Vestibular Syndrome – strokes in dogs

My twelve year-old collie, Juno had an attack of Vestibular Syndrome this week. These are what we used to call Strokes, but advances in imaging and investigation have led us to realise that they’re not quite the same, even though they appear just as suddenly and with some of the same symptoms.

Dogs can and occasionally do have Strokes, but they tend to be less serious than in humans. In humans, Strokes – or Cerebrovascular Accidents – refer to a bleed in the brain, so that an area loses its blood supply and is starved of oxygen. Damage quickly becomes irreversible and we all know how variable and tough the aftermath can be, for the sufferer and carers alike. Dogs can, rarely, go through the same events, but are more likely to have an episode where, instead of bursting, the blood vessel spasms and shuts down for a short period. Whilst there can still be damage, recovery tends to be quicker and more complete.

Juno

Juno

Vestibular events are slightly different again, but often something of a mystery. The vestibular system – the inner ear – is about balance and so problems lead to classic signs of dizziness. There is staggering (ataxia), flicking of the eyes (nystagmus) from side to side, up and down or even rotationally, and a head tilt to one side. Facial nerve tics or paralysis are sometimes present. Motion sickness can be obvious, or may present as reduced appetite, which is hardly helped by the confusion and anxiety that most patients experience.

Juno had a sudden onset of these symptoms about four days ago, accompanied by a bit of leaking urine, and has been gradually improving for the last 48 hours. As of today, she’s not too bad when walking in a straight line, but getting out of her basket is still a bit hit and miss and sharp turns tend to become handbrake slides. She’s still eating her food, but for the first time ever seems full up before the bowl is empty. Life isn’t all bad, though – her basket has been moved in front of the fire and with the TLC she’s getting from the whole family, she’s more likely to die of happiness than from dizziness. And hopefully, over the next few days to weeks, she’ll gradually return to normal.

Vestibular disease can have a number of causes: infections, from the brain itself or from the middle ear, cancer, poisonings, parasitism, immune disorders, occasionally as a sign of Hypothyroidism (underactive thyroid), and commonly as an idiopathic event. Idiopathic basically means that we don’t know the cause, but know that it isn’t due to anything else. Idiopathic Vestibular Syndrome is something that comes on unexpectedly, for unknown reason, and then usually goes away on its own, albeit often with some residual signs like a minor head tilt.

Currently, it appears that Juno’s condition is the idiopathic version, and not due to something nasty lurking underneath, or else possibly thyroid-related, which is easily treated with thyroid supplements. Juno’s not otherwise ill, has no history of ear disease (although it can sometimes be silent), and doesn’t have any progressing symptoms. I ran some bloods the day after it all started, which were entirely normal. However, if she should relapse, I’ll be looking at more investigation, which may be a lot more complicated.

Testing for brain disease can be very difficult: to make a definitive diagnosis, we generally need to look at sampling the fluid around the brain – the Cerebrospinal Fluid (CSF) – and/or performing an MRI. Both require a general anaesthetic, are potentially risky procedures and can be very expensive. Right now, for Juno they’re not a priority as things are looking OK, but remain as options.

In the meantime, I’m supporting Juno as much as possible, whilst waiting for the results of thyroid tests. Even though we don’t usually know the cause of Vestibular Syndrome, there are a number of useful drugs which are commonly used:

  • Most vets will use anti-sickness drugs, to combat the motion sickness.
  • A fair few use steroids, a common treatment for neurological conditions, particularly when a decision has been made not to investigate further.
  • Some vets will use Vivitonin, which is often used to enhance blood flow to the brain and which we’re using more and more for heart disease. Whilst there’s no solid evidence that it works in vestibular problems, there can’t be any harm in making sure that the blood supply is topped up.
  • Sometimes we’ll prescribe a human drug called betahistine, which is used for vertigo, as it’s reported to speed up recovery.
  • In terms of general boosting of brain activity, there are supplements like Aktivait and Selgian, which are usually used to combat signs of senility in older patients, and essential fatty acids.

