“Help, my pet is having a stroke!” This is often what we think if we see our pet falling down, stumbling, or tilting their head to one side. As scary as this appears, it is almost never caused by a stroke. These signs can occur in both dogs and cats due to "vestibular" events.
The vestibular center is located in the inner ear and sends information from the middle ear to the cerebellum and brain stem. Responsible for maintaining our balance and orientation, the vestibular center lets us know if we are upside down, how we can correct ourselves if we are falling or walking on uneven ground, and allows our eyes to follow objects without becoming dizzy.
If this area is compromised, you could become uncoordinated and even nauseated. And it is no different with our pets. They may look like they are falling down drunk, or even rolling over on the ground. They often have their head tilted to one side, their eyes may dart back and forth (this is known as nystagmus) and they may even vomit. In mild cases, it may just seem like the room is spinning but in some more severe cases, they literally cannot tell which way is up.
There are several reasons that the vestibular system can be affected and they are typically divided into two main categories – central lesions (in the brain) and peripheral lesions (in the ear). Central lesions include tumors, infections such as Rocky Mountain spotted fever in dogs or Toxoplasmosis in cats, various toxins, and in very rare cases, vascular accidents. Peripheral causes include middle ear infections and polyps or tumors in the ear canal, but the most common cause of vestibular issues in our pets is actually idiopathic (meaning, we cannot identify a cause).
In order to try to determine the cause, and to confirm it is indeed a vestibular issue (and not a seizure or heart condition), a physical exam and medical history are indicated. The exam includes an otoscopic exam and a neurologic exam and can often determine if the problem is central or peripheral. If not, imaging such as CT or MRI is indicated.
Treatment, of course, depends on the cause. If there is an infection, antibiotics are often prescribed. If there is a growth, removal is considered if possible. Thankfully, the most common cause, idiopathic, will typically resolve without treatment. Most dogs improve within 2-3 days and are normal within 2 weeks. Cats can take a bit longer (2-3 weeks) but also tend to resolve without treatment. Supportive care such as fluids and antinausea medication are given if the pet is not eating or drinking or if they are vomiting. They must be kept in a safe environment – away from any stairs or sharp surfaces they could fall on to. Sometimes, a head tilt can remain, but does not impact their health or quality of life.
While seeing your pet have a vestibular episode can be terrifying, most of the time it is self limiting or treatable. However, because there are scarier causes out there, it is very important to have your pet evaluated as soon as possible.
Should you have any questions, comments, or concerns, please don't hesitate to contact us by phone at 845-876-6008, or by e-mail at [email protected].
Thank you for choosing us to be part of your pet's healthcare team!
With warmest regards,
Your friends at Rhinebeck Animal Hospital