Head tilting usually occurs due to an abnormality in the vestibular system. This can include the inner ear, the nerves and the brain, which all help your pet maintain balance. Head tilting can be caused by a number of reasons, and although some may be more dangerous than others, until the cause is officially determined it should be treated as a serious disease. In many cases, head tilting can be a symptom of a dangerous illness, and therefore should be dealt with immediately. Causes of head tilting can be separated into three main categories that all have several more specific causes:

Besides the obvious head tilt, there are also other symptoms that you should watch out for. For example, look out for your dog staggering, walking in circles, losing their appetite, vomiting, acting confused or moving their eyes in unnatural ways, like up and down and side to side.

Head tilt can occur for different reasons, depending on the area affected. There can be problems occurring within the ear, something wrong with the balance organ or issues with the brain. Your dog’s tilted head can have a cause, or it could simply be something that they develop as they age.

Problems involving the ear can cause your dog to walk with their head positioned in an abnormal manner. This can include ear infections, tumors, polyps, a foreign object that is stuck inside and irritating the ear, or even a bad reaction to ear drops. As a hint to determine if your dog has an infected ear, lift the flap to see if there is any discharge or foul smell. Also be on the lookout for heat, redness or swelling. Ear infection can be caused by ear mites, bacteria or yeast. Dogs with allergies or excessive hair growth can be more prone to ear infections.

The balance organ is found within the inner chamber of your dog’s ear and relays the information to the brain. Issues with the balance organ that can cause head tilting are an infection, drugs that may have side effects that cause damage to the balance organ and vestibular disease. Infections will most likely start in the ear and could possibly work their way downward to the balance organ. Vestibular disease is an illness that comes on suddenly and has no known cause, but will resolve itself once given time. The signs of vestibular disease, which is the most common cause of head tilts, include a drunken walk, strange eye movements and, of course, a tilted head. 

If the disease takes place in the central nervous system, your dog will often show weakness on one side of the body which can cause them to drag their feet on only one side as well as lethargy, loss of muscle over the head and, in some cases, difficulty eating and swallowing. There is an illness called old dog vestibular disease, otherwise known as idiopathic vestibular disease, which only occurs in elderly dogs. It is similar to vertigo and can cause your dog to feel sick and unbalanced. It will develop when there is a problem with your dog’s vestibular system and can occur with no known causes.

Diseases in the brain can also be the source of your dog’s head tilt. Strokes, tumors, infections like meningitis, and trauma can all be causes. Strokes are caused by blood clots that form in the brain or by cerebrovascular accidents. Brain tumors are rare, and the symptoms vary depending on the location. Tumors originating from membranes around the brain are more commonly seen in Collies and other breeds with long heads and noses. Other breeds that are predisposed include Boxers, Golden Retrievers and Boston Terriers. Dogs that have brain tumors will show differences in behavior, such as circling or pacing, increase in hunger and thirst, decreased vision on one side of the body, seizures, or signs of pain in the head. 

Weakness on one side of the body, head tilting, staggering, a loss in appetite, difficulty swallowing and vomiting will occur if the tumor is affecting the brainstem. Tumors can also lead to an inability to move the eyes, a change in the voice or paralysis. Head trauma can occur from car accidents or direct hits to the head. If you think that your dog could have suffered head trauma, watch out for different sized pupils, rigid or flaccid limbs, unusual levels of consciousness, strange eye movements, head tilt, bleeding from the nostril or ear canal, and seizures. While waiting to go to the vet, keep your dog warm and with their head elevated. If you suspect either head trauma or brain tumors, bring your pet to your veterinarian immediately as they are both severe.

When you first notice your dog developing a head tilt, take note of the symptoms and take video footage if possible. This information will help your vet diagnose the problem and get your dog walking straight again. If your dog is feeling unsteady, they may have trouble getting up. If this is the case, make them a nice bed to lay in and bring their water bowl close by until you can get veterinary assistance. Once you make sure that your dog is in a safe and comfortable spot where they cannot fall down stairs or get hurt or lost, call your vet. If your pet is vomiting or is showing difficulty with balance, treat it as an emergency and proceed to the vet as soon as possible. If you think that it is an infection, it is most likely not quite as urgent but your dog should still be brought to the vet that day. Your vet may or may not need to sedate your pet, so as a precaution do not feed your dog before visiting the vet. 

Once there, your vet will watch the patient’s movements and coordination and observe whether they seem to be aware of their surroundings. Physical and neurological examinations, routine tests and in some cases, x-rays, will then take place. A thorough inspection of the ear canal will aid in ruling out infections or growths. This will help the veterinary decide whether they think that the head tilt is caused by a problem relating to the brain, the ear or the balance organ. They will then perform any tests that are necessary and decide how to proceed with the remedy. 

If diagnosed as an infection, your vet will prescribe the appropriate antibiotics and your dog should eventually return to normal once they take effect. Vestibular disease will most likely resolve on its own, usually within 1-2 weeks. The treatment will include medication to reduce the nausea which will allow your dog to eat and nursing care to avoid pressure sores from lack of mobility. Brain tumors will be treated using surgery, radiation therapy and the possible chemotherapy. To treat head trauma, your pet will undergo supportive care, control of seizures, treatments for brain swelling or skull fractures and treatment for shock.

Head tilt will usually occur without much warning and is difficult to prevent. The best way to avoid it is to try to keep your dog away from any dangers that may cause head trauma. You can keep your dog from developing ear infections or yeast infections by watching for any unnatural behavior such as shaking of the head, or odor or discharge coming from the ear. The symptoms can be best prevented by catching the infection early on. 

The best way for dogs to recover from vestibular disease is to give them time. Therefore, when recovering from vestibular disease, you should try to keep your dog from becoming overly active too quickly. Instead begin slowly and gradually increase their level of exercise. Do not limit them too much, but do not push them to recover too quickly. To avoid head tilting due to ear infections, keep your dog’s ears clean and free of bacteria or waste. Check them regularly and gently dry them after baths or swimming. Also keep them up to date with the application of preventative flea or mite medication and groom them if there is excessive hair, especially pointing inwards in the ear.

Curing your dog’s head tilt will very in cost depending on the required treatment. Ear infections, tumors and reactions to ear drops can cost $300, $3000 and $300 respectively. Treating vestibular disease will cost you an average of $1000. If your pet has suffered a stroke, treatment will be about $1500. Brain tumors may cost $12000 to treat.