First Walk is on Us!

✓ GPS tracked walks
✓ Activity reports
✓ On-demand walkers
Book FREE Walk

Jump to Section

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).

Book First Walk Free!

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

Jack
Australian Shepherd
12 Years
Serious condition
1 found helpful
Serious condition

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

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
The head tilt will improve with time, it can take seven to ten days for the head tilt to correct itself; since we are not aware of the underlying cause of the head tilt (idiopathic) it is difficult to make any meaningful recommendation. Take the improvements day by day and follow up with your Veterinarian if there is no resolution after ten days. Regards Dr Callum Turner DVM

Add a comment to Jack's experience

Was this experience helpful?

Jack
Border Collie
3 Weeks
Serious condition
0 found helpful
Serious condition

Has Symptoms

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.

Dr. Michele King, DVM
Dr. Michele King, DVM
1604 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.

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?

Add a comment to Jack's experience

Was this experience helpful?

Coco
Yorkshire Terrier
9 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

front legs buckle
blank stare
Head held low

Medication Used

Methocarbamol
Carprofen

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.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 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

Add a comment to Coco's experience

Was this experience helpful?

Sweety
Golden Retriever
8 Years
Moderate condition
0 found helpful
Moderate condition

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

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
Normally, idiopathic vestibular disease normally self resolves within ten days or so if it is going to resolve; after this time, if there are still symptoms or the condition is progressing it is best to perform diagnostic imaging tests like CT or MRI to see if there are any lesions in the brain or inner ear which may explain the symptoms. If Sweety is improving day by day, it may be best to wait it out a bit longer but this is down to you; your Veterinarian may have noticed other clinical signs during a physical examination which would indicate a need for diagnostic imaging. Regards Dr Callum Turner DVM

Add a comment to Sweety's experience

Was this experience helpful?

Lulu
Terrie yorkie
19 Years
Mild condition
1 found helpful
Mild condition

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.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
With a dog Lulu’s age there are many possible causes for the symptoms you are describing including vestibular disease, liver disease (hepatic encephalopathy), kidney failure, poisoning, head trauma among other causes; without an examination I cannot give you any specific details. If finances are an issue, try to find a charity clinic in your area or contact a nonprofit; see links below. Regards Dr Callum Turner DVM www.aaha.org/pet_owner/lifestyle/cant-afford-critical-veterinary-care-many-nonprofits-can-help!.aspx https://iheartdogs.com/cant-pay-for-your-pets-needed-care-these-12-programs-can-help/

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..

Add a comment to Lulu's experience

Was this experience helpful?

Belle
Pomeranian
14 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Breathing Difficulties
Head Tilt

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?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
A head tilt may be caused by a few different conditions including vestibular disease, ear infections, nasopharyngeal polyps, poisoning among other causes; you should have your Veterinarian take a look at Belle to be on the safe side especially if she is struggling to breathe. Regards Dr Callum Turner DVM www.acvs.org/small-animal/nasopharyngeal-polyps

Did you find out what was wrong with your dog?

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.. :(

Add a comment to Belle's experience

Was this experience helpful?

Charlie
Yorkshire Terrier
5 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Partial face paralysis
Head Tilt

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 .

Dr. Michele King, DVM
Dr. Michele King, DVM
1604 Recommendations
Thank you for your email. Without examining Charlie, I'm not sure whether his head tilt will resolve or not. He may have had an infection, or an embolic event 'stroke', or an episode of vestibular disease. If something occurred in his brain, he may have that head tilt permanently, or it may resolve over time. It might be a good idea to either follow up with your veterinarian to get a better idea as to what might be happening, or have a referral to a neurologist to have him evaluated. I hope that he does well.

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

Add a comment to Charlie's experience

Was this experience helpful?

Vinny
Pomeranian
9 Years
Fair condition
0 found helpful
Fair condition

Has Symptoms

Head Tilt

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?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
Dogs shouldn’t be given expired medicines or medicines which haven’t been stored correctly; NexGard should be used with caution in dogs with a history of seizures and is noted in the prescribing information. There is a lot of bad press online of people complaining about side effects and adverse reactions after NexGard administration, I cannot comment as there is no reputable source for these claims. If Nexgard is the cause, it is going to be a case of waiting for it to leave his system; if there are seizures or he seems in distress visit your Veterinarian. Regards Dr Callum Turner DVM www.nexgardfordogs.com/Style%20Library/nexgard/docs/NexGard_PI.pdf

Add a comment to Vinny's experience

Was this experience helpful?

Dante
Siberian Husky
2 Months
Moderate condition
0 found helpful
Moderate condition

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.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 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

Add a comment to Dante's experience

Was this experience helpful?