It’s Not a Stroke!

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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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19 thoughts on “It’s Not a Stroke!”

  1. I put my dog to sleep because she kept walkin’ in circles one day when I arrived home from work. The VET did not say anything to the contrary.

    • You cannot second guess yourself for something in the past. For all you and the vet know, it was a stroke. But information is always good for future use. :o)

  2. Wow, I’m so glad I read this article! My black lab (13 yrs old) was doing this-well mostly the eye twitching thing and couldn’t stand up very well. I was kind of waiting until it happended again (it hasn’t) before freaking out. Thank you so much for this information!

    • My chocolate Labrador woke me up panting last night. She pooped her bed and can’t stand up. Her eyes are twitching. Waiting for the vet to open to carry her in. 14 years old.

  3. This article is so timely! I have a friend who just had an older dog experience this over the weekend. Her first thought was that it was a stroke. Fortunately she got some good advice from the emergency vet, and is currently providing supportive care to her dog. I have sent her a link to this article and hope it will give her more encouragement that Izzy will do just fine! Thanks–Life With Dogs rocks!!

  4. I was sitting on our sofa one night talking to my Mom on the phone and all of a sudden, our very healthy Champion Basenji named Dustin, leapt off of the sofa like someone flipped a switch of high volt electricity through his butt. He literally went from sleeping to about 3 feet from the sofa turning in circles. Long story short, Idiopathic Vestibular Disease is what he had. We thought he honestly thought it was a stroke. My wife (at the time, God Bless Her Soul) is and has been a research Librarian for 20 something years. She researched this until she found out exactly what it was. PLEASE, don’t give up hope on your pet if they develop this. Research it. Research ANY problem your pet may have, but the internet has a plethora of information. I’m VERY happy to report that Dustin is doing just fine today. He has recovered 100%, so like I said, PLEASE don’t give up hope, we’re all they have.

  5. My family dog for over eight year has came down with what one of my stepsons thinks is the old dog vestal (misspelled) or a stroke and thinks he will recover. Me and mostly my wife have taken him too 3 vets and not one has said anything like a stroke is what is going on with him. They have done blood work and pee test and looked in every hole he has. He is getting no better if anything worse. His simptoms are walking in circles, walking in to things, dulling like a water spickett, his body twitches constantly he has slowly stop eating, and its been all going on sense new years eve. and has got worse every day not better. One thing I see as a simptom that he DOESN’T HAVE is the eye moving or twitching just a blind stare in to space NO MOVEMENT. Before new years this is a dog you did not walk he walked u. Very very active very alive and vibrant and never ever did his business in side. Now he can’t control when or where he goes it just happens. The last vets would only say “you need a neurologist” and that she would recommend one.if it is a stroke why would 3 vets not say that’s what they think it was. Again this did not happen over night he has gone down slowly for the last 2 to 3 weeks.

  6. thank you so much for this website!!! if it wasn’t for this, I would not have my little dog anymore! he had these symptoms, and vet said it was a tumour!!! he is improving every day. Nearly back to normal, just a bit wobbly. Di

  7. Please I need help my dog’s symptoms are:
    Can’t stand
    Eye twitching
    And his tongue is sticking out…

    • Hi, my greyhound had these symptoms two weeks ago. She couldn’t move south of her shoulders and didn’t feel pinch pain in her legs. The vet suspected Vestibular at first but then thought something much worse as she didn’t feel pain and had front leg stiff and prone. Only and MRI could tell us for certain. We put her to sleep, age 14yrs, 4 months. very difficult. What happened with yours? thanks.


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