Head tilt as a clinical sign of cervical spinal or paraspinal disease in dogs: 15 cases (2000-2021).

Objectives: To characterise head tilt as a rare clinical sign of cervical spinal or paraspinal disease in dogs.
Materials and Methods: Retrospective single-centre case-series study of dogs with head tilt and cervical spinal or paraspinal disease in the absence of intracranial abnormalities. Descriptive statistics were used.
Results: Fifteen dogs met the inclusion criteria of this study. Median age at onset was 6 years (range 2.5 to 12 years). Onset of neurological signs was mainly chronic (9/15, 60%). Most common presenting complaints included head tilt (9/15, 60%) and cervical hyperaesthesia (8/15, 53%). Most common neurological findings included head tilt (15/15, 100%), generalised proprioceptive ataxia and tetraparesis (6/15, 40%) and cervical hyperaesthesia (8/15, 53%). Diagnoses included post-operative complication of C2 spinal nerve root mass removal (2/15, 13%), C3-C4 intervertebral disc extrusion (2/15, 13%), cervical paraspinal myositis (2/15, 13%) and one of each: C2 vertebral malformation, C2 spinal nerve root mass, C1-C2 meningioma, C2 vertebral fracture, C4-C5 intervertebral disc extrusion, C4 vertebral body mass, C5-C7 osseous-associated cervical spondylomyelopathy, and concurrent C5-C6 and C6-C7 intervertebral disc protrusions. Two dogs were euthanased shortly after diagnosis and two of 15 were dogs lost to follow-up. No post-mortem examination was performed for these cases. For the 11 of 15 remaining dogs, head tilt resolved in eight of 15 (53%) dogs after treatment of the underlying condition and in three of 15 (20%) dogs, it remained static.
Clinical Significance: Head tilt can be a rare clinical sign of cervical spinal or paraspinal disease in dogs.
(© 2023 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)