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...


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.

28 thoughts on “Can Canine Vestibular Syndrome Occur Twice?”

  1. My dog recently had his first bout with CVS. Was horrible watching him go through it. He refused to eat for a week and a half. Thankfully he didn’t refuse water. I have heard that hypo-thyroid can be one of the causes. I’m hoping I never see him go through that again. At least now I know he wasn’t the only one going through it.

  2. My hound retriever mix is now on his second run with CVD within the past 2 months. He didnt completely recover the first time which took solid weeks, he had a slight head tilt. He started thrashing again two days ago, nystagmus and vomiting which is particularly dangerous for him as he is a diabetic. The first time through, vet placed him on meclizine 25mg twice a day–12 hours apart. Had a rough time getting him to eat the first time thru until an hour to an hour and a half after his meclizine–then he wolfed down canned food (did i mention he has no teeth either?). I found that if i give him a small ice cube (tray half filled with water) and he sucks on a couple of those after the meclizine dose, he eats much better. This time thru i am getting a referral for a scan to see if there is a tumor and to visualize the inner ear. His blood sugar has gone all over the place–but low, not high, which should be the opposite if he has a middle ear infection. He is responding the same way to the meclizine this time as last though his gait symptoms are a bit worse this time. He was also incontinent of urine, not a big deal on my linoleum floors and that happened the last time as well but fully resolved. I feel really bad for those folks that were told to put their dogs down when there was a good chance this was CVD, but I can tell you that watching this happen to him was very scarey for me. He now gets his meclizine, eats, plays with his squeaky toy and falls asleep. Vet thought maybe we should increase the meclizine but I asked we try the previous dose because it made him so dry the last time his insulin wasnt getting absorbed like it should but this time the former doses seem to be tolerated better. Its funny that meclizine, a very cheap otc drug, can actually help them get thru this.

  3. My 12 year old lab had experienced something similar in Easter night. She is in Zanax for thunderstorms. It was very stormy this night very scary she was stuck laying to one side and kept hitting her head on the floor and causing me to bleed from scratching as I was trying to hold her still. The doctor said perhaps she had a brain tumor that ruptured and mentioned VBS and Meclizine. She said we could take for MRI an hour away I had her out down as I could not handle her suffering so bad. I started researching this now after and find she may have recovered. I thought she had a stroke. She has bad anxiety and was very anxious going through this I was very confident in my decision now I am feeling bad? Am I a good pet parent because I did not understand this? It was 3:30 in the morning major thunderstorms, happening unemployed due to covid could not even go in clinic when I brought her in although they let me hold her when she was out to sleep her whole body relaxed. And was not very stiff as she had been for 5 hours we even had to carry her out in a blanket as she was dead weight trying to twist. Very sad and traumatic experience for all involved. Did I do the right thing?

    1. Yes, you did. We’re fighting our way through our 2nd round of this with our 15 year old 110 lb dog.

      This is my 12th dog, and these decisions never get any easier. The present price of veterinary care, and the often stunning lack of veterinary awareness of this condition, doesn’t make things any easier.

      I’m very glad you were there for her to say goodbye – it’s the least a good pet owner could do.

      Best wishes to you as you heal, and best wishes getting through this economic disaster called Covid.

  4. Constance H Whitley

    Does anyone know the dosage for betahistine for dogs? I want to give it to my 14.5 yo diabetic toy poodle with vestibular disease & my vet doesn’t. This is a new vet who took over the practice when our old vet retired & he just wanted to put my Charlie down.

    The thing is that he made a huge recovery from his first bout with CVS & is a happy little camper, loving life, healthy appetite, great mobility, etc. He has a good quality of life & I see no reason to end it prematurely.

    Have Googled my head off & cannot find the dosage for betahistine for canine use. TIA.

  5. I believe my 6 year old husky has vestibular disease. The vet prescribed Meclizine. He has been taking it for two weeks but symptoms are still there. He seems disoriented, wobbles when be walks and constantly goes around in circles. Im very worried and hoping its not serious. Can anyone help with advice/suggestions? Dows it take more then teo weeks? Has anyone seen improvement with other medicine? Thank you

  6. Our dog Samson started with his first episode in August. Very severe, recovered in four days. Since then he’s had four more episodes. They seem now to come every 2 weeks. Each time he seems to fully recover and seems in perfect health. Each time he has an episode his one eye has a lot of discharge. Blood work and ears are fine. Can’t really get answers as to why this keeps happening. I think the eye discharge is connected to the issues.