Equally, though, nursing and TLC is all-important for these patients:

  • Reassurance
  • Palatable and digestible food
  • Help with movement, but only enough to make up for what’s lacking – if all she needs is a hand under the bum to get up, then she gets it, but that’s all she gets.
  • Promoting the idea of ‘horizontal’ by providing strong visual cues in the house. Juno’s basket is in front of the wide, flat sofa and thin, tall objects have been removed. In severe cases, horizontal masking tape on the walls and doors may help
  • Frequent trips to the garden for balance and urination
  • Keeping pathways through the house clear of clutter, to reduce bump hazards
  • Gentle and short walks in straight lines
  • A nappy, to reduce the anxiety of leaks: purpose-made wraps are available for longer term conditions, but for now we’re using large disposables with a hole ripped for her tail.

It’s important to note that because, by definition, we don’t know what causes Idiopathic Vestibular Syndrome, treatments and care are largely based on common sense and logic. It’s true that if left alone, many patients recover by themselves, although this can take several weeks, but anything which reduces the recovery time, and makes it more bearable, must be a good thing. So far, Juno is responding well and I’m hopeful that we’ll be out of the woods before too long, but in the meantime I’m giving her every chance that I can.

  • Elaine j says:

    My old boy jonny has had a bad day the vet thinks he has vestibular disease and I agree, some days he seems ok although wobbly but today he has rolled and been really unsettled however his petite is good I have to help him but he is continuing to eat well. He gets up and staggers to he door to be taken out and manages well a he toilet although I have to support him. My vet never offered any medication so I am not sure where this will go he is almost 14.

  • Jane B says:

    My 17 year old jack ruissell, lakeland Dexter had an attack yesterday. This comes on the back of being attacked by a Staffie last week. All the drugs he was taking seemed to have given him a sudden burst. Then lat night he got up and collapsed, head to oneside, back end wouldnt stay up. I was so scared, i thought this was the end. let him sleep on my bed all night to keep and eye, not much imrovement. rang an emergency vet and what do you know, he got up head almost straight, back end just his usual wobble. But I do know this will happen again. leaky heart, blind, still chases squirells and is my life. This site has been a god send.

  • C says:

    Our collie cross boy has had two bouts of vestibular syndrome, first one when he was 13 and another about eight months later. The first one was worse; think he knew what to expect the second time and he lay down more instead of trying to stagger about. Good recoveries both times; no vet treatment; I diagnosed him from the Internet and monitored him very closely, invalid diet including a little butternut squash for easy bowel movements and lots of TLC etc. He will be 15 in June and is normally well; eats well; is very deaf and his sight is poor but he is a cheerful little chap and very much loved.
    Yesterday he collapsed 3 times, just straight down, his legs went under him, but he got up again pretty much straightaway. He slept more and wasn’t hassling me for his evening Bonio as he usually does. Wee and poo all normal but he had more trouble keeping steady out in the garden, however he still tries to trot everywhere, listing to one side or the other. He seems better this morning.
    So dogs can have several bouts I think.
    I’m trying not to get panicky at the thought of the end but he is old now and hope I will be strong enough when the time comes.

  • Danny says:

    My collie cross (14) had an attack on wednesday, sick and poo in the kitchen, eyes flickering….he was in a terrible state, he has bad hips as it is but with this stroke his walking was ten times worse. He was like a drunk bambi on ice! after two days at the vets he was standing, still wobbly, and had a head tilt. After a day at home getting spoilt with TLC, the third day he was much better. More steady on his feet, head tilt not so bad and he loves a packet of chicken for tea and breakfast (along with his hidden medication) my old boy is getting there and hopefully he will be back to himself soon!

  • sheelagh says:

    Just had five very worrying days with my 12 year old and very fit dalmatian. Through a friend I heard of vestibular syndrome. I have not come across it before. Vet talked about inner ear infection/vascular/tumour etc. Having read article my beloved pet’s condition is accurately described. With the help of my vet things can now improve. She is on antiotics (Noroclav and Marbocyl) plus an anti sickness injection today and a steroid. She has seemed much better this afternoon and has just enjoyed chicken with rice.

