The role of the vestibular system is to provide the brain with information about motion, head position, and spatial orientation. The vestibular system is located in the inner ear, and information from the vestibular system is processed in the brainstem. The vestibular system consists of fluid filled canals which contain tiny hairs and small calcium crystals. When the body moves in a certain direction, the fluid movement causes displacement of the crystals or hairs. This in turn sends a signal to the brainstem about the body’s movement. Issues with the vestibular system can occur at the level of the inner ear (a peripheral problem) or in the brainstem (a central problem).
Causes of peripheral vestibular disease include ear infections, benign or cancerous masses, drug toxicity, congenital malformations, or trauma to the head. Another cause of peripheral vestibular disease is called idiopathic vestibular syndrome. While not fully understood, there is some evidence that this syndrome is caused by the crystals in the inner ear becoming dislodged. Causes of central vestibular disease include infectious disease, benign or cancerous masses, or drug toxicity.
Classic signs of vestibular dysfunction in pets include: holding the head in a tilted position, nystagmus (rapid, uncontrolled eye movements either in a horizontal or vertical direction), loss of balance, incoordination, and falling. Horizontal nystagmus is more often associated with peripheral disease (inner ear), and vertical nystagmus with central disease (brainstem).
A neurologic exam can help narrow in on the cause, but further diagnostic tests may be needed. At Walking Paws Rehab, we perform neurologic exams in our initial appointments. If central vestibular disease is suspected, an MRI of the brain may be recommended to narrow in on the cause of the vestibular signs.
Rehabilitation for vestibular disease focuses on retraining the vestibular system and improving the other systems that the body uses for balance, such as vision and proprioception. This usually involves various balancing exercises incorporating eye and head movements. We will also address any neck pain or tightness associated with a head tilt. If the cause of your pet’s dizziness is thought to be idiopathic vestibular disease, we can use a specific pattern of head movements to try to reposition the crystals in the inner ear. This is a technique used in human medicine adapted for animals. We also may recommend other medical treatments for underlying disease. At Walking Paws Rehab, we have had great success treating patients with vestibular disease. A lot of the techniques we use are pulled from human physical therapy that we have adapted to our canine patients.
