Cat Head Pressing: What You Need to Know

What is Cat Head Pressing?

Cat head pressing can be a normal marking behavior known as bunting or it can be a sign of a serious neurological problem. Learn more about the normal behavior in cats in this article What is Head Pressing in Cats?

When head pressing is abnormal, it can be a symptom of a brain disease. Below we will review symptoms of a brain problem in cats, share a list of possible diseases that can cause cat head pressing, review diagnostic tests that can help determine the underlying cause, and discuss treatment options.

Symptoms of Brain Disease in Cats

Signs of brain disorders in cats can depend on the underlying cause and the exact part of the brain affected. Signs of brain disease in cats may include any of the following:

  • Head pressing
  • Abnormalities in pupil size
  • Behavior changes
  • Blindness
  • Circling (walking in one direction)
  • Changes in learned behavior
  • Coma
  • Decreased or loss of appetite
  • Falling over
  • Head tilt
  • Inability or difficulty walking
  • Inability to blink the eyes
  • Incoordination
  • Less engaged with family activities
  • Lethargy or sleeping more
  • Loss of consciousness
  • Nausea and vomiting
  • Restlessness and pacing
  • Seizures
  • Sleeping in different locations
  • Stuporous behavior
  • Weakness
  • Weakness and incoordination

Diseases That Can Cause Cat Head Pressing

Disorders of the cat brain can be divided into the following causes:

  • Congenital abnormalities – are problems that cats can be born with. One cause is cerebellar hypoplasia which is the underdevelopment of the cerebellum. It is a congenital disorder, having occurred before birth. Cerebellar hypoplasia in cats is usually due to infection of the pregnant mother with the feline panleukopenia virus. Cerebellar hypoplasia results in difficulty or abnormal walking that often appears as incoordination in the kitten.
  • Infectious diseases – can cause cat head pressing. In cats it may be caused by viral diseases such as feline infectious peritonitis (FIP) virus, feline leukemia virus (FeLV) or rabies. Other causes may include parasitic infestations, protozoal infections (toxoplasmosis, encephalitozoonosis), numerous bacteria, and fungal infections (blastomycosis, cryptococcosis, histoplasmosis).
  • Metabolic disorders – such as low blood sugar, high or low blood sodium levels are possible causes for abnormal neurological signs.
  • Peripheral vestibular disease – is a condition that affects the brain and nerves that control balance. Signs of vestibular disease in cats include head tilt and falling over.
  • Seizures disorders – create abnormal brain activity that may result in convulsions that manifest as odd behaviors, tremors, muscles contractions, salivation and defecation. Seizures can occur from toxin exposure or from epilepsy. After a seizure many cats will have abnormal control of their bodies and unusual behavior which can include difficulty walking, balance problems, falling over, and/or head pressing. Learn more about Seizures in Cats.
  • Toxic conditions –such as rat or pesticides, antifreeze, mouse bait and flea and tick prevention medications can cause symptoms of brain disease such as cat head pressing.
  • Traumatic injuries- Head trauma can occur in cats from being in a blunt trauma (being hit in the head), penetrating injury (such as a pellet or bullet wound), hit by a car or by falls. This can cause bleeding in the brain or around the brain and swelling of tissues.
  • Tumors – or cancer of the brain can occur in cats. Brain tumors may be primary and arise from brain tissues, or they may be secondary and develop from either surrounding or distant tissues.