  • Lynn Baldwin says:

    Thanks you so much for this information. I watched my13year old dog suffer this evening. My vet was brilliant. She has had a st emetic injection and dead reason injection and prescribed vivitonin tablets. Next 24hours will be hard.

  • Tara says:

    Wolfie’s triumph over vicious Vestibular…

    I want to relay what my baby Wolfie and his devoted mummy :) have endured, to impart hope to everyone reading this.

    Firstly, let me just tell you that I rescued Wolfie in August 2011. He had been terribly neglected for years (he’s an ageing chap) and was, frankly, at death’s door. We might well be a “nation of animal lovers”, but some people are still getting away with incomprehensible cruelty! To cut a very long story short, the vets were doubtful he would survive – how he had lived until then, so malnourished and undoubtedly in excruciating pain (with a mouthful of rotten teeth and riddled with infection from head to toe, literally), is beyond me – but I was determined his life would not be in vain. An operation (to remove all his teeth save his canines), a myriad of medications, and lots! of TLC… and he was a different dog. In the words of the vet, “he looks like a dog now”. Sprightly, very happy and enjoying his new life to the full.

    >>>That was until just over 2 weeks ago. On the evening of Thursday 4th April, he started collapsing and his head tilted dramatically to the left. I thought he was having a stroke. I should mention, on the Monday, his back legs went a few times. That was unnerving, but then he was absolutely fine on Tuesday, Wednesday and Thursday during the day. I took him to the vets first thing on Friday morning – I have no means of transport, but he managed to walk (it’s local) albeit very wobbly, bless him. The vet simply prescribed yet another course of antibiotics for suspected otitis media / interna, i.e. middle / inner ear infection and instructed me to up his steroids to 2/day. So, we left the vets, with his mummy just hoping and praying. Sure enough, my little fighter really started picking up and by the following (last) Wednesday, he was – or seemed to be – doing great. I still wasn’t taking him for his usual long walks, but his balance had returned. However, on Thursday (one week exactly after the initial attack), he regressed and the Vestibular symptoms, including vomiting, came back with a vengeance. Come Friday morning, he was hardly able to walk, he turned his nose up at his breakfast, he was sick… and his left eye (in particular) was twitching. Frantic, I called the vet. She said if he didn’t eat or drink during the day, he would have to be put on a drip that night. No chance! After everything he’s been through, the last thing I wanted, was for my baby to be alone (he’s been with me 24/7 since I rescued him) in a hostile environment, ill and frightened out of his wits. I can honestly say, I do not believe that scenario would have ended well. [She also said the eye twitching indicated ‘it’ had “gone to his brain”.] So, she informed me there was only one other option and I would have to make that decision by the time the clinic opened again that evening. Needless to say, I was beside myself. Nonetheless, I resolved to fight it. Wolfie survived against all the odds when I rescued him – if anyone could get him through this, I could.

    Well, I’ve not been back to the vets yet (it’s been just over a week since that damning telephone conversation)… and my baby is doing ok; better than ok. :) He’s made progress day by day – he’s walking normally (with just a few wobbles here and there, notably when he sneezes), has a slight as opposed to pronounced head tilt, the eye twitching ceased and his eyes are bright again, his appetite has returned to normal, and no more vomiting. How did we do it? Along with Wolfie’s resilient willpower (do not underestimate a happy dog’s will to live!), I determinedly nursed him back to health. I hand-fed him when he wouldn’t / couldn’t eat or drink of his own accord, gave him all his favourite ‘treat’ foods (including tuna, white fish, mince and chicken), put milk in his water because he wouldn’t drink it otherwise, certainly didn’t starve him when he vomited, and gave him all the kisses and cuddles you can imagine. He is still on antibiotics (20 days in total) and 2 steroids daily – the antibiotics finish next Wednesday and I am reducing the steroids to 1/day as of Monday, 3 days before the antibiotics finish. Please God, he will continue on the road to full recovery!

