Head Tilt in Horses

Head tilt is uncommon in horses, and can be an indication of severe underlying conditions that may be life-threatening.

If head tilt appears alongside difficulty walking, weakness, or swelling or injury around the head, require emergency veterinary attention.

Head tilt in horses is usually the result of injuries or infections affecting the brain, ears, or mouth.

Some foals are born with a tilted head due to the birthing or uterine position. This typically resolves itself in a few days.

The severity of this symptom primarily depends on whether the onset is sudden or gradual. The degree of head tilt does not usually indicate the severity of underlying disease. Horses with other symptoms such as uncoordinated movement or weakness are more likely to have conditions affecting the brain.

Sudden onset of head tilt typically indicates the presence of a foreign body, or an injury. Gradual onset may indicate an infection, or progressive disease such as temporohyoid osteoarthropathy or dental disease.

Diagnosis of head tilt focuses on identifying the underlying condition, and whether the mouth, ears, or brain is affected.

Diagnostic tools include:

• Physical examination especially of the ears, neck, and mouth
• Neurological examination
• Bloodwork
• Diagnostic imaging such as CT, ultrasound, and X-rays
• Testing for infections

Treatment depends on the underlying cause, and may include:

• Antibiotics
• Wound care
• Removal of foreign bodies
• Dental treatment
• Anti-inflammatories
• Surgery

Horses may tilt their head briefly when investigating a new or strange object next to them on the ground, or if an insect is bothering their ear on one side. In these cases, the head tilt rapidly resolves when the stimulus is removed.