Should You Put a Dog Down with Vestibular Disease?

Vestibular disease is a term that many dog owners might not be familiar with. However, it is a condition that can significantly affect the life of your furry friend.

The aim of this article is to provide a comprehensive understanding of what vestibular disease is, how it affects our beloved pets, and what we can do about it.

By the end of this reading, you will be armed with the knowledge necessary to spot the signs, understand the potential causes, and navigate the treatment options.

As caring and responsible pet owners, it’s crucial that we stay informed about such conditions to ensure our dogs live their happiest and healthiest lives.

Understanding Vestibular Disease

The vestibular system plays a critical role in a dog’s life. It’s the system responsible for maintaining balance and coordinating movement. When this system faces disruption, it results in a condition we refer to as vestibular disease.

Understanding this disease is the first step in being able to protect and care for our dogs adequately. The following sections look into the intricacies of vestibular disease, its symptoms, and its different types.

What is the Vestibular System?

The vestibular system is a complex network in your dog’s body that plays a key role in maintaining their balance and coordinating their movement.

This system includes parts of the inner ear and the brain that work together to process sensory information, such as your dog’s orientation relative to the ground, their speed of movement, and changes in their head position.

Understanding this system is vital, as it is often the primary affected area in dogs suffering from vestibular disease.

Recognizing the Symptoms

A dog with vestibular disease may display a range of symptoms, most of which are related to balance and movement. A head tilt, leaning or falling to one side, tight circling, and even strange eye movements, are all signs that something might be wrong with your pet’s vestibular system.

Also, your dog might also have difficulty standing or walking, appear disoriented, or even suffer from nausea. Recognizing these symptoms early can make a significant difference in managing your dog’s condition and ensuring they receive the right treatment.

Causes of Vestibular Disease in Dogs

When it comes to vestibular disease in older dogs, the potential causes are numerous. This condition can originate from several different areas, including the inner ear, the vestibulocochlear nerve, the brainstem, or even the cerebellum.

Some common causes include idiopathic vestibular disease, otitis media/interna, ischemic stroke, and neoplasia. However, other less frequent but equally significant causes may include hypothyroidism, toxins or drugs, or meningoencephalitis.

The key to effective treatment lies in accurately determining the cause and location of the disease.

Differentiating Between Central and Peripheral Vestibular Disease

Identifying whether the vestibular disease is central or peripheral is a critical step in understanding your dog’s condition. The signs of these two types of disease can be very similar, but there are certain unique indicators to each.

Central vestibular disease often brings additional neurological signs, such as changes in mentation, while peripheral vestibular disease may cause additional signs like Horner’s syndrome or facial nerve paralysis.

Knowing these differences can provide valuable information to guide the choice of treatment.

Common Causes of Vestibular Disease

Getting a better grasp of the potential causes of vestibular disease can greatly help in understanding your pet’s health situation. Here are some of the most common culprits and their typical characteristics.

Idiopathic Vestibular Disease

Often seen in older dogs, idiopathic vestibular disease is a peripheral vestibular disorder. ‘Idiopathic’ means that the cause is unknown. The symptoms usually improve after a few days and continue to get better over 1-2 weeks or more.

Otitis Media/Interna

This is an inflammation of the dog’s middle and inner ear. It is another peripheral vestibular disorder, and its progression can be static or progressive.

Ischemic Stroke

A more serious central vestibular disease, an ischemic stroke occurs when blood flow to the brain is blocked. The improvement rate varies, but it could range from regaining normalcy within a few hours to gradual improvement over several days or weeks.


This is a medical term for tumors. Neoplasia as a cause of vestibular disease is central and its progression is usually static or progressive.

These are not the only causes, but they are some of the most common. Understanding the specifics of each one can help guide you and your vet towards a suitable treatment strategy.

Why Distinguishing Vestibular Diseases Matter

It’s essential to distinguish between the various causes of vestibular disease in dogs. Some conditions may appear similar at first but have vastly different underlying causes and treatments. Let’s dive into this a bit further.