    As I sit here scribing, my little boy is full of beans and merrily licking his bone, which brings sheer joy to his mummy’s heart. :)

    In the words of Paul O’Grady, “people are really affected by animals [and] spending time with animals is good for your soul.” Don’t we know it! We just need more Paul O’Gradys in the world… and more of us. Keep going fellow animal lovers and never give up hope!

    All our love, Tara & Wolfie xx

  • Julie says:

    13 year old Sweep is on the winning side of a Vestibular Syndrome attack. She is on steroids, antibiotics and Vivitonin. Although she didn’t go off her food she seemed to be having difficulty eating. Instead of putting her food in her usual stainless steel feeding bowl, which has deep sides, I used a flat dinner plate instead. It made all the difference! She is now eating all her meals, and enjoying them. She has her tablets in Brussels pate, which she loves. More tablets just means more pate!

  • Doreen says:

    My 10 year old lab has diabetes and has recently lost his sight.
    We took him to the vet for a curve test which tests the glucose and when we picked him up, his eyes were flickering back and forth and he couldnt walk straight. It has been gut wrenching to say the least, but thanks to all the feedback, I see that there is still hope for my boy. My vet advised me to call a neurologist, but seeing all the comments maybe we dont have to go down this path. Unfortunately the cost of him having diabetes has taken a toll financially, but he is definately one of the family and worth fighting for, for sure :)

  • Heather says:

    My 14 year old Lassie Collie had Vestibular last August. My “then” Vet told me that she had lived far beyond her lifespan anyway, and wanted to put her to sleep, like Taras Vet. Needless to say I now use another Vet. She recovered completely, with just a slight head tilt, but today she has started vomiting like she did in August. Thankfully both her and us now know the symptons, so she is calm, as we are. Watching her carefully now, just in case she gets worse, she is sleeping peacefully.

  • elaine says:

    my 12 year old lab had this and still having them he had it 5 times now for over a year now the eyes.. the head tilt and the toilet coming away from him once that happened had one last night stay up with him all nite with the lights no and telly off hes back to normal now still a bit unsure but getting here not a nice thing to see him going thou as the vets have told me just have to be there for him and he come round on his own …he had two mild ones also they coming every couple of weeks now so just have to be here for him he eating and walking ok i can tell the signs before he get attack as he just lies there and he dont move even when you call him to come so i can see if he walking ok as it a drunking walk he does ..

  • louise says:

    my border collie is 15 and suffered his first vestibular attack last august. He recovered but relapsed in April 2013.He had the steroid injections both times and recovered. He again relapsed after 4 days. What helped us was to get him to play games and concentrate on a toy or ball. We use his favourite ball and move it side to side so he concentrates his gaze and then we hide it. I would suggest this as something that may help, but it will require patience and time, but if you care about your dog this is a small price. He has had all the other tests and is otherwise very fit. Hope this helps any good luck to you all.

    Louise

  • Judith says:

    Thank you so much for this helpful explanation. My 12 year old mongrel has just had what seems to be a vestibular event. She has been treated by a lovely vet and we are now just hoping she may recover. The information you put on this site was very clear and useful.

  • Jane Bevan says:

    My 13 year old Bearded Collie has just been diagnosed with suspected vestibular syndrome after what I though was his right back leg failing as he is getting quite arthritic and was showing signs of stiffness and wobbleyness when getting up after lying down. Yesterday he collapsed completely and had to be carried to the car to visit the vet …luckliy the practice is in my village. Very worried about his difficulty in walking as it requires lots of encouragement to get him up to go out into the garden to urinate. Not eating either at the moment, ( though to be fair he has always been a fussy eater, so not easy to adminster the drugs he has been prescribed. Appreciated this very useful description of the condition and common sense tips – very reassuring at such a time. Fingers firmly crossed he will improve.

