Section: Overview
The vestibular system is primarily responsible for keeping the head and body in the correct orientation with respect to gravity.
This system will alert the brain if we are standing, sitting, lying down, falling, spinning in circles, and keeps the body balanced. The vestibular system is comprised of nerves that start in the brain and continue to the inner ear. The sensors in the inner ear are responsible for informing the brain about any movement. Vestibular disease affects the ability of the brain to recognize abnormal body positions and also affects the brain's ability to correct these abnormalities.
Disorders of the vestibular system are divided into central vestibular disease and peripheral vestibular disease.
Central vestibular disease occurs due to an abnormality within the brain. Peripheral vestibular disease occurs due to an abnormality within the nerves of the inner ear. Most cases of vestibular disease are peripheral and no known cause is determined. These are referred to as idiopathic.
Vestibular disease typically affects older dogs with an average age of 12 to 13 years.
Animal afflicted with vestibular disease become suddenly very dizzy and the symptoms can be very drastic and frightening to the owner.
What to Watch For
Falling
Incoordination
Head tilt to one side or another
Circling
Rolling
Eyes continually drifting side to side or up and down
Stumbling or drunken walking.
Diagnosis
Vestibular disease can affect an animal very suddenly. Due to the signs of head tilt, circling and staggering, many owners feel their pet has had a stroke. Fortunately, strokes are rare in animals.
Veterinary care should include diagnostic tests and subsequent treatment recommendations. Other disorders that result in signs similar to vestibular disease include:
Inner ear infections
Thiamine deficiency
Head trauma
Metronidazole (antibiotic) toxicity
Middle ear polyps
Middle ear cancer
Diagnostic tests are needed to determine the presence of an underlying disease or cause for the vestibular disorder and to differentiate vestibular disease from other disorder affecting the balance system of the body. Vestibular disease, for which an underlying cause cannot be determined after thorough diagnostic evaluation, is called idiopathic.
Tests may include:
Your veterinarian will take a complete medical history and perform a thorough physical examination including a complete neurologic examination and complete examination of the ear canal.
Blood tests may be recommended to determine your pet's general health and the presence of an underlying disease that may be causing the vestibular disease. Recommended blood tests may include:
A complete blood count (CBC or hemogram)
Serum biochemistry tests to evaluate blood glucose, liver and kidney function and electrolytes
Urinalysis
Other diagnostic tests may be recommended based on the results of the history, physical examination and initial laboratory tests such as spinal tap, CT, MRI or skull x-rays.
Treatment
Results of the history, physical examination and initial laboratory tests will determine the need for further diagnostic tests and will help determine the appropriate treatment for your pet's vestibular disorder. Treatment will be dictated by the underlying cause. When possible, the specific underlying cause of the vestibular disorder should be treated. Idiopathic peripheral vestibular disease generally slowly improves over the course of one to two weeks and little treatment is needed.
Due to dizziness, some pets benefit from motion sickness medication such as meclizine or diphenhydramine.
For central vestibular disease, treatment is specific for the cause of the disease.
Home Care and Prevention
Call your veterinarian promptly if your pet is showing signs of vestibular disease. This is a frightening experience for your pet so speak calmly and soothingly. Make sure he does not injure himself. Avoid steps and watch for worsening of signs such as vomiting or seizures.
For idiopathic vestibular disease, there is no known preventative since the cause is not known. For other causes, avoid traumatic incidence by keeping your dog on a leash or in an enclosed area. Keep your pet vaccinated and avoid exposure to poisons or toxins.
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