1. Animals with a head tilt or signs of disorientation and loss of balance require immediately veterinary care and attention.
  2. Affected animals may be particularly distressed when moved as they cannot right themselves, and may appear to thrash around. Transport them in a carrier or box lined with soft bedding, and cover with a towel or sheet to reduce stimulation.
  3. Most affected animals will settle if they remain in one position but become distressed or disoriented if they try to stand or walk.
  4. If your animal is being treated for any ear infections, bring medications with you.


Vestibular disease is any disease process that affects the vestibular system in the body, which is responsible for balance and controlling posture and movements of the body and eyes. A dysfunction of the vestibular system leads to dramatic signs of loss of orientation.


  • Pronounced head tilt
  • Inability to stand, clinging to the ground
  • Uncoordinated gait (ataxia)
  • Walking in circles
  • Nystagmus (abnormal horizontal, vertical or rotational eye movements)
  • Changes in mentation
  • Head tremors
  • Weakness in limbs
  • Horner’s Syndrome: Prominent third eyelid, droopy eyelid, constricted pupil of the affected eye
  • Facial nerve paralysis (signs of weakness/decreased ability to move muscles of the ears, eyelids, lips and nostril).
  • Nausea, vomiting
  • Inappetence
  • Lethargy
  • Excessive salivation


The two main components of the vestibular system are the inner ear or the brain. There are a large number of possible causes of vestibular disease, including degenerative disease, cancer of the middle ear or brain, inflammation of these structures, middle ear infection, intoxication, trauma, or vascular disease causing haemorrhage. In many cases an underlying cause is not determined.


A complete history, physical and neurologic examination will be performed by your vet to try to localise the site of disease and underlying cause.

Some animals require hospitalisation to minimise distress. Anti-emetics may be administered, and animals that are not able to eat or drink may require intravenous fluids and assisted feeding.


Platt SR (2009) Vestibular Disease. In: Small Animal Critical Care Medicine. Ed. Silverstein DC & Hopper K. Missouri, USA: Saunders Elsevier.