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).
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
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
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.
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.
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.
Head Tilt Questions and Advice from Veterinary Professionals
My dog was diagnosed with Idopathic Vestibular Disease 3 days ago.
He was taken to the emergency vet. and treated with antibotics and anti-nausea medication. He has improved and now standing and walking with minimal assistance. His head tilt has not improved at all, dispite his balance and stability improving. Is there anything I can do pro-actively to assist with the head tilt - ex. Massage, accupunture etc.
Thank you,
Sandy
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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.
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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?
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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.
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My dog Sweety (GR) 8 years old. Hysterectomy done few years ago. Obese, being in the apartment not much physical activities. She is hyper when she see known person etc.
On 3rd Sept 2017 (Sunday) she suddenly shown symptoms of Vestibular disease. On 4th on wards proper treatment given. Temperature was 104^F. On 5th on wards she has shown improvements. Now apart from head tilt she is almost normal. Blood test almost normal except SGPT higher side. X'rays revealed mild spondalities and beginning of osteoarthritis hip side. She is eating and drinking well. Urine and motion normal. Walking she is showing some reluctance. Now doctors are advising MRI
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Hi I'm just noticing my dog is tilting her head and losing her balance as if she is drunk. I don't know what to do. I'm in a financial crisis that I can Not afford to take her to the vet. She also fell on her head when I took her for a walk.
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My 4 month old Great Pyrenees mix was perfectly fine and normal until about 4pm today. Suddenly he was lethargic, dizzy, and off balance. His head keeps rolling around on his shoulders and he kept laying down.. otherwise he knew he would fall. I took him to the vet ER and all his blood work and vital signs were fine... he was lit lethargic afterwards, but still has all the other symptoms. He is sleeping now and wet the bed. :( not sure what to do. Afraid he is going to get worse..
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My 14 year old Pom has been having some issues lately. We believe her to have arthritis but she also has developed a head tilt and has a lot of difficulty breathing. She almost does a hacking/gasping thing, increased with the cold air we’ve gotten lately. What could this be? Is it worth taking her to get tons of tests done? Or is there something I can do to simply make her comfortable at home?
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My Great Pyrenees mix is 4 months old and all of a sudden he is off balance and his head keeps rolling around on his shoulders... I took him to the vet ER and his vital signs and blood work came back perfectly normal. He was more spunky after that, but still dizzy. Now he is sleeping, but every time he wakes up to adjust, his head still rolls around and he is still severely disoriented/dizzy. He also wet the bed.. other than this, he is eating fine and even tried to play and steal my dinner. I’m afraid he is going to get worse.. :(
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Charlie had zero balance, his eyes were farting left to right, the left ear would not move, the left eye would not move, and my local vet said it was either an inner ear infection or a brain tumor. After we gave Charlie his meds about a week, and a half later he was seemingly normal. At the moment he has a head tilt, and leans over from time to time. I would like to know how to fix the head tilt. His left ear still doesn’t move along with his left eye not blinking .
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My dog Recently has had his head tilted in one direction he keeps trying to shake it out but his head will not move the other way At all he’s 10 years old and I’m wondering if it’s possible that they can have their neck out of adjustment but the way he’s acting it seems like his neck is painful right now
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My 9yo pomeranian got head tilt about a week ago. He was perfectly ok before. The only thing that was new for him i gave him Nexguard as a flea treatment ,which was 1 month expired. The other dog was treated too,but is ok.
The pom also got some twitching,seuzure-like symthoms at the same time.
What is your opinion?
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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.
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