Signalment: 13 year old, neutered female, Labrador Retriever; Primary Complaint: Acute onset of left head tilt, horizontal nystagmus and inability to stand, ambulate or urinate; History: The dog acutely developed a severe head tilt to the left, inability to rise from lateral recumbency and horizontal nystagmus and was taken to an emergency clinic. On physical examination, only evidence of vestibular disease was seen with no other cranial nerve deficits. The tympanic membrane was intact in the right ear, but there was debris in the left ear and the tympanic membrane could not be viewed. The dog received conventional therapy but persistently remained agitated and unable to stand, ambulate or voluntarily urinate on her own. The caretaker requested the patient be returned home and the dog was discharged with cephalexin (30 mg/kg orally every 12 hours), meclizine (25 mg orally once daily) and acepromazine (12.5-25 mg orally as needed, no more than every 8 hours). The caretaker also requested an in-home traditional Chinese veterinary medicine (TCVM) evaluation and treatment the evening of her hospital discharge (Day 4 after onset of signs).