Head tilt in dogs

Overview

• ‘Head tilt’ is a term used to describe when your dog’s head is tilted to one side, usually for a long time.
• There are many possible causes for a head tilt. Some of the most common causes are an ear infection or vestibular disease – a problem with your dog’s balance.
• Most of the conditions that cause a head tilt also cause other symptoms such as head shaking, circling, loss of balance or a reduced appetite.
• Contact your vet if you notice your dog’s head is tilted to one side, even if there are no other symptoms.

Does your dog have a head tilt?

A head tilt is when your dog’s head is turned to one side, so that one of their ears is held lower than the other. It’s normal for many dogs to tilt their head to one side for a few seconds while listening to an unusual noise for example. However, if your dog’s head is constantly tilted or cocked to one side, it’s important to contact your vet for an appointment as there may be an underlying medical issue.

Causes

• Ear infection
• Something stuck in the ear such as a grass seed
• Vestibular disease – caused by a problem with your dog’s balance
• Certain medicines – some medications can be toxic to the ears and have the potential to cause vestibular disease
• Stroke
• Tumour – in the ear or brain
• Inflammation of the brain
• Trauma – to the ear or head

Other symptoms to look out for

Some dogs will have no symptoms other than a head tilt, however depending on the cause, you may notice other symptoms such as:

• Head shaking
• Itchy/painful ear(s)
• Face/head rubbing along the furniture or ground
• Red or hot ears and smelly discharge from the ears
• Aural haematoma – swollen ear flap
• Nystagmus (flickering eye movements)
• Loss of balance – falling over, unsteady walking, circling or leaning to one side
• Seizures
• Reduced appetite or vomiting

Diagnosis and treatment

There are many possible causes for a head tilt, so the tests your vet recommends will depend on what other symptoms your dog has and may include:

• An otoscopic exam - using a scope to see down both ears
• A neurological exam - a number of simple tests done during your dog’s examination that allows your vet to check if there are any problems with your dog’s nervous system
• A blood test
• X-rays

Sometimes, more advanced imaging such as a CT or MRI is needed to diagnose a problem in the nervous system (brain and spinal cord). This is usually done at a specialist referral practice.

The treatment and outlook for your dog will depend on their symptoms and diagnosis. Some of the more common causes of head tilt are less serious and your dog will often respond to treatment. However, there are some more serious causes that have a worse outlook.

When to contact your vet

Contact your vet if your dog has a head tilt, even if they don’t have any other symptoms. You know your dog best, always contact your vet if you’re concerned.

Published: January 2024