Nystagmus in Dogs – Vet Guide 2025 🐶👁️🩺 

By Dr. Duncan Houston BVSc

Hi there! I’m Dr Duncan Houston, BVSc, founder of Ask A Vet. If your dog’s eyes are flickering, darting or circling without control, it’s called nystagmus. Although it can look alarming, it’s most often a symptom—not a disease—indicating an issue in the vestibular system (inner ear and brain). In this comprehensive guide, we'll explore the types, causes, diagnostic steps, treatment strategies, and critical home-care advice to support your dog’s recovery and keep them safe and comfortable. Let’s help your pup find their center again! 💙

📘 What Is Nystagmus?

Nystagmus is involuntary, rhythmic eye movement—eyes may move side-to-side (horizontal), up-and-down (vertical), or in circles (rotary). Physiological (normal) nystagmus occurs when your dog’s head is moving, such as when they’re riding in a car, but **pathological nystagmus** occurs at rest—when the head is still—and indicates underlying disease.

🔄 Types of Nystagmus

• Horizontal: side-to-side flickering—can point to ear or brain issues.
• Vertical: up-down movement—typically central nervous system involvement.
• Rotary: circular motion—ear or brain problems.

🐾 Common Causes

The vestibular system—made up of the inner ear and parts of the brain—controls balance and stable vision. Nystagmus signals its disturbance. Causes include:

• Idiopathic vestibular syndrome (“old dog vestibular”): sudden onset in senior dogs, often improves with supportive care.
• Ear disease: middle/inner ear infections, inflammation, polyps—also cause head tilt, ataxia, falling.
• CNS disease: brain tumors, stroke, encephalitis, trauma—all potentially serious.
• Medications/toxins: e.g., aminoglycosides—may disrupt the vestibular nerve.
• Hypothyroidism: rare vestibular signs including nystagmus, can occur.
• Congenital vestibular dysfunction: seen in puppy ear development issues or inherited problems.

🚨 Recognizing Red Flags

While nystagmus itself isn't painful, it often accompanies other alarming signs:

• Head tilt, circling, falling, or body roll-over.
• Ataxia or severe imbalance.
• Nausea, vomiting, loss of appetite.
• Sudden onset, cross-eye positions, or vertical motion usually indicates central disease.

If your dog shows any of these, seek veterinary help immediately.

🔍 Veterinary Diagnosis

1. Physical exam & otoscopy: check ears, look for inflammation, fluid, or perforated eardrum.
2. Neurologic exam: noting nystagmus types, head posture, gait, reflexes.
3. Blood work & routine labs: check for systemic disease, infection, thyroid status.
4. Imaging: CT or MRI to view inner ear, brainstem, or masses.
5. Cerebrospinal fluid analysis: if brain inflammation suspected.
6. Referral to neurologist/ENT: for further diagnostics and specialized treatment.

💊 Treatment Strategies

• Address the underlying cause: antibiotics for ear infection, antifungals, or surgery for polyps.
• Idiopathic cases: supportive care (fluids, anti-nausea meds like maropitant), rest—resolution typically in 72 hours to 2 weeks.
• CNS diseases: may require steroids for inflammation, surgery for tumors, chemotherapy, or long-term neurological care.
• Vestibular therapy: anti-vertigo medications, environmental modifications for safety.

🏠 Home Care & Safety Tips

• Safe space: use padded rooms, remove trip hazards, block stairs.
• Assistance: support your dog during walking or holding wet food/water bowls to prevent spills.
• Monitor nausea: offer small, frequent meals; speak to vet on anti-nausea prescriptions.
• Gentle head positioning: allow upright position against your body or pillow.
• Regular check-ins: note changes in balance, eye movement, appetite, vomiting.

📅 Prognosis & Follow‑Up

• Idiopathic vestibular: excellent; many recover spontaneously.
• Ear disease: good with appropriate antibiotic/antifungal therapy.
• Central lesions: variable—depends on tumor, infection, stroke; may have residual head tilt or visual issues.
• Congenital: dogs adapt; consistency in environment supports independent safety.

🩺 When to Follow Up

• If no improvement after 72 hours or worsening signs.
• Repeat neurologic exams every 1–2 weeks until stable.
• Re‑imaging and diagnostics if relapsing or unable to treat the underlying disease.

✨ Key Takeaways

• Nystagmus is uncontrolled eye movement—indicates vestibular or neurological issues, not a standalone disease.
• Types (horizontal, vertical, rotary) help localize the underlying cause.
• Diagnosis includes ear/neurologic evaluation, imaging, lab work, and CSF when needed.
• Treatment ranges from infection control and supportive care to advanced therapy for CNS causes.
• Home safety and comfort dramatically help recovery—remove hazards & support your pet.
• Most cases, especially idiopathic or ear-related, improve. Central causes may require long-term care.

If you notice your dog’s eyes flicking at rest, especially with head tilt or imbalance, reach out promptly to your veterinarian or contact Ask A Vet. Early diagnosis and supportive care help your dog regain stability and confidence. 🐾

🐾 Ask A Vet

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