“Old Dog Disease”: Understanding Idiopathic Vestibular Disease
Most people have never heard of Idiopathic Vestibular Disease (IVD), also known as “old dog disease” or “old rolling dog syndrome.” It is a sudden, non-progressive disturbance of balance most common in senior dogs.
If you’ve never heard of it or seen it happen, it can be quite frightening, but rest assured, IVD is typically harmless.
What Is Idiopathic Vestibular Disease?
If your senior pet suddenly begins to walk in circles, has an unsteady gait, seems dizzy, or holds its head tilted to one side, Idiopathic Vestibular Disease may be the cause.
The word Idiopathic indicates a condition that comes on spontaneously and has an unknown cause. Vestibular refers to the balance and coordination system within the inner ear of mammals including dogs and humans.
IVD is very frightening for dog parents as its symptoms are similar to those of a stroke or brain tumor. Luckily, IVD is far less serious and usually gets better on its own with time and minimal treatment. It is also painless for your dog.
The Vestibular System
Just like in people, a dog’s vestibular system is responsible for maintaining a sense of balance. When something goes wrong with this system, it’s like being drunk on a rocky boat. Dogs with IVD will have some combination of the following signs:
- A head tilt
- An unsteady gait, loss of balance, or falling over
- Circling in one direction
- Eyes rapidly moving from side to side, known as nystagmus
- Sudden vomiting
If you witness any of these signs, your dog should see a veterinarian for a neurologic and otoscopic examination.
The dog in the following video has a severe case of IVD. Notice the tilted head, unsteady gait, and loss of balance. You can also see her eyes moving rapidly from side to side (nystagmus).
“I think my dog just had a stroke.”
An important thing to note is that these symptoms are not unique. Idiopathic Vestibular Disease and other more serious illnesses often present in similar ways. These include strokes, brain tumors, inner ear infections, inflammatory diseases, and sudden bleeds into the brain.
In early 2019, Tenille Collard of Denver, Colorado came home to find her Husky, Dillon unable to walk or stand. At first, she attributed the problem to the dog’s glaucoma. He had already lost his right eye to the condition, and the veterinary ophthalmologist warned there was a chance the other eye could become affected.
When she gave Dillon his emergency eye drops, Collard noticed his eyes moving rapidly back and forth. The symptom, known as nystagmus, is often associated with strokes. Shocked by the sudden symptoms, Collard and Dillon headed to the emergency vet.
Thankfully, a neurological exam revealed Dillon did not suffer a stroke. Instead, he was diagnosed with vestibular disease. Medications for nausea and motion sickness helped him slowly improve over the next few days, and a complete blood panel at his follow-up visit ruled out an underlying condition.
With time and supportive care, Dillon made a near-full recovery. Like many dogs with IVD, his head still tilts to one side and he is sometimes unstable when walking.
Photo c/o Tenille Collard
Veterinarians typically recommend blood work and a blood pressure check for dogs showing vestibular signs. MRIs can also be done to evaluate the inner ear and brain. This allows for the best evaluation of disease but is often not pursued due to cost.
Evaluation should include both ear canals since inner ear infections are a possible cause of vestibular disease. The inner ear (pictured below) is something you cannot directly see during an exam because the eardrum covers the view. However, if there is inflammation in the outer ear and eardrum, there is a good chance inner ear disease is present as well.
Image courtesy of leospetcare.com
Caring For A Dog With Vestibular Disease
If clinical signs are so severe that the dog cannot walk, your vet may recommend supportive care with IV fluids and anti-nausea medications. If clinical signs are mild, pets can often be managed at home with nursing care and over-the-counter meds for motion sickness.
Dillon’s mom recommends the Help Em Up Harness which proved to be a lifesaver in helping get the large dog outside during the worst of his dizziness.
What Is The Long-Term Prognosis For Dogs With IVD?
Idiopathic Vestibular Disease has a very loose rule of thumb: If there is gradual or complete improvement within 72 hours, it is most likely IVD. If there is no improvement or if there is a progression of symptoms, the cause could be something more serious, such as a brain tumor. In this case, an MRI is recommended.
With idiopathic vestibular disease, slow but steady improvement and a return to normal (or almost normal) is typically seen in 7 to 14 days. For some dogs, a head tilt will persist for the rest of their lives.
Why pets and cannabis don’t mix
Veterinary experts warn cannabis can be a fatal poison to dogs and cats.
November 05, 2018 By Geoff Mcmaster
Ingesting cannabis can be a pleasant experience for people but for dogs and cats, it will almost certainly require a visit to the vet.
In the hype around marijuana legalization, and the variety of cannabis products that will soon abound, it may be easy to forget that THC is toxic for pets.
If your pet ingests cannabis
It doesn’t take much THC to poison a dog or cat. A discarded joint or a small amount of an infused edible can throw your pet into distress, said animal science instructor Connie Varnhagen.
If you do suspect your pet has ingested cannabis-showing symptoms such as dizziness or wobbling, unusual lethargy, loss of appetite or incontinence, agitation, vomiting, increased or decreased heart rate, or lowered body temperature-keep it warm and offer, but don’t force, water to keep it hydrated.
