Geriatric Vestibular Disease in Dogs: Timeline and Home Care

It happens most frequently in older dogs, which is why it's also known as old dog vestibular disease.¹ Your dog still needs a vet visit, because the same signs have other causes. Everything below sits alongside our wider guide to caring for an older dog.

What geriatric vestibular disease is, and why it looks so frightening

The vestibular system helps a dog maintain balance and move normally, with central components in the brain and peripheral components in the inner ear and the nerves connecting it to the brain.²

Signs usually develop suddenly, often in less than an hour.² They include sudden loss of balance and coordination, falling or circling to one side, involuntary darting eye movements called nystagmus, reluctance to stand or walk, and nausea, vomiting or reduced appetite.² Most dogs will be reluctant to walk or stand and will often fall or lean in the direction of the head tilt.¹

The timeline most dogs follow

Signs are often most severe during the first 24 to 48 hours, many dogs begin to improve within 72 hours, and the head tilt and stumbling often improve over a 7 to 10 day period.² If a dog with canine idiopathic vestibular syndrome improves over the first two to four days, there is a good chance for a full recovery.¹ Most dogs recover completely within two to three weeks, although some may have a lasting head tilt or slight unsteadiness.²

Why the vet still needs to see your dog

Old dog vestibular disease is only diagnosed when the vet runs tests and still can't find any specific cause.¹ Other causes include an ear infection in the inner or middle ear, hypothyroidism (an underactive thyroid gland), tumours or polyps in the middle ear, trauma to the ear such as a ruptured eardrum and, very rarely, a reaction to medication.¹ Middle ear inflammation can progress to inner ear inflammation, which can cause balance loss and deafness.³ If the infection spreads beyond the inner ear to the brain, other neurological signs can appear, and that changes the picture.³

Your veterinarian will diagnose vestibular disease based on your pet's medical history and physical, neurological and ear examinations.² Additional tests, including blood and urine tests, ear examination and sometimes scans to look for tumours or other brain abnormalities, may be recommended to identify the underlying cause or rule out more serious conditions.² If your dog does not improve or gets worse, a more serious underlying disorder may be present, and your vet may recommend advanced testing or referral to a veterinary neurologist.²

Vestibular disease or something in the back end?

Degenerative myelopathy, a disease of the spinal cord, causes slowly progressive hind limb weakness and paralysis,⁴ and its first signs can be subtle, like your dog dragging a rear foot, having a wobbly gait, or taking a wrong step here or there.⁵ The hind paws knuckle or turn under, and the hindquarters appear to sway when standing still.⁴ In its early stages it can resemble arthritis, which often occurs secondary to hip dysplasia (a poorly formed hip joint) in large breed dogs,⁴ so a vet exam matters here too. There is more on tracking these changes in our notes on what to watch for as a dog ages.

Nursing your dog through the first few days

Make the world small, soft and flat. In less severe cases, nursing care at home will likely be sufficient, and this care includes helping your dog get up, walk and go to the bathroom, plus help with eating, drinking and keeping clean in case of accidents.² Eliminate dangers in the environment, such as stairs and slippery floors, and keep your dog calm and quiet.¹ If your dog's balance is affected, restrict activity to prevent falling injuries, and you may need to temporarily hand-feed, as moving their head down into a dish may stimulate nausea.⁶

Practical extras: pen the dog in on rugs or yoga mats, block ponds and pool steps, turn a dog who cannot shift position, keep bedding dry, and carry rather than walk them to the yard. A supportive, easy-to-clean bed for an older dog helps. Dogs often panic in this state, and our piece on anxiety in aging dogs may help you settle them.

Slings, support and when a wheelchair fits

Hold the dog under the belly and chest, not by the collar. A folded towel under the belly works for the first days. Management of degenerative myelopathy includes using rugs, carpets or yoga mats on hard floors, adding ramps or steps, using a sling or harness to assist with walking and standing, booties to protect scuffed paws, and considering a wheelchair to support the hind limbs.⁷

The nature and temperament of the affected dog determines whether a mobility aid, such as a wheelchair, will improve their quality of life in the short term.⁴ The OldPal Rear Support Dog Wheelchair comes in five sizes and is fitted from one measurement, rear leg height. Take that measurement with the size guide and fit finder, or email a photo to help@oldpalpets.com.

Getting steady again

Physical therapy has been shown to slow progression, prolong quality of life and preserve muscle mass in dogs with degenerative myelopathy, and keeping an affected dog as physically active as possible for as long as possible is recommended.⁴

Call the vet now if

• There is no improvement by 72 hours, or signs are getting worse
• Your dog cannot swallow, has facial droop, seems dull or confused, or has a seizure
• Your dog cannot eat or drink normally due to nausea or disorientation. Hospitalization for fluids given through a drip is generally warranted then, as nausea must be controlled and dehydration avoided.⁶
• Your dog was already weak behind before this started

Frequently asked questions

Related guides

• Caring for a senior dog, day to day
• Signs your dog is aging
• Helping an anxious older dog
• Choosing a bed for an older dog

Sources

Related guides

• Aging Dog Symptoms: Arthritis or Nerve Damage