Peripheral Vestibular Disease in Dogs: Signs, Causes & Care (Vet Answer)

Peripheral Vestibular Disease in Dogs: A Closer Look at Constipation and Loss of Appetite

Introduction
If you‘ve ever witnessed your older dog suddenly develop a head tilt, have trouble walking, or seem extremely nauseous and off balance, you likely feared they were having a stroke. But in many cases, these scary symptoms are actually caused by a condition known as peripheral vestibular disease. While vestibular episodes are distressing for both you and your dog, the good news is that most dogs recover with supportive care and time. However, it‘s important to be aware of some of the potential complications, including loss of appetite and constipation. In this article, we‘ll take an in-depth look at vestibular disease in dogs, with a special focus on constipation and what you can do to help your furry friend feel better.

What is Peripheral Vestibular Disease?
The vestibular system is responsible for maintaining balance and spatial orientation. It includes structures in the inner ear and brain that sense the position of the head and coordinate movements of the eyes, head, and body to maintain equilibrium. Peripheral vestibular disease refers to a dysfunction of the inner ear portion of this system, while central vestibular disease involves the brain. Peripheral vestibular disease is much more common in dogs, especially older dogs, which is why it‘s often called "old dog vestibular disease" or "canine idiopathic vestibular disease."

Signs of Vestibular Dysfunction in Dogs
A dog suffering from peripheral vestibular disease will often show an acute onset of some very distinct and distressing signs:

Head tilt, usually to one side
Nystagmus, or involuntary rhythmic eye movements, often side to side
Ataxia, or lack of coordination, leading to stumbling, circling, or falling
Motion sickness, nausea, drooling, and vomiting
Reluctance or complete inability to stand and walk
"Alligator rolling," or complete rolling to one side

You may also notice that your dog has a complete loss of appetite, seems lethargic and depressed, and may be constipated or have difficulty defecating. We‘ll discuss the connection between vestibular disease and GI upset in more detail later.

Causes of Peripheral Vestibular Disease in Dogs
In many cases of peripheral vestibular disease, a definitive cause is never found. These idiopathic cases are the most common and tend to occur in older dogs. However, there are some other potential causes, including:

Middle or inner ear infections
Trauma or injury to the ear or head
Tumors of the ear or brainstem
Stroke affecting the blood supply to the vestibular system
Toxicity from certain medications

To determine the underlying cause, your veterinarian will perform a thorough physical and neurological exam. They‘ll look in your dog‘s ears for signs of infection or inflammation and assess their balance, coordination, and reflexes. They may also recommend bloodwork, x-rays, or advanced imaging like MRI to rule out other causes.

Treating Vestibular Disease in Dogs
Treatment for peripheral vestibular disease depends on the underlying cause, if one can be identified. For example, if your dog has an ear infection, your vet will prescribe appropriate antibiotics or anti-inflammatory medications.

However, in idiopathic cases, the mainstay of treatment is supportive care to keep your dog comfortable and prevent complications while their body compensates and recovers. This typically includes:

Anti-nausea medications like maropitant or ondansetron to control vomiting
Motion sickness medications like meclizine to reduce dizziness
Fluid therapy to correct dehydration from loss of appetite or vomiting
Nutritional support like appetite stimulants, hand feeding, or syringe feeding
Pain medications if the dog is uncomfortable
Physical support with a harness or sling to help them walk safely

Most dogs start to show improvement in their symptoms within 72 hours, with many recovering to near-normal within 7-14 days. However, some dogs may have a residual head tilt even after clinical signs resolve.

Vestibular Disease and Constipation in Dogs
One often overlooked complication of vestibular episodes in dogs is constipation or difficulty defecating. There are a few potential reasons for this:

Loss of appetite and decreased food intake can lead to dehydration and slower GI motility.
Nausea and motion sickness may make your dog not want to eat, exacerbating dehydration and constipation.
Lack of exercise and movement due to difficulty walking can slow down digestion and lead to harder stools.
The stress of the vestibular episode may alter your dog‘s normal bathroom habits and routine, making them reluctant to posture to defecate.
Some anti-nausea or motion sickness medications can cause constipation as a side effect.

If left untreated, constipation can progress to obstipation, where the stool becomes so hard and dry that it‘s impossible for your dog to pass it without intervention. This can lead to lethargy, loss of appetite, vomiting, and abdominal pain. Severe cases can even lead to megacolon, a serious condition where the colon becomes stretched out and loses its ability to contract and move stool along.

