Understanding Idiopathic Head Tremors in Dobermans: A Different Approach
The Lady of Cloudfall, her main home: Persephone
When we first noticed our Doberman puppy Persephone's head tremors, we were concerned and confused. While we had heard about idiopathic head tremors and that they’re relatively common in the breed, we had never had to deal with the condition before. So, naturally, we asked ourselves: What are these tremors? Why are they happening?
As we found out quickly, conventional veterinary medicine appears to have deemed idiopathic head tremors not very concerning. That is despite the fact that the cause of these tremors, as ‘hides’ in the word idiopathic, is unknown. Maybe the lack of concern is also why there seems to be no real effort, or maybe no funding, to fully study their origins and treatments.
While we are not implying that other veterinarians are careless, we have read a fair share of comments in Doberman forums that their veterinarians basically ignore guardian’s concerns and suggest to just accept the condition as a harmless blip in the dog’s system. We understand the reaction because when you are a veterinary professional and there is no hard evidence pinpointing a cause and a treatment, you might not feel comfortable to recommend anything outside of your usual toolkit to your clients, especially if you understand the idiopathic head tremors as an isolated condition of little to no concern.
However, if you, like our veterinarian, look at the tremors as a symptom of something not functioning correctly within the dog's larger system, you might not be as comfortable to just ignore the tremors because they’re supposedly not concerning. That is where we are at. Ignoring is not good enough for us because do we really know that the head tremors are not an expression of a larger problem that may or may not lead to serious health issues down the road? After all, the condition may be described in veterinary literature, but its pathogenesis is under-researched.
All of these concerns lead us to adopt a more integrative approach to explore the issue. What follows is a personal account of what we did for Persephone. Given that idiopathic head tremors can spontaneously get better or disappear, and are sometimes described as intermittent or sporadic (Shell et al., 2015), the following account should not be regarded as anything more than a personal account.
Note: If you are interested in some of the theories about the causes or interconnected variables, you may want to check out another article about idiopathic head tremors on our blog here.
What Are Idiopathic Head Tremors?
Idiopathic head tremors are involuntary movements of the head, often resembling a "yes" or "no" motion (video 1shows the yes motion; video 2 shows the ‘no’ movement). Episodes have been reported to last from 10 seconds to 3 hours. The onset of this condition varies with some dogs showing the first episodes under a year of age, while others show a more sporadic form that usually starts later in life. The former is often referred to as the familial early-onset form. The term "idiopathic" indicates that the exact cause is unknown. Despite this, it’s crucial to recognize that these tremors are not without origin. In a systems approach to health, they are, at least to us, a sign that something in the dog's body may be out of balance. For us, this meant looking beyond the symptoms to understand and address some of the potentially underlying issues affecting Persephone's health.
Our Journey with Persephone
Persephone's journey with idiopathic head tremors began around four months of age, coinciding with the period we were taping her ears. Initially, the ‘no’ movement tremors (of course, our sassy girl would never signal ‘yes’ universally) occurred about twice a month. However, after a deworming treatment (PPM Dewormer) for roundworms at six and a half months, her tremors increased dramatically, occurring daily and multiple times a day. Looking back at our personal documentation of her health and treatments, her tremors actually started after her first two rounds of dewormer for hookworms (Panacur-Fenbendazole) at around 3.5 months of age. Our integrative vet confirmed that, in her experience, the dewormers could exacerbate the tremors. Moreover, especially in integrative medicine, we were told that fenbendazole is considered less harmful than other wormers, which seems to be true for Persephone, as the head tremors she showed afterward were much less severe and less frequent. The thinking behind using the PPM wormer to treat her roundworms, however, was that she needed only a single dose, and we had not made the connection between the wormer and the tremors at that point, yet. Read more on our thoughts regarding the dewormers in this context here.
Our Integrative Support Approach
In our quest to help Persephone after her diagnosis, we decided to explore integrative, supportive treatments. It’s important to note that while this approach may have worked for Persephone, it may not work for every Doberman. As mentioned before, idiopathic head tremors are not researched very well, and none of the statements we make in this blog post should be construed as evidence-based. Instead, they are simply an observational, non-scientific study of one. We are sharing our experience in hopes that it might help others facing similar challenges.
Nux Vomica
Our vet initially suggested a round of Nux Vomica, a homeopathic remedy, administered twice a day for three days. Unfortunately, but not surprisingly, this did not alleviate Persephone's tremors. (We are not supporters of homeopathy, but felt it is easier to show that they did not work and move on than fighting to try)
Liver Tonic, MCT Oil, and Vitamin C
We then decided to use a Liver Tonic and incorporate MCT oil and Vitamin C into her daily diet. Persephone went through the entire bottle of the liver tonic as recommended, which took about 2.5 weeks. Remarkably, her tremors ceased after just four days on these three products and have not returned since.
