The dog has a persistent tilt or turn of the head along the central axis to one side. A head tilt usually indicates a problem in the middle or inner ear. Causes could be Ear infections or mites, drugs, Punctured ear drum, Hypothyroidism, Encephalitis, or tumors. Common signs to watch for are A tilt of head to one side, Redness or pain associated with the ear, Falling, circling, or rolling (usually toward the direction of the head tilt), Nausea, Vomiting, Lack of appetite, Pain associated with chewing or opening the mouth.