Ear & Vestibular Disorders in Dogs & Cats
Head tilting, loss of balance, circling, nystagmus (involuntary eye movement), and chronic ear infections that won’t resolve can all point to disease within the middle or inner ear. These structures are buried deep within the skull, making them impossible to examine directly and difficult to evaluate with standard imaging.
At Sage Veterinary Imaging (SVI), our 3-Tesla MRI provides detailed visualization of the tympanic bullae, middle ear, inner ear, and the vestibular portions of the brainstem — all structures that X-rays and CT evaluate with limited soft-tissue contrast. MRI reveals fluid accumulation, soft-tissue masses, nerve involvement, and brainstem changes that determine whether ear disease is peripheral or central, guiding the most effective treatment.
SVI offers advanced MRI services at our centers in Round Rock, Texas; Spring, Texas; and Sandy, Utah.
Common Ear & Vestibular Problems We Diagnose
Ear and vestibular conditions range from treatable infections to serious neurological disease. The key diagnostic challenge is determining the location and cause of the problem — and MRI is uniquely suited to answer both questions.
Otitis Media & Interna
Otitis media (middle ear infection) and otitis interna (inner ear infection) are common extensions of chronic external ear disease, especially in dogs with floppy ears and narrow ear canals. MRI shows fluid and soft tissue within the tympanic bulla, enhancement of the bulla lining indicating active infection, and involvement of the inner ear structures responsible for balance and hearing. This detail helps veterinarians determine whether medical therapy alone will suffice or whether bulla osteotomy surgery is needed.
Learn more about otitis media and interna →Inner Ear & Nasopharyngeal Polyps
Inflammatory polyps are benign growths that commonly arise from the middle ear lining in cats, particularly young cats. They can extend into the ear canal, nasopharynx, or both, causing ear discharge, respiratory noise, and vestibular signs. MRI reveals the polyp origin, its extent into surrounding structures, and whether it has caused secondary complications like otitis media. This mapping is essential for surgical planning — incomplete removal leads to high recurrence rates.
Learn more about ear polyps →Vestibular Syndrome
Vestibular syndrome causes sudden onset of head tilt, loss of balance, nystagmus, and often nausea. While “old dog vestibular disease” (idiopathic peripheral vestibular syndrome) is common and typically self-limiting, MRI is important to rule out more serious causes: middle/inner ear disease, brainstem tumors, strokes, or inflammatory brain disease. MRI definitively distinguishes peripheral from central vestibular disease — a distinction that fundamentally changes the prognosis and treatment approach.
Learn more about vestibular syndrome →Cholesteatoma
Cholesteatomas are destructive accumulations of keratinized debris within the middle ear that gradually expand, eroding bone and potentially extending into the brain. They typically develop as a complication of chronic otitis media. MRI shows the characteristic non-enhancing mass within an expanded tympanic bulla, bone erosion, and critically, any intracranial extension that would significantly change the surgical approach and prognosis. Early identification prevents life-threatening complications.
Learn more about cholesteatoma →Cranial Nerve & Tympanic Bulla Disease
Disease within and around the tympanic bulla can affect several cranial nerves that pass nearby, causing facial nerve paralysis (drooping lip, inability to blink), Horner’s syndrome (small pupil, drooping eyelid), or trigeminal nerve dysfunction (jaw weakness). MRI evaluates the bulla contents, identifies the cause of nerve compression or inflammation, and maps the extent of disease for surgical planning. For pets being considered for bulla osteotomy, MRI provides the complete picture needed for safe, effective surgery.
Learn more about cranial nerve and bulla disease →Breeds Commonly Affected
Ear and vestibular conditions affect certain breeds more frequently. Cocker Spaniels, Basset Hounds, Labrador Retrievers, and Springer Spaniels are predisposed to chronic otitis and secondary middle ear disease. Cavalier King Charles Spaniels are prone to primary secretory otitis media (PSOM). Cats, particularly young domestic shorthairs, commonly develop inflammatory polyps. Brachycephalic breeds with narrow ear canals face higher risk of chronic ear infections. Older dogs of any breed can develop idiopathic vestibular syndrome.
How Advanced MRI Helps
MRI is the imaging modality of choice for ear and vestibular disease because it provides superior soft-tissue contrast of the middle ear contents, inner ear structures, and adjacent brainstem. While CT shows bony changes of the tympanic bulla well, MRI reveals the nature of the material filling the bulla (fluid vs. soft tissue vs. cholesteatoma), inner ear inflammation, and brainstem involvement — all critical for treatment decisions.
Each study is reviewed by our board-certified veterinary radiologists, who provide detailed reports and work directly with your veterinarian to determine whether medical management, surgery, or further diagnostics are most appropriate.
What to Expect During Your Visit
Ear and vestibular MRI studies typically take 45–60 minutes and include specialized sequences focused on the temporal bones, tympanic bullae, and brainstem. Your pet will be placed under general anesthesia to ensure complete stillness. Contrast-enhanced images are obtained to evaluate for active infection, inflammation, or tumor involvement.
Results are interpreted by a board-certified veterinary radiologist, and your veterinarian typically receives a detailed report the same day.
Learn more about veterinary MRI at Sage →
Dr. Jaime Sage, DVM, MS, DACVR
Dr. Jaime Sage is the founder of Sage Veterinary Imaging and a board-certified veterinary radiologist (DACVR) with advanced expertise in diagnostic MRI for companion animals. Dr. Sage personally interprets complex cases and works closely with referring veterinarians to ensure every imaging study delivers clear, actionable diagnostic answers.
Her published research on MRI in veterinary medicine — co-authored with Dr. Patrick Gavin, a pioneer in the field — has contributed to advancing the standard of care for pets requiring advanced diagnostic imaging.
Why Choose Sage Veterinary Imaging
Get Answers for Your Pet
If your pet has a chronic ear infection that won’t resolve, sudden vestibular signs, facial nerve paralysis, or Horner’s syndrome, advanced MRI can reveal the underlying cause and help your veterinarian plan targeted treatment.
Schedule a Diagnostic MRI Study
Visit one of our three locations to learn more and schedule your pet’s ear or vestibular imaging study.
Ear & Vestibular Imaging FAQ
Ready to Get Answers?
Advanced MRI can reveal the cause of your pet’s ear or vestibular symptoms and guide effective treatment. Visit one of our locations to get started.