By Dr. Becker
Most of us who share our lives with pets have been charmed by the many funny, adorable and affectionate things our four-legged friends do. For example, how great does it feel when your dog leans into you to be as physically close as possible, or when your kitty purrs while rubbing her head against yours?
These types of behaviors are enjoyable for both you and your pet and are completely harmless and loving. However, there is one very strange but sort of cute behavior pets can engage in that is actually a sign of a serious medical emergency. It's called head pressing.
Head pressing is when your pet compulsively pushes the top of her head against a stationary object. Usually it’s a wall, but not always. It can be a couch, a corner or another hard surface. She presses her head very intently against the object for an extended period of time, or over and over again.
A pet who is head pressing will often push continuously, moving along the item against which she’s pressing until she reaches a corner and gets “stuck” there with her head pressed against it.
If you see your dog or cat doing this, it’s a sign that something has gone seriously wrong with your pet’s brain or central nervous system.
Causes of Head Pressing
There are a number of potential causes of head pressing, all of which are quite serious. They include:
✓ Prosencephalon disease, which involves damage to the forebrain and thalamus
✓ Hepatic or renal encephalopathy, which means blood-borne toxins have crossed the blood-brain barrier
✓ Exposure to toxins
✓ An infection of the nervous system, such as rabies or a fungal infection
✓ Metabolic or glandular disorders
✓ Acute head trauma
Obviously, regardless of the cause, head pressing is a serious medical emergency. If your dog or cat is doing it, you need to make an appointment with your veterinarian for the next day or go to the nearest emergency animal hospital if your pet can’t seem to stop the behavior.
It's also important to note that a normal behavior of healthy cats and some dogs is head butting or head bunting, as it is sometimes called. This is, as I described earlier, when your healthy, happy kitty rubs her face against you or bumps her head against yours in an affectionate gesture.
Head pressing and head butting are two distinctly different behaviors with different causes, and it's important to know the difference.
Additional Symptoms to Watch For
Often there are other symptoms along with head pressing that depend on the underlying cause of the problem. For example, there can be abnormal vocalization, and compulsive pacing and circling that seems to have no end and results in sores on your pet’s feet.
There can also be problems with balance, disorientation, behavior changes, visual problems, seizures and trauma to the head or eyes from the head pressing.
Diagnosing Head Pressing
Because there are so many potential underlying causes for head pressing, a diagnosis can be quite challenging. At your veterinarian's office, you'll be asked for a thorough history of your pet's health. Have you traveled to other states or introduced anything new into your pet’s environment?
Your vet will also want to know when the head pressing started and possible incidents that might have triggered the behavior.
A central diagnostic test for an animal with head pressing is an examination of the retina and other structures in the back of the eye (called a fundic exam) to check for infectious or inflammatory diseases, as well as irregularities in the brain.
Your veterinarian will check for an elevation in blood pressure, and will also need imaging scans of the brain, either via CT (computed tomography) or MRI (magnetic resonance imaging). (X-rays do not allow for visualization of brain tissue.)
A urinalysis will be performed to evaluate potential metabolic issues, and blood tests will be needed to check for toxins or toxic exposure, as well as potential infections. Other diagnostic tests may be needed depending on your pet's symptoms and the underlying disorders your veterinarian feels may be involved.
If your dog or cat is experiencing severe clinical symptoms, he'll need to be hospitalized until his condition is stabilized. Treatment of head pressing is entirely dependent on an accurate diagnosis of the underlying cause, as each requires a different method of treatment.
No treatment should be given until you have a confirmed diagnosis. Depending on the underlying cause, treatment can vary widely in cost, difficulty, time involved and overall prognosis. Some underlying conditions involve medical management, while others may require surgery.
If a benign tumor in your pet’s brain is the cause, removal of the tumor can be curative. Often in the case of complicated neurologic diseases involving the brain, veterinarians refer patients to a specialist, a veterinary neurologist. The most important thing to remember is that head pressing is never a normal symptom in your dog or cat and it should be addressed immediately if it occurs.