Can Canine Vestibular Syndrome Occur Twice?

photo 2009 Bill Harrison | more info (via: Wylio)Dear Dr. Barchas, I have a neutered mixed breed dog, Louie, who will be 15 years old...

dogedit  |  May 7th 2011

Even old dogs need holidaysphoto 2009 Bill Harrison | more info (via: Wylio)
Dear Dr. Barchas,

I have a neutered mixed breed dog, Louie, who will be 15 years old in July 2011. He’s 50 pounds and has always been in good health (other than arthritis) up until August 2010, when had his first episode of canine vestibular syndrome. It lasted a little over two weeks. When I had taken him to my vet, she didn’t know what was wrong (Louie had a complete geriatric blood profile done and his results were all within normal ranges).

I ended up researching his symptoms (head tilt, nystagmus and balance problems) and came to the conclusion it was CVS. He made a full recovery (except for still being a little off balance at times) and seemed to be back to normal.

A few weeks ago, he started having the same symptoms (although the nystagmus wasn’t as noticeable). The severity of his symptons lasted about two days but he still has residual symptoms. He still walks with a little bit of a stagger and his head is slightly tilted. It’s been almost a month now and I’m wondering if there’s anything I can do to reduce the chance of him having another “episode”.

My research seems to suggest that CVS doesn’t usually reoccur. I’m wondering if I need to have him tested for another cause. I hate to anesthetize a 15 year old dog and put him through a battery of tests. Do you have any suggestions?

Thank you so much, Dr. Barchas!!


Midland, MI

P.S. Your black lab is adorable!

Complimenting my pal Buster is a clever way to get your question answered! Asking a good question also doesn’t hurt.

Canine Geriatric Vestibular Syndrome, also known as Old Dog Vestibular Syndrome (or ODVS) occurs most frequently in elderly, large breeds of dogs. The syndrome usually is quite dramatic: affected dogs become very dizzy. They usually can’t stand up and their eyes usually rock back and forth in the sockets (which is called nystagmus). They may writhe in circles, and they may vomit due to perceived seasickness.

The syndrome occurs most frequently at night. Distraught family members usually assume their dog has had a stroke, and that immediate euthanasia will be necessary.

Expressions of grief usually are replaced with incredulity, and then relief, when I tell clients that euthanasia is strongly not recommended. The cause of vestibular syndrome is not known. One fact, however, must not be forgotten: the overwhelming majority of dogs recover from the syndrome.

Recovery may take several days, and it may not be complete — some dogs will have residual head tilts, nystagmus, or mild staggering. But the vast majority of dogs recover to the point that they resume their normal lives, just like Louie.

Many dogs require hospitalization and nursing care while they are recovering. IV fluids and anti-nausea medications may be administered. I recommend hospitalizing dogs until they are able to eat, drink, walk, urinate, and defecate without professional assistance.

I also recommend testing for other causes of dizziness in dogs. The second most common cause of dizziness is a middle or inner ear infection; usually (with rare exceptions) some evidence of these infections can be seen when the ears are assessed. Rarely, brain tumors or other serious conditions can cause vestibular symptoms in older dogs.

Vestibular syndrome usually occurs only once in any dog’s life. However, I have known several dogs who went through the syndrome three or more times. Amy, despite the recurrence of symptoms, I am still betting that your dog does not have any problem other than CVS. I therefore am betting that he will be fine.

However, you definitely should have his ears assessed by a vet. You also may want to consider chest and abdominal X-rays to screen for tumors that may have metastasized to the brain. These tests do not require anesthesia for most dogs.

The true test for brain tumors is an MRI. This test requires anesthesia, and it is available only in select areas. If Louie were my dog I probably wouldn’t pursue this option. Symptoms from brain tumors don’t often improve the way Louie’s symptoms have. He probably had CVS, and he’ll probably be fine.