  • Jan Bending says:

    Thank you so much for this informative and reassuring article.
    My Border Collie Kezzie aged 12 years 5 months has exactly the same signs/symptoms. It started last Thursday with sudden onset of instability of hind legs/collapsing, head tilt ‘wobbly gait’ and vomitting.
    I suspected that a stroke/vestibular incident might be the cause but could not seek veterinary help until yesterday due to being forbidden to drive following shoulder surgery. I thought a possible differential diagnosis might be an ear infection -hence head tilt etc but my vet did a thorough examination and said ears were clear and diagnosed vestibular syndrome. She has commenced steroid therapy and we are continuing with masses of TLC and encouragement. I think she’s enjoying all the extra attention -being one of 12 dogs ,she must appreciate this !

  • Sherri says:

    Our German Shepherd Occa, 12 years and 3 months old, was hit with this on Monday this week. She was eating breakfast and became very unstable. She started to stagger and ultimately fell over. It has now been four days and she is slowly showing some improvement. Very slowly. I have given her some betahistine for the last couple of days which I think has helped. Her head tilts also. She is eating, and doing her business – just a matter of time I guess. We rescued her when she was 9 years old – she is the best dog we have had the pleasure of spending time with. Hope we can get her through this and she has a few more good years with us.

  • nuala says:

    Hi This morning walking my spaniels when my oldest ( Danny) started walking sideways and in circles. He is now in vet, blood tests ok, ears ok. Last couple of weeks off food and sleeping more than usual, also has been staring at me with a frightened look in his eyes.
    Nuala

  • Joanne says:

    My 15 year old German Shepard X suffered one major suspected stroke and in hindsight several minor ones over the past 12 months. He was treated quickly and with a few days of rest and tlc he made a remarkable recovery. Getting treatment quickly is vital so if you see any of these symptoms in your dog take them to a vet asap.
    Sadly my dog passed away on the weekend after several weeks of good health it came as a shock. He collspsed and vomited and seemed a little disorientated but after a ten minutes appeared to be fine again and we just put it down to an upset stomach and being unsteady on his feet generally (suffered with arthritis). A few hours later we popped out to do some shopping, again he seemed fine, although he didn’t want to go into the garden before we left. We came home a few hours later and to our shock found him collapsed on the kitchen floor and he had already passed away. His legs were splayed which was not a normal resting position for him; we knew immedialey that he had collapsed and our vet suggested that a major stroke or heart attack was probably what took him in the end.
    He was an old boy and a gentle giant and we have many fantastic memories of him and I will miss him terribly. We probably couldnt have saved him on this occasion but I will always regret not being with him when he passed away.
    You cant be with you pets 24 hours a day but if they display any of these symptoms please don’t delay, take them straight to a vet to get them treated; as it really can make all the difference!

  • Shaun says:

    Hi I’ve got a 13 year old springer spaniel,we went to take him for a walk this evening he was full of life and his back legs started to go and then 5 minutes later his front and he just looked like he was drunk, we got him home an then he started to vomit and head wobbling, I think he’s got this vestibular disease

  • Dawn says:

    Hi. My 13 yr old bearded collie bitch was yesterday diagnosed with suspected vestibular syndrome having suffered loss of strength in legs and walking “crab like”. Vet checked ears & eyes etc and has now put her on course of antibiotics just in case of injection. We lost our other 15 yr old beardie last December with a major stroke which unfortunately led to her having to be put down. I am now so scared this is going to happen to Skye; she has been my soulmate for the last two months since the death of my husband – she is the most loving dog in the world and I couldn’t bear to be without her.

  • Dawn says:

    Hi. My 13 yr old bearded collie bitch was yesterday diagnosed with suspected vestibular syndrome having suffered loss of strength in legs and walking “crab like”. Vet checked ears & eyes etc and has now put her on course of antibiotics just in case of infection. We lost our other 15 yr old beardie last December with a major stroke which unfortunately led to her having to be put down. I am now so scared this is going to happen to Skye; she has been my soulmate for the last two months since the death of my husband – she is the most loving dog in the world and I couldn’t bear to be without her.

Leave a Reply

More Useful Information

Examining your pet

Simple ways to check the health of your pet. Vets use these techniques as part of their clinical examiniation.

Medicating your pet

Arming you with the same simple techniques for stress free pill giving.

Worming & Flea Treatment

Information and advice in treating your pet for worms and fleas.