Do not attempt to induce vomiting, because it could result in aspiration, also potentially fatal. Immediately take your pet to a veterinary clinic, where symptoms can be monitored during recovery.
Most important, be honest if you suspect your pet has ingested cannabis. It’s much easier to treat poisoning if your vet knows what caused it, said Varnhagen. “Your vet is not going to call the police on you.”
It takes only a small amount to cause symptoms of poisoning in a dog or cat, said University of Alberta animal science instructor Connie Varnhagen.
“Dogs have so many more cannabinoid receptors in their brain and throughout their body,” she said, and that sensitive network can simply be overwhelmed by THC, the psychoactive cannabinoid in marijuana.
“They can die from the overdose. People get high; dogs get poisoned,” said Varnhagen, who is also a veterinary nurse and president of the Alberta Helping Animals Society.
Cats are also susceptible to cannabis poisoning but are less likely to ingest it, she said. They are far pickier eaters, don’t generally have a sweet tooth and aren’t particularly attracted to unfinished joints or dried bud.
Although there have been no known fatal cannabis overdoses in humans, dogs in rare cases have been known to succumb when they ingest large amounts, said Natasha Russell, an Edmonton veterinarian and president of the Edmonton Association of Small Animal Veterinarians.
“The danger is more acute for smaller dogs,” she said. “Small dogs are especially sensitive to becoming hypothermic, so their body temperature can get too cold, and the body starts to change in ways we don’t want.”
When dogs are admitted to an animal hospital with THC toxicity, she said, “We keep them well hydrated in a safe, enclosed space where they can’t fall off anything, and then they just have to sleep it off.” Recovery usually takes between 12 and 24 hours.
Veterinarians will rarely induce vomiting, said Russell. However, if there are other accompanying toxins involved-such as chocolate in a brownie or the sugar substitute Xylitol-dogs may be made to purge, she said.
In advance of legalization last month, the Canadian Veterinary Medical Association (CVMA) issued a warning to pet owners explaining what can happen when pets ingest THC. It pointed to a fourfold rise in reported toxicity in dogs following legalization in Colorado.
The increase may be due in part to a growing social acceptance of the drug, said Varnhagen, and a willingness among pet owners to come clean when their pets get into their cannabis.
She warned that even second-hand smoke can cause respiratory harm in pets, which have “smaller lungs and much faster metabolism. They’re much less able to cope with smoke of any kind.”
The CVMA recommends smoking cannabis outdoors or away from pets.
The promise of CBD medications
While the risk of THC pet poisoning is one obvious downside to marijuana legalization, there is huge therapeutic promise in the plant’s other major cannabinoid-CBD, or cannabidiol, said Varnhagen.
As is the case with humans, there is growing anecdotal evidence of CBD’s effectiveness for anxiety, various forms of pain and inflammation, epilepsy and even some forms of cancer. Last summer the U.S. Food and Drug Administration approved the use of CBD to treat human epilepsy, the first time it has approved any cannabis-related drug.
“We’re doing really poorly with epilepsy in dogs and cats right now, and owners can’t afford the new drugs available for people,” said Varnhagen.
So far Health Canada has not approved any veterinary medicine with CBD, which has prompted some to use either unregulated or human products, such as tinctures and oils, on their pets, said Varnhagen. Although the law may soon change, veterinarians are currently prohibited from recommending CBD.
“The big problem is there’s very little quantitative research on it, and veterinarians are not part of the conversation,” said Varnhagen.
“We can’t even legally talk about it with clients,” unless they choose to bring it up themselves, she said. “A lot of our clients will say, ‘I put some CBD oil on my cat.’ You can’t say much, but I do say you have to be very careful about the essential oil that it’s in, because it can be toxic.”
Russell agreed giving pets CBD oil unapproved for animals could be risky, even if the cannabinoid itself is unlikely to cause harm.
“I’m worried about people giving pets oils-that’s where we will likely see an increase in toxicity cases,” she said, noting that human CBD products may still contain low levels of THC. “It’s hard to find those CBD products that are truly THC-free.”
Until cannabis-based medication for animals is legalized, both Russell and Varnhagen urge pet owners to talk to their vets first about CBD therapy before reaching for the oil.
“I want my clients to talk to me about it,” said Russell. “Even if we’re not allowed to prescribe it, they should be getting information about it from us, and only us. Even though our hands are tied for now, that’s going to change quite soon.”
Dog Car Sickness and Motion Sickness
For many dogs, going on an outing in the family car is an enjoyable adventure. However, for dogs that experience motion sickness, car rides are anything but enjoyable, no matter how fun the destination may be.
What Causes Dog Car Sickness and Motion Sickness?
Motion sickness in dogs can result from conflicting sensory signals that are sent to the emetic (vomiting) center in the brain.
In other words, the signals from the vestibular system in the inner ear (which is involved in balance) conflict with signals from the eyes, possibly leading to nausea and vomiting, similar to motion sickness in people.
