Common Causes of Head Tilt in Dogs

Without a doubt, one of the truly adorable mannerisms of your dog is when he tilts his head to one direction without breaking eye contact. This little head tilt can look like curiosity, listening more intently, and even playful judgment. Whatever your dog’s intentions, when he cocks his head to the side, it’s sure to get your attention.

But what does it mean when the head tilt becomes less of an adorable quirk and more of a regular occurrence? Some dogs suffer from what is commonly referred to as “head-tilt,” wherein a dog will keep his head tilted to one side. Whether sitting or standing, head tilt goes from funny to worrisome rather quickly, especially when it becomes normal behavior instead of an occasional attribute.

Head tilt in dogs may be an indication of Vestibular disease, which is a dog’s inability to regulate their sense of direction. Similar to what humans experience with vertigo, Canine Vestibular disease turns a dog’s world onto its side, leaving your pup feeling dizzy, anxious, and potentially nauseated. 

Before you get too worried at the sight of the word disease, it is important to note that not all causes of head tilt are Vestibular disease. This article will overview some of the most common causes of head tilt and their respective treatments.

What Is Vestibular Disease?

Commonly referred to as “old dog syndrome,” canine idiopathic vestibular disease is often an ailment that affects older dogs. Caused by inflammation of the inner ear, Vestibular disease affects balance and a dog’s sense of direction. According to Pet MD, when the vestibulocochlear nerve becomes inflamed, your dog’s brain is unable to regulate balance and tries to remedy the sensation by cocking his head to one side.

Even though it may sound serious, Vestibular disease is treatable and often concludes in a full recovery. Usually, the underlying cause of the inflamed vestibulocochlear nerve is something minor, like a canine infection. Still, there are circumstances where Vestibular disease develops due to a more severe condition like a canine tumor. The syndrome can leave almost as quickly as it originates, and most dogs experience a recovery timeline between one and three weeks.

To diagnose Vestibular disease, your vet will perform a multitude of tests that may include x-rays, a blood draw, and urinalysis. If there is no severe underlying issue, then your vet will likely prescribe a simple anti-nausea medication and advise you to make your dog as comfortable as possible until the sensation dissipates in a few days.  

How Ear Infections Cause Head Tilt?

Canine ear infections are certainly related to Vestibular disease, but not all ear infections develop into inflammation of the vestibulocochlear nerve. While there is overlap between the two, it is far more common that an ear infection manifests itself as an infection of the ear canal rather than the inner ear itself.

Ear infections are typically the result of a bacterial infection, and most commonly are an overgrowth of yeast in the ear. Canine ear infections will identify themselves with a few key symptoms that the American Kennel Club lists as:

  • Head Tilt
  • Discharge from the ear
  • Excessive head shaking
  • Foul Odor
  • Scabs on the ears
  • Swelling and redness in the ear canal

Ear infections lead to head tilt because of the pain and pressure caused by the infection. As the ear canal becomes infected, fluid builds up and causes your dog pain and discomfort. In an attempt to alleviate this pain, many dogs aggressively shake their head and then leave it tilted as an attempt to lessen the pressure and fluid build-up. Most canine ear infections are bacterial, which means they are treated with antibiotics. The recovery time for an ear infection is anywhere between four and 14 days, and most dogs show improvement after 48 hours. 

While ear infections and Vestibular disease are the two most common causes of head tilt, Today’s Veterinary Practice asserts that head tilt can also be the result of these other causes: 

  • Degenerative disease
  • Spinal malformation
  • Brain tumors
  • Vitamin deficiency
  • Hyperthyroidism
  • Cerebrovascular Disease
  • Ototoxicity 

For most dogs, head tilt is a minor condition that poses no serious long-term health threats. However, as head tilt does have the potential to be a symptom of a more severe underlying cause, head tilt must be treated immediately. If you see your dog tilting his head, take notice of when he does it. If he exhibits any other symptoms of possible infection or inner-ear distress, take him for an examination right away. 



“Head Tilt, Disorientation in Dogs.” PetMD,

Carnes, Michelle B. “Head Tilt in Dogs: A Clinical Approach.” Today’s Veterinary Practice, 15 Oct. 2019,

Racine, Elizabeth. “Dog Ear Infections: Symptoms, Causes, Treatment, and Prevention.” American Kennel Club, 21 Oct. 2019,

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