    1. Stephine,

      Keep us updated. My dog just had her second bout of vestibular and it was two weeks in between as well. Doctor is saying it’s rare for it to happen so close together, or to reoccur at all. Hoping it’s not a brain tumor. Is your dog on Rimadyl?

  7. My springer spanial has had this twice now (a year apart) the first time it was 50% worse then the 2nd time, we got tablets from the vet on both occasions, kept him on a short lead and let him toilet in the garden , we held his held straight as much as possible the the world didnt spin round that much, it effected his legs (i think, he slightly drags his back legs so we put him on dog omega 3 capsules and a health tablet with glucosamine chondroitin , these are excellent, my dog would be completly dragging his back legs if he wasnt on these, the glucosamine, chondroitin takes about 3 weeks to build up in there system to work, read up on them, brilliant, there are dog versions online on natures best website. Im please to say my 13 year old is now much better but has been left with his back legs 90% working – good luck everyone , just make sure u go to the vets straight away to get steriods and motion sickness tablets, bring a bowl of water up to your dog for him to drink throughout the illness, and after day 2 bring your dog rice and boiled chicken in small quantities, this all worked for us

  8. My 8 yr old multi-poo is on his 5th Vestibular disease episode, within the last 6 months. It’s heart breaking, my vet suggested an MRI which is available 400 miles away. He was also just diagnosed with cancer on his left back leg, which an amputation is suggested. I’m at a loss don’t know what to do, as it is he is not able to walk during the VS episodes, much less with an amputated leg. The cost for an MRI is around 5000. I would 100% do it if he didn’t have leg cancer. My heart is broken. He is the most precious doggie.

    1. you can get wheels for his back legs , please google it, a guy down the road from me, his dogs rear end is set on wheels, its brilliant

  9. My 15 year old golden retriever had his first VS episode in September then a second in December. His third episode came exactly one year later, this past December. The first time was the worst, probably because we didn’t know what was going on. He bounces back each time but it seems to take a little bit out of him each time.

  10. Our girl Wednesday just had 2nd bout of vesticular. first time this past Dec 14. today Jan 10th. She made a 90 % recovery the 1st time. She is a 14 yr old Australian Shephard/Chow mix. We are not giving up! the vet wanted to put her down on Christmas Eve day. We are understanding of her age and being realistic. The vet did say not to do testing on her because of her age other than bloodwork which we did and agreed. There is kidney disease, we started Hills Kidney foood. She won’t eat it. So that is another issue. Ultimately whatever is presented to any of us at the time we do out of love and that is all part of loving them.

  11. My 14.5 yr old Border Collie had her first round of vestibular in July. Recovery was hard and took 2 to 3 weeks. Did not end up being a full recovery. She never had good walking after that, lots of stumbling and falling. Permanent head tilt. But improved and I was happy to get what I got. This pa st weekend she stumbled a lot more then normal..would take a step and sometimes tremble down to a fall. 3 am she woke me in full vestibular again with the eye flashing. I feel so terrible…she weighs 55 lbs and the prior time I had to carry her in and outside up a ramp. I have a bad neck injury and it was not easy. I couldnt imagine how we could go threw this again for 3 weeks, I also work full time. We made a trip to the nearest emergency vet 45 min Way and I had them euthanize. It all happened so fast…now I am regretting not trying more…

  12. My dog Buddy had his teeth cleaned and several extracted, he done ok but a week later developed this disease all of a sudden, he as well had a enlarged heart, we rushed him to vet clinic where they kept him 2 nights to treat but after 2 nights he wasn’t able to walk, so I had to make decision to put him to sleep, he was 15, such a horrible thing to see your dog going thru, I just knew in my heart that Buddy couldn’t recover from this, our hearts are broken????????????????

  13. My pug is going through the third episode of vestibular within four months.. she’s a tiny little girl and they hit her really hard. She’s also totally blind with severe pigmentry keratitis and I’ve had doctors mis diagnose her because they can’t actually see her eyes. But she absolutely has vestibular disease and it’s so cruel to watch. She’s also had some squelching sounds in her ears but the doctors don’t seem to be too worried about this however I’m concerned that she has an ear infection which is causing the frequent repeats. Thoughts? Also, the doctors are reluctant to give her medication because last year she suffered severe liver disease so we’re in a bit of a precarious situation. She’s been given some anti nausea wafers this morning in the emergency vet which help to stop throwing up but it did nothing to stop the swaying. She wasn’t eating or drinking but she has started eating and drinking again tonight. I guess I came on here trying to find how common it is for dogs to get repeat attacks of vestibular disease.

