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Dog ear infection head tilt: Why muscle twitching after walks?

Updated on September 23rd, 2025

Pet's info: Dog | Pug | Male | neutered | 10 years and 4 months old | 25 lbs

My dog was diagnosed with a middle ear infection which resulted in ataxia nystagmus and head tilt. A week later head tilt is still present. Since a couple of days I’m noticing muscle twitching in his neck or head, it’s like localised muscle tremors under his skin. He’s on Cefixime 400mg a day. The twitching usually occurs after his morning walk which is also when he takes his meds. Can this be due to exertion from head tilt or meds? It stops in a few hours.

1 Answer

Most Helpful Answer

Jenna Beyer, DVM, MBA, cVMA

Answered By Jenna Beyer, DVM, MBA, cVMA

Veterinarian, Certified Veterinary Acupuncturist

Published on May 8th, 2019

It can possibly be induced by the exercise. Make sure to walk Coco with a harness around the chest rather than the collar around the neck (and I would not have a collar on at all during this healing time). If it resolves on its own, I would not be too concerned with the twitching. If it occurs at other times of the day, I would call the vet to see if it is a concern.
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