This Catastrophic Event Often Has a Happy Ending

If you’re the owner of a thirteen- or fourteen-year-old dog or cat, we know how you feel. You’re aware, in the logical part of your brain, that everybody has to die somehow, but you are still attached to the notion that he could just keep holding on… forever. From the moment you realize—sometimes very abruptly and unexpectedly—that he is “old”, you’re living under the shadow of his eventual departure. When this guy comes down with even a minor illness, you’re sweating bullets. Now imagine how you’d feel if you found him in your garden on his back, limbs flailing, head thrashing from side to side, writhing in apparent agony and completely disoriented. This violent seizure-like activity is terribly painful to witness in a treasured companion, and for most people, euthanasia is the most logical and merciful response. Spoiler alert: this story has a happy ending.
Geriatric vestibular syndrome is a common occurrence in aging dogs and cats. It looks just awful, as described above, and the owners of these pets bring them in to us with very low expectations. Although the pet looks like he is having full-blown convulsions, this is simply a sudden episode of severe vertigo, or dizziness. The patient is often thrashing from side to side or even rolling madly across the floor, perhaps even crying in confusion, but he has not actually lost consciousness and there is no evidence that this condition is painful. These episodes come on very abruptly and look terribly violent, but euthanasia is not required, and most patients can be treated at home until they are normal again—or very nearly so—in a week or two. The worst after-effect is usually a slight head tilt to one side or the other.
The cause of geriatric vestibular syndrome (sometimes called “old dog vestibular syndrome”) has never been discovered. Some veterinarians believe that it could be a result of pinpoint inflammation in the balance apparatus or a tiny stroke of some kind, but there are no physical findings or tests, expensive or otherwise, that have shown an exact cause. It’s usually diagnosed simply, by the jerking motion of the eyes and tilted head, along with a lack of abnormality in the rest of the nervous system. The treatment is also simple and pretty inexpensive. If the patient has an appetite or vomiting problem due to his extreme dizziness, those issues are addressed with pills or injections. The occasional pet needs a few days’ hospitalization if vomiting is severe.
Some old cats and dogs do have life-threatening grand mal seizures. Some have vertigo that actually came from meningitis or a brain tumor. But try not to jump to the worst conclusion if you find your pet in this hideous-looking state. More often than not, it’s a temporary condition that will resolve with a minimal amount of intervention. However improbable it seems, your pet can make a complete comeback to his previously healthy self. See, I told you there was a happy ending.

Dr M.S. Regan