What this means
A tilted head is also everyday dog behaviour: when your dog listens to your voice or is thinking, the head briefly tips. But a head that stays tilted and does not straighten when your dog stops listening is something else. It is not the illness itself but a sign that something is happening in the balance system: in the ear, the brain or the nerves.
The sense of balance is tied to the inner ear, so an ear infection can tilt the head and cause stumbling. Nervous system disorders can also tilt the head. Some puppies are born with poor coordination or differences in head structure. Telling these apart can only be done at an examination.
Write down when the head tilted (suddenly or gradually), to which side, and whether there is also stumbling, walking in circles, eye movement (quick flicks from side to side), vomiting, an ear smell or discharge. Film your dog's behaviour: a video is generally more useful to a vet than a description.
Possible causes
These are things that can cause this sign. It is not a diagnosis, and they are not equally likely for your dog.
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Ear infection
An inflamed middle or inner ear upsets balance. The head tilts towards the sore ear, and the dog may stumble, scratch the ear or shake the head.
About the condition: Ear infections -
Inner-ear balance disturbance
Sometimes a head tilt, stumbling and quick eye movements come on suddenly while the ear looks normal. It can look alarming, but a vet needs to assess it.
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Nervous system disorder
Illnesses of the brain or nerves can tilt the head and upset coordination. Changes in behaviour, weakness or walking in circles may come with it.
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Inborn head or coordination differences
Some puppies are born with a tilted head, stumble or move in an uncoordinated way. It shows from a very young age.
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Head injury
After a blow to the head the head may tilt and balance be upset. In that case your dog should be examined as soon as possible.
What else to watch for
These observations help your vet build the picture faster. Note down what you saw and when.
- When the head tilted: suddenly or gradually
- Which side it tilts to, and whether it is constant
- Whether your dog stumbles, falls or walks in circles
- Whether the eyes flick quickly from side to side
- Whether the ears smell, are red or have discharge
- Whether your dog is vomiting, refusing food or dull
When to book a routine visit
Book a visit if the head has been tilted for more than a few hours, if your dog is also stumbling, if the ears smell or discharge, or if it keeps recurring. If the head tilted suddenly and your dog is stumbling, do not wait: call the same day.
Related conditions
Conditions whose entries mention this sign. The list is somewhere to read on, not a way to reach a diagnosis.
- Ear infections Ears and hearing An ear infection is inflammation of the ear canal kept going by bacteria or yeast, which can be started by an allergy, a foreign body such as a grass seed, ear mites or trapped moisture. An inflamed ear itches and hurts, and long-lasting or repeated inflammation can change the ear canal for good. That is why it matters not only to calm the inflammation but also to find out what set it off.
- Cerebellar ataxia Nerves and muscles Cerebellar ataxia is a loss of coordination caused by damage to the cerebellum, the part of the brain that fine-tunes movement and helps keep balance. In dogs it can be inherited and appear in puppyhood or adulthood, but the cerebellum can also be affected by other causes, such as inflammation or a tumour. Strength may be preserved, yet movements become imprecise and poorly coordinated.
- Hydrocephalus Nerves and muscles Hydrocephalus is a condition in which too much cerebrospinal fluid builds up in and around the brain and presses on the brain tissue. It can be present from birth and show up in puppies, or develop later when inflammation, an injury or a tumour blocks the fluid from draining. The pressure on the brain can affect a dog's behaviour, movement, sight and ability to learn.
Body systems: Ears and hearing Nerves and muscles