Diagnosis of Brain Disease or Injury in Cats

Diagnostic tests to evaluate brain injury may include various tests that may include:

  • Complete physical exam including a thorough neurological examination. The neurological exam can provide valuable information on the function of the brain and spinal cord.
  • Skull radiographs provide information about the bony skull around the brain, and the vertebrae that surround the spinal cord. The brain and spinal cord themselves do not show up well on X-rays, but a special procedure called a myelogram can help highlight various areas of the spine.
  • A complete blood count (CBC) may be within normal limits, but an elevated white blood cell count may be present if there is also secondary infection.
  • A biochemical profile may be within normal limits or reveal electrolyte such as high or low sodium levels, or evidence of concurrent disease.
  • A urinalysis is generally unremarkable unless concurrent disease is present.
  • Abdominal radiographs (X-rays) are an important part of any baseline work-up. Although they may be within normal limits it could reveal evidence of cancer.
  • Abdominal ultrasound is recommended in some cats with neurological disease to evaluate for concurrent diseases. Ultrasound is a noninvasive procedure that often requires the expertise of a specialist and/or referral hospital.
  • Blood pressure measurement is recommended for all cats with neurological disease.
  • Cerebrospinal Fluid (CSF) Tap in Cats is a test that involves collecting cerebrospinal fluid that is found in the space surrounding the brain and spinal cord. The analysis often provides valuable information as to the presence of infection, inflammation, and other abnormalities.
  • Computed tomography (CT scan or CAT scan) is a special X-ray technique that provides serial images of the brain and spinal cord using enhanced computer processing.
  • Magnetic resonance imaging (MRI) uses the properties of certain tissues subjected to extremely powerful magnetic fields to generate detailed images of body organs. MRI is a very useful tool in evaluating both the brain and spinal cord.
  • Various electrodiagnostic tests are available to assess different functions of the brain and spinal cord.
  • Tests may include brainstem auditory evoked response (BAER), the electroencephalogram (EEG), and nerve conduction velocity (NCV). These tests can help evaluate hearing, seizure activity, and nerve function.

Treatment of Brain Disease or Injury in Cats

  • Treatment of brain disease will depend on the underlying cause of the disease and the severity of the condition. Therapies for cat head pressing and brain disease may include:
  • Intravenous fluids to maintain hydration.
  • Dextrose may be added to fluids to treat hypoglycemia (low blood sugar).
  • Hyperosmotic agents such as mannitol are often used in patients with elevated cerebrospinal fluid (CSF).
  • Steroid therapy may be recommended to treat inflammation or swelling.
  • Oxygen therapy may help reverse the cerebral (brain) edema and prevent the progression of brain damage.
  • Blood pressure medications to treat hypertension.
  • Heart medications to treat the underlying heart disease.
  • Thyroid medications to treat hyperthyroidism.
  • Medication to control seizures, such as diazepam (valium®) or phenobarbital. Appetite stimulants or anti-nausea medications to treat poor appetite or vomiting.
  • Elevation of the head may help decrease intracranial pressure and facilitate resorption of spinal fluid.
  • Careful consideration of nutritional needs and calorie intake to ensure adequate nutritional needs are met.
  • Nursing care as needed to keep the eyes lubricated, rotating pets that are not moving from side to side, constant cleaning of urine and feces, and/or warm environment to provide optimal comfort.
  • Administration of antidotes for known toxin ingestion.

Prognosis for Brain Disease or Injury in Cats

The prognosis for brain disease in cats depends on the underlying cause, severity of the clinical signs, and your cat’s response to treatment. The prognosis can vary from very good such as with some toxins to grave with conditions such as a brain tumor.

How Pet Insurance Can Help You Cover Brain Disease or Injury in Cats

Treatment for brain injuries depends on the underlying cause, other secondary or related conditions, and/or concurrent diseases. The cost of care can vary on these factors and the severity of the symptoms in your cat. For example, trauma to the brain can also result in broken limbs, skin lacerations that require additional diagnostic tests, treatments, surgery, and/or ongoing care.

Some cats with severe symptoms of illness will require hospitalization with intravenous fluids, medications to control seizures, medications to stimulate the appetite, and other symptomatic treatments as needed.

Cost of care can range from hundreds to tens of thousands of dollars. Because this condition can be critical, is requires ongoing care and monitoring.

The best pet insurance offers coverage that’s broad enough for whatever care your pet needs and with enough options to get the perfect coverage for you and your pet.

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