Call Alfred Hitchcock — Can Dogs Get Vertigo?

When I awoke one night to the sound of Meadow, my 10-year-old Alaskan Malamute, throwing up and stumbling around, I was worried. But when I looked at her face and saw her eyes darting rapidly from side to side, I panicked. I called an emergency vet and was told to stay home and watch her through the night. I remembered how three years earlier, I’d had a sudden case of extreme dizziness, and my own eyes had danced uncontrollably, just like Meadow’s. An ER doctor diagnosed me with vertigo. Could the same thing be happening to Meadow? Do dogs even get vertigo?

What is Vertigo in Dogs?

Also known as vestibular disease, vertigo in dogs is a real thing. It’s a type of dizziness, a sense of motion when one is stationary, due to a dysfunction of the vestibular system in the inner ear. It is often associated with nausea and difficulty standing or walking.

“Vertigo is a human description of a feeling; dogs can’t tell us what they’re feeling, so vestibular disease is the term used,” Dr. Beverly Sturges, associate professor of clinical neurology/neurosurgery at the UC Davis School of Veterinary Medicine, says.

According to Dr. Sturges, the most frequent cases are referred to as idiopathic or “old dog” vestibular disease because it’s most often seen in older dogs and there’s no obvious cause. “It’s benign; we still have no real understanding of why it occurs,” she says. “It’s self-limiting, [requiring] no treatment except supportive care and comforting the dog.” The second most common cause is infection — especially Rocky Mountain spotted fever — or inflammation.

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Dr. Sturges describes two broad categories of canine vertigo: outside the brain, and inside. “When outside the brain, it involves the middle or inner ear and is referred to as peripheral vestibular disease. This type is more treatable, with a better prognosis,” she says. This includes the “old dog” syndrome.

“Inside the brain means it involves the brain stem and is referred to as central vestibular disease. In small breeds — Maltese, Yorkies, Pugs, Poms — it’s usually caused by a non-infectious inflammation of the brain stem, often referred to as inflammatory brain disease. It occurs mostly in younger dogs [less than] two years of age. In larger breeds, central vestibular disease is usually caused by brain tumors [putting] pressure on the brain stem. Or, sometimes, trauma to the head.” Symptoms of central vertigo may be more subtle, with gradual onset.

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That frightening eye-darting I saw in Meadow? It’s called nystagmus, a rapid, involuntary eye movement, side to side or, less frequently, up and down. “Nystagmus is not seen in all cases, but [it] is common,” says Dr. Sturges. “It lessens as the dog gets used to the sensation.” 

Struges adds that nystagmus can be profound in old dog vestibular disease, but it usually dissipates after a couple of weeks — max. It’s a reliable symptom, too: If there’s nystagmus, vestibular disease is usually the diagnosis, not a seizure.

Symptoms of Vertigo in Dogs

An online search of “vertigo in dogs” and “dogs with nystagmus” brings up plenty of videos of pups showing classic symptoms of vertigo, such as head tilt, a drunken-like walk (also known as ataxia), and nystagmus. The videos are hard to watch, but being aware of the symptoms could save you a night of fear and stress, or help you notice warning signs of vertigo, allowing early intervention and an increased likelihood of a good outcome for your dog.

How Vertigo in Dogs is Diagnosed

Diagnosis is based on a description of symptoms, or better yet, actual observation of symptoms. When appropriate, a vet will do a CT scan or an MRI to see if there are tumors or brain swelling. The type of nystagmus observed (horizontal versus vertical) and the direction of the dog’s head tilt (another common symptom) can help a neurologist differentiate between the peripheral and central disease. Other issues involving the inner ear, such as an ear infection, will be ruled out if symptoms persist.

Because the symptoms are often confused with seizures, Dr. Struges says it’s a good idea to film an episode if you can. “A neurologist could maybe tell the difference,” she says. “An EEG to measure brain electricity and some other tests could help differentiate. But actually seeing the episode is the best way to diagnose.”

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Treatment for Vertigo in Dogs

Treating central vestibular disease in dogs depends on the type and cause. “We’re pretty good now at removing tumors from the brain stem,” says Dr. Sturges. “If there’s inflammation and fluid, that can be drained surgically if necessary. We can prescribe antibiotics or an antifungal. When a vascular cause is suspected — a temporary or permanent lack of blood supply — vestibular issues usually get better on their own,” she says. “Toxins are another possibility. Metronidazole [Flagyl] and a few other medicines can cause toxicity, including vestibular disease. Taking the dog off the drug and substituting another can resolve it.”

A sudden onset of acute symptoms and an absence of other physical findings usually mean peripheral vestibular disease. You and your vet may elect to wait a few days to see if improvement occurs before doing extensive diagnostics. After some online research, this was the choice I made for Meadow. Some vets will prescribe corticosteroids to reduce swelling and antibiotics just in case the cause is inside the brain. Ultimately, the final diagnosis of old dog vestibular disease is made by the self-limiting nature of the symptoms. According to Dr. Sturges, five to 10 percent of dogs who experience this problem may have additional episodes.

For those who have never experienced vertigo, let me assure you that it’s sudden, overwhelming, and incredibly frightening. You don’t know what’s happening and your brain seems disconnected from your body. Dogs must experience similar fear. And it can be dangerous, depending on when and where it occurs. 

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A Happy Ending

After her episode, Meadow and I eventually fall asleep. Around 7 am, I’m awakened by movement. I open my eyes to see Meadow sitting up. “Meadow! Good girl!” I say excitedly. This is progress. “Do you want to go outside?” Before I finish the sentence, Meadow leans forward to get her hind legs underneath her. Helping her up, I usher her unsteadily toward the door. Out in the yard, she immediately pees and poops. I’ve never before been so excited about normal bodily functions. 

Within a few days, Meadow’s walk is back to normal. She doesn’t have the lingering head tilt common with vertigo, but displayed every other symptom. Follow-up blood work discloses that she’s hypothyroid, a possible cause of vestibular disease.

After the dust settled, I shared my experience with friends, and many have had similar episodes with their dogs, along with misdiagnoses. So, let this be a reminder that if a diagnosis doesn’t ring true for you, trust your own observations and get another opinion. You know your dog better than anyone.