Has your pet suddenly lost its balance?
Sudden balance problems can look alarming and have many causes. Contact your veterinarian promptly, and go to an emergency hospital now if your pet:
- can’t stand or keeps falling over
- is vomiting repeatedly or can’t keep water down
- seems dull, confused or less responsive than usual
- has weakness on one side of the body, or a seizure
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Vestibular disease
What is the vestibular system?
The vestibular system controls balance. It includes parts of the inner ear and the brain, and it tells your pet which way is up and how its head is moving.
When part of this system is affected, pets can suddenly lose their balance, tilt their head or feel as if the room is spinning. Veterinarians separate the causes into peripheral (the inner ear and its nerve) and central (the brain), because the tests needed and the outlook are different.
Signs to look for
Signs of vestibular disease
The signs usually start suddenly.
Common signs
- A head tilt to one side
- Loss of balance, stumbling or falling
- Circling or leaning to one side
- Unusual eye movements, flicking side to side or up and down (nystagmus)
- Standing with the legs wide apart
Often seen with them
- Nausea, vomiting or drooling
- Not wanting to eat
- Not wanting to stand or walk
- Anxiety or distress
Causes
Common causes
These are the causes veterinarians see most often.
Idiopathic vestibular disease in older dogs
Sometimes called old dog vestibular disease. It starts suddenly and can look dramatic, but most dogs improve within days and recover over a few weeks. A mild head tilt can remain. It’s often mistaken for a stroke.
Middle and inner ear disease
Ear infections that spread deeper into the ear, and growths such as polyps in cats, can affect balance. Some also cause facial drooping or changes to one eye.
Causes in the brain
Less often, inflammation, strokes, tumors or certain medications and toxins affect the balance centers in the brain. These usually need an MRI to diagnose.
Drug toxicity
Occasionally, medications such as metronidazole can cause neurological toxicity affecting balance. Certain ear cleaners or medications can also damage the inner ear, particularly if the eardrum is ruptured.
Other causes include an underactive thyroid gland in dogs.
Diagnosis and treatment
How it’s diagnosed and treated
- ExaminationA neurological examination helps tell whether the problem is in the inner ear (peripheral) or the brain (central), and an ear examination checks for infection.
- Blood testsThese tests may be recommended to assess your pet’s general health and investigate possible underlying causes.
- ImagingCT or MRI may be recommended if an ear or brain cause is suspected, or if the signs don’t improve.
- TreatmentDepends on the cause. Anti-nausea medication and supportive care help many pets while they recover, and ear infections need targeted treatment.
For pet owners
Caring for your pet at home
Many pets with vestibular disease feel dizzy and nauseous. Gentle support helps them eat, drink and move safely while they recover.
At home, it helps to
- keep your pet in a safe, padded area away from stairs and pools
- support them when they stand and walk, with a towel or harness under the belly
- offer food and water by hand or in raised bowls, as your veterinarian advises
- keep things calm and quiet, and carry small pets
- tell your veterinarian if the signs get worse or don’t improve
Questions owners ask
Common questions
If your question is about your own pet, your veterinarian is the best person to ask.
Is vestibular disease a stroke?
Not necessarily. Vestibular signs can result from several conditions affecting the inner ear or brain. A stroke affecting the brain’s balance centers can cause vestibular signs, but other causes include inner ear disease, inflammation and idiopathic vestibular disease in older dogs. A veterinary examination is important to help identify the underlying cause.
Will my pet’s head tilt go away?
It often improves a lot, but a mild head tilt can remain. Most pets adapt well and live comfortably.
Can it happen again?
It can. Some pets have more than one episode.
My dog keeps vomiting and can’t stand. What should I do?
Contact your veterinarian or the nearest emergency hospital now. Your dog may need medication for nausea and fluids.