Dog News

It’s Not a Stroke!

by Shawn Finch, DVM

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…and it’s not a brain tumor.  Thank goodness!  Because neurological signs in older dogs are super scary.

Neurological signs in older dogs can only mean bad news, right?


Idiopathic Vestibular Disease is a COMMON condition in older dogs.  Signs develop suddenly and include:

  • a head tilt
  • ataxia (lack of coordination)
  • nystagmus (eye twitches)
  • (sometimes) circling
  • (sometimes) fear or distress
  • (sometimes) disorientation
  • (sometimes) inability to stand
  • (sometimes) nausea and vomiting
  • (rarely) rolling

Big Stupid Medical Words

idiopathic – having an unknown cause

vestibular – having to do with balance, which is controlled in large part by the components of the inner ear

neurological – having to do with the nervous system

central nervous system – brain and spinal cord.  Problems involving the brain and spinal cord are generally bad news.

peripheral nervous system – “everything else”  When the peripheral nervous system has problems, they tend to be manageable and carry a better prognosis than disorders of the central nervous system.  That is a huge oversimplification, meant only to help you start getting things into categories in your head.  Then you can understand why a disease that seems so horrible can end so well.

Great pug shot
This Pug is tilting his head on purpose! Vestibular dogs do not.

Photo owned by Olathe Animal Hospital.  Used with permission.  Thank you Dr. J.C. Burcham!

Idiopathic Vestibular Disease

Idiopathic Vestibular Disease is a disease of older dogs involving the peripheral nervous system.  It may be caused by noninfectious inflammation of the inner ear or a change in the viscosity of the fluid of the inner ear, though the cause is unknown.  Signs typically improve within two or three days without treatment, and dogs usually completely recover within three weeks, though a slight head tilt may remain.  Relapses are uncommon.

The prognosis for this condition is excellent.

Other diseases that can cause similar signs include inner ear infections and hypothyroid-related neuropathies, which also have excellent prognoses.

Synonyms for idiopathic vestibular disease are “old dog vestibular disease,” “geriatric vestibular disease” and “idiopathic vestibular syndrome.”

Cat Tangent

A very similar condition has been reported in cats, though it does not seem to be age related as it is in dogs.


The only treatment needed for idiopathic vestibular disease is supportive care.  Keep affected dogs safe (away from stairs and such) and help them eat or drink if they are unable to do so on their own.  Sometimes anti-nausea medications are helpful.

Why discuss a disease that needs no treatment and resolves spontaneously?

The reason that will make you sad:  Strokes in dogs are possible, but they are so rare, especially compared to the occurrence of strokes in people.  Signs of ideopathic vestibular disease mimic what people imagine a stroke in a dog would look like.  It has a sudden onset of horrible neurological signs that persist just long enough for the pet’s people to talk themselves into a really bad place.  I have heard this sentence way more often than I ever want to hear, and I never want to hear it again:  “My dog had a stroke, so we had him euthanized.”

The reasons that will make you happy:  I love medicine, and this condition is so intriguing.  Also, I love stories that end with a healthy, happy, old dog.  Mostly, though, having a dog with severe clinical signs like stumbling, falling, circling and other possibly confusing neurological signs is frightening and upsetting.  Having something serious happen to your older pet, as you know, adds a whole other level of worry.  If your dog has neurological or other potentially serious signs, as always, I want you to take him or her to the vet as soon as possible. 

But I also want you to remember this:  “As scary as this is, everything could be just fine.”

May your dogs’ stories always end as happily as those of idiopathic vestibular disease ought.

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