Vestibular disease can be a debilitating neurologic disease in dogs. The causes can be central or peripheral in nature. Before treatment can begin for this disease, dogs must be definitively diagnosed.
Treatment is largely dependent on primary cause. Ear infections are typically treated with strong oral and topical antibiotics for anywhere from 2-4 months. Relapse is common in ear infections so aggressive therapy especially in light of vestibular signs is vital. Dogs with chronic ear disease may be beyond medical therapy. In these cases, there is a salvage procedure called a Total Ear Canal Ablation and Bulla Osteotomy (TECA-BO). In this surgery, the entire ear canal is removed including the middle ear. This typically leaves the patient deaf but pain and symptom-free.
Thyroid supplementation is routinely used in dogs diagnosed hypothyroid. Typically, dogs will need to be on supplementation for life.
Idiopathic vestibular disease has few proven treatment options. For those animals that are nauseous, vomiting, or cannot walk, there are oral and injectable anti-nausea medications (maropitant and meclizine are the most commonly used) that will help the body find its center and disrupt the vomiting/nausea cycle. There has been back and forth debate on the effectiveness of steroids in this presentation of vestibular disease, with the pendulum swinging against their use at this time. Many times the body simply has to compensate and work through the neurologic abnormalities until they subside over a period of days-weeks.
Central Nervous System infection or inflammatory disease has a number of effective treatments once a diagnosis has been made. Antibiotics and/or anti-inflammatories must be used for a long period of time to clear the CNS of these types of diseases. cancer can be managed well in dogs with chemotherapy, radiation, or surgery; however, cure rates for most canine CNS tumors, similar to other tumors, is low. With that being said, treatment many times will provide excellent quality of life for extended periods of time.