My Dog Walks With Its Head Tilted

We may have seen a dog with its head tilted at some point, but do we know what this means? Below we'll explain what causes a dog to be unable to straighten its head.

Although there can be several reasons behind it, it's important to understand that we should see a vet quickly, since the dog is likely in pain, and delaying treatment can make the condition worse.

Should I Worry If My Dog Tilts Its Head?

Even though it might look like a funny pose, a dog walking around with its head tilted really is cause for concern. It isn't a disease in itself, but it is a symptom telling us it's suffering from some condition.

In fact, this abnormal head position often shows up alongside other clinical signs. This picture, together with the medical history we give the vet, will help the professional reach a diagnosis.

Why Does a Dog Tilt Its Head?

When a dog tilts its head, our first thought might be that there's a physical problem or obstruction in the area that makes it impossible to turn or hold the head in its normal position. That's why we can feel around the neck for any abnormality or sign of pain.

But we should know that, in most cases, the head tilt corresponds to pain located in the ear, in any of its regions. The dog feels discomfort and turns its head toward the affected side in an attempt to ease it.

Not being able to hold the head in its normal position can also stem from disorders affecting balance. In these cases, we'd be dealing with a neurological problem, and the resulting head tilt can be permanent. Let's go over these causes in more detail below.

Otitis

Otitis is the name for inflammation of the ear canal. Some dogs are more prone to it due to their particular anatomy, or due to circumstances that make them more susceptible, such as skin allergies, walking through vegetation that can get into the ear, bathing frequently, etc.

A dog with otitis will shake its head, scratch or rub at the affected ear due to the pain, whine if we try to touch it, and hold its head tilted toward the inflamed ear. There's usually a foul-smelling discharge, and we'll often notice the folds of the ear canal red and swollen.

Otitis usually starts in the outer part of the ear but, if left untreated, can keep advancing into the canal. We should never put anything in the dog's ears on our own, since it's essential for the vet to check the state of the eardrum and the cause of the inflammation.

• More information on Otitis in dogs

Vestibular Syndrome

The vestibular system keeps the body balanced and spatially oriented. A disorder here can stem from inner ear infection, damage to the cranial nerves (peripheral form), or to the brainstem (central form), which occur in distemper or meningoencephalitis.

A tilted head is a hallmark symptom, along with nystagmus, an involuntary movement of the eyes, or strabismus. We may also notice ataxia, which is a loss of coordination that can make the dog walk in circles or fall.

Despite the tests currently available in veterinary medicine, sometimes it's not possible to determine the exact cause of the syndrome. In that case, it's said to be idiopathic.

Brain Tumors and Abscesses

Lastly, we should mention brain tumors or abscesses as a cause of head tilting in dogs, which luckily aren't very common. They affect middle-aged and older dogs more, especially those with a rounded skull and short muzzle.

The symptoms triggered depend on their location and size. There can be seizures, behavioral changes, stumbling, nystagmus, weakness, and paralysis, in addition to the head tilt. Specific tests are needed to detect them.

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When Should I See a Vet If My Dog Tilts Its Head?

The answer is immediately. As soon as we notice any of the symptoms mentioned, we should contact the vet. Although there are serious conditions that can cause a persistent head tilt, it's more often due to easily curable otitis. If we wait, it can get worse.

How Is the Problem Solved?

For our dog to recover a normal head position, the first thing we need is a diagnosis. The treatment the vet prescribes will depend on it. In the case of otitis, treatment will target the underlying cause. Discharge needs to be cleaned and the right medication applied. If there's a foreign body, the vet will remove it.

If vestibular syndrome is what's affecting the head's position, we need to find out what caused it — which isn't always a simple task. If it's due to middle ear infection, cleaning the canal along with oral antibiotics for several weeks is usually prescribed.

Idiopathic vestibular syndrome can resolve on its own. In some dogs, the head tilt improves but doesn't fully go away. If the syndrome is due to a neurological problem, the prognosis will depend on the cause. Abscesses require antibiotics. Tumors can only be treated with surgery.

Bibliography Carlson and Giffin (2002): Manual práctico de veterinaria canina. Madrid: Editorial el Drac.