Many receptors are involved in this process, including:
Chemoreceptor trigger zone (CRTZ)
Neurokinin 1 substance P (NK1) receptors
Fear, anxiety, or a previous traumatic experience in a vehicle may also trigger motion sickness in dogs. Dog motion sickness can occur during travel in any type of vehicle.
Puppies seem to be more susceptible than adult dogs because the parts of the inner ear that are involved in balance are not yet fully developed in puppies. The good news is that motion sickness in puppies often improves and resolves with age.
Signs of Dog Motion Sickness
There are many potential signs of dog car sickness to watch for, including:
Excessive lip licking
Are There Natural Remedies for Dog Motion Sickness?
There have been many natural remedies suggested for dogs that experience motion sickness.
There is anecdotal evidence that ginger helps treat nausea and vomiting in dogs. Consult your veterinarian before trying it, though, as it should not be given to dogs with known bleeding disorders or in dogs that are taking anticoagulants or nonsteroidal anti-inflammatory drugs (NSAIDs).
Adaptil is a calming pheromone product for dogs that comes in a spray or collar. The collar can be used daily for calming effects, while the spray is intended to be used 15-20 minutes prior to travel or any other stressful event.
Spray the inside of your vehicle or the travel kennel that your dog will be riding in prior to loading your dog.
There are several supplements that are designed to calm dogs when given orally, including:
Some may need to be given daily for several days to weeks for maximum benefit. There are few negative side effects associated with these products, so they are safe options for most dogs.
Lavender is also a safe aromatherapy option that you can use in a spray form. You can also saturate a cotton ball with lavender essential oil and place it in your vehicle a few minutes before leaving the house.
Just be sure to either throw the cotton ball away after your trip and to put it in an area where your dog cannot get to it and ingest it before or during the trip.
One other product you might consider trying for dog motion sickness is CBD (cannabidiol). CBD has become more widely available and comes in many forms, including chews, treats, and oil.
Regulations concerning CBD vary widely, and the quality of the CBD in products is not always guaranteed. If you are interested in trying CBD for motion sickness in your dog, contact your veterinarian to discuss reliable options.
Is There Medicine for Motion Sickness in Dogs?
There are a few pharmaceutical options for preventing motion sickness in dogs.
Cerenia (maropitant) is the only FDA-approved prescription medication for vomiting due to motion sickness in dogs. It blocks the NK1 receptors in the brainstem vomiting center, which is the location most responsible for the nausea and vomiting caused by motion sickness.
Dogs should be at least 8 weeks old to receive Cerenia, and it is given once daily. It is highly effective—in a study of dogs, only 7% vomited during a one-hour car ride after being treated with Cerenia.
Meclizine is an antihistamine with sedative and anti-vomiting effects that’s available over the counter and by prescription. The most common side effect is drowsiness. It is given once daily.
Benadryl and Dramamine
Two over-the-counter options that may be used for motion sickness in dogs are Benadryl (diphenhydramine) and Dramamine (dimenhydrinate).
Both products are antihistamines that can be given every 8 hours and may have sedative effects.
Dramamine may be better tolerated given with a small amount of food. Benadryl can have potential gastrointestinal effects such as vomiting, diarrhea, and decreased appetite.
If using Benadryl, be careful not to get combination products that may be used for colds in people—the product should only include Benadryl (diphenhydramine) as the active ingredient.
If your dog suffers from anxiety in the car that results in motion sickness, an anti-anxiety medication may be needed, along with behavioral modification.
For any medications you would like to use for motion sickness in your dog, your veterinarian can provide guidance on safety and what will work best in your four-legged family member.
How to Prevent Car Sickness in Dogs
Here are a few different things you can do to help minimize your dog’s car sickness while traveling.
Use Car Safety Restraints
Whether your dog suffers from car sickness or not, it is always a good idea to use a dog car seat, a dog harness with the seat belt, or a travel crate. Such products will help minimize sudden movements or a change in position that may trigger nausea.
Allow Your Dog to See Out the Window
It is also helpful if your dog can see out the window to help their eyes and vestibular system coordinate what is happening during travel.
If possible, cracking the windows just a little may help equalize pressure and minimize negative effects on your dog’s vestibular system.
Avoid Feeding Your Dog Right Before Traveling
Don’t feed your dog a large meal right before travel, and try to take breaks on long trips, which is helpful for human and canine passengers.
Work on Conditioning Your Dog to Car Rides
Whether you bring your dog home as a puppy or adopt an older friend, take the time to acclimate them to car rides.
For fearful dogs, this may mean a long process of desensitization and counterconditioning to help your dog overcome fear and anxiety associated with car rides.
Start by just sitting in the car with your dog for a few minutes and not driving anywhere. When your dog is successful with that, try going for a ride of less than 5 minutes, and gradually extend the length of the trip as your dog becomes used to the idea of car rides being safe and even fun.
As more families travel with their dogs, keeping everyone safe and comfortable has become more important. With a little time and patience, road trips can be another way to keep the whole family connected and to expand your dog’s horizons.
Featured image: iStock.com/Ulrika
“Overview of Motion Sickness” by Dr T. Mark Neer, DVM, DACVIM, Merck Veterinary Manual digital app