Tips for Managing Constipation in Dogs with Vestibular Disease
If you notice your dog straining to defecate, passing small hard stools, or not defecating at all, it‘s important to take steps to manage their constipation before it becomes a bigger problem. Here are some tips:

Keep your dog well-hydrated by offering fresh water at all times and encouraging them to drink. You can try flavoring the water with low-sodium chicken broth or offering wet food to increase moisture intake.
Ask your veterinarian about using a stool softener like docusate sodium or a gentle laxative like psyllium powder or pumpkin puree. These can help make stools easier to pass.
Gradually increase the fiber in your dog‘s diet by adding canned pumpkin, bran, or a fiber supplement recommended by your vet. Fiber helps draw water into the stool to keep it soft.
Encourage gentle exercise and movement as your dog is able. Short, slow leash walks or range of motion exercises can help stimulate digestion and keep things moving.
If your dog hasn‘t defecated in over 48 hours, seems uncomfortable, or is showing signs of obstipation, contact your veterinarian. They may need to give an enema, perform manual evacuation under sedation, or prescribe stronger medications to relieve the constipation.
Monitor your dog‘s appetite closely and report any vomiting, diarrhea, lethargy, or signs of abdominal pain to your vet promptly, as these could indicate a more serious complication.
Consider adding a probiotic supplement to support a healthy gut microbiome during recovery. Look for products containing beneficial bacteria like Enterococcus faecium or Bacillus subtilis.

When to Seek Veterinary Care
While most dogs with idiopathic vestibular disease show significant improvement within a few days to a week, it‘s important to keep a close eye on their progress and appetite. Contact your veterinarian if you notice any of the following:

Worsening of clinical signs after initial improvement
Inability to walk or support themselves even with assistance after 1 week
Complete loss of appetite for more than 24 hours
Vomiting, diarrhea, or signs of abdominal pain
Severe constipation or straining to defecate with no productionpainful abdomen, hunched posture, crying out when defecating
Lethargy, weakness, collapse, or difficulty breathing

Your vet can determine if additional diagnostics or treatments are needed to manage complications and support recovery. Be sure to attend any recommended follow-up appointments so your vet can assess your dog‘s progress.

Caring for a Dog with Vestibular Disease
Seeing your beloved dog suffer a vestibular episode is scary, and recovery can be a slow and frustrating process. In addition to following your vet‘s recommendations for medications and supportive care, there are things you can do at home to keep your dog safe and comfortable:

Set up a quiet, confined, well-padded area for your dog to rest, away from stairs, slippery floors, and hazards. Provide extra bedding and roll up towels or blankets to help prop them up comfortably.
Use a harness, sling, or mobility aid to support your dog when walking and toileting. Let them move at their own pace and offer lots of encouragement.
Hand-feed or syringe-feed small meals if needed to get nutrition in. Warming up food can make it more appetizing. Your vet can prescribe a high-calorie liquid diet if necessary.
Gently wipe away any drool or vomit from your dog‘s face and keep their eyes and nostrils clear of discharge.
Express your dog‘s bladder or manually evacuate their bowels if they‘re unable to posture normally to eliminate. Your vet can teach you how to do this safely.
Keep a close eye on their hydration status and report any lack of urination, dark urine, sticky gums, or sunken eyes to your vet.
Provide lots of comforting love, affection, and reassurance to your dog. Stay calm and positive, as they may be feeling anxious and disoriented.

With time, care, and patience, most dogs can recover well from vestibular episodes and go on to enjoy a good quality of life. Work closely with your veterinarian and don‘t hesitate to reach out if you have any concerns along the way.

Conclusion
Peripheral vestibular disease is a common and scary condition that affects many older dogs. While the acute onset of symptoms like head tilt, nystagmus, ataxia, and nausea can be very distressing, the long-term prognosis for idiopathic cases is generally good with supportive care. However, it‘s crucial to be aware of potential complications like loss of appetite and constipation that can develop, especially in the first few days of the episode.

By working closely with your veterinarian, keeping your dog well-hydrated and nourished, managing their comfort and mobility, and monitoring their overall progress, you can help support them through a vestibular episode. Don‘t forget the power of your loving care and reassurance in helping your furry companion navigate this stressful time. With patience and dedication, you can get them feeling better and back on all four paws again.