Sudden balance loss in older dogs (vestibular disease)
Sudden head tilt, walking in circles, eye flicking in an older dog often points to idiopathic vestibular disease — looks like a stroke, but most recover; vet assessment essential.
In the next 60 seconds
- Phone the vet — same day visit.
- Keep the dog confined and safe (no stairs, no slippery floors).
- Support to toilet on lead.
Recognise the signs
- Sudden head tilt
- Walking in circles or falling to one side
- Eyes flicking side-to-side (nystagmus)
- Nausea, vomiting
- Reluctance to move
First aid steps
- Phone the vet — same day visit.
- Keep the dog confined and safe (no stairs, no slippery floors).
- Support to toilet on lead.
Do NOT
- Do not assume it's a stroke and that nothing can be done — vestibular disease usually improves.
- Do not give human anti-nausea medications.
While transporting to the vet
- Help the dog walk or carry; minimise stress.
When to phone the vet immediately
- Other neurological signs (seizure, weakness on one side, confusion)
- Not improving over a few days
- Severe nausea preventing eating/drinking
Common causes
- Idiopathic (commonest, older dogs)
- Inner ear infection
- Brain disease (rare)
What the vet will need to know
- Sudden vs gradual onset
- Other neurological signs
- Recent ear infection or trauma
Aftercare
- Anti-nausea medication, supportive care.
- Most idiopathic cases improve within 1–2 weeks; some retain a slight head tilt.
- Treat any underlying ear infection.
Prevention
- Manage ear infections promptly.
Breed-specific notes
- Older dogs of any breed; reported in many breeds.
Frequently asked questions
Is it a stroke?
Strokes are uncommon in dogs. Vestibular disease looks similar but usually has a much better prognosis. Vet exam often distinguishes.
Will my dog recover?
Most idiopathic cases improve significantly over 1–2 weeks. Some retain a slight head tilt as a permanent souvenir but adapt fully.
Can it recur?
Yes, in some dogs. Each episode usually resolves with similar timeline.