Idiopathic Vestibular Disease vs. Ischemic Stroke

At first glance, idiopathic vestibular disease and ischemic stroke might seem identical. Both conditions occur in older dogs, have an abrupt onset, and typically improve over time without targeted therapy. However, there’s a crucial difference between them.

While idiopathic vestibular disease can recur, it’s less common than with strokes. The interval between episodes is typically longer for idiopathic vestibular disease, stretching to months or more, compared to strokes, which might recur within days to weeks or more.

The Significance of Recurring Strokes

Understanding the difference becomes especially critical when considering recurring strokes. Approximately half of the dogs that suffer from strokes have an identifiable underlying cause that predisposes them to having more strokes.

This ongoing risk places them at potential danger for continued morbidity or even mortality.

Identifying the underlying cause of the stroke and treating it can significantly reduce the risk of further strokes and other complications. This shows the necessity of distinguishing between different vestibular diseases, as their management and implications can be starkly different.

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Underlying Causes of Strokes in Dogs

Strokes in dogs can be caused by various underlying health issues. Let’s explore these in more detail:

1. Hypertension

High blood pressure, or hypertension, is a common condition in older dogs. It can increase the risk of strokes by causing damage to the blood vessels in the brain, leading to a stroke.

2. Chronic Kidney Disease

Chronic kidney disease can lead to an increase in toxins and waste products in the blood. These toxins can cause damage to the blood vessels, leading to a stroke.

3. Cushing’s Disease

This is a condition that causes the body to produce too much cortisol. Over time, high levels of cortisol can lead to damage in various parts of the body, including the blood vessels, increasing the risk of stroke.

4. Hypothyroidism

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. This can lead to various health problems, including an increased risk of stroke.

5. Protein Losing Disease

Conditions that cause a loss of protein from the body, such as protein-losing enteropathy and protein-losing nephropathy, can increase the risk of blood clots and, subsequently, strokes.

6. Hypercoagulability

This is a state in which the blood is more prone to clotting than usual. It can lead to the formation of blood clots, which can travel to the brain and cause a stroke.

7. Hyperviscosity

Conditions that cause the blood to become too thick or viscous, such as polycythemia vera or hyperglobulinemia secondary to multiple myeloma, can also increase the risk of stroke.

8. Tumor Emboli

Tumor emboli refer to clumps of cancer cells that break off from the primary tumor and travel through the bloodstream. These emboli can lodge in the brain and cause a stroke.

Diagnostic Evaluation for Dogs Suspected of Having a Stroke

Should your vet suspect a stroke, they will carry out various tests to confirm the diagnosis and understand any underlying causes. Here’s what you can expect:

1. Fundic Exam

A fundic exam involves examining the retina and other structures at the back of your dog’s eye. This can often give a good indication of your dog’s overall health, including blood pressure, which may hint at the possibility of a stroke.

2. Blood Tests

Complete blood count (CBC) and chemistry panel tests are usually conducted. These tests can help to assess the overall health of your dog, including kidney and liver function, blood sugar levels, and white and red blood cell counts.

3. Urinalysis and Urine Protein: Creatinine Ratio

These tests can help to assess your dog’s kidney function. As chronic kidney disease can be an underlying cause of a stroke, understanding your dog’s kidney health is crucial.

4. Blood Pressure Measurement

As hypertension is a risk factor for strokes, measuring your dog’s blood pressure is an important part of the diagnostic process.

5. T4/TSH Test

A T4/TSH test is done to check the thyroid gland function. It helps to identify if your dog is suffering from hypothyroidism which could increase the risk of a stroke.

6. ACTH Stimulation or Low Dose Dexamethasone Suppression Test

These tests are performed to diagnose Cushing’s disease, another potential underlying cause of strokes.

7. Abdominal and Thoracic Imaging

These tests can help to identify any tumors or abnormalities in the organs that could increase the risk of stroke.

8. Coagulation Panel and Hypercoagulability Assessment

These tests measure how well your dog’s blood clots and can help to identify any blood clotting disorders, another potential cause of strokes.

