Head tilt in dogs – what does it mean?

1st September 2017


Don’t assume it’s a stroke

If you find one day that your beloved pet is suddenly holding its head to one side, don’t just assume it’s a stroke and that there is nothing you can do. Our vets need to have a good look at all the signs, and the good news is that in many cases we’ll be able to give something to help.

A head tilt in dogs is usually a sign of a balance or vestibular problem and is often associated with involuntary eye movements from side to side and a drunken staggering walk. This is usually as a result of an ear or central nervous system complaint.


Ear disease

The semi-circular canals or balance organs are found in the middle ear so anything that causes inflammation or damage to this area may cause a problem. This includes;

  • Idiopathic vestibular disease - the most common cause of a head tilt is idiopathic vestibular disease. The signs can start very suddenly and may be confused with a stroke. Many dogs go on to make a good recovery.
  • Infections – at Bollington Veterinary Centre we see ear infections almost every week. They are usually either bacterial or fungal in origin and will need treatment.
  • Mites – ear mites will cause inflammation and irritation and are a common problem in puppies.
  • Abnormal reactions – occasionally we find that drops or solutions placed into the ear will cause a problem if the eardrum is damaged. Never put anything into the ear unless we’ve had a chance to check the eardrum first.
  • Trauma – an injury to the head from a road accident may cause bleeding and injury to the balance organs.
  • Tumours and polyps – anything growing inside the ear is a problem. Many growths are benign and the problems will resolve once removed.


Brain disease

If the ear isn’t the cause of a head tilt then it’s usually a brain dysfunction. At Bollington Veterinary Centre we’ll be looking for one of the following;

  • Tumours – some dogs do unfortunately develop brain tumours that can affect the areas that control balance. If we suspect this we may recommend a CT or MRI scan.
  • Trauma – any kind of injury to the head may result in bleeding and swelling within or around the brain.
  • Inflammation – conditions such as meningitis may result in significant inflammation which could result in a head tilt. Some of these conditions may respond well to steroids.
  • Drugs – high doses of the antibiotic metronidazole can cause some odd neurological signs, including a head tilt. Recovery will often take place within days of stopping this medication.


How do we investigate a head tilt?

In order to work out what might be causing a head tilt, we’ll often carry out a full physical and neurological examination together with blood tests and xrays. Our vets will check the ear canal using an auroscope, looking for infections, mites, fluid and polyps. We may need to use sedation or an anaesthetic if our patient is in pain.


How do we treat a head tilt?

Once we’ve made a diagnosis we’ll be able to recommend treatment to ease the signs and treat the cause. Supportive care usually involves using drugs to reduce any associated nausea or vomiting, whilst antibiotics and anti-inflammatory drugs may be used for infection and inflammation.


Call us if you are worried >