Head tilt in dogs is a common medical symptom. A dog will tilt its head for a variety of reasons, and head tilt is not always considered serious. Dogs can head tilt because of geriatric vestibular disease that leaves them with balance problems or it could be due to ear infection or head injury. The vestibular system is involved in providing normal balance and orientation and was this system is disrupted, you may notice your dog with a head tilt. The symptoms and treatments vary depending on the cause. This article will discuss all you need to know about head tilts in dogs, including what causes head tilt in dogs, different symptoms and treatment options based on the diagnosis.

Ear infections and Head Tilt in Dogs

When head tilts are caused by an ear infection, the condition is called otitis interna or otitis media. Your dog may show symptoms like head shaking and scratching at its ears to alleviate discomfort. It will also exhibit other signs such as lethargy and poor appetite if it has a fever. Otitis interna is the most common cause of head tilt in dogs, with up to 50% of all cases originating from this condition. As the inner ear contains anatomy related to the vestibular system, any disruption in that area can cause a head tilt. Treatment for an ear infection would include antibiotics, anti-inflammatory medications, and pain relief. If the infection is not treated promptly or completely, it can lead to permanent damage to the ear and even deafness.

Geriatric Vestibular Disease in Dogs (Old Dog Imbalance)

One of the most common causes of head tilt in dogs is due to geriatric vestibular disease. This is also known as Idiopathic Vestibular Disease. This disorder typically affects older dogs (usually over the age of 5) and can result in head tilt, falls, and imbalance. You may also notice a rapid shifting of the eyes from side to side, known as nystagamus and well as circling. Unfortunately, no underlying cause has been discovered. Pets with this condition need a calm, quiet environment to reduce stress. They should not be moved quickly but instead given ample support so the pet can accommodate and feel secure in its new surroundings. To ensure that your pet stays safe, it should be kept in a restricted area and should have its access blocked to stairs, tall furniture, slick flooring or open sources of water. Darkness should also be avoided as it makes visual accommodation difficult resulting in exacerbation of clinical signs.

Treatment is usually supportive with anti-nausea medications. Most dogs with Geriatric Vestibular Disease (Idiopathic Vestibular Disease) will start to improve within a few days and generally recover over a few weeks with supportive therapy.

Head Injuries and Trauma in Dogs

Head injuries or trauma are another cause of head tilt in dogs. Symptoms will vary depending on the severity of the injury and may not appear for days or even weeks after the incident. Approximately 50% of all head trauma cases are a result of a motor vehicle incident. If the result of trauma is damage or impairment to the middle or inner ear, a head tilt can occur. Other symptoms may include seizures, blindness, circling, and head pressing. Treatment will depend on the extent of the injury and may range from medications to surgery.

Other Causes of Head Tilt in Dogs

There are other causes of head tilt in dogs that have been less commonly reported. These can include tumours or masses in the head or neck region, neurologic diseases such as meningitis, encephalitis, brain tumours, or problems with the blood vessels in the head (such as a stroke). Your veterinarian will be able to isolate the particular cause based on their examination and diagnostics tests.


Head tilt in dogs is a head or neck injury, an ear infection or other type of head trauma. It can also be caused by geriatric vestibular disease (idiopathic vestibular disease) and tumours. Treatment varies depending on the cause but may include antibiotics for infections, anti-inflammatory medication to reduce pain and fever, as well as supportive care with medications that help manage nausea. Most dogs will start to improve within a few days and make a full recovery over a few weeks. With prompt treatment, most cases of head tilt in dogs can be resolved successfully.