Head Tilting in Dogs: Why Do Dogs Tilt Their Head?

Most of us know and love the endearing head tilt our dogs give us when they hear us talking or encounter a new noise. The wide eyes, cocked ears, and cute tilted head are some of the most endearing expressions of the canine face. In these moments, a head tilt is usually not considered a medical issue, and we may even intentionally elicit our canine friend’s head tilt for a cute picture on our social media pages. However, persistent head tilting, especially when accompanied by a loss of balance, vomiting, or stumbling, indicates that your pet should see a veterinarian immediately.

Below, we share what to look for and possible causes and treatments for head tilting in dogs.

Head Tilt To Hear You Better

Although dogs hear sounds at higher frequencies than humans, they also have different ear canal anatomy that may make it more difficult for them to hear certain sounds based on where the sound is located. Dogs may naturally tilt their head when concentrating on sounds and position their ears for optimal sound collection.

Sounds travel from the dog’s inner ear to the middle, and then to the brain. The part of the brain that controls the middle ear muscles also controls muscles that control facial expression and head movement. So when your dog cocks his head at you, he’s trying to hear you and also to let you know that he is listening to you. And since those cute expressions usually get a smile, a pat, and a kind word, your dog also gets positive reinforcement from you for tilting his head, making it more likely he’ll do it again.

Head Tilt and Ear Infections

Ear infections are prevalent in dogs, especially those with allergies or long ear flaps hanging over the ear’s opening. Ear infections may affect the external ear (otitis externa), causing head shaking, itching, pain, and the occasional head tilt. Because the inner ear anatomy is related to the dog’s vestibular system, any inner ear infection (otitis interna) can cause a more persistent head tilt and cause hearing loss. If you feel your pet may be experiencing an ear infection, call your primary care veterinarian to schedule an appointment. Treatment may include ear cleaning, allergy medication, and antibiotics.

Head Tilt in Dogs and Idiopathic Vestibular Disease

One of the most common medical causes of head tilt in dogs is a neurological problem called vestibular disease. Canine idiopathic vestibular disease in dogs is often called “old dog vestibular syndrome” and is a sudden but non-progressive disturbance in your dog’s balance. It usually affects dogs older than five with no known cause (idiopathic).

Vestibular disease affects your dog’s middle and inner ear, which are also responsible for balance. Common symptoms include wobbly gait, dizziness, difficulty maintaining balance, and head tilting.

Signs are usually most severe during the first twenty-four to forty-eight hours, and luckily, most dogs start to see symptoms improve over the following seventy-two hours. For many pets, idiopathic vestibular syndrome resolves entirely on its own within two weeks.

Other Causes of Vestibular Disease and Head Tilt in Dogs

Ear damage. Ear damage, such as a punctured ear drum, can cause a head tilt.

Tumor, inflammation, stroke, or brain infection. Also known as central vestibular disease, a head tilt can be caused by cancer, head trauma, or significant injury or illness to the brain.

Nutrient deficiency. Thiamine deficiency can be a factor in head tilting in dogs.

Hypothyroidism. Hypothyroidism can cause vestibular syndrome and a head tilt.

Side effect of antibiotics. Unfortunately, some vestibular syndrome can be caused by antibiotics, usually containing aminoglycosides. Talk to your veterinarian about side effects if your dog is prescribed antibiotics.

Ear hematoma. A blood-filled pocket on the inside of the ear flap.

Treatment for Vestibular Disease

Although many cases of vestibular disease resolve independently, monitoring your dog closely for any worsening symptoms is essential. Ensure your dog has a safe, quiet place to rest away from stairs or where they could fall, and ensure they have access to food and water. Call your primary care veterinarian or the emergency service for further evaluation if your dog’s symptoms have not resolved within 48 hours.

Some dogs will need hospitalization or medications to help them recover, especially if they are vomiting or dehydrated. Patiently waiting while your dog recovers from canine idiopathic vestibular disease may be difficult, so if you have questions, call us at 757-935-9111. The COVE is here for you and your pet.