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Why Is My Dog Walking Like a Drunken Sailor?

If you have an older dog, they could have a condition called idiopathic vestibular disease. Here's everything you need to know.

by Dr. Shea Cox
July 9, 2021
Two brown senior pointer dogs
Studio Porto Sabbia / Adobe Stock

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When a dog suddenly starts walking like a drunken sailor, with their head tilted, many pet parents assume it's due to a stroke or seizure. Some even think it's a brain tumor. And while it’s natural to think the worst when these symptoms arise, they — along with some other disturbing signs — can also indicate a much less serious condition called idiopathic (meaning unknown cause) vestibular disease in dogs. It looks really bad, but it often improves on its own with little or no treatment.

According to Dr. Beverly Sturges, DVM, associate professor of clinical neurology/neurosurgery at the UC Davis School of Veterinary Medicine, another name for this illness is “old dog” vestibular disease, because it’s most often seen in geriatric dogs and its cause is typically unknown. “It’s benign. We still have no real understanding why it occurs,” she says. “It’s self-limiting, [requiring] no treatment except supportive care and comforting the dog.” 

What Are the Symptoms of Vestibular Disease in Dogs?

A dog’s vestibular system is composed of portions of the brain and ear and is responsible for maintaining balance. When something goes wrong within this system, it’s like being drunk on a rocky boat. Dogs with idiopathic vestibular disease typically show some combination of the following signs:

  • A head tilt

  • An unsteady gait, loss of balance, or falling over (ataxia)

  • Circling in one direction

  • Eyes rapidly moving from side to side (nystagmus)

  • Sudden vomiting

Now for the caveat: These clinical signs are unfortunately not unique or diagnostic for idiopathic vestibular disease. Other things can cause this same presentation such as a brain tumor, an inner ear infection, inflammatory disease, or sudden brain bleeds — to name a few. The sudden onset of vestibular disease and a seizure can also be hard to tell apart. If your dog is experiencing these symptoms and the diagnosis is unclear, do your best to record the episode and show it to your vet so they can closely examine the signs.

How is Vestibular Disease in Dogs Diagnosed?

For a dog showing the above signs, I first discuss the possible causes. Next, I recommend blood work and a blood pressure check to make sure there is no “obvious” disease. I then discuss the availability of an MRI to evaluate the inner ear and brain. (An MRI allows for the best evaluation of disease, but it’s often not pursued due to cost — about $1,500 here in the Bay Area.)

Moving forward, I examine both ear canals and if an infection is suspected, I discuss antibiotic therapy, as inner ear disease is a possible cause of vestibular signs. Technically, you can’t see the inner ear during an exam because the eardrum obscures the view, however, a nasty-looking outer ear and an inflamed eardrum may indicate that inner ear disease is present.

The diagnosis conversation ends with discussing a very loose rule of thumb: If there is gradual or complete improvement within 72 hours, it’s likely the dog has idiopathic vestibular disease and additional testing is not necessary. If there is no improvement or progression of signs, it is likely something much more serious, such as a tumor, and an MRI would be recommended to reach a definitive diagnosis. 

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Treatment for Vestibular Disease in Dogs

If clinical signs are mild, dogs can often be managed at home with over-the-counter Meclizine for “motion sickness.” However, if they’re unable to walk, I then recommend supportive care with IV fluids and injectable anti-nausea medications. Urinary catheters are also sometimes placed for hygienic reasons and instructions for general nursing care are provided, including how to prevent falls. Marked improvement is usually evident within 72 hours, and recovery should happen within one to two weeks, despite a head tilt persisting in some dogs.

It should also be noted that idiopathic vestibular disease in dogs is not a painful condition, which is why I recommend waiting to see if conditions improve before making the permanent decision to euthanize. Why not wait and see, giving time a chance? Again, improvement is very likely, and the difficult decision of euthanasia can always be made at a later date if there’s a change in your dog’s quality of life. 

Personally, I feel there’s reason to hold out hope and be cautiously optimistic, as idiopathic vestibular disease is the most common form of vestibular disease in dogs. It is the direction I would take if it were my own pup.

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Dr. Shea Cox

Dr. Shea Cox is the founder of BluePearl Pet Hospice and is a global leader in animal hospice and palliative care. With a focus on technology, innovation and education, her efforts are changing the end-of-life landscape in veterinary medicine.