Vestibular disease is related to a problem in the middle ear whereby the normal orientation of the body related to earth is not normal. It causes dizziness and is similar to motion sickness. In dogs, it is called Old Dog Vestibular Disease and in cats, it is called Feline Idiopathic Vestibular Disease. The cause of either is unknown. Vestibular disease, in my experience, is seen much more commonly in older dogs than in older cats. Symptoms include, ataxia (lack of coordination), nausea, which may lead to vomiting, lack of appetite, inability to rise, and falling over if getting up is attempted. One of the most common symptoms at the onset is movement of the eyes back and forth. This is called nystagmus and can help in determining if vestibular disease is involved. However, the nystagmus may not be obvious after a short time and this can complicate the determination of vestibular disease. Usually there is a head tilt that may persist permanently. In some cases, an ear infection is present, but more often than not, there is no specific cause. When first observed by the pet mom or dad, the syndrome leads them to think their pet has had a stroke. The symptoms can be very dramatic and the animal can be normal one moment and be unable to function the next. This is extremely upsetting to observe because it’s so acute. In some cases, the animal will thrash around, banging into walls and furniture. The relative good news is that the disease is self limiting and improvement will be seen in 48 to 72 hours. However, this isn’t always the case and in some are unable to function for 1-2 weeks. In the rare pet, the symptoms can last for up to 30 days, although there is constant improvement during that time. Large dogs with this syndrome can be extremely difficult to deal with because of their size and inability to stand and walk normally. There is no specific treatment. Meclizine HCl (Bonine) can minimize the vomiting, but will not improve the course of the disease. Veterinarians will often use a medication called Cerenia (Maropitant) to stop vomiting. However, this medication does not relieve nausea. In most cases, when the animal begins eating again, they are often on the road to recovery. See the following article for more detailed information.
Here is a video of handsome Mochie with an early case of vestibular syndrome. This shows nystagmus and a head tilt. He is also licking his lips, which may indicate nausea.