Vestibular Disease

Summary

Vestibular disease is a broad term for any disease that affects the vestibular (balance) apparatus located in the inner ear. Yet it's most often applied to the idiopathic geriatric syndrome in which vestibular symptoms come on suddenly and typically resolve over days to weeks. Old dogs are the typical target for this confounding disorder of the balance system.

This common vestibular disease, however, is a completely distinct entity from the more rare congenital disease referred to as vestibular disease or, more appropriately, "congenital peripheral vestibular disease" or "congenital deafness and vestibular disease" in which young puppies present with evidence of abnormal balance and hearing loss.

Congenital vestibular disease been determined to be inherited as an autosomal recessive trait (at least in the Doberman Pinscher).

Symptoms and Identification

In the case of this congenital disease (acquired in utero), vestibular symptoms that presumably compare to those of the human condition we call vertigo are observed in young puppies, usually before 20 weeks of age. A head tilt, circling, incoordination and nystagmus (a characteristically vestibular lateral eye movement) are all common symptoms. Luckily, most of these symptoms improve with age but will never completely resolve.

Deafness is the final blow to these affected dogs. Almost all become deaf by the time they're three weeks old. The hearing loss associated with this disease is permanent.

Diagnosis is achieved via clinical signs associated with balance, age, breed (specific breeds are affected) and hearing evaluation. BAER testing, a specialized hearing test typically performed by a veterinary neurologist, is strongly recommended as deafness can often be difficult to diagnose.

There is no test for congenital vestibular disease.

Affected Breeds

The Doberman Pinscher is by far the most commonly affected breed of dog. Deafness in connection with vestibular signs has also reported in the Beagle, Akita, English Cocker Spaniel, German Shepherd, Shetland Sheepdog and Tibetan Terrier. It's tough to tell whether we're dealing in the same disease, though, poorly understood as its origins are.

Treatment

No treatment is available for this disease. The most important issue is to understand that while the vestibular signs may improve the deafness will not. For this reason, pups are often euthanized. Increasingly, however, training deaf dogs to obey hand signals has picked up momentum as an acceptable approach for this disease and for others that result in early-onset hearing loss.

Veterinary Cost

The cost of this disease is relatively low given its limited treatment options. Neurologist evaluation and BAER testing can prove expensive, though. Consider $500 to $1,000 typical for pup evaluations. Specialized training won't come cheap, either.

Prevention

There is no known mode of prevention beyond the obvious: Removal of affected dogs and their first degree relatives (parents and siblings) from the breeding pool.

References

Wilkes, M.K., Palmer, A.C. 1992. Congenital deafness and vestibular deficit in the doberman. J. of Small Animal Practice. 33: 218-224.

Canine Inherited Disorders Database