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What is Head Tilt?

When your dog’s vestibular system is not functioning as it should, he will not know whether he is sitting or standing and it will cause him to be dizzy and nauseous. You will likely notice more than just a head tilt since other more noticeable symptoms usually accompany the head tilting such as incoordination, abnormal eye movements, and vomiting. If you notice that your dog is having any of these symptoms, you should take him to a veterinary care provider as soon as you can.

Dogs that tilt their head may just be acting silly or trying to hear something, but if you notice your dog is tilting his head all the time, he may have an illness such as vestibular disease. This condition affects your dog’s balance due to a problem with his vestibular system, which is what tells the brain whether your dog is laying down, sitting, standing, or falling. When the vestibular system is not working properly, it cannot detect the position of the head or send messages to the brain. There are two types of vestibular disease, which include central vestibular disease (abnormality in the brain) and peripheral vestibular disease (abnormality in the ear).

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Symptoms of Head Tilt in Dogs

Head tilting is more of a symptom than a condition and can indicate many different illnesses, some of them life threatening. If you notice that your dog is tilting his head to one side (either side), you should watch for other symptoms such as:

Peripheral Vestibular Disease

  • Circling, leaning
  • Eyeball moving around or up and down rapidly
  • Not being able to focus
  • Unusual clumsiness (falls, stumbles, lack of coordination)
  • Vomiting
  • Nausea
  • Loss of appetite

Central Vestibular Disease

  • Abnormal eye movements (jerking side to side, up and down, or around)
  • Weakness of the body
  • Rolling around on the ground
  • Strange behavior
  • Head tremors
  • Depression
  • Facial paralysis

Types

There are two types of vestibular disease, but peripheral vestibular disease is the most common in dogs.

  • Peripheral vestibular disease is caused by a condition in the middle or inner ear such as ear infection, perforated eardrum, and ear mites
  • Central vestibular disease is due to a disturbance in the brain such as inflammation, infection, tumors, cancer, or head trauma
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Causes of Head Tilt in Dogs

The cause of either vestibular disease is idiopathic (unknown), but veterinary professionals believe it may be due to one of these causes:

Peripheral Vestibular Disease

  • Middle or inner ear infection
  • Reactions from certain antibiotics such as metronidazole
  • Head trauma
  • Hypothyroidism

Central Vestibular Disease

  • Infections
  • Tumor
  • Inflammatory disease such as encephalitis or granulomatous meningoencephalitis (most common in Maltese and Yorkshire Terrier)
  • Hyperadrenocorticism
  • Metronidazole toxicity
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Diagnosis of Head Tilt in Dogs

To diagnose your dog, the veterinarian will need to perform a physical examination and conduct several diagnostic and laboratory tests. Some of the most important tests include a head x-ray, CT scans, MRI, spinal fluid analysis, urine and blood tests. One of the specialized tests for diagnosing vestibular disease is an otoscope examination. This is done by sedating your dog while the veterinarian uses a magnifying tool called an otoscope to look at the eardrum and the ossicles in the middle ear.

Also, a myringotomy may be done if the veterinarian thinks it is needed. This is done by making a tiny incision in the eardrum to collect a sample of fluid from the inner ear for a culture. If an inner ear problem is ruled out, the veterinarian will most likely suspect that your dog has central vestibular disease. The veterinarian may take a sample of spinal fluid to analyze as well.

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Treatment of Head Tilt in Dogs

Initial treatment of nausea and vomiting can be treated with motion sickness medication. There is no cure for vestibular disease except to treat the condition that is causing the condition. These treatments depend on which type of vestibular disease your dog has and what is causing it.

Ear Infection

Antibiotic or antifungal cream or ear drops will be used and a steroid injection to relieve the swelling and pain. It usually takes about four to six weeks to heal.

Tumor

If the tumor is benign (not cancerous), the veterinarian may just remove it to fix the problem. However, if the tumor is malignant (cancerous), other treatments like radiation and chemotherapy have to be done after removal.

Hyperadrenocorticism

To treat hyperadrenocorticism, there are several choices, which are medical, surgical, and radiation. It depends on the cause and severity of the condition.

Metronidazole Toxicity

The effects of metronidazole toxicity should go away within one to two weeks after stopping the medication.

Brain Infections

Infections of the brain such as toxoplasmosis and encephalitis, will be treated by intravenous (IV) antibiotics or antifungals. Your dog will likely be kept overnight for observation.

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Recovery of Head Tilt in Dogs

With prompt treatment, your dog has a good chance of recovery with peripheral vestibular disease of any cause. However, central vestibular disease can be much more serious and the prognosis may be poor to grave, depending on the cause. You should follow your veterinarian’s instructions carefully and bring your dog back for his follow-up visit to make sure he is okay.

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Head Tilt Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Pit Bull

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Unsure

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Unknown severity

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0 found helpful

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Tilt Neck

My puppy is crying he’s holding his neck tilted and as I can see something may be wrong with his neck I’m unsure but I know it’s the neck area n his right side of the ear is hanging

July 25, 2020

Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your question. Unfortunately, without being able to see your puppy, it is not possible for me to say what might be going on. If you feel like there is something abnormal, the best thing to do would be to have a Veterinarian look at your puppy. They will be able to examine the puppy, see what might be going on and see what treatments might be available. I hope that all goes well.

July 25, 2020

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Boston Terrier

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1 month

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Unknown severity

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Unknown severity

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Sneezing,Spitting Up Vomiting

He keep vomiting through his nose and sneezing and whimpering. He's the smallest of the litter and still eating pretty well.

