End-of-Life Decisions
Severely affected vestibular animals are of the most difficult to care for. They pose a significant challenge in nursing care as they are generally nauseated, vomiting, and unwilling to eat on their own.
In addition, they can be non-ambulatory and will fall or roll uncontrollably. This combination of signs makes for a high risk of aspiration pneumonia, urinary tract infections, and all the cutaneous complications that come with recumbency. Death of the patient with vestibular disease can come from the primary disease, such as progression of the brain tumor or inflammatory brain disease, or from related complications such as aspiration pneumonia. Vestibular patients that do not improve or progress in the face of treatment should be reevaluated for other confounding factors or signs of progressive disease. Quality of life should be evaluated in those cases and discussed with the owners; progression to non-ambulatory status and intractable nausea causing anorexia are generally considered end points for this condition.
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