  14. Melanie Bosch-Reitz

    I have a 13 year old golden retriever. She is recovering at the moment from a second bout of vestibule disease. It is so distressing to see your baby go through it. Sasha took 2 weeks to come right the first time. Rushed her to pet emergency thinking it was the end. It is so scary to see the legs go and the eyes rolling around.

    I keep wondering if it will keep happening.

  15. My border collie (15 years) has had three episodes in one year. It’s really painful to watch. Each instances was treated in hospital followed by medication (prednisone).

    1. My GSD is on her 3rd episode within the year. I’m worried I should get her an MRI. Did anything more go on with your furry friend?

  16. Hello, do you have an update on your dog? I’m very curious as i just put my 14/15 yo dog down but I think he likely had more than just CVS. Or, in hi case, Idiopathic VS. I’m kinda thinking to myself now, wow, was it only CVS? Sunny also had LarPar and required a tie-back procedure. He had Cushings and Hypo-T. He had 2 Vestibular events in his life and the second one just never seemed to go away. In fact, he would lay to the right constantly in the most seemingly uncomfortable positions. Towards the end, he would lean up against things too kinda like balancing himself. The LarPar is part of a more generalized neuropathy so there was that – hind leg weakness, and muscle wasting. He had dropped to 35 lbvs. So, although there likely was some VS still existing – I guess now I’m trying to convince myself that there was more to his story than that. I didn’t take him back to the Neuro because they are so far away and he was not tolerating traveling well. He was also likely in the middle to advanced stages of cognitive decline – with incontinence and off cycle sleep patterns, and getting stuck unable to navigate turns. It was awful to watch but now I just want to know what it was – the not knowing is painful. If it was just residual vestibular I’d likely go into a deep depression for having put him down.

    1. Hello Elizabeth, seems like we are going through the same. My 17 year old dog had VS in April she was fine after about a week with some staggering left and also a little more disoriented. Nothing in May. In June we had Antibiotics twice for what seemed to be tooth infections. (swollen lymphnode). Now I think maybe it was an ear infection. The she had a syncope and 2 seizures the last one so violent …A few hours after the seizure she developped symptoms of VS again. Could not stand on her own bit she wanted to poo, pee and drink although she could hardly stand, she was very weak and hat rotating nystagmus. The vet (who was ot my regular vet he was on holiday) made me understand that she was old and suffering. I had her put down and I can’t stop thinking I should have waited …..I am depressed all the time and I will never have an answer….I don’t know what was right or wrong…all I know is that I didn’t want for her to suffer. Like your dog she would get stuck somewhere and not find a way out.

      1. Although it is almost unbearable to make this decision the saying “better a week too early than a day too late” is what you need to think about. A vet wouldn’t help you with this decision unless they really thought it was the right thing to do. To end the suffering of our pet friends is a real gift we can give them – maybe the most important – and you should be proud of yourself not worrying (naturally) whether you did the right thing. Please be content that you gave the greatest gift in the end – we all need to be strong for our friends at this time.

  17. My 13 year old boston terrier is experiencing her second episode of this too. The second episode started about 2 days ago, and she was taken to her usual vet and prescribed medication to deal with the dizziness- recovered within a day or 2. Her first episode, which happened about 4-5 months ago was very strong and apparent. She was taken to the emergency vet in the middle of the night, given medicine, and seen by her regular vet the next day. She recovered completely in about 2 weeks. Now that she is experiencing her 2nd episode, spells are coming and going about every 20 minutes….off she goes to the emergency vet again, as it is the weekend and the regular vet is not open. Prayers to your dog and mine– I hate to see them go through this. I am not sure if this will be a re-ocurring illness, and if it is, I hope that there will not be any neurological damage that will require us to put her down.

  18. My 13 yr old pit bull is on a second episode of vestibular right now, second in the last year. Wondering if this will be as severe as the first time which lasted 13 weeks. And if you think this will keep occuring? What is your experience/opinion?

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