July 19, 2020

Owner

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Dr. Michele K. DVM

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Thank you for your question. If he has vomit coming through his nose, he should be seen by a veterinarian. He may have a cleft palate, and those puppies are very prone to pneumonia and infections. They will be able to help control his vomiting and assess what else might be going on with him. I hope that all goes well for him!

July 19, 2020

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Dante

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Siberian Husky

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2 Months

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Moderate severity

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4 found helpful

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Moderate severity

Has Symptoms

Head Tilts

I got a puppy from a breeder 6 days ago. He was born May 27, 2018. Ever since we got home (I didn't have contact with him before that) he walks and sits with his head tilted to the left. I don't know why this is. The vet told me to give him some ear drops for infection for 5 days. It has been 2 days and he keeps tilting his head. Please help.

July 17, 2018

Dante's Owner

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3320 Recommendations

Inner ear infections are common causes for a head tilt in young pups although head trauma, poisoning, congenital disorders among other causes may also lead to a head tilt; two days is still early in treatment but something stronger than antibiotic ear drops may be needed if there is an inner ear infection. Check in with your Veterinarian if there is no improvement by Friday or Saturday. Regards Dr Callum Turner DVM

July 18, 2018

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Coco

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Yorkshire Terrier

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9 Years

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Serious severity

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Serious severity

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Head Held Low
Blank Stare
Front Legs Buckle

For the past 4 months, our 9 year old Yorkshire Terrier, Coco, has been holding her head down low and has been stumbling on her two front legs when we took her for walks. We took her to her primary vet, who thought it was luxating patella and referred us to an orthopedic vet. We took her to the orthopedic vet, who said it wasn't a luxating patella, but potentially a neurological issue and prescribed two medications Methocarbamol and Carprofen. Those medications seemed to help and were refilled one more time. She hasn't been on them for 3 weeks because they ran out and now she's having the same problems again. I called the orthopedic vet, and he's now referring us to a neurologist. I feel like we're getting the run around and spending several hundred dollars and still not finding out what's wrong with Coco. I did some online research to try to find out what's wrong with her, and one potential problem I came across is that she could have a pinched nerve in her neck, which is highly possible because she does shake her toys rather aggressively, watching her do that makes my neck hurt! Would a neurologist be able to help diagnose her? I'm also worried that it could be a tumor. I just want someone to figure out what's wrong with her without us having to go to several different vets and spending so much money to figure it out.

March 29, 2018

Coco's Owner

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3320 Recommendations

A consultation with a Neurologist would be useful as they will be able to look at the neurological system as well as looking at issues with the spine to look for pinched nerves or other issues. Without examining Coco I cannot say what the cause is, but you should visit the Neurologist before you give any other medication as is may lessen the severity of symptoms which may make diagnosis more difficult; if your Veterinarian or the Orthopaedic Specialist took an x-ray you should refer the image to a Specialist (PetRays) who will be able to give you a second opinion on the image. Regards Dr Callum Turner DVM www.petrays.com

March 29, 2018

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Jack

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Border Collie

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3 Weeks

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Serious severity

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Head Tilt

I have 3 week old Border Collie Puppies. Friday morning the puppy was fine but by lunchtime the puppy had a severe head tilt to the left and is now starting to walk in circles. There is no vomiting and he feeds well. His sister has started doing the same thing 2 days later. Neither has a temperature and the emergency vet can't find an answer to the problem. He has ruled out ear infection and Neurological The puppy area is very clean and the bitch has been feed the best food possible.

March 11, 2018

Jack's Owner


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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. Without examining Jack or the other puppies, I'm not sure that I can shed any light on what might be going on with them. Parasites can have strange effects on puppies, and deworming is a good idea, if they haven't already been dewormed. Possible treatment for Neospora may be advisable, but it would be best to follow up with your veterinarian for further diagnostics. I hope the puppies do well.

March 11, 2018

Hello, I a standard poodle 8 weeks old and giving the same symptoms. As you described. Did you find out what was wrong with your puppy?

May 18, 2018

Gigi

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Puddin

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Lhasa Apso

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Six Years

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Fair severity

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Tilting Head

My 8 year old dog she just started tilting her head told. But before I Noticed it she jumped on my be shaking really hard an going under my blanket . So I thought she was just cold until I picked her up an her head was tilted while still shaking. So now she just walking around with her head to the side an shaking it like ever 20 seconds or 1 minute. I checked to see if she had anything in her ear but nothing was in there. So I started to feel close to the the back of her ear an a close to her jaw an she making this little noise.

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Kudi

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Bischon frise

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9 Years

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Moderate severity

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Head Tilt

Kudi, 9 yr old, Bischon Frise has a severe head tilt. All tests at the vet are good. Vet prescribed antibiotics, wet food and steroids. He is eating and drinking but head tilt is severe. Vet said no inner ear infection because there was no evidence of outer ear infection. Any suggestions to help my baby?

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Beautiful

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Red nose and razor back pit

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8 Weeks

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Fair severity

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She'S Tilting
She'S Tilting Her Head

Hello my 8 week old puppy Head is tilt her eyes are fine she's weak but when I took her outside she was running with me and everything she still playful but she's very

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oreo

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Cocker Spaniel

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14 Years

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Serious severity

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Tilt Head

hello my 14 year old dog started witha head tilt yesterday and cant wlk he tries but he falls down. he is also not eating. i cant afford a vet exams needed what do i do i dont want him to be in pain do i need to put him asleep ?

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