Inarguably, us having started and used three different products at the same time does not allow to discern what, if anything, helped Persephone. Was it just one out of the tree, the combination, or none of the above and they would have stopped without these interventions? While we would like to believe these supportive measures did help, we also note that the improvements we have seen may be spontaneous. Believing is not the same as knowing for a fact. We have no truly objective evidence that what we were doing is indeed the reason why her idiopathic head tremors stopped.
Update, January, 2026: Persephone stopped taking MCT oil and Vitamin C, as well as the Liver Tonic, which we only gave twice a year. However, when we stopped this regimen, her tremors returned. She is now back on this regimen. So far, her tremors have not retuned in several months.
Why MCT Oil, Liver Tonic, and Vitamin C?
MCT Oil
First off, there is currently no evidence that MCT oil treats idiopathic head tremors. However, Medium-chain triglycerides (MCTs) are metabolized differently from long-chain fats and are generally easy to digest. We included MCT oil as part of Persephone’s broader support plan primarily because many of her health issues seemed to involve her gut, and MCTs may have positive effects on gut health and a possible interconnection to the neurological system. Research in dogs is still limited, but canine studies suggest that MCTs can influence the gut microbiome and may supportcognitive function. Human and laboratory-animal research is more developed and suggests possible effects on intestinal barrier function in obese individuals, inflammation, and brain energy metabolism. Given the suspected gut involvement in Persephone’s case, and given that idiopathic head tremors have been theorized to involve neurological or neuromuscular pathways, we felt MCT oil was a reasonable way to cover a few possible angles at once. Mechanistically, a connection between gut health, inflammation, and neurological function is possible, although applying that reasoning to idiopathic head tremors is still speculative.
Liver Tonic
The liver plays a crucial role in naturally occurring detoxification and overall health. The ingredients in the liver tonic support normal liver function (not to be confused with any ‘detox’ beyond what the liver already does by design). Here’s a closer look at the individual ingredients:
Taraxacum Officinalis (Dandelion Root): Dandelion root has been studied mainly for its potential liver-supportive, antioxidant, and anti-inflammatory effects, although it is important to mention that most of the research comes from laboratory and animal studies rather than clinical studies in dogs.
Chelidonium majus (Greater Celandine): This herb is a bit controversial, maybe especially for us Doberman guardians. In general, the use of Greater Celandine in phytotherapy and alternative medicine is widespread. Limited human and animal research supports liver health and bile production, as well as anti-inflammatory and antioxidant properties.
However, there are two caveats to consider that make it even more crucial than usual to use any product that contains Greater Celandine only under veterinary guidance:
At least one study found that Greater Celandine extracts may increase the risk of ventricular arrhythmias that can be fatal.
There has been discussion about liver toxicity and liver injury based on human case reports, but these case reports have not established a clear, generalizable connection. As a plant, Greater Celandine is classified as toxic to dogs, but that does not necessarily mean an extract is toxic to dogs in the same way as eating the plant.
Given that Persephone is otherwise healthy, we are using a combination product and will only give it to her for a limited time with our veterinarian's green light. We have weighed the risks and are monitoring her while on the product. However, as always, we do not recommend starting any product without consulting your vet.
Cardus Marianus (Milk Thistle): Milk thistle is a well-known liver tonic, largely because of research on its extract silymarin and its major active compound, silybin that may protect liver cells from toxins and support regeneration. Limited research has shown it has anti-inflammatory and antioxidant effects that can promote overall liver health.
Berberis Vulgaris (Barberry): Barberry contains the plant alkaloid berberine, which has shown to support liver function and bile production. It has also been studied for antioxidant, antimicrobial and anti-inflammatory properties that may help maintain a healthy digestive system. Most of the research, again, comes from laboratory, animal, and human studies rather than clinical studies in dogs, so we view it as a supportive ingredient rather than proof of a specific liver or digestive effect in dogs and Dobermans.
The combination of these ingredients may support the liver’s natural detoxification processes, which we believe can be especially important after exposure to substances like dewormers in medically sensitive dogs. At this point, two veterinarians (our integrative primary vet and one conventional, internal medicine vet) have now confirmed that Persephone has a sluggish liver, slow digestion (on diets such as kibble, gently cooked and raw), and is sensitive to medications.
Vitamin C
Let’s start with a few simple truths:
Vitamin C is not required as a routine supplement for healthy dogs because dogs can synthesize Vitamin C on their own. While studies in dogs are sparse, one study also reports no effect on healthy dog’s measurable immune parameters.
Vitamin C supplementation is contraindicated in copper storage disease and copper toxicosis, and, therefore, if your Doberman has Copper Associated Hepatopathy - CAH, you also want to stay away from Vitamin C supplementation, or, at the very least talk to your veterinarian first.
We are aware of megadose recommendations in the alternative medicine world, but we are not fans of megadoses, as they are generally not scientifically supported and carry risks we are not willing to take.
