Tibetan Terrier Balance Issues: Winston Starts Staggering and Walking in Circles

What do you do if your dog starts stumbling and walking in circles?

Walking in circles alone can have various reasons—anxiety, pain, neurological issues or vestibular disease. Circling together with stumbling and eye movement narrows it down to an issue with the balance center.

Tibetan Terrier Balance Issues: Winston Starts Staggering and Walking in Circles

Winston’s story

Winston was a senior Tibetan Terrier in generally good health. As Winston reached eighteen years of age, he became less active but still enjoyed short walks. Upon return, he’d happily run into the house and straight on a couch for rest.

Recently, however, when trying to jump up to settle in his favorite spot, he’d stumble and had a hard time. His mom noticed that Winston would walk in large circles instead of going straight.

She became concerned and brought Winston to see a veterinarian.

At the vet’s office

The veterinarian immediately noticed that Winston’s eyes were moving rapidly from side to side. This is referred to as nystagmus, which is an involuntary rhythmic back-and-forth movement of the eyes. The common cause of nystagmus is vestibular disease.

Vestibular disease also has circling and balance issues on the list of symptoms.

Vestibular disease can be caused by

middle or inner ear infections
trauma or injury
tumors
hypothyroidism

When the cause cannot be determined, veterinarians refer to the problem as an idiopathic vestibular syndrome. Just because a cause cannot be found, however, it doesn’t mean there isn’t one.

The diagnosis

Back then, the most likely diagnosis was what was referred to as “old dog vestibulitis”—inflammation of the balance center in the inner ear. Dogs were treated with anti-inflammatory medications and usually recovered within days or weeks.

Without an MRI scan to rule out issues with the brain, it was just a working hypothesis. A therapeutic trial with anti-inflammatory medications, however, was cheaper and less invasive. Response to treatment would confirm the diagnosis.

Winston did not respond to treatment

Anti-inflammatory medication did nothing to improve Winston’s symptoms. It would have been time to pursue MRI to look for evidence of a brain tumor, bleed or clot in the brain. Given his age, a slow-growing brain tumor would have been likely.

Winston’s mom, though, did not want to put him through all that.

His veterinarian was able to make Winston feel better with supportive treatment. With his symptoms stabilized, Winston still has minor issues but can enjoy the outdoors at his own pace.

The question

When and why was the diagnosis of vestibulitis abandoned and replaced by an unknown cause? Was it because dogs usually improved with or without anti-inflammatory treatment? That seems to be the case. The drug of choice in the past was steroids and I do admit I’m not a fan.

Yet, according to Veterinary Partner, there can be a seasonal aspect to the onset, at least in cats.

For unknown reasons, cats are most commonly affected in the northeast U.S. in the late summer and early fall.
Veterinary Partner

Wouldn’t that suggest an immune response to something in the environment? Would a similar principle apply to dogs? Inflammation seems a somewhat more useful label than an unknown cause. If the environment wasn’t to blame, what about vaccinations for example?

The problem seems to be that since most dogs improve with time with or without anti-inflammatories, it would make such treatment redundant. It could, however, help shed some more light on the issue and perhaps improve treatment or prevention options.

I do know dogs who didn’t have any known underlying cause yet continued o have issues. They didn’t follow the pattern of the problem settling down with time. Perhaps they could benefit from anti-inflammatories?

Some places do seem to include this strategy as part of the treatment.

Further reading:
Vestibular Disease in Dogs and Cats
TCVM Treatment of Vestibular Disease