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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

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Chihuahua

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Nine Years

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Unknown severity

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4 found helpful

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Unknown severity

Has 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

Owner

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Dr. Sara O. DVM

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4 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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Bully

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10 Years

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6 found helpful

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Shaking His Head And Tilting His Head And While Walking He Leans To The Side That The Ear Is Itchy On

My dog is having problems with his ear and when i take him out he leans to that side

Dec. 31, 2020

Owner

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Dr. Sara O. DVM

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6 Recommendations

Hello, this could be an inner ear infection causing him to lean to the side. Also, strokes can cause a head tilt and walking to one side. It would be best for your vet to see him to see which one it is. If it is an inner ear infection, your vet will start him on antibiotics to help with the ear infection.

Dec. 31, 2020

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German Spitz

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Three Years

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2 found helpful

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Tilting Of Head Balance Inssues

Hello my dog was playing with my other dog who is a lot bigger than him and he is now walking with his head tilted with his neck turned to the side by a great amount and is kind of moving from side to side he isn’t crying of pain and is still wagging his tail and seems happy please give me answers

Dec. 16, 2020

Owner

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Dr. Michele K. DVM

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2 Recommendations

Thank you for your question. It is possible that your dog has injured its neck or back, or is having a muscle spasm or a strain or sprain from the activity. A smaller dog can be quite traumatized by a larger dog if they play the wrong way. It would be best to have your dog seen by a veterinarian as soon as possible, as they can examine your dog and see what treatment they may need so that they can feel better.

Dec. 16, 2020

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miniature pin

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16 Years

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3 found helpful

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Leaning To The Side And Fallin

Hello, my dog is starting to lean to the left and keeps falling over. She can't walk straight and is very wobbly. This just started happening over the last couple hours. Is there anything I can do to help her?! I appreciate any suggestions I'm freaking out. My dog takes gabapentin, hycaden, Prozac, cbd, mucinex, and pepcid every day for the last 4 years.

Nov. 16, 2020

Owner

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Jessica N. DVM

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3 Recommendations

Hello- Thank you for your question. It sounds like your pup needs to see a veterinarian immediately to have her neurologic symptoms evaluated. It could be old dog vestibular disease, a possible infectious process or a brain tumor potentially. Once she has been evaluated by your veterinarian he or she can decide whether diagnostics such as bloodwork and imaging are warranted and prescribe appropriate treatment. I hope she feels better soon.

Nov. 16, 2020

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Poodle

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Thirteen Years

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2 found helpful

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Redness

My dog is tilting his head to the side

Nov. 14, 2020

Owner

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Dr. Linda S. MVB MRCVS

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2 Recommendations

From the photo, the head tilt appears mild. However, we cannot say what is causing it from a photo alone. He needs a full check over and the vet may even have to run some further tests (such as a blood test) to get to the bottom of things. If we are dealing with something simple, such as an ear infection, he may simply require some anti inflammatories and antibiotics. However, there are a number of potential causes. He should be examined by a vet as soon as you can have him seen. What a sweet boy by the way!

Nov. 14, 2020

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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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0 found helpful

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Fair severity

Has Symptoms

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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0 found helpful

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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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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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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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