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What's up with our old dog's sudden head tilt?

Q: Our Boxer Wagatha has been going a bit senile in her old age, but she was still pretty with it until last night when she woke up from a nap and couldn’t stand up. Her head is now all cocked to one side and she can hardly walk even with our help.

Slumdog's "natural" head tiltThe ER veterinarian said she’s got old dog vestibular disease. What does that even mean? We’re really worried and our regular vet is out of town. Help!

A: The newest term for this common neurologic disorder of geriatric dogs is idiopathic vestibular syndrome, but we also refer to it as old dog vestibular disease or geriatric vestibular disease.

The commonest version of this disease happens when the inner ear’s vestibular apparatus (AKA, balance system) goes haywire for no clear reason, impeding several normal nervous system functions, including:

  • Eyeball movement
  • Limb extension
  • Conscious perception of position
  • Coordination of the eyes, neck, body, and limbs in relation to how the head moves
  • Control of vomiting and motion sickness

That’s why the most common signs of this disorder include:

  • Head tilt: Affected dogs will tilt their head to one side or another.
  • Nystagmus: These are rhythmic, involuntary eye movements that are usually horizontally directed).
  • Strabismus: This is an abnormal position of the eyeballs best observed when a dog is on her back).
  • Ataxia: This word refers to generally being “off balance” but vestibular dogs will usually be ataxic in that they’ll fall or roll to one side.
  • Circling: Affected dogs that are able to walk will often circle in one direction or the other. Not all will do this, though.

To diagnose this problem in Wagatha, your ER vet will have performed a full physical examination and a neurological examination.

The primary goal in diagnosing this problem as the common “idiopathic vestibular disease” is to distinguish it from other diseases that can elicit similar symptoms. In particular, the possibility of a deep ear infection or a brain lesion must be ruled out. And that’s usually doable with careful examination of the patient.

So what’s the upshot for Wagatha? If you’re uncomfortable with the ER vet’s findings or recommendations, see your regular veterinarian for a “second opinion” as soon as possible. And if she’s at all nauseous or her creaky joints hurt from being all twisted in an odd position, consider seeking help for these specific symptoms common to dogs with idiopathic vestibular disease.

But know that for most dogs with these symptoms and this preliminary diagnosis, this is a problem that will slowly and gradually improve over time. The worst cases may end up with a permanent tilt of the head but that’s typically the worst of it.

Should the true diagnosis be something more sinister, however (such as a brain lesion or dangerous ear infection), her condition will likely continue to deteriorate unless imaging and very specific intervention are elected.

Still curious? Read about in two more science-y (and expanded) versions of the above: Here and here.

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Reader Comments (1)

My dog is a 12.5yr old Gordon setter/Border collie. He just went to our vet(whom i've been going to his whole life) and got his yearly exam and vaccines. 2 days later my husband texted me a pic of his head tilted slightly to the left. he doesn't have any other symptoms listed except occasionally on our slick noncarpeted floors he will slip and he will fall flat on his tummy. i brought up the slipping to the vet and he said it is most likely arthritis, joint type problem. in the last 6 months he has maybe slipped 7 or 8 times. we also are dog sitting a very active 2yr old husky/German Shepard dog who loves to play. i am worried that my old guy maybe played to rough, or maybe be developing idiopathic vestibular syndrome. his head has been tilted for the last 2 days, and it only is tilted when he is just walking around or hanging out. its not tilted when he licks his paws or turns to see who is coming behind him ect..... he isnt showing any obvious signs of pain and he is even still playing with the other dogs. This dog is my life, he is my companion and my baby. we,like many others, have fallen on bad times and i don't have the money to take him in for another exam or ex-ray or anything right now. i was hoping for some tips or advice on what may be going on or something i could do if its just a neck strain, i hope you read this and find the time to maybe write me back.
thank you so much.

November 25, 2013 | Unregistered CommenterHeather

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