Vestibular disease in dogs: association between neurological examination, MRI lesion localisation and outcome

Abstract

Objectives To determine whether the neurological examination correctly distinguishes between central and peripheral vestibular lesions in dogs. Materials and Methods Retrospective study on dogs with vestibular disease presenting to two referral clinics in Germany. Results Ninety‐three dogs were included; neurological examination suggested central vestibular disease in 62 and a peripheral lesion in 31. MRI diagnosis was central vestibular disease in 68 dogs and peripheral in 25. Of the 62 dogs with a lesion localisation diagnosed as central vestibular by neurological exam, 61 were correctly identified (98.4%). Twenty‐four of the 31 dogs diagnosed with a peripheral lesion by neurological exam had a consistent lesion on MRI (77.4%). Clinical Significance The neurological examination is efficient at identifying lesions in the central vestibular system but less so for peripheral lesions. Therefore it is prudent to recommend imaging in dogs that show signs of peripheral vestibular syndrome but do not rapidly respond to treatment.

Vestibular disease in dogs under UK primary veterinary care: Epidemiology and clinical management

“…French Bulldogs and Bulldogs had the highest odds of diagnosis with VD compared to crossbreed dogs: 9.25 and 6.56 times, respectively. French bulldogs have previously been reported as more frequently affected by VD compared to other breeds 5 . In a United Kingdom‐based referral population of French Bulldogs that presented with neurological disorders, 16/343 were diagnosed with peripheral VD and 25/343 were diagnosed with brain neoplasia 20 .…”

“…This is the largest study to explore the wider presentation of VD in dogs attending primary‐care practices by analyzing clinical data from a multicenter primary‐care research database. Previous studies of VD 5,7,17‐19 have relied mainly on referral populations and therefore might be poorly representative of the general population. The overall prevalence of VD in the current study was 8 per 10 000 dogs, but the prevalence in dogs aged 9 years or older was significantly higher at 36 per 10 000 dogs.…”

Clinical signs, MRI findings and outcome in dogs with peripheral vestibular disease: a retrospective study

“…Vestibular disease was the underlying reason for approximately one third of dogs undergoing advanced imaging of the brain for investigation of a neurological problem at a referral institution [5]. There are now several studies looking at how to differentiate from peripheral and central disease and looking at their possible underlying causes [5][6][7][8].…”

“…The main causes for this are ear disease and idiopathic vestibular syndrome (IVS). The latter is a benign condition that generally resolves spontaneously within a few weeks and for which the underlying cause is yet unknown [2,8,9]. Other causes of PVD include toxicity (caused by systemic aminoglycosides or topical chlorhexidine), hypothyroidism (which typically causes polyneuropathy, affecting also the facial nerve) [10][11][12], congenital vestibular disease and head trauma or neoplasia affecting the petrous portion of the temporal bone or the middle ear [2].…”

“…This study, somewhat limited by the use of radiography as their preferred imaging diagnostic technique, found otitis media/ interna as the most common cause for PVD. Recently, a study investigating vestibular disease through advanced imaging found IVS as the most common cause of PVD in dogs but this was in a small population of only 25 patients [8].…”