Vestibular Disease and Canine Idiopathic Vestibular Syndrome (or Geriatric Vestibular Syndrome)
How to look after a dog post-vestibular syndrome.
A common cause of the worrying condition of Vestibular Disease, in a dog, is an inner ear infection. This could happen at any age. Geriatric Vestibular Syndrome is a condition that occurs in the older dog. Symptoms are similar in both cases.
This Vestibular Episode help sheet is designed to help the owner cope with those first few weeks of nursing care, until recovery. It is not to inform on the technical and pathological reasons, and causes, of the syndrome. If you require further knowledge of the condition then key "Vestibular Episode" into the search engine, on your computer, this will enable you to browse many websites cataloguing the condition.
The best advice that you can receive for a dog that has had a Vestibular Episode (sometimes called a stroke because of the similarity of symptoms with the human stroke) is from your Veterinary Surgeon. An immediate trip to the vets is essential where the dog will be given medication, possibly Vivatonin, which increases oxygen to the brain. Oxygen is one of the best ways of healing and reducing inflammation. There is a difference of opinion; with many vets seeing no advantage in keeping the dog on medication once recovery has taken place.
Thereafter TLC enhances the medical care, plus the owner keeping totally calm throughout the illness, putting the dog on a speedy road to recovery.
When an elderly dog has a Vestibular Episode it is very frightening for both the dog and owner. It usually happens suddenly with the dog falling all over the place, wide based stance, going around in circles, vomiting and, the most noticeable and distressing of all, the eyes rapidly flickering from side to side. There will also be significant head tilt, and possibly the body leaning to one side. The dog may display some or all of these symptoms, depending on the severity of the disease. This makes the dog feel very queasy and unsteady. The dog may not be able to stand and certainly will not want to eat. The effect that this has on the dog has been likened to seasickness.
The first week can be worrying and very hard work for the anxious owner who may feel very despondent, and confused, as to how best to look after the suddenly incapacitated dog. Affected dogs usually improve spontaneously within two weeks, although there may remain a slight persistent head tilt. The majority of dogs make a 95% recovery, going on to have many more years of active life. Something that an owner wouldn’t have believed possible, when the dog initially became ill.
When you return from the vets you will need to carefully prepare the general environment that the dog is to be kept in. A quiet room, capable of being darkened, where the dog will not be bothered by any other family pets or humans. It should have relatively easy access to the outside, as you may need to carry the dog outside for toileting. As walking will be difficult a carpeted, and restricted, area will prevent slipping. Move as much furniture out of the way as possible. In the first few days further physical injury, caused by the dog falling awkwardly, must be avoided. Some owners prefer to crate the dog. Getting a dog in and out of a crate can be difficult, especially when it cannot assist you and is a bit of a dead weight.
Due to the dogs’ inability to balance, getting in and out of their usual bed will be difficult. Instead, a large piece of white vet bed, or a blanket, spread on the floor will be preferable for the first week or so. The dog may also be incontinent for the first few days; some animals become quite distressed about this. A way around this problem is to put their bedding onto a plastic sheet with a thick layer of newspaper between it and the bedding, ignore the wetness, and quietly without fuss change the paper when required. If the dog is on vet bed then the moisture will not cause any ill effect to the dog, as moisture will wick through to the paper below.
Before settling the dog down, if you think that it will not distress the dog further, trim any excess fur from the bottom of the feet. This will help to prevent slipping.
Food isn’t of prime importance at this time although water is essential. It is highly unlikely the dog will be able, or want, to drink. You may need to syringe water gently and slowly into the side of the mouth, holding the head slightly upwards to allow it to slowly trickle into the throat. Care should be taken not to cause choking.
Prepare some tasty bits of cooked chicken and other favourite foods for when the dog is ready to eat. You can even resort to tiny amounts of tinned cat food, which can stimulate appetite. You will probably have to mince or liquidise the food and gently feed through the gap in the premolars, together with any prescribed medication. Don’t worry if food isn’t accepted for the first day or two, remember the dog is feeling nauseous. Appetite should start to return within a few days or a week. A point to remember is that following a Vestibular Episode the digestive tract is not as supple. In the future the dog may have problems swallowing exceptionally large, or hard, pieces of food.
This should, with taking outside for toileting, be the routine for the first days or week. After this there will be small signs of improvement, which will increase day by day.
After several days, or a week, the dog will actively look for food and will have the desire to feed itself. Because of the eye disturbance, they may find it difficult to focus on their bowls. Sometimes making awkward "hit and miss" attempts to eat from their bowls, with little success. Here there are a few tips that you may like to try. Put a large white plate, or sheet of paper, on the floor and place the food on this. Even putting food straight onto the floor is better than using a bowl. The dog can locate it more easily and will not keep missing, or bumping into, the dish. Others have found that raising the bowl, so that the dog does not have to bend down, has also been very successful. It is also much better, for the queasy dog, to split the meals up into several smaller meals to be fed through the day.
Throughout the whole period talk to the dog frequently, especially when it starts to move around. Sight is poor, especially near vision, so they will need to be able to locate you by sound and scent. They need the reassurance of your close proximity.
When the dog has recovered enough to go out you may need to give some support or physical guidance. They can find uneven ground or sudden changes of direction difficult to manoeuvre, and fall over. I have known owners to help by supporting the rear end with a gent’s tie, or by using a long scarf. Do not mix the dog unsupervised with other household animals, until walking is very steady.
After about four weeks you should see a significant improvement. At this point, if it will not cause distress, a trip to the chiropractor may be beneficial. If they have had a few falls treatment may be necessary, coupled with some gentle massage to increase blood flow to weakened limbs. A nail trim may be needed for overgrown nails that have not been worn down by exercise.
Gentle short walks can be introduced as soon as the dog shows willing, as mental stimulation will be very important in giving back the dog its confidence, mobility and health.
Initially the symptoms of Vestibular Disease are exceptionally dramatic. Experience has shown how the dog can, and does, make an excellent recovery, going on to lead a completely normal life for many years. It also doesn’t follow that the dog will automatically have another "episode" in the future. In the majority of cases the problem never reoccurs. Therefore, unless the veterinary surgeon has made another diagnosis for the cause of the disease, before making any major decisions, it is safer to wait several weeks to see how recovery progresses. TLC works wonders and the results are so inspiring in this condition.
Some useful websites:
Copyright of Sylvie Derrick