Does Vestibular Disease Recur in Dogs? What Pet Parents Need to Know

If you’ve ever witnessed your furry friend suddenly tilting their head, walking in circles, or struggling with balance, you might have experienced the frightening reality of canine vestibular disease. As a dog parent who’s been through this myself, I know how scary it can be to see your pup suddenly acting like they’ve had one too many trips to the doggy bar!

But after your dog recovers from this disorienting condition, a nagging question remains will it happen again? Let’s dive into what the experts say about vestibular disease recurrence in our four-legged companions

What Exactly is Vestibular Disease in Dogs?

Before we tackle the recurrence question, let’s make sure we’re all on the same page about what vestibular disease actually is.

The vestibular system is basically your dog’s internal GPS for balance and orientation It includes parts of the inner ear, the vestibulocochlear nerve (cranial nerve VIII), the brainstem, and a region of the cerebellum When any part of this system goes haywire, your pup might show these classic symptoms

• Head tilt (often to the side of the problem)
• Leaning or falling to one side
• Tight circling
• Unusual eye movements (nystagmus)
• Positional strabismus (abnormal eye position)
• Difficulty walking or standing
• Nausea or vomiting
• Reluctance to eat

This condition is sometimes called “old dog vestibular syndrome” because it frequently affects senior dogs, though dogs of any age can experience it.

The Big Question: Does Vestibular Disease Come Back?

Yes, vestibular disease can recur in dogs. But exactly how common is recurrence? Let’s look at what the research shows

According to a study cited on SeniorTailWaggers.com, about 17.6% of dogs experienced a recurrence of vestibular disease within the first 12 months after their initial episode. That’s nearly 1 in 5 dogs!

Other data points are even more telling:

• Some dogs may experience multiple episodes throughout their lives
• Recurrences can happen months or even years after the initial episode
• The severity of recurrences can vary – some might be milder than the first episode

Dr. Jennifer Michaels, a board-certified veterinary neurologist, notes that while idiopathic vestibular disease can recur in dogs, the interval between episodes is typically longer (months or more) compared to other causes like strokes (which might recur within days to weeks).

What Determines If Your Dog Will Have a Recurrence?

Several factors may influence whether your dog experiences a recurrence:

1. The underlying cause – Idiopathic (unknown cause) vestibular disease has different recurrence patterns than vestibular disease caused by ear infections, strokes, or other issues

2. Age and overall health – Older dogs and those with other health conditions may be more susceptible to recurrences

3. Presence of persistent symptoms – Dogs who never fully recover from their first episode may be at higher risk

4. Management of underlying conditions – If vestibular disease was caused by something like ear infections or hypertension, proper management of those conditions may reduce recurrence risk

Persistence of Symptoms vs. True Recurrence

Something important to understand is the difference between persistent symptoms and actual recurrence. According to a study of clinical signs and MRI findings in dogs with peripheral vestibular disease (followed for about 12 months):

• 34.5% of dogs had a persistent head tilt
• 28.5% of dogs continued to show facial weakness (paresis)
• 4.1% of dogs had ongoing incoordination (ataxia)
• In total, 52% of dogs had some form of persistent neurological deficit

These persistent symptoms are different from a true recurrence, which involves a dog recovering (partially or completely) and then experiencing a new episode of acute symptoms.

Recovery Patterns After Vestibular Disease

Most dogs with vestibular disease follow similar recovery patterns:

• Initial improvement typically begins within 2-4 days
• About 71% of dogs show improvements after a median of 4 days
• The majority make a full recovery within 2-6 weeks
• Head tilt and incoordination often disappear within the first 1-2 weeks

But as we’ve seen, many dogs never completely return to normal. And even those who do recover completely may experience future episodes.

Different Types of Vestibular Disease and Their Recurrence Patterns

Not all vestibular disease is created equal! The likelihood of recurrence depends partly on what caused the problem in the first place:

Idiopathic Vestibular Disease

This is the most common form in older dogs, where no specific cause can be identified.

