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Head Tilt in Cats (Vestibular Signs)

By: Dr. John McDonnell

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A head tilt is a persistent tilt or turn of the head along the animal's central axis to one side or the other and is usually described according to the side of the head that turns down. A head tilt usually indicates vestibular signs that may be a problem in the animal's middle or inner ear.

There are many causes for head tilt. Some of these include:

  • Ear infections or mites
  • Idiopathic (unknown cause)
  • Foreign bodies such as grass seeds
  • Head trauma
  • Ototoxic drugs (drugs that are toxic to the ear)
  • Punctured ear drum
  • Hypothyroidism (underactive thyroid)
  • Encephalitis (inflammation of the brain)
  • Cancer

    What to Watch For

  • A tilt of your pet's head to one side or the other
  • Redness or pain associated with the ear
  • Falling, circling, or rolling (usually toward the direction of the head tilt)
  • Nausea due to vertigo
  • Vomiting
  • Lack of appetite
  • Pain associated with chewing or opening the mouth.

    Diagnosis

    A head tilt is a symptom of a potentially serious medical condition. The cause of the head tilt should be investigated thoroughly by your veterinarian. Your veterinarian may investigate your pet's head with a variety of means, which may include:

  • A complete medical history
  • A complete physical examination
  • Neurologic evaluation
  • Blood and urine tests
  • X-rays of the head
  • CT scan or MRI of the head
  • Brainstem auditory evoked response (BAER) test
  • Spinal (or cerebrospinal) tap

    Treatment

    Treatment of a head tilt is primarily supportive until a definitive cause can be identified. Supportive treatment can include:

  • Intravenous fluids, especially if the pet is vomiting from nausea
  • Antiemetics
  • Antivertigo medications
  • Topical ear medications
  • Injectable or oral antibiotics

    Home Care

    If your pet is falling or rolling, protect him from objects such as furniture and stairs. Your pet may need assistance with walking or require being carried. Always support your pet, especially the head. If your pet has a head tilt, be careful and assist with descending and ascending stairs.

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