Having a vet identify and treat these underlying causes is crucial to reducing the risk of further strokes and improving your dog’s overall health. But how does vestibular disease relate to all of this? We’ll take a look at this in the next section.

Vestibular Disease and Euthanasia: A Tough Decision

When a dog is diagnosed with vestibular disease, it can be a shocking and heartbreaking experience. Not only do you see your furry friend in distress, but you may also face the difficult decision of whether or not to euthanize your pet.

The decision should be made after understanding the complete situation and considering your pet’s comfort and quality of life.

Understanding the Prognosis

As we discussed above, vestibular disease can be caused by a variety of underlying conditions, including strokes, tumors, infections, and more. The prognosis of the disease greatly depends on the root cause.

For instance, if the vestibular disease is due to an infection or stroke, the chances of recovery are relatively high with appropriate treatment and care. However, if a malignant tumor is causing the condition, the prognosis may be poor.

Considering Your Dog’s Quality of Life

You should always consider your pet’s quality of life when deciding on euthanasia. Symptoms of vestibular disease can be distressing for a dog and may significantly impair their ability to lead a normal, happy life.

These symptoms include loss of balance, dizziness, and difficulty walking or standing. However, it’s important to understand that the severity and duration of these symptoms can vary greatly depending on the underlying cause.

Taking the Time to Decide

Euthanasia is a personal and difficult decision, and it’s crucial that you take the time you need to make the choice that’s best for you and your pet.

This includes talking with your vet, who can provide you with all the information you need about your dog’s condition, prognosis, and treatment options.

The Role of Veterinary Support

Your veterinarian will be a critical partner in navigating this difficult journey. They can help you understand the progression of the disease, manage your pet’s symptoms, and discuss the various treatment options available.

It’s essential to have open and honest conversations about your concerns and your dog’s quality of life.

Looking at Treatment Options

There are various treatment options available depending on the underlying cause of the disease. For instance, if the vestibular disease is due to an infection, antibiotics may be prescribed.

If a stroke is the cause, your vet may recommend managing any underlying health conditions, such as kidney disease or hypertension, to prevent further strokes.

The decision to put a dog down is never an easy one, but understanding the disease, considering your dog’s quality of life, and having open conversations with your vet can provide some clarity in a challenging situation.

No one knows your dog better than you do, and the final decision will always lie in your hands. It’s essential to remember that whatever decision you make, it is made out of love for your pet and a desire for them to live a comfortable, happy life.

Coping with the Decision

Deciding to put a dog down is one of the most challenging decisions a pet owner can make. It’s normal to feel a range of emotions during this time, from sadness and grief to guilt and uncertainty.

It’s important to remember that every situation is different, and every decision is made in the best interest of your beloved pet.

There are resources available, such as pet loss support groups and hotlines, to help you cope with the grief and sadness that accompany euthanasia. Talking with others who have experienced similar situations can provide comfort and understanding during this difficult time.

Remembering Your Pet

While this is undoubtedly a challenging time, it’s essential to remember the happiness and love that your pet brought into your life. Many pet owners find solace in memorializing their pets in some way.

This could include creating a photo album, writing a letter to your pet, or even planting a tree in their memory.

Adopting Another Pet

Many pet owners wonder when it would be the right time to adopt another pet after euthanasia. There’s no ‘one size fits all’ answer to this question. For some, adopting a new pet can help fill the void left by their lost pet.

For others, it takes time to grieve and heal before they’re ready to welcome another pet into their lives. It’s important to do what feels right for you and your family.


Facing a vestibular disease diagnosis in dogs is undoubtedly challenging, and the decision to euthanize is heartbreaking. It’s important to remember that this decision should be guided by a deep understanding of the disease and your pet’s quality of life.

With the support of veterinary professionals and loved ones, you can navigate this difficult situation with compassion and care. After all, the most important thing is ensuring your beloved pet is comfortable and loved, no matter what.

References: Acute Vestibular Disease in Old Dogs

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