Clinical reasoning in canine vestibular syndrome: Which presenting factors are important?

Vet Rec. 2021 Mar;188(6):e61. doi: 10.1002/vetr.61. Epub 2021 Feb 19.


Background: Although the use of clinical reasoning has been evaluated for several neurological presentations, this approach has not yet been investigated for dogs with vestibular syndrome.

Methods: Two hundred and thirty-nine dogs presenting with vestibular syndrome were included in this retrospective study. Univariate analysis of variables (clinical history, signalment, clinical presentation and neurological examination findings) was performed. Variables with p < 0.3 were selected for logistic regression.

Results: Ninety-five percent of dogs were represented by eight conditions: idiopathic vestibular disease (n = 78 dogs), otitis media interna (n = 54), meningoencephalitis of unknown origin (n = 35), brain neoplasia (n = 26), ischaemic infarct (n = 25), intracranial empyema (n = 4), metronidazole toxicity (n = 3) and neoplasia affecting the middle ear (n = 3). Idiopathic vestibular disease was associated with higher age, higher bodyweight, improving clinical signs, pathological nystagmus, facial nerve paresis, absence of Horner's syndrome and a peripheral localisation. Otitis media interna was associated with younger age, male gender, Horner's syndrome, a peripheral localisation and a history of otitis externa. Ischaemic infarct was associated with older age, peracute onset of signs, absence of strabismus and a central localisation.

Conclusions: Discrete clinical features can be used to identify the most likely diagnosis in dogs with vestibular syndrome.

MeSH terms

  • Animals
  • Clinical Reasoning*
  • Dog Diseases / diagnosis*
  • Dogs
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Vestibular Diseases / diagnosis
  • Vestibular Diseases / veterinary*
  • Veterinarians / psychology*