Vet examines dog for head titling

Vestibular Disease In Dogs: Why Is My Dog’s Head Tilting?

Darlene Pomroy never heard of vestibular disease in dogs. She had no idea why her Cocker Spaniel’s head was tilting. Pomroy thought 13-year-old Emmie had a stroke. 

“Vestibular disease is a sudden and non-progressive disturbance of balance,” according to Dr. Judy Morgan

Dr. Morgan says if the symptoms seem to get worse and worse, an MRI is warranted for the possibility of a brain tumor or some sort of growth inside the inner ear. The disease is sometimes called old dog vestibular syndrome or canine idiopathic vestibular disease. Sometimes the cause is idiopathic, meaning there is no firm reason for the cause. 

Dogs with vestibular disease tend to get better very quickly, but there can be other reasons for head tilting. Because the vestibular system is responsible for balance, you can imagine how a dog feels when his vestibular system is compromised. 

What Is Vestibular Disease in Dogs?

The vestibular system is responsible for maintaining a dog’s normal balance. Its central components are located in the brain, with peripheral components in the inner and middle ear. 

Sharon Daley, who is a DVM candidate with the class of 2023 at North Carolina State University, has helped treat dogs with vestibular disease. Her own Cocker Spaniel, Hershey, was affected by the condition, too. 

“Most of the time, it comes on quickly,” she says. “They’re fine the day before and then you notice a head tilt. Maybe they don’t want to walk or can’t walk.”

Your dog may fall over or hug the wall and make circles. Sometimes they get nauseated and vomit due to the loss of balance. Pet parents may notice rapid eye movement, or nystagmus, which can be horizontal, vertical, or circular. The direction of the eye movements can help establish a diagnosis. 

What Causes Vestibular Disease In Dogs?

Once the diagnosis of vestibular disease is made, the cause may or may not be certain. In some dogs, the cause is a perforated eardrum, a middle ear infection, or a tumor. In Cocker Spaniels and other floppy-eared breeds, vestibular disease may be attributed to ear issues. 

Dr. Judy Morgan says untreated hypothyroidism can cause vestibular disease. She recommends dogs diagnosed with this condition have both a T4 and free T4 test performed to check their thyroid levels. 

In the same way people can get a ringing sensation in their ears, so too can dogs. Imagine your ears ringing and not being able to tell someone, and that’s how your dog likely feels. 

Side effects of antibiotics may trigger vestibular disease in dogs as they do in humans. A brain tumor can cause instigate this condition. Other times, veterinarians have no idea what causes the issue, so they call it idiopathic, meaning unknown. 

“If an ear flush is applied to a dog with a ruptured eardrum, that dog may develop vestibular disease,” Daley shares. “There is a long list of things that can cause vestibular disorders in dogs.”

Symptoms of Vestibular Canine Disease

Most often, symptoms appear suddenly (acute) and without warning. These include, but are not limited to:

  • Walking in circles
  • Walking as if off-balanced
  • Head titled to one side 
  • Unable to stand upright at all or for long
  • Seeming to be dizzy
  • Falling to one side 
  • Nausea or vomiting 
  • Nystagmus (darting eye movements)
  • Head shaking 
  • Abnormal eye positions or squinting
  • Standing with a wide stance 

Sometimes dogs may appear car sick suddenly or lay down to drink or eat from their bowls. These could be signs of vestibular disease. 

Treatment for Canine Vestibular Disease

Daley says there are two ways to approach a dog with vestibular disease symptoms. First, the animal is offered supportive care with antihistamines, fluids, anti-nausea medications, appetite stimulants, and time.

Dr. Morgan agrees. She recommends getting nausea and vomiting under control and making sure dogs are well-hydrated. 

Dogs cannot miss water,” Dr. Morgan shared on a Facebook Live recently. “This may mean water or bone broth through a syringe, IV fluids in the hospital, or subcutaneously under the skin.” 

Make sure your dog receives supportive care until she regains her balance. Block off any stairways with baby gates and make sure she can’t run into anything (i.e. furniture, doors, walls, etc.) 

Another option is supportive care plus diagnostics which include an ear examination, middle ear x-rays, CT or MRI of the skull, and a myringotomy. In the latter, a surgical incision is made through the eardrum in order to drain fluid. Daley says that fluid is sent out for cytology and culture.

How Long Will Vestibular Disease Affect My Dog?

