Emergency — phone the vet now
Within hours
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.
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.