him drink throughout the day.

Making a room spray with essential oils that have calming effects (e.g. Lavender, Roman Chamomile) can also help.

Add 5-6 drops of Lavender or Chamomile to a 15-ml spray bottle filled with water. Shake well each time before spraying. Use it to spray the dog’s bed, and the room.

Help Your Old Dog Move

For bigger and heavier dog, you may need a support harness to help him get up and go outside to potty.

To enhance and speed up recovery, help your dog up and help him stand for at least 5 minutes every hour.

For idiopathic vestibular disease, the symptoms usually improve within a few days, but some dogs take longer to recover. Some may also have a permanent head tilt and may even be a bit wobbly for a while.


If your dog is diagnosed with idiopathic old dog vestibular disease but his symptoms do not improve (or get worse) within days, take him back to the vet immediately. There is a higher chance that the problem is caused by a more severe health issue, such as a stroke, or brain tumor.