A head tilt and eye dilation means there's some kind of neurological problem, usually, though it CAN happen with severe untreated ear infections as well (more common in dogs than cats), and a few very rare conditions I'd have to do a search for. You'd want to do a full neurological exam to figure out the extent of the problem, and determine if it's affecting quality of life. Many times there's no quality of life lost, so I don't know why your vet would automatically euth on just that alone, maybe there was more you were not aware of at the time.

Phaewryn
 
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