Few things unsettle pet parents more than seeing their dog suddenly lose balance—leaning or falling to one side and struggling to hold its head upright. Many pet parents rush to Google the symptoms and quickly find the term vestibular disease in dogs. But what does that actually mean, and is it as serious as it looks?
As veterinary neurologists, we see dogs with vestibular signs almost every day. The good news is that many of these dogs recover. The challenge is that not every case is the same. Understanding what’s really going on and acting quickly can make a meaningful difference in your dog’s prognosis. Here are seven things every pet parent should know about vestibular disease in dogs.
The term “vestibular disease” can be misleading because it doesn’t refer to a single illness. Instead, it describes a group of symptoms caused by problems affecting the body’s balance system.
The balance system, or vestibular system, has two main parts:
Problems affecting the central vestibular system are generally more serious than those in the peripheral vestibular system.
When the vestibular system is disrupted, dogs may suddenly:
Saying a dog has vestibular disease simply means that something is disrupting these balance pathways—it doesn’t tell us where the problem is or what is causing it. Determining whether the issue is peripheral or central is key to guiding treatment and understanding the likely outcome.
Nystagmus is rapid, involuntary eye movement and is one of the most telling symptoms of vestibular disease in dogs. Its direction provides valuable information about the cause.
These patterns might look like small quirks to the untrained eye, but they provide critical information. Combined with other neurological findings, they help veterinarians prioritize likely causes.
This is one of the most misunderstood aspects of vestibular disease in dogs. Even when your veterinarian looks in your dog’s ear and says it appears clean, there could still be a problem deeper inside.
The middle and inner ear, where the vestibular structures live, aren’t visible with a simple otoscope. An ear canal can look clean while deeper structures are affected by:
These hidden problems can cause severe balance problems while leaving the visible ear canal looking perfectly normal. That’s why advanced imaging, such as MRI, is sometimes the only way to find the true source of the issue.
Because vestibular disease can stem from many causes, advanced imaging is often recommended. MRI allows neurologists to see details of the brain and inner ear that no physical exam can reveal.
Vestibular signs can arise from problems in the inner ear (peripheral vestibular disease) or within the brain itself (central vestibular disease).
Peripheral causes are usually less serious and resolve with treatment or even natural compensation:
Central causes are more serious and usually require specialized treatment:
MRI doesn’t just reveal which underlying cause is responsible, but also how serious it is. Knowing the exact cause and severity allows veterinarians to choose the most appropriate therapy and provide a more accurate prognosis.
Neurologists don’t call a case “idiopathic” until more serious causes have been ruled out, ensuring that your dog isn’t sent home with a “wait and see” plan when there’s actually a treatable—or dangerous—condition.
In certain cases, the problem isn’t just in one spot. A severe or chronic ear infection can erode bone and extend into the brain, leading to both peripheral and central vestibular disease at the same time.
These complex cases can cause additional symptoms such as:
Treatment might include ear surgery to remove infected tissue, long-term antibiotics, and medications to control inflammation in the brain. Recovery can take weeks to months, but many dogs do well once the infection is fully resolved.
One of the most common and fortunately least serious types of vestibular disease in dogs is canine idiopathic vestibular syndrome, also known as “old dog vestibular disease.” This condition tends to affect senior dogs suddenly, often overnight, with a dramatic head tilt and staggering walk.
Despite the severity of the onset, many dogs begin improving within three days, even without specific treatment. The improvement over time is actually one of the biggest clues that it’s idiopathic.
Supportive care is still important: anti-nausea medication, good hydration, and safe, padded rest areas can help your dog feel better while the body’s natural compensation process takes over. Most dogs recover fully within two to three weeks, although a small head tilt may persist.
It’s important not to assume that vestibular disease in older dogs is always idiopathic. There are a lot of other conditions affecting older dogs that can cause vestibular symptoms, and idiopathic vestibular disease is a diagnosis of exclusion, meaning it can only be confirmed after ruling out more serious conditions.
True idiopathic vestibular disease usually only happens once. If your dog experiences repeated episodes, it’s a sign that something else may be at play.
Recurrent or progressive symptoms raise concern for conditions such as:
Any recurrence warrants evaluation by a veterinary neurologist.
For most dogs, especially those with idiopathic or peripheral causes, the prognosis is excellent. Central (brain-based) causes can carry a more guarded outlook, but early diagnosis and treatment make a meaningful difference.
The key takeaway? While the sudden onset of vestibular signs can be frightening, many dogs recover when they receive an accurate diagnosis and proper treatment. If your dog is showing any signs of vestibular disease, contacting Southeast Veterinary Neurology (SEVN) ensures a thorough evaluation, proper diagnosis, and the best possible treatment plan for your pet. Reach out right now to one of our Florida hospitals in Miami, Boynton Beach, and Jupiter, or to our Virginia Beach, VA location!
Can vestibular disease in dogs go away on its own?
Yes, especially with the idiopathic form, which is most common.
Is vestibular disease painful for dogs?
No. While it’s disorienting, it’s not typically painful.
Can vestibular disease in dogs come back?
Recurrence is uncommon, but can happen depending on the cause. Always have your dog rechecked if signs return.
Is vestibular disease in dogs the same as a stroke?
While strokes can cause vestibular symptoms depending on the area of the brain affected, vestibular symptoms can be secondary to many other causes apart from stroke.