There is the adorable heat tilt that dogs do when you talk to them. And then there is the head tilt that is a sign of a problem. How do you tell the difference?
The head tilt we all love can vary from side to side, in response to an interesting stimuli. The dog is looking at the source of the stimulus and is happy and intrigued. When whatever was interesting stops, so does the head tilt.
A persistent head tilt to only one side needs medical attention. It looks different, and it is quite easy to recognize that something is going on. If your dog’s head tilt has a medical reason, though, I may or may not be easy to figure out. The primary reason for a head tilt is an issue with the vestibular system.
Head tilt with no other signs
Once Jasmine gave us quite a scare when she suddenly started walking funny, holding her head low, tilting it to one side and whimpering. It came out of the blue and she looked very unhappy. When I checked her ear, though, I found the cause immediately—and it had nothing to do with her vestibular system. She had a tick latched to her ear flap.
Jasmine wasn’t a cry baby; I assume that it might have bitten her right at a nerve ending or something like that—that stuff can hurt. In my experience, pain or discomfort of any kind can make a dog to tilt their head like that. Cookie does that when something is bothering her ears, such as deer fly bite or itch.
Any pain and discomfort of the ear might cause your dog to tilt their head toward the affected side: insect bites, ear infections, foreign bodies.
Those signs have nothing to do with the vestibular system; it’s the dog’s response to the unpleasant sensation or pain.
Inner ear infections
One of the common causes of head tilt is an inner ear infection. Inner ear infections are the most common diagnosis in dogs with vestibular signs—head tilt. An affected go can also have problems with balance, walk in circles, and show other signs of a problem.
We were fortunate that our guys never suffered from ear infections but many dogs have chronic ear problems.
Other signs of an ear infection include:
- smelly ears
- excessive head shaking
- pawing and scratching at the ear
- brown, yellow or bloody discharge
If the infection is left untreated, ruptures the eardrum, and moves through the middle ear into the inner ear, the dog might eventually develop a head tilt, loss of balance, and start circling. Inner ear infections can also develop through the bloodstream or after an outer ear infection has resolved. In these cases, the part of the ear you can see will look perfectly normal.
Idiopathic vestibular disease
Vestibular disease is the second most common cause of head tilts in older dogs. Veterinarians use the word idiopathic because the underlying cause or trigger is unknown. Idiopathic vestibular disease is diagnosed based on age, history, and by ruling out other potential causes. The issue is most common in senior dogs.
Typical signs include:
- head tilt
- abnormal posture
- circling or rolling
- abnormal eye movements
- poor balance
- nausea and vomiting
Thankfully, while it looks scary, most dogs with the idiopathic vestibular disease recover with simple nursing care over the course of a couple of weeks.
Other causes of vestibular dysfunction and head tilts in dogs include:
- ear injuries
- head injuries
- brain inflammation or infection
- Cushing’s disease
- stroke, cancer affecting the ear or brain
- anatomic abnormalities within the brain
- and certain drugs such as Metronidazole
Drunken Gait/Ataxia in Dogs: Why Is My Dog Stumbling Around?
Head Tilt in Dogs: A Clinical Approach