Peripheral Vestibular Disease in the Dog: Causes

There are many possible causes of periperal vestibular disease in the dog.Peripheral Vestibular Disease in the Dog: Causes

Otitis – Ear infection is a common cause of vestibular disease that affects your pet’s health.  Many times, these infections can start mild and limited to the superficial part of the canal (called otitis externa).  Left undiagnosed and untreated, these infections will spread deeper into the canal and eventually rupture the tympanic membrane (ear drum).  This more severe disease, called otitis media, presents a much greater challenge and has more serious consequences.  Not only is this painful (if one had ear infections as a child, they will know this can be debilitatingly uncomfortable), but can have chronic, irreversible consequences on the canal and nervous system.

Infection causes by yeast or bacteria causes a series of inflammatory reactions with the body’s immune system.  The body’s destruction of these invaders creates debris, fluid, and inflammation in the ear canal.   These byproducts affect the hair cells’ ability to assess changes in gravity and balance, thereby leading to the clinical signs of head tilt, difficulty walking, and nausea.

Congenital Vestibular Disease – There are reported syndromes in certain purebred dogs such as Dobermans, Cockers, Akitas and Beagles.  The signs are usually apparent within the first few weeks of life.  Severity is variable, though most dogs can adapt and appear clinically normal.  Some dogs will have a residual head tilt for life, though many times this is merely a cosmetic issue.  Interestingly, deafness is seen with congenital vestibular disease.  If suspected, a BAER test may be performed by a veterinary neurologist.  This tests the nervous pathways to hearing.

Schunk K.L.:  Disorders of the vestibular system.  Vet Clin North Am 18. 641-655.1988

Forbes S., Cook, Jr. , Jr.J.R.:  Congenital peripheral vestibular disease attributed to lymphocytic labyrinthitis in two related litters of Doberman pinscher pups.  J Am Vet Med Assoc 198. (3): 447-449.1991

Aural (ear) tumors – Tumors in the canal can put pressure on the inner ear mechanisms or even invade the cellular layers themselves.  Tumors of the ear in dogs are malignant 60% of the time, with invasion into the local boney structures and the brain the most common metastatic occurrences.  Swelling on the outside of the ear may be the first indication of disease.  If CT/MRI of this area indicates boney destruction, cancer is much more likely than other disease.

Ototoxicity (ear toxicity) – A number of substances and medications are known toxins to the ear.  The mechanism is typically inducing death or damage to the hair cells responsible for hearing and balance.  While the vestibular signs are typically reversible, or are at least compensated for, the deafness is usually permanent.

Interestingly, a number of medications used to treat ear infection are themselves toxic to the vestibular apparatus.  This includes over-the-counter ear cleaners obtained from the pet store.  These substances are only toxic in the absence of an intact ear drum.  The importance of a veterinarian’s otoscopic examination (examination of the inside of the ear) cannot be emphasized enough due to these potentially severe and permanent consequences.  Some common medications known to be toxic include chemotherapy agents (platinum derivatives), diuretics (furosemide/lasix), and antidiarrheals (metronidazole/flagyl).

Idiopathic – This term means there is a recognized syndrome of vestibular disease that does not have a known mechanism.  This is more common in older dogs.  This is typically a quick-onset disease.  Signs progress quickly to the point where pets may roll due to the severe vertigo and inability to stand.  This is commonly mistaken for a seizure, however consciousness is not lost like in a seizure.
Higgins MA, Rossmeisl JH Jr, Panciera DL. Hypothyroid-associated central vestibular disease in 10 dogs: 1999-2005. J Vet Intern Med. 2006 Nov-Dec;20(6):1363-9

Click here to learn about the causes of central vestibular disease in dogs.

Click here to learn about the diagnosis or treatment of vestibular disease in dogs.

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Dr Roger Johnson and Dr Kyle Marano

Roger K. Johnson, DVM, Diplomate ACVIM (internal medicine) is a board-certified veterinary internal medicine specialist. His professional interests include cardiology as well as using advanced diagnostics to help his patients. His particular favorites include echocardiography, abdominal ultrasonography, and endoscopy. Kyle Marano, DVM is a small animal veterinarian practicing out of Northern Colorado. He has written pieces ranging from sports commentary and analysis to quips on the every day life of veterinary medicine. His furry family includes a chocolate lab mix and an overly nosy cat.

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  1. avatar Candy says:

    Nice blog you got here. Helped me out a bunch. I have a few qieotusns though, is there anyone I could contact to answer them here? I could use a few opinions.

    1. Hello!

      Please feel free to ask any veterinary questions right here on our website! They will be answered by one of our veterinarian contributors. We are happy to help!