Why Does My Dog Suddenly Have a Head Tilt?

When your dog suddenly develops a head tilt, all sorts of horrible things run through your mind: Has he had a stroke? Could he have a brain tumor? Is he going to die?

Although the signs are dramatic, especially if your dog comes staggering drunkenly to greet you, the outlook isn’t always as bad as it first looks. There are many reasons a dog may develop a head tilt, including strokesand brain tumors, but another condition called “old dog vestibular syndrome” is far more common and has a better outlook.

So let’s not jump to conclusions and instead take a look at some of the reasons a dog might develop a head tilt.

What Causes a Head Tilt?

A head tilt is a symptom of a problem rather than a diagnosis.

Here are a few issues with specific body parts that may cause a tilt:

The Ear

1. A sore ear, as happens with an ear infection (Hint: Lift your dog’s ear flap and have a good sniff. An offensive smell or yucky discharge could indicate an infection.)
2. A bad reaction to ear drops
3. An irritated ear canal (for example, if a foxtail gets stuck in the ear canal)
4. Ear polyps (fleshy lumps within the ear's chambers)

Balance Organ

Located within the inner chamber of the ear, the balance organ feeds vital information to the brain about which way is up and how to stay on your paws.

1. Infection, perhaps caused by a severe ear infection that tracks inward
2. A drug that damages the balance organ as a side effect
3. Vestibular disease, which is a sudden onset condition with no known cause

Brain

1. A stroke (cerebrovascular accidents or a blood clot that lodges in the brain)
2. A tumor (rare)
3. Trauma
4. Infections such as meningitis

What to Do

Don’t panic. Stay calm and watch your dog. Make a note of any symptoms and video record the dog to help the veterinarian know what's going on.

Look for signs beyond the head tilt, such as: Staggering as if drunk Walking in circles Vomiting Loss of appetite

• Eyes that flick from side to side (or up and down)
• Confused mental state

Make sure the dog is in a safe place and can’t take a tumble downstairs. If he has difficulty getting up, then make him comfortable in a soft bed and place a bowl of water within easy reach (he may feel too unsteady to walk to his water).

Now call the vet.

If the dog has balance issues or is vomiting, then seek an urgent appointment. If you suspect an ear infection, a same-day visit will do. As a precaution, don’t feed your dog in case the vet needs to sedate him for tests.

Assessment

The vet watches how the dog moves, notes his coordination and checks if he is fully aware of his surroundings. Then she thoroughly examines the dog to see if the

problem is related to the ear, balance organ or the brain.

Getting clues from a physical exam as to the problem's location, the vet then devises a plan of action. This may involve sedating the dog to examine the ear canal or image the brain or inner ear.

Watch this courageous dog pull through a bout of old dog vestibular syndrome:

Outlook

The outlook for an ear infectionis very good. Once appropriate antibiotics are selected, the dog returns to normal.

In older dogs, the commonest cause of a sudden onset head tilt is that “old dog vestibular syndrome.” This comes on out of the blue and causes signs similar to severe vertigo in people. The dog feels sick, loses balance and tips his head to one side.

The good news with vestibular syndrome is that it often resolves of its own accord after 1–2 weeks. Treatment is based around reducing nausea so the dog can eat and nursing care to prevent pressure sores due to lack of mobility. Some dogs recover but are left with a permanent head tilt. However, they can otherwise lead a normal life.

Other conditions such as a stroke or a brain tumor can be very serious, but these are less common. So seek your vet’s opinion before thinking the worst -- there’s a good chance your dog may be fine after all.

This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Oct. 11, 2018.