Contributors: Laurent Garosi

 Species: Canine   |   Classification: Diseases

Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading


  • Most frequent peripheral vestibular syndrome in older dogs.
  • Signs: acute onset of severe vestibular signs.
  • Diagnosis: negative findings on investigations for other vestibular diseases.
  • Treatment: none.
  • Prognosis: good.
    Follow the diagnostic tree for Vestibular disease.

Presenting Signs

  • Vestibular signs:
    • Head tilt.
    • Ataxia Ataxia.
    • Nystagmus.
    • Falling, rolling, leaning to one side.

Geographic Incidence

  • Worldwide.

Age Predisposition

  • Older dogs.

Breed Predisposition

  • Any breed.

Cost Considerations

  • If X-ray, CT or MRI performed.



  • Unknown.

Predisposing Factors

  • Age.


  • Idiopathic.


  • Acute onset.
  • Stabilizes in a few days.
  • Gradual improvement in a few weeks.


Presenting Problems

  • Gait abnormalities.
  • Head tilt.
  • Nystagmus.
  • Falling, rolling, leaning to one side.

Client History

  • Acute onset of severe vestibular signs.
  • Older dog.

Clinical Signs

  • Head tilt.
  • Falling, rolling, leaning to one side.
  • Wide base stance.
  • Ataxia with normal postural reactions.
  • Pathological nystagmus , usually horizontal or rotatory and not altered with position of the head.

Diagnostic Investigation

  • No findings.
  • Otoscopy:
    • No findings.

Definitive diagnostic features

  • Diagnosis by exclusion of other causes of acute peripheral vestibular syndrome.

Histopathology Findings

  • No lesions found.

Differential Diagnosis


Initial Symptomatic Treatment

  • No specific treatment has proven beneficial.
  • Meclizine (12.5 mg PO q12h), diazepam (0.1-0.5 mg/kg PO q8h) Diazepam and/or maropitant (1 mg/kg SC q24h or 2 mg/kg PO q24h) Maropitant citrate are sometimes helpful in decreasing signs associated with acute vestibular disturbance (nausea, anorexia, anxiety and, in some instances, the severity of head tilt and ataxia).



  • Good: most dogs recover without treatment, though a head-tilt may persist.
  • May recur within a period of weeks to months.
  • Some animals may be left with episodic ataxia or a persistent head tilt.

Expected Response to Treatment

Reasons for Treatment Failure

Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rossmeisl Jr J H (2010) Vestibular disease in dogs and cats. Vet Clin North Am Small Anim Pract 40 (1), 81-100 PubMed.
  • Thomas W B (2000) Vestibular dysfunction. Vet Clin North Am Small Anim Pract 30 (1), 227-249 PubMed.

Other sources of information

  • de Lahunta A, Glass E (2009)Vestibular system - special proprioception.Veterinary Neuroanataomy and Clinical Neurology. 3rd edn. W B Saunders, Elsevier, St Louis, Missouri. pp 319-347.
  • Munana K R (2004)Head tilt and nystagmus.In:BSAVA Manual of Canine and Feline Neurology. 3ed edn. S R Platt & Olby N J (eds). pp 155-171.
  • Bagley R S (2000)Vestibular disease of dogs and cats.In:Current Veterinary Therapy XII.Ed: R W Kirk. Philadelphia: W B Saunders. pp 966-971.

Further Reading

Other Sources of Information