Searching For Balance: Managing Canine Idiopathic Vestibular Disease
When Deb Hipp noticed her 17-year-old dog, Toby, was having a hard time getting up, she thought he might just be having a bad day. He had experienced problems with mobility before; however, when Hipp tried to rouse him again later, she noticed Toby had a noticeable head tilt.
Alarmed, Hipp rushed Toby to the veterinary hospital. After a thorough exam, Toby’s veterinarian put Hipp’s fears to rest with a diagnosis of canine idiopathic vestibular disease, which is sometimes also referred to as “old dog disease” or “rolling dog syndrome.”

The diagnosis came with a hopeful prognosis that proved to be true: Toby fully recovered within several days.
What is vestibular disease?
The vestibular system is made up of organs and canals located within the inner ear. According to the Vestibular Disorders Association, “the vestibular organs provide the brain with vital information about body position with respect to gravity.”
The word “idiopathic” indicates that a cause has not been determined.
“Just as with some people who experience vertigo, we don’t always know what causes this condition,” said Patrick Mahaney, VMD, owner of California Pet Acupuncture and Wellness, Inc. in West Hollywood, California.
Signs of canine idiopathic vestibular disease include:

  • Loss of balance, appearing dizzy, or falling over
  • Difficulty rising or walking
  • Nausea or vomiting
  • Circling or rolling
  • Tilting the head to one side

If you notice any of these signs, it is important to contact your veterinarian immediately.
“These symptoms can also be signs of something more serious, such as a brain tumor, so it is very important to take your dog in to a veterinarian for a full exam,” said Daniel Fletcher, PhD, DVM, DACVECC, associate professor of emergency and critical care at Cornell University College of Veterinary Medicine.
Diagnosis and treatment
Fletcher said vestibular disease is presumptively diagnosed after a thorough exam, which includes observing the dog’s eye movements, behavior, reflexes, nerve responses, and gait. Your veterinarian may also ask questions about the duration and severity of the signs, including whether they appeared gradually or suddenly. Lab work and X-rays may be ordered to rule out any other possible causes.
While most cases of canine idiopathic vestibular disease do not require hospitalization, Fletcher said confinement is encouraged at home to prevent falls or other injuries. Owners are also advised to refrain from allowing the dog on furniture or to walk up or down stairs.
If you have a large dog, your veterinarian can show you how to use a towel or sling to help him walk or posture to relieve himself.
If your dog is experiencing extreme difficulty eating or drinking, he may be hospitalized and given fluids to keep him hydrated. Medication may be prescribed to alleviate nausea and vomiting, and sedation can also be helpful in some cases to prevent circling or rolling.
Most dogs diagnosed with canine idiopathic vestibular disease fully recover within one to two weeks, though it can reoccur, Mahaney said. Typically, the head tilt takes the longest to resolve.
“The important thing is for owners to be patient,” he said.
If your dog has been diagnosed with canine idiopathic vestibular disease and is not improving within a week, Fletcher recommends scheduling a follow-up visit with your veterinarian for further evaluation.
Kerri Fivecoat-Campbell is a freelance journalist who has written about animal welfare for more than two decades. She lives in the Ozark Mountains with her husband of 30 years and their five recycled (rescue) dogs. Her book, “Living Large in Our Little House: Thriving in 480 Square Feet with Six Dogs, a Husband and One Remote” was published by Reader’s Digest Books in June 2016.

Oregon Veterinary Specialty Hospital (OVSH) has been serving the Portland and Beaverton area community since 1979. Drs. Steven F. Skinner (Neurology, Neurosurgery) and Robert T. Franklin (Internal medicine.) We welcome referrals from veterinarians all over the Pacific Northwest. Our goal is to help your pet regain health and live a long and happy life.

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