Picture this scenario:

It’s 4:40 PM in the afternoon. It’s been a very long day, and you are looking forward to heading home and getting a little downtime. Then you get a call from one of your regular clients, who is panicked, and convinced that Ginger has had a stroke.

“It’s Ginger. She was fine this morning when I left, but when I came home from work I found her staggering around the kitchen, like she was drunk or something. Her head was tilted at this awkward angle, and sometimes when she tries to walk, she falls over. She just seems to be going in circles and seems very disoriented and out of it. I found some vomit in the kitchen, and she seems to be drooling. I am not sure if she has had a seizure or a stroke. What should I do?”

Ginger is a 12-year-old labrador retriever. Me? I’m a veterinarian, and I’ve been working in small animal practice on the east coast for over 14 years.

And I’m certain that, after I run through a list of questions and confirm that Ginger did not get her paws on a toxin, that she has what we call ‘old dog vestibular syndrome.’

The vestibular system has a very important and specific purpose in both animals and people. In short, it’s what keeps us all from falling over and gives us a sense of where we are in space.

The vestibular system has two essential components: The peripheral system, located deep within the inner ear, and the central system, located in the brain. Ultimately, both of these parts are interconnected. It’s what allows us to stay interconnected, integrated and responsive to the world around us. Specialized nerve cells and receptors live in the inner ear. These receptors are constantly responding to fluid-filled canals located in the cochlea (a structure in the inner ear, divided into three fluid-filled parts). When an animal’s head changes position, the fluid shifts, sending immediate and valuable information to the brain, allowing the animal to know just where it is in space, if it’s moving or not, and if it is moving, which direction it is moving in. In a healthy animal, all of this input and output flows pretty effortlessly.

In a “dis-eased” animal, however, the situation can look very different, if not downright dramatic (and often horribly frightening for the owner).

There are two main forms of vestibular disease that we see in veterinary medicine.

The more common of the two is called peripheral vestibular disease. The other, less common ( and potentially more serious) form is central vestibular disease. I will focus primarily on peripheral vestibular disease, since it is the more common of the two, but in general, vestibular disease can result in any combination of the following clinical signs:

Sudden onset, head tilt (usually towards the affected side), ataxia ( loss of balance and coordination, walking as if “drunk”), disorientation, nystagmus ( jerky, irregular eye movements, sometimes up and down, sometimes side to side), a reluctance to stand and walk, falling or leaning in the direction of the head tilt, vomiting, drooling (indicating nausea), circling, stumbling, staggering, rolling, and vertigo (dizziness).

Causes of vestibular disease can be varied. Sometimes a cause cannot be determined, in which case it is called ‘idiopathic’. If an underlying cause can be determined, a few of the most common are:

  • Otitis media/ interna, which means an infection of the middle/ inner ear. Commonly, this is secondary to an otitis externa (chronic, recurrent ear infections) that has progressed into the middle and inner ear.
  • Nerves of the inner ear can also be damaged by trauma (head injury), overzealous cleaning of the ears, stroke, tumors, drugs, polyps, and certain drugs that if used improperly can be ototoxic and cause deafness (certain aminoglycoside antibiotics: amikacin, gentamicin, neomycin, tobramycin).
  • Hypothyroidism: Dogs that are diagnosed and treated tend to respond well once they begin thyroid supplementation.

Some older dogs can become very stressed and anxious as a by-product of experiencing such jarring clinical signs, and will need appropriate supportive care in the form of sedatives and/or natural calming agents such as herbs, tryptophan and ambient essential oil therapy (such as QueaseEASE).

Using essential oils to calm pets is still a fairly novel concept. So far, there is no formal research that documents what quantity of volatile plant lipid molecules it takes to lead to a physiologic effect with ambient essential oils. However, to my knowledge, there has not been a single documented case of ambient essential oils (such as those used in QueaseEASE) causing any adverse effects, in either dogs or cats. All adverse reactions, most especially in cats, have been associated with either topical use or ingestion, neither of which I would ever recommend)

I have used QueasEASE in my hospital as an adjunct to post-surgical care, attaching a sample to the
animal’s cage, as well as offering it to clients who have cats that vomit, drool, cry or won’t travel well. From the limited response I have had, it is nothing but favorable.

The good news with vestibular disease is that it is usually not life-threatening, self -limiting, and most cases improve within 72 hours, with complete recovery in about 2-3 weeks. Sometimes, there may be residual signs, and usually the head tilt is the last neurologic sign to improve. In some cases, the head tilt is permanent. This, however, does not interfere with an animal’s quality of life.

So, next time you cuddle up with your furry friend, give a thought to all the neurons and receptor sites and cells that are working so very hard to keep him ( and you) upright! And keep QueaseEASE nearby, it might come in handy for the both of you.


– Dr. Kristina Mainella received her DVM degree from the Cummings School of Veterinary Medicine at Tufts, before moving to Maine to practice in 2003, where she has since worked with small animals in several practices.