Head Tilt in Dogs (Vestibular Signs)

Overview of Head Tilt in Dogs (Vestibular Signs)

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:

What to Watch For

Diagnosis of Head Tilts in Dogs

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:

Treatment of Head Tilt in Dogs

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

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.

In-depth Information on Canine Head Tilts

Vestibular signs, a disturbance of our sense of balance, can be seen as a head tilt as well as other alarming signs such as falling, rolling, continuous circling and nystagmus (rhythmical, jerky movements of the eyes). Other signs of vestibular disease include nausea, vomiting and lack of appetite.

The vestibular apparatus in the inner ear maintains our sense of balance. It is a delicate sense organ that is completely surrounded by an extremely hard bone (petrous temporal bone) at the base of the skull. The inner ear has intimate connection with the brain via the auditory and vestibular nerves. The inner ear is also associated with the middle and external ear.

Since the inner ear is intimately associated with the middle and external ear, signs associated with ear infections such as malodorous discharge from the ear, scratching or shaking the ear and pain or redness of the ear may be seen.

A head tilt is usually described according to the side of the animal’s head that turns down. Animals typically fall or roll towards the same direction as the head tilt. Nystagmus (an involuntary rhythmic movement of the eye) is only a symptom of vestibular disease and does not indicate severity of the disease.

Since the middle and inner ear are located close to the temporal mandibular joint (jaw), there may be pain associated with chewing or opening the mouth. These animals may even yelp out in pain while they are yawning.

Causes of Head Tilts in Dogs

The most common cause of vestibular signs is ear infections. Damage to the inner ear structures or the brain itself may cause vestibular signs. Vestibular signs indicate either a problem in your pet’s inner ear or brain. It is very important for your veterinarian to determine quickly whether the cause of your pet’s vestibular signs are due to disease of the inner ear (peripheral vestibular disease) or to disease of the brain (central vestibular disease). The choice of different diagnostic tools and the prognosis depend on the suspected location of the problem. In general, peripheral vestibular disease has a better prognosis than central vestibular disease.

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

Antibiotics such as gentamycin, streptomycin, amikacin, neomycin, kanamycin, erythromycin, chloramphinocol, polymyxin B or metronidazole.

Some ear cleaners including ethanol (alcohol), chlorhexidine, idodine containing medications, centrimide and benalkonium chloride.

Diuretics such as furosemide, ethancrynic acid and bumetanide.

Antineoplastic (cancer fighting) medications such as nitrosoureas (CCNU and BCNU) and cisplatin.

Some of these drugs can also cause deafness.

Other causes of head tilt include:

Diagnosis In-depth

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. Diagnostic tests are needed to determine the presence of an underlying disease or cause for the head tilt. Your veterinarian may investigate your pet’s head with a variety of means, including a complete medical history. Be able to answer the following questions:

Additional tests may include:

Tests listed below may require general anesthesia. In general, modern veterinary anesthesia is very safe and well tolerated by pets. However, animals with vestibular dysfunction may show worse signs after waking up from anesthesia. The more severe signs usually resolve over 48 to 96 hours.

Therapy In-depth

Your veterinarian may recommend one or more of the diagnostic tests described above. In the meantime, treatment of the symptoms might be needed, especially if the problem is severe. The following symptomatic treatments may be applicable to some but not all pets with vestibular signs. These treatments may reduce severity of symptoms or provide relief for your pet. However, nonspecific therapy is not a substitute for definitive treatment of the underlying disease responsible for your pet’s condition.