Vestibular Disease: How Do You Know if Your Dog Had a Stroke?

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For more from Dr. Justine Lee, find her at www.drjustinelee.com or on Facebook!

Making the decision to humanely euthanize a pet can be a traumatic one, especially if you think your pet is acutely deteriorating. 

One classic scenario that I often see in the emergency room is people bringing in their pet to euthanize for having an acute stroke. However, before you consider euthanizing, pay heed! I’ve often had to convince owners not to euthanize when they suspect that their dog or cat has acutely “stroked out.”

In today’s blog, we’ll cover dogs and “acute strokes,” while in next week’s blog, we’ll cover cats and their “acute strokes.”

It’s scary to see your dog suddenly look drunk, not be able to walk, develop rapid, abnormal eye movement (called a nystagmus) and fall to his or her side. When this happens, one common benign cause may be due to “old dog vestibular disease.”

What does this mean? 

While it’s not the fanciest disease name, old dog vestibular disease looks like a stroke. In actuality, it’s an acute inflammation of the vestibular nerve. This nerve runs through the inner/middle ear and stems from the brain, and its purpose is to help us all to stay physically balanced. This is the same nerve that makes you motion sick or causes tinnitus.

Old dog vestibular disease occurs acutely for several reasons: from ear infections and sticking a Q-tip too far down in your dog’s ear to cleaning your dog’s ear with liquid ear medications, old trauma or underlying metabolic problems (like thyroid conditions), or for the simple reason that your dog is old.

Signs of old dog vestibular disease include:

  • sudden imbalance
  • falling over to the side
  • not being able to walk
  • vomiting
  • nausea
  • inappetance (who wants to eat when they are nauseated?)
  • rolling or circling to one side
  • nystagmus

The good news with old dog vestibular disease?

It typically resolves after a few days with marked, sudden improvement. In fact, it often goes away as soon as it is developed. Unfortunately, it can leave some rare side effects like a permanent head tilt (though that can make your dog even cuter by making him look eternally curious and perplexed!).

Unfortunately, if these signs don’t go away within a few days, the more serious differentials may include a brain tumor or severe inflammation of the brain. An MRI, CT, spinal tap, and a visit to the veterinary neurologist are a must.

Another rare cause for acute “strokes” in dogs is something called a fibrocartilagenous emboli (FCE).  In dogs, FCEs occur when microscopic pieces of fibrous tissue and cartilage develop in the body and break off somewhere, blocking blood flow to the spinal cord. This results in acute, profound neurologic signs similar to old dog vestibular disease. FCEs can be seen more commonly in certain breeds such as Labrador retrieversMiniature Schnauzers, and Shetland sheepdogs. The only true way to diagnose an FCE is by physical exam findings in conjunction with a CT or MTI (which needs to be done under anesthesia). Unfortunately, there is no cure for a FCE. However, with supportive nursing care, many dogs improve and recover from the paralysis; however, recovery may be gradual and slow as compared to old dog vestibular disease.

When in doubt, seek veterinary attention immediately – and if your veterinarian isn’t sure, a visit with an internal medicine specialist or neurologist is a must. Just keep in mind that not all “acute strokes” warrant a bad prognosis or euthanasia, and some may turn out okay with supportive care.

If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.

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