• Can recur, but typically with longer intervals between episodes (often months or years)
• Improvement usually begins after 2-3 days
• Most dogs recover within 2-6 weeks, though some may have a permanent head tilt

Otitis Media/Interna (Middle/Inner Ear Infection)

• More likely to recur if the infection isn’t completely resolved
• Symptoms tend to remain static or progressively worsen without treatment
• Proper antibiotic treatment reduces recurrence risk

Ischemic Stroke

• About 50% of dogs that suffer strokes have an underlying condition that predisposes them to more strokes
• Recurrence can happen within days to weeks if underlying causes aren’t addressed
• Improvement occurs at variable rates – from hours to weeks

Neoplasia (Tumors)

• Symptoms generally remain static or progressively worsen
• Not technically a “recurrence” as symptoms don’t typically resolve and then return

How to Reduce the Risk of Vestibular Disease Recurrence

While we can’t prevent all cases of vestibular disease from recurring, there are steps we can take to minimize the risk:

1. Get a proper diagnosis – Don’t assume all vestibular episodes are idiopathic. Work with your vet to identify potential underlying causes.

2. Treat underlying conditions – If your dog has hypertension, Cushing’s disease, hypothyroidism, or other conditions that might contribute to vestibular issues, managing these conditions is crucial.

3. Complete all prescribed treatments – If your dog has an ear infection, make sure to complete the full course of antibiotics.

4. Regular check-ups – Older dogs should have more frequent veterinary exams to catch potential issues early.

5. Monitor blood pressure – High blood pressure can increase stroke risk, which can cause vestibular symptoms.

When to Consider Advanced Diagnostics

If your dog has recurrent episodes of vestibular disease, your veterinarian might recommend more advanced testing. According to Dr. Michaels, these situations warrant consideration of referral to a specialist for imaging (typically MRI):

• Progression of clinical signs over time
• Neurologic examination findings suggestive of central vestibular disease
• Recurring vestibular episodes

Other diagnostic tests that might be recommended include:

• Fundic examination (looking at the back of the eye)
• Blood tests (CBC, chemistry panel, thyroid tests)
• Urinalysis
• Blood pressure measurement
• Tests for Cushing’s disease
• Abdominal and thoracic imaging
• Coagulation panel

Our Experience with Recurrent Vestibular Disease

I’ll never forget when our 13-year-old Labrador, Max, experienced his first vestibular episode. It was absolutely terrifying – we thought he was having a stroke! The good news was that he improved significantly within about a week.

However, almost 8 months later, it happened again. This time, we knew what we were dealing with, so it wasn’t quite as scary. But we also learned an important lesson: just because it’s called “idiopathic” doesn’t mean we shouldn’t look for underlying causes.

It turned out Max had developed hypertension, which might have contributed to his vestibular episodes. Once we got his blood pressure under control with medication, he didn’t experience any more episodes for the remainder of his life.

The Bottom Line on Vestibular Disease Recurrence

So, does vestibular disease recur in dogs? The answer is a definite yes – it can and does recur in many dogs. About 17.6% of dogs will experience a recurrence within the first year, and many dogs live with persistent symptoms even after their acute episode resolves.

The good news is that with proper veterinary care, many underlying causes can be identified and treated, potentially reducing the risk of recurrence. And even when recurrences do happen, most dogs recover from subsequent episodes similar to how they recovered from their first.

If your dog has experienced vestibular disease, work closely with your veterinarian to:

1. Identify any possible underlying causes
2. Create a management plan for persistent symptoms
3. Know what to do if a recurrence happens
4. Recognize the difference between persistence of symptoms and true recurrence

Have you dealt with recurrent vestibular disease in your dog? I’d love to hear about your experience in the comments below!

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Disclaimer: I’m not a veterinarian, just a fellow dog parent sharing information gathered from veterinary resources. Always consult with your veterinarian for proper diagnosis and treatment of your pet’s medical conditions.

Yes, old dogs can recover from idiopathic vestibular disease, with many showing significant improvement within days to a few weeks, though some residual effects like a permanent head tilt may remain. The prognosis for idiopathic vestibular disease is generally good, but it’s crucial to seek prompt veterinary care to rule out other, more serious underlying conditions like tumors or severe infections, and to provide supportive care and comfort during the recovery period.

You cannot reliably prevent vestibular disease in dogs because it is often idiopathic (has no known cause) or is caused by underlying conditions like infections, trauma, or tumors. However, you can help prevent potential causes, such as ear infections, by performing regular veterinary check-ups and cleaning your dog’s ears with a vet-approved cleanser.