Key takeaways
Dogs naturally tilt their heads in order to concentrate on noises and hear them more clearly.
- Normal head tilting is characterized by a dog lifting one ear higher than the other
- If a dog tilts his head involuntarily or chronically, especially when along with other symptoms like ear pain or lack of balance, it may be a symptom of an underlying medical condition
- Injuries, infections, foreign bodies, tumors, and vestibular disease are examples of common conditions that cause head tilt
- Diagnostics include a physical examination, blood tests, diagnostic imaging, and cerebrospinal fluid tests
- Treatment and prognosis vary depending on the underlying condition
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A closer look: Head Tilt in Dogs
Head tilt as a medical symptom is uncommon and results from a variety of underlying conditions. If a dog has a head tilt accompanied by other symptoms such as circling, difficulty moving, lack of coordination, vomiting, confusion, or lethargy, these are signs of an emergency and require urgent medical attention.
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Possible causes
Risk factors
Consistency and duration of the head tilt may suggest particular underlying causes, as will the presence of any other symptoms.
A dog with a foreign object in its ear may scratch at their ear or rub it on the ground. Veterinary assistance is often required to remove foreign objects from a dog’s ear, particularly foxtails (grass awns).
Dogs with damage or disease to their central vestibular system (brainstem) are also likely to exhibit changes in posture, slower mental responses, and difficulty moving. These symptoms require immediate medical attention.
Testing and diagnosis
In addition to physical examination, further diagnostics for a dog presenting with head tilt include:
- Otoscopic exam
- Neurologic exam
- Blood tests
- Urinalysis
- Diagnostic imaging, including specialized imaging such as MRI or CT
- Cerebrospinal fluid test
- Thyroid panel
Underlying cause determines treatment. For severe underlying conditions, fluid therapy and rehabilitation in a hospital setting might be required.
There are very few treatment options available for strokes or cancers affecting the brain. In these cases, the focus is on supportive care.
Similar symptoms
Head tilt is often mistaken for regular dog behavior, where a dog tilts their head so as to better identify or concentrate on sounds. A dog cocking its head to one side while listening or concentrating is a voluntary reaction to a stimulus that resolves quickly when the stimulus stops or the dog gets bored. Head tilt as a symptom persists as long as the underlying condition is present.
The symptom of head tilt can be confused for another neurologic symptom called head turn. With head turn, a dog involuntarily turns his head to one side instead of pointing his nose straight forward in line with his body. This is often accompanied by circling.
Associated symptoms
Other symptoms vary depending on the underlying condition.
