Head Tilt in Dogs

Written By hannah hollinger
Published: 05/26/2017Updated: 12/22/2021
Veterinary reviewed by Michele K.
Head Tilt in Dogs - Signs, Causes, Diagnosis, Treatment, Recovery, Management, Cost

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 signs usually accompany the head tilting such as incoordination, abnormal eye movements, and vomiting. If you notice that your dog is having any of these signs, 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 sign 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 signs 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


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

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

Causes of Head Tilt in Dogs

Some causes of vestibular disease is idiopathic (unknown), but veterinary professionals believe it can 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
  • Idiopathic Vestibular Disease

Central Vestibular Disease

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

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 might 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 while the veterinarian uses a magnifying tool called an otoscope to look at the external ear canal and the eardrum.

Also, a myringotomy may be done if the veterinarian thinks it is needed to identify inner ear infections. This is done by making a tiny incision in the eardrum to collect a sample of fluid from the inner ear for a culture. This procedure would require sedation.  

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

Topical ear medications, and possibly oral treatments,  can be given to relieve the swelling and pain. 


If a tumor in the ear canal is benign (not cancerous), the veterinarian may be able to 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.


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 hospitalized 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. 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.

Head tilting could be symptomatic of vestibular disease. To avoid high vet care expenses, secure pet health insurance today. The sooner you insure your pet, the more protection you’ll have from unexpected vet costs.

Head Tilt Questions and Advice from Veterinary Professionals





Two Years


22 found this helpful


22 found this helpful

My pet has the following symptoms:
Head Held High/ To The Right Of Midline
My dog is seeming to have discomfort, shakes, rolling eyes, and some form of almost neck discomfort. She moves her neck to the right side in a very tender fashion and doesn’t move to the left. Her mood is very slowed down and she’s normally a fast-paced dog

April 17, 2021

Answered by Dr. Linda S. MVB MRCVS

22 Recommendations

I'm sorry to hear this; she sounds very unwell. She needs to see a vet urgently to examine her, run some tests and determine what's wrong. Possible causes include a slipped disc, meningitis, a sprained muscle, ear infection etc.

April 17, 2021

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Nine Years


18 found this helpful


18 found this helpful

My pet has the following symptoms:
Raising And Lowering Head
She keeps raising and lowering her head and when she lowers it, I can see her back end moving

Jan. 10, 2021

Answered by Dr. Sara O. DVM

18 Recommendations

Hello this can be a neurologic issues with your dog or neck pain. It would be best for you to see your vet. They can asses what is wrong and start her on medications to help her feel much better

Jan. 10, 2021

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