A six year old female spayed Pomeranian dog presented to Cornell with vestibular signs localizable to the cerebellum. MRI identified a well-demarcated, wedge-shaped lesion in the distribution of the right rostral cerebellar artery which was hyperintense on T2 and mildly contrast-enhancing, a classic presentation for vascular accident. Cerebrospinal fluid analysis was unremarkable. Ancillary testing revealed azotemia, mild nonregenerative anemia, increased urine protein-to-creatinine ratio, increased fibrinogen, increased D-dimers, and decreased antithrombin. Based on the results of these tests, a diagnosis of cerebellar vascular accident secondary to protein losing nephropathy was made. Cerebellar vascular accident pathophysiology, clinical signs, diagnostics, imaging, underlying causes, treatment, and prognosis are briefly discussed.