• Ear cytology: A sample of debris from the ear canal is collected which identifies if yeast, bacteria, mites (or a combination) is causing an ear infection. Not all ear infections extend past the ear drum into the inner ear. Based on symptoms, the physical exam, and test results, your veterinarian can determine if an ear infection is the likely cause of the vestibular disease.

• Complete blood count: Confirms or denies other systemic infections or blood-related abnormalities like anemia that may also cause stumbling similar to vestibular disease.

• Internal organ function or biochemistry test: Although it cannot determine cancer or tumor location, this test can suggest if further cancer or other organ dysfunction testing is needed.

• Urinalysis: Results, in conjunction with other tests, identify if an underlying condition may be the cause of the vestibular disease.

• Advanced imaging: X-rays (radiographs) or CT (computed tomography) scans confirm the suspicion of polyps or tumors.

• older dog

• sudden onset of peripheral vestibular signs

• no detectable cause (i.e., no signs of outer- or middle-ear infection, ototoxicity, trauma, hypothyroidism, infectious disease, etc.)

• signs resolve over several weeks

 

What are common symptoms of vestibular disease in dogs?

How is vestibular disease treated?
Treatment is directed at the underlying cause, if one can be identified. In severe cases, supportive therapy such as intravenous fluids and hospitalization may be required until the dog can eat and walk on its own. If the dog is seriously disoriented or ataxic (stumbling, unable to stand or walk), it may be given sedatives to help it relax. Drugs that help combat nausea or motion sickness may be beneficial. Antibiotics may be used in cases suspected of having middle or inner ear infections. Although corticosteroids have been used in the past, there is little scientific evidence to support their use in this condition and are generally not recommended.

What is the prognosis for a dog diagnosed with vestibular disease?
The clinical signs associated with vestibular disease are often most severe during the first twenty-four to forty-eight hours. Many pets begin to improve within seventy-two hours. The head tilt and stumbling often improve over a seven to ten-day period. Most patients are completely recovered within two to three weeks, although some will have residual symptoms such as a head tilt or mild “wobbling” for life.

If the patient fails to improve or worsens, then a more severe underlying disorder should be suspected, and advanced diagnostic testing should be pursued. A referral to a veterinary neurologist may be advised.  You should see a vet immediately if your dog or cat shows any of these signs mentioned above.

 

 

Contributors: Malcolm Weir, DVM, MSc, MPH; Ernest Ward, DVM