However, all of that does not mean modest, targeted use is automatically irrational, especially when used conservatively and with awareness of context, tolerance, and contraindications. A few points to consider:
A newer study suggests that an antioxidant blend containing vitamin C, vitamin E, and β-carotene improved antioxidant status and cell protection in kibble-fed dogs and cats.
Even the authors of the study in healthy dogs that showed no effect on immune parameters note that during stress or intense exercise, vitamin C needs may exceed liver synthesis capacity.
In human research, vitamin C appears most relevant in higher-stress contexts: human and laboratory-animal research cited in veterinary texts discusses vitamin C as a water-soluble free-radical scavenger that can help limit lipid peroxidation and oxidative tissue injury, especially in inflammatory or high-stress physiological states. Some of that work also connects vitamin C to endothelial barrier function and microcirculation during systemic inflammation, which is more relevant to an stress-response argument than the old and often cited common-cold example in the alternative medicine world. Of course, that does not prove a benefit for dogs or every dog, and it certainly does not justify megadosing, but it may leave room for conservative, targeted use in individual cases.
In Persephone’s case, our veterinarian suspected that her immune system was bi-directionally involved in many of her problems: a weaker starting point may have made her more susceptible to stress, while stress may further affect immune balance. Her easily aroused, somewhat high-strung temperament in a very calm and balanced environment also fit that picture. For that reason, we used vitamin C as conservative antioxidant support in the context of her suspected stress-immune pattern, rather than as a megadose or because dogs have a defined dietary requirement for supplemental vitamin C. We use acerola cherry as a whole-food vitamin C supplement and give an intentionally conservative 250 mg per day for two weeks out of every month. Persephone weighs about 70 lb.
Update 2026: We transitioned her to seedless sea buckthorn from Germany. We consider this the better, less stomach-irritating choice for her because of its different combined properties compared with acerola, which can be too acidic or irritating for some dogs.
Ongoing and Future Integrative Approaches
Liver Tonic: We plan to administer the liver tonic thrice a year to maintain liver health and support ongoing detoxification assistance. (Update 2026: as mentioned above, we had stopped this regimen, but she is back on it twice a year).
Probiotics: We rotate her probiotics regularly to support a healthy gut microbiome, which, we think, is crucial for immune function. (Update 2026: We have stopped probiotics and no longer view probiotics as important in her long-term care)
MCT Oil: We will keep MCT oil as a permanent part of her diet due to its numerous health benefits. (Update 2026: She is getting MCT oil every other day)
Vitamin C: Acerola Cherry Vitamin C will stay in Persephone’s rotation for 2 weeks out of every month. (Update 2026: Persephone is on seedless sea-buckthorn on the same schedule)
Exploring Additional Treatments
We are currently exploring the potential benefits of CBD oil and medicinal mushrooms to further support Persephone's immune system. CBD oil is known for its anti-inflammatory and neuroprotective properties, while medicinal mushrooms can boost immune function and overall health.
Update 2026: We have not used CBD oil or medicinal mushrooms for Persephone at any point. Persephone has a very delicate GI-system, and a scaled-down, simpler approach seems to work best for her overall needs.
Persephone's Diet
Persephone started out on kibble. Her tremors started on a kibble diet, but we reject the idea that they caused the tremors. Persephone is, nowadays, raw-fed with a balanced recipe, and we ensure she only receives whole-food-based supplements (not because we necessarily believe that only whole-food-based supplements are viable, but because they, a) appear to work best for her and b) we are not treating a numerical deficiency). This approach has seemingly significantly improved many of the health issues we initially observed in her, such as gastrointestinal problems, skin rashes, and thin coat on her flanks and lower back. Can we prove these issues improved because of a dietary change or supplementation as opposed an improvement that would have occurred anyways? No. We cannot. However, we will share more details about her diet in an upcoming blog post.
Update 2026: Persephone was on a gently cooked, balanced diet for several months. The diet did not improve her remaining GI health challenges in any meaningful way. In fact, we noticed more stool inconsistencies, and she did not appear to enjoy it as much as her raw diet. We then moved her to beef (or other protein) chunks rather than ground protein, and, ever since then, her poops have been more consistent.
A Note on Breeders and Health Challenges
We want to make it clear that we do not blame Persephone's breeder for her health challenges. Call us biased, but Persephone’s breeder (which is the same as Sir Francis Drake’s) is one of the best, most responsible and most dedicated Doberman breeders in the USA. As we have stated, idiopathic head tremors have no known cause, yet. Dealing with a puppy’s health is part of the journey, and we're committed to providing Persephone with the best care possible.
Final Thoughts
While the tremors themselves may not be as distressing to our Dobermans than they are to us as guardians, we think that ignoring an issue is not the best course of action, especially when the cause has not been identified, yet. Ultimately, we hope our story provides insights and potential ideas for others facing similar challenges. Always consult with a knowledgeable veterinarian before starting any new treatment regimen for your pet.
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