Dr. Morgan says most symptoms resolve within 24 to 48 hours, and dogs return to normal within 7 to 10 days. 

According to Sharon Daley, idiopathic, geriatric vestibular disease can take days to weeks. She has seen some dogs recover within three to four days, others have a one-and-done episode, and some dogs are affected every few months. 

“Some dogs recover but have a slight head tilt permanently,” she reports. 

Darlene Pomroy’s Cocker, Emmie, still has the effects of her vestibular attack in the form of a head tilt. When it first happened, she had a head tilt, fluttering eyes, and lost her balance on the right side. She kept leaning over when she tried to walk. 

Emmie’s veterinarian says the head tilt might improve, but there is a 90 percent chance this could be permanent. Dr. Morgan shares that most dogs learn to live with it, and it doesn’t affect their well-being.

Is It Stable Vestibular Disease or Something Else?

After a week or so, if outward symptoms are not improving, pet parents should consider more advanced diagnostics and imaging, such as a CT scan or MRI. 

“These diagnostics rule out cancer or stroke, which can cause the same signs, depending on the location,” Daley mentions. “Many dogs that have had strokes can continue enjoying a quality of life when given time to recover.”

She has seen many Cocker Spaniels affected by vestibular disease, and Dr. Morgan relates Dobermans and German Pinschers are overrepresented as well.

Dogs who suddenly lose their sense of balance may be experiencing a heart issue, infectious disease, trauma, low blood sugar, a thyroid issue, as a side effect of medication, or a spinal cord problem that makes them walk funny. 

If an underlying disorder is suspected or the condition worsens, your vet may refer you to a veterinary neurologist. 

Two dogs with vestibular disease
Milo, seen on the left.

How to Feed a Dog With Vestibular Disease

While your dog is recovering, use caution in feeding her. She will require water and food, but water is of utmost importance.  Some people hand-feed their dogs while the animal recovers.

In terms of feeding, talk to your veterinarian about the quantity and method by which to feed her. You may need to syringe feed your dog until she regains her sense of balance and loses the nauseated feeling. Think about times you felt sick to your stomach–it was hard to eat anything, but it is necessary to get well and keep your strength up.

When Welcome Knox’s Cocker Spaniel mix, Milo, became unsteady on his feet, she rushed him to the vet’s office. The dog fell three times in an attempt to stand up, so Knox loaded him, into her vehicle and rushed for help.

Milo experienced nystagmus of the eyes and a diagnosis of vestibular disease was made. He was given anti-nausea medication and sent home. He walked in circles and was unable to stop doing so. Thankfully, he made a full recovery in his South Carolina home. 

What Does Vestibular Disease Look Like?

Because the symptoms are similar to other canine issues, as mentioned above, always call your veterinarian or visit the local emergency hospital. Never diagnose a dog at home. 

Here are a few videos of dogs in the throes of a vestibular disease attack:

dog with vestibular disease
Collie with vestibular disease

These dogs have more than a “drunken gait” as their main symptom. Dr. Morgan says in 99 percent of dogs affected, they have a head tilt and nystagmus. 

How To Keep A Dog Comfortable During Recovery

As your dog recovers from vestibular disease, here are some things you can do to ensure she is comfortable and safe:

  • In a comfortable place to rest 
  • Does not have access to steps or areas where she may stumble and fall
  • Has easy access to water and food 
  • Is in an area that is free of obstacles on the floor
  • Use a harness to help guide and support your dog until she recovers
  • Some pet parents report their dogs to prefer their heads on a pillow or rolled-up towel during recovery 
  • Assist your dog with potty breaks. A supportive harness can be very helpful. 

Vestibular disease is not painful but it can be uncomfortable and scary for dogs. Although it often affects older dogs, it can affect younger dogs as well.

Why is my dog's head tilted?


  1. Thank you for the article on Vestibular disease in Cockers.We took Beauregard to the Emergency Vet because he couldn’t walk 3 years ago…they thought it was a resurgence of his IVDD.A few days later he fell off of the couch and could not walk again,we got him to our regular vet and he immediately noticed a slight head tilt and the nyastagmus…I had not noticed either thing yet.Once on medication he was better within a couple of days.Thankfully he has not had another episode because it was very scary for both of us.

    1. I remember when that happened. I am so glad he was okay after that. It is very scary to witness. Hugs.

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