If your dog suddenly seems dizzy, unsteady, or begins tilting their head to one side, it reflects a disruption in their awareness of where their body is in space. Many pet parents fear the worst, such as a stroke, when they see these symptoms. In dogs, however, the more common cause is vestibular disease. While it can look alarming, understanding what’s happening will help you respond with greater confidence while working with your veterinarian.
Understanding Your Dog’s Balance System
Have you ever wondered how your dog can twist midair to land on their feet or sprint across uneven ground without stumbling? The secret lies in their vestibular system, the part of the body that controls balance and spatial orientation.
The vestibular system works like your dog’s internal gyroscope. It’s made up of two main parts:
The inner ear (peripheral vestibular system): Inside each ear are tiny fluid-filled canals and sensory cells that detect head movement and position. When your dog tilts their head, turns quickly, or jumps, these sensors send signals to the brain about how their body is moving in space.
The brainstem and cerebellum (central vestibular system): These areas process signals from the inner ear and coordinate them with information from the eyes and muscles. This helps your dog keep their eyes steady while moving and maintain posture—even when running full speed after a ball.
What Is Vestibular Disease?
In dogs, vestibular disease occurs when there is a disturbance in the balance system. It can be classified as:
Peripheral Vestibular Disease: the most common form, usually involving the inner or middle ear. Idiopathic causes or ear-related disease are the most common contributors.
Central Vestibular Disease: less common but more serious, caused by issues within the brain itself.
Signs You May Notice at Home
Dogs with vestibular disease often show sudden onset of:
Head tilt
Loss of balance, stumbling, or falling over
Circling to one side
Nystagmus (involuntary eye movements)
Nausea, drooling, or vomiting due to dizziness
Reluctance or inability to stand
Nystagmus Directions:
Horizontal (side-to-side): most common, often associated with peripheral disease. The fast phase usually “runs away” from the problem side.
Vertical (up-and-down): more often linked to central disease, which has a more serious prognosis.
Rotary (circular): more often linked to central disease, which has a more serious prognosis.
👉 Important: If you notice vertical, rotary, or changing-direction nystagmus is more concerning for central disease. In these situations, veterinarians may discuss advanced evaluation options, including referral to a neurologist or imaging as part of determining the underlying cause. Seek veterinary evaluation promptly if these signs are observed.
A Word of Caution with Ear Symptoms
If your dog shows vestibular signs along with ear issues (such as discharge, odor, redness), it’s important to understand that not all ear medications are safe in every situation. In some cases, certain products can cause serious complications (such as hearing loss) if the eardrum is damaged. Do NOT put anything in the ear until after a veterinary evaluation.
When to See Your Veterinarian vs. Seek Emergency Care
Vestibular signs alone: In most cases, an evaluation with your regular veterinarian is appropriate.
If your vet cannot see you promptly: Seeking emergency care may be appropriate. While vestibular disease is often not life-threatening, it can be very uncomfortable. Prompt veterinary evaluation ensures that rare but serious conditions aren’t missed, and that your dog can receive medications to ease nausea, dizziness, and discomfort while you wait for recovery.
Helping Your Dog During Recovery
Most dogs with idiopathic vestibular disease or ear-related cases begin to improve within a few days, though recovery may take weeks. While healing, they may need extra help:
Walking support: A towel or reusable grocery bag (cut off sides without handles) can be used as a temporary support under their belly like a sling. For large, uncoordinated dogs, may require more than one person for safety.
Bathroom breaks: Some dogs temporarily lose house training during recovery. Be patient and provide a place to eliminate close to where your pet rests. Especially important if you leave them for prolonged periods.
Stairs: Most dogs cannot handle stairs safely when experiencing vestibular signs. Block access and carry them only if it’s safe for you both.
Cover eyes: vestibular disease can cause symptoms similar to motion sickness, covering the eyes when resting can reduce this and help them rest comfortably.
Harnesses: For dogs who need long-term assistance, specialized harnesses such as the Help ’Em Up harness make it easier to support mobility and allow elimination without mess.
Your safety matters too: Use proper lifting techniques and get help if needed to avoid injuring yourself.
Vestibular disease is usually not life-threatening, even though the symptoms can be dramatic and distressing. Most dogs with idiopathic or ear-related disease recover well, though improvement may be gradual or uneven. Partnering with your veterinary team and understanding what to expect can help you support your dog through recovery with confidence.
Dog Sense contains information related to veterinary health care and does not replace veterinary advice. For any concerns about your dog's health, consult your veterinarian. Dog Sense content is not individual advice and should be considered in the context of your dog’s individual health needs.
Dr. C, DVM - a veterinarian who has worked in private practice and animal welfare while occasionally donating her time to research to improve the safety of animal products. Working in animal welfare inspired her to pursue opportunities that foster open educational dialogue that meet people where they are in their lives. In her spare time she enjoys gardening, hiking, and cooking with her family.