My dog bumped his head. Is a head tilt a sign of brain injury?

Unfortunately I agree with your vet that MRI is probably the next step. Even though his ears appeared normal inner ear disease is still possible although fairly unlikely, especially since there is no nystagmus eye movement noted. A head tilt can be a sign of infectious or inflammatory brain disease, a stroke or blood clot in the brain, or even a brain tumor. If the head tilt is the only neurologic symptom and your dog is otherwise acting like his normal self you could consider simply monitoring for additional neurologic signs - with most of these neurologic problems I would expect more symptoms to develop as the disease progresses.

Monitor for any vomiting or trouble walking or a head tilt. If you notice any eye movements jumping back and forth or a head tilt, that is a sign of head trauma. If you notice no signs after 12 -24 hours then you have nothing to worry about

It sounds like your Toby is suffering from a brain condition, This could be so-called vestibular syndrome, a brain bleed or similar lesion. Vestibular syndrome is a condition affecting old dogs. We do not know what causes it, however most of the time the dogs recover from it within about 4-6 weeks. Sometimes a head tilt remains,, but does not bother them. You need to take Toby to a vet to rule out other brain conditions, possibly for some iv fluids and medicine to combat nausea and fear, if indicated. Here is some really good information: http://vestibular.org/sites/default/files/page_files/Vestibular%20disease%20in%20dogs%20and%20cats.pdf

It is quite possible he has suffered a head or high spinal injury but a 'broken neck' is unlikely given the fact he is mobile and able to move. The clear blood results are positive and although an MRI or CT scan may provide additional information, if he is eating, mobile and able to toilet normally then rest and TLC may be enough to promote recovery. Hills make a specialist b/d diet may help with brain and neurological health and speed recovery, acupuncture may also be worth considering

Dogs can have head tilts because of a neurologic problem (such as vestibular syndrome), or if something related to their head is bothering them. If the issue just started after your walk, and given Charlie's young age and the fact he was wearing a muzzle, I would be suspicious there's something bothering him with one of his ears - perhaps the strap of the muzzle irritated it, or he has an early ear infection, or got a little debris in his ear. Even if his ears look fine to you, the ear canal has a bend in it that requires an otiscope to be able to see all the way down to his eardrum. Problems in the mouth don't usually cause a dog to tilt their head. If the issue just started, and if he's acting completely normal otherwise, I'd keep an eye on it for a day or two. If he keeps tilting his head, or if any other symptoms start, I'd have him seen by a vet. Hope this helps!

The first question to answer is, if he lost his consciousness when he fell. Being 'knocked out' suggest brain trauma, concussion at least. If he was conscious at all times, then most likely the brain did not suffer any serious injury. Dogs have relatively small brains (compared to human), which are also well protected by the skull bones. Brain injuries are much less common in dogs than in human patients. So, my advice is : as long as Milo is looking normal, he is bright and alert, he is not vomiting, his pupils are of equal size, he is not in any obvious pain or discomfort you should monitor him at home. If he becomes lethargic, weak on legs, crying for no reason or vomiting you need to call your regular vets or your nearest emergency service asap.

That is very unusual. There are several things that come to mind that could cause the signs. Ingesting toxins, an inner ear infection, stroke or viral infections are all possible. Anytime a pet appears off-balance you should be concerned and I recommend to take Nigel in to see a veterinarian right away. The doctor will need to perform a few basic tests to try to figure out the cause of the imbalance. Treatment will depend on the cause. Best of luck and I hope this is helpful. Please feel free to post any additional questions.