Geriatric vestibular disease is characterized by a sudden onset of loss of balance and disorientation in geriatric dogs, usually those over 8 years old. It is caused by dysfunction of the vestibular system controlling balance. Symptoms include wobbly or unsteady gait, head tilt, uncontrolled eye movements, and sometimes nausea. Treatment involves intravenous fluids, anti-nausea and anti-vertigo medications. Most dogs recover fully within 2-3 weeks with supportive care. The case study describes a 13-year old golden retriever presenting with vestibular disease and making a full recovery over 3 days of hospitalization and treatment.

1. VESTIBULAR DISEASE OF
GERIATRIC DOGS
A case study by Allison Kirchgatter

2. WHAT IS GERIATRIC VESTIBULAR
DISEASE?
 The vestibular system controls balance
 Geriatric vestibular disease is characterized by sudden and
non-progressive loss of balance
http://www.vcahospitals.com/main/pet-health-information/article/animal-
health/vestibular-disease-in-dogs/856

3. WHO IS AT RISK FOR GERIATRIC
VESTIBULAR DISEASE?
 Geriatric dogs; usually older than 8 years old
 More frequently affects medium to large breed dogs

4. HOW DO YOU RECOGNIZE GERIATRIC
VESTIBULAR DISEASE?
 Geriatric vestibular disease is characterized by a sudden onset of the
following symptoms:
 Wobbly, loss of balance, inability to walk
 Disorientation
 Head tilt
 Nystagmus (uncontrolled eye movement)
 May or may not present with nausea and vomiting from the dizziness
http://www.myvetcare.com.au/Ringwood_East_Vetcare/Blog/Entries/2013/6/1_geriatric_ve
stibular_syndrome.html

5. HOW WILL GERIATRIC VESTIBULAR
DISEASE BE TREATED?
 The patient should receive:
 Intravenous fluids
 Meclizine- a medication to prevent motion sickness caused by the dizziness
 Cerenia- an anti nausea medication
 A Urinary catheter may need to be placed if the animal cannot stand to
urinate to prevent skin wetness and irritation

6. WHAT SHOULD BE EXPECTED POST-
TREATMENT?
 Prognosis for geriatric vestibular disease is very good
 Rapid improvement and recovery is expected
 Most dogs make a nearly full recovery within 2-3 weeks

7. DIFFERENTIAL DIAGNOSIS
 Geriatric vestibular Syndrome can often present with similar clinical
signs of a brain tumor.
 Vestibular Syndrome is sudden, and will resolve, whereas neoplasms grow
slowly and present with symptoms that progress over time.
 An MRI would be needed to definitive diagnosis to determine which
disease process is occurring
 Geriatric vestibular Syndrome will show rapid improvements with
proper hospitalization and supportive care, while a tumor will not.

8. CASE STUDY: KOBY WEST
 13 Year old Neutered male Golden Retriever
 112.6 pounds
 Koby presented at IVS unable to walk
 Koby’s owner noted that he was weak and stumbling, then
Koby fell and could not stand.

9. KOBY’S PROGRESS: PRESENTATION
 Koby presented as non-ambulatory, but was able to stand if we assisted
him.
 Clinical sings:
 Tremors
 Head tilt to the left
 Vertical nystagmus (eye twitching up and down)

10. PROGRESS: 24 HOURS
 Koby remained unable to stand unassisted
 His head continued to tilt to the left
 His nystagmus switched from vertical to horizontal
 Koby still refused to eat (possibly due to persistent nausea)

11. PROGRESS: 48 HOURS
 Koby stood up on his own and was able to walk with assistance
 His nystagmus and head tilt both decreased in severity
 Koby’s owners came to visit and were able to get him to eat
 He developed a small cutaneous lesion (a hot spot) on his elbow from
laying down for extended periods of time
 This was clipped, cleaned, and he was started on Cephalexin to prevent
infection

12. PROGRESS: 72 HOURS
 By the 3rd day of hospitalization Koby was able to stand and walk by
himself
 Nystamus and head tilt had resolved
 Appetite returned
 Koby was discharged and sent home
 Over a month later, the owners report that Koby is doing well