I have a 4 year old girl who is holding her head tipped to the right. She has no other symptoms, is running, climbing stairs and even jumping over the fence in the back field (Snow drifts are up to a foot from the top) without problems. This has gone on for about three weeks. First vet visit, tentative diagnosis was an inner ear infection. Put on cephalexin- no effect. Second vet visit - switched to an antibiotic that gets into the CNS - no effect. Third visit- X-rayed neck and skull. No obvious problems except a possible cloudiness in the right ear - very subtile. Placed on steroids, and she does seem to be improving slightly. She still holds her head tipped when in motion but often straightens it when standing still, and the tipping does not seem to be as extreme. Anyone experienced anything similar? How was it treated and what was the outcome? My vet says I need to give it time to resolve. Any ideas on how long to wait? The next step is to go to a specialist, an NMR, etc. This girl was in training for her CDX and SH, and I don't want to proceed until she is 100%.

Google "vestibular disease dogs" and see if that looks suspicious.

When My old guy had an inner ear infection my vet made up a Baytril solution to use in the ear itself. It worked wonderfully. Apparently this is something they typically use for cats since cats are hard to "pill" but since an inner ear infection is a deep tissue infection it is a good way to treat the ear topically.

It might be worth looking into with your vet.

Good Luck.

Thanks for the responses. The issue seems to be resolving itself.

Did you check her thyroid? Do you feed soy (goitrogenic) by chance? According to Jean Dodd's soy can effect the thyroid and head tilt is mentioned under neuromuscular function below. Probably not this but I thought I'd mention it anyway.

Isoflavones in soy are the primary compounds linked to decreased thyroid function. Isoflavones such as genistein interfere with the TPO (thyroid peroxidase) gene’s role in making thyroid peroxidase, an enzyme necessary for the chemical reaction that ultimately produces T4 and T3 via the protein thyroglobulin.

In dogs, the result is hypothyroidism (low thyroid function), the most common endocrine disorder affecting our canine companions. Hypothyroidism in dogs can result in disruption to a variety of critical systems causing many symptoms, including:
• Metabolic changes: (lethargy, weight gain, mental dullness, cold intolerance, exercise intolerance, mood swings, chronic infections, seizures)
• Neuromuscular (nerve/muscle) problems: (weakness, stiffness, facial paralysis, head tilt, incontinence, drooping eyelids)
• Skin diseases: (dry, scaly skin and dandruff, chronic offensive skin odor, hyperpigmentation, “rat tail,” “puppy coat,” pyoderma)
• Reproductive disorders: (infertility, absence of heat cycles, silent heats, testicular atrophy)
• Cardiac abnormalities: (slow heart rate, cardiac arrhythmia, cardiomyopathy)
• Gastrointestinal and liver disorder: (constipation, diarrhea, vomiting)
• Blood disorders: (bleeding, anemia, bone marrow failure)
• Eye disorders: (corneal lipid deposits, corneal ulceration, “dry eye”)
• Behavioral disorders: (fear, aggression, anxiety)

http://drjeandoddspethealthresource.tumblr.com/post/42291453086/soy-exposing-popular-pet-food-protein

It is probably a muscle spasm. That's why the steroids are helping. they can last for days until it resolves by itself. It looks like you should look for a new vet.

Do you have any other symptoms? Like turning more one direction the the other? If you pinch toes on each foot, does he respond equally on each foot, ie pull back a paw. If you sit in front of him on the floor, take a pair of forceps or a pen, brush them across the whiskers ends. Does each side react the same, ie does his face twitch like tickles. Wave a hand, coming from behind the ear, in front of each eye. You would like to see him close each eye. Any squinting when he goes from inside to out into the bright light? Like we would so with a bad headache? I have several others if you'd like some more.

You gave Peggy the exact, correct diagnosis. That was absolutely vestibular disease! Steroids do help it. Good job 'breeder'. Too bad the vet took 3 visits and didn't know. This is sad when some senior dogs are diagnosed with a stroke, recommended to be PTS and it's senior vestibular disease that resolves in a few days. Even general practioner vets should know this common illness, young or old.