Understanding Idiopathic Vestibular Disease in Pugs: A Simple Guide for Dog Owners

What Is Idiopathic Vestibular Disease?

Idiopathic vestibular disease—sometimes called “old dog vestibular syndrome”—is a sudden, non-progressive condition that affects a dog’s balance and coordination. “Idiopathic” means the exact cause is unknown. It’s similar to vertigo in humans and can be quite alarming, but it’s usually not life-threatening.

What Causes It?

While the term “idiopathic” means we don’t know the exact cause, this condition is believed to be linked to age-related changes in the inner ear or brain. It’s more common in older dogs, and while any breed can be affected, pugs may be slightly more prone due to their unique anatomy and predisposition to neurological issues.

Other possible causes of vestibular symptoms (which must be ruled out) include:

  • Inner or middle ear infections

  • Brain tumors or inflammation

  • Reactions to certain medications

  • Trauma to the head or ear

Signs to Watch For

Symptoms often appear suddenly and may include:

  • Head tilt (often to one side)

  • Loss of balance or falling over

  • Staggering or walking in circles

  • Rapid eye movements (nystagmus)

  • Nausea or vomiting

  • Reluctance to eat or drink

  • Standing with legs wide apart for stability

These signs can mimic a stroke, which is why it’s important to seek veterinary advice immediately1.

What to Do If Your Pug Shows Symptoms

  1. Stay calm – Your dog is likely scared and disoriented.

  2. Keep them safe – Prevent falls by confining them to a small, padded area.

  3. Avoid stairs or slippery floors – Use rugs or mats for traction.

  4. Offer water and food – Hand-feed if needed, and elevate bowls to reduce neck strain.

  5. Call your vet – Even if it seems mild, a vet visit is essential to rule out other causes.

Veterinary Care and Tests

Your vet may perform:

  • Physical and neurological exams

  • Ear examination (to check for infections or damage)

  • Blood tests (to rule out metabolic issues)

  • Imaging (like MRI or CT scans, if symptoms persist or worsen)

If it’s confirmed to be idiopathic vestibular disease, treatment usually focuses on supportive care.

Treatment and Recovery

Most dogs begin to improve within 2–3 days and recover fully in 2–3 weeks1. Treatment may include:

  • Anti-nausea medications

  • Vestibular suppressants (to reduce dizziness)

  • Hydration support

  • Nutritional assistance (especially if appetite is low)

  • Gentle physical therapy (to help regain balance)

  • Follow-up care to monitor progress

In severe cases, hospitalization may be needed for IV fluids and intensive care.

Outlook for Pugs

The good news? Most dogs, including pugs, recover well with proper care. Some may have a lingering head tilt, but it doesn’t usually affect quality of life. The key is early recognition, gentle support, and veterinary guidance.