Horse Side Vet Guide ®

Equine Health Resource

Head Tilted or Cocked to Side

Code Red - Call Your Vet Immediately, Even Outside Business Hours

Code Orange - Call Your Vet at Their First Available Office Hours

Code Red - Call Your Vet Immediately, Even Outside Business Hours

  • If you notice apparent wobbliness or weakness, in addition to this sign.
  • If the results of the Whole Horse Exam (WHE) in the resting horse indicate fever (Temp >101F/38.3C) or heart rate greater than 48 BPM.

Code Orange - Call Your Vet at Their First Available Office Hours

  • If the problem is very mild and does not seem to be causing much harm to the horse.
  • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.

Many disease processes can cause a horse to tilt or cock their head. It is classically associated with neurologic (brain) injury or disease, but it can be caused by conditions affecting the inner, middle or external ear, neck injury or pain, or mouth pain. In the case of brain injuries, dysfunction of the vestibular (balance) system causes the horse to establish a new “set point” which is not level. A horse may also tilt its head if a foreign object is lodged in its ears or mouth, or if due to dental issues.

A head tilt is commonly seen in otherwise normal healthy newborn foals, and is thought to result from birthing or uterine position. In this case, it usually resolves within a few days.

WHAT TO DO

Assess the horse’s general health using the Whole Horse Exam (WHE), paying particular attention to the presence of absence of fever, general attitude and appetite and the ability to walk around normally. Is this behavior associated with eating or not? Offering a small amount of feed tests appetite and the ability to chew and swallow feed.

Assess your horse’s ears and mouth using a bright headlight. Look down into the ear canals for ear ticks or a foreign body (often a seed head or piece of hay). If possible to do it safely you might remove the foreign object, resulting in immediate relief and resolution of this problem.

WHAT YOUR VET DOES

Your vet may perform a full physical examination, neurologic exam, ear exam and/or oral exam in trying to determine a cause for this observation. Diagnosis may require additional testing, including radiology and blood work. Your vet will likely want to perform a complete exam on the foal before concluding that the head tilt will likely self-resolve.

NOTE: This observation is associated with Rabies, which is very rare in horses but does occur. As a precaution, wear gloves when handling a horse exhibiting this sign.

Author: Doug Thal DVM Dipl. ABVP

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