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The Difference Between Strokes and Idiopathic Vestibular Disease in Dogs

Owning an older dog is a wonderful experience. The understanding and camaraderie that comes with years spent together is priceless. However, as a beloved pet ages, concern over a catastrophic illness developing also increases. When an older dog develops stroke-like symptoms, it might appear that an owner’s worst fears have been realized, but that is not always the case.

The risk of a dog developing a condition known as idiopathic vestibular disease increases with age. Symptoms of vestibular disease include:

  • a head tilt
  • unsteadiness or falling while walking
  • circling or rolling in one direction
  • abnormal eye movements (they flick back and forth, up and down, or rotate in a circle)
  • loss of appetite
  • nausea and vomiting

Like a stroke, the symptoms of idiopathic vestibular disease seemingly arise out of nowhere. The dog is normal one minute and exhibiting terrifying symptoms the next. Veterinarians are not sure exactly what the underlying cause of idiopathic vestibular disease is, but since the vestibular system (portions of the brain and ear) is critical to our sense of balance, dysfunction there makes a patient feel as if the world is spinning.

A veterinarian typically relies on a combination of the dog’s age, clinical signs, and a physical and neurologic exam that fails to reveal any other significant problems to differentiate idiopathic vestibular disease from other conditions (e.g., inner ear infections, brain tumors, and inflammatory diseases) that cause similar symptoms. In most cases, dogs with idiopathic vestibular disease start to improve over the course of several days to weeks with only symptomatic treatment, which is usually not true for the other problems that adversely affect the vestibular system. When uncertainty over the cause of a dog’s symptoms exists, veterinarians may order blood work, skull x-rays, CT scans, MRIs, and other diagnostic tests to reach a definitive diagnosis.

Treatment for idiopathic vestibular disease includes assistance with eating, drinking, urination, and defecation, keeping the patient clean and comfortable, and when necessary, anti-nausea medications and sedatives or anti-anxiety medications to help the patient relax and sleep. Dogs generally recover most, if not all of their normal function, over the course of several weeks, though in severe cases euthanasia may be necessary when quality of life does not rebound sufficiently. Reoccurrences are possible, but they are generally not as scary as the initial bout since owners recognize the symptoms and know that idiopathic vestibular disease is to blame.

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{ 5 comments… add one }
  • anna almond January 16, 2014, 6:35 am

    How can you tell the difference between stroke and vestibular disease?

    • VetDepot January 21, 2014, 2:09 pm

      Hi Anna, we spoke with the veterinarian who wrote this article, and this was her response:

      The incidence of strokes in dogs is actually quite low. So, if you see symptoms along the lines of what was described above and they begin to resolve after a few days to a week, idiopathic vestibular disease is the more likely diagnosis. Of course, a veterinarian is the only one in a position to determine what might be going on in a particular patient based on the results of a complete history, physical examination, and any necessary diagnostic tests.

    • Randall May 17, 2018, 6:08 pm

      My sidekick is currently going through this. It terrified me. But he seems to be getting better I’m only 4 days in and the first 48 were brutal.

      The way to tell the differences between vestibular and a stroke.. (from my research. Vets and observing my best pal)

      Seems to be the eye flicking back and fourth. That is not a symptom of a stroke. Also. If their paws flip back when you fold em over.

  • Anita kyle December 13, 2015, 8:59 pm

    Our almost 14- yr old Rotty, suddenly lost her appetite, wanted to stay outside (she’s a house dog, not very active these last few years only 3 legs ( back left amputated at 2 mos, so she adapted well). Gets Rimadyl for pain and I give her Adequan shots every 4 weeks for her hip dysplasia in her one back leg))
    Took her to vet same day, had nystagmus and head turned to right. All blood work was normal!!
    Vet put her on 2 meds for dizziness and anxiety Dec 10/12. After 2 doses of meds, appetite decreased. After 3 doses today Dec 13, no appetite for food or drink. I’m forcing pedialyte down her throat with a 50 ml syringe. ( in an pedi ICU nurse).
    I’m afraid kidneys will shut down if she doesn’t get some fluids. I could start an IV if I had the supplies !! Any ideas anyone? If I continue the meds, she starves to death or die of dehydration. If I stop the meds the condition returns. She is able to walk with her front legs with us holding a towel
    Under her tummy without falling over!

    • Janet Marek December 15, 2015, 11:16 am

      My vet suggested I give IV fluids at home. So, they trained me on how to administer the fluids and then sold me the supplies to do it. Ask your vet to sell you the supplies needed.

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