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If he is old, he may have what is called an aural cholesteatoma (a cyst in the middle ear) it may have been caused by Allergies or a respiratory infection. The cyst can harm eardrums and bones of the middle ear, and often causes secondary infections. If that is the case then it can the infection can be treated with an anti-inflammatory injection from your vet, followed by a course of antibiotics. Often after treatment, the gerbil will keep it's head tilt, because the cyst never fully dissappears but it will live fine and adapt.

This may not be the cause of it though, there are a few other things which may cause it, but I would recommend that you take the gerbil to the vet no matter whether you know what is wrong or not.

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Q: Your gerbil is tilting his body and head to one side and walking funny What is wrong?
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