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Ask a Vet: What Causes Head Pressing in Cats?

Different than head butting, head pressing is pathological, and it is not about showing affection.

Dr. Eric Barchas  |  Mar 10th 2015

My friends at Catster recently contacted me. They have been receiving lots of questions about head pressing in cats. I never would have guessed that feline head pressing could become a trending topic, but that shows what I know about predicting Internet trends. So let’s talk about it. What is head pressing, and why does it happen?

Let me start by saying that the type of head pressing I’m discussing in this article is not the same as feline head butting. By head butting, I am referring to the affectionate behavior exhibited by cats in which they bump their head and then rub their face on your hand, face, leg, or an inanimate object. This behavior, which occurs in domestic and wild cats (I have seen lions and tigers do it), is a gesture of friendliness and a solicitation of affection. (It is wise to give affection to domestic cats engaging in this behavior; it is very unwise to attempt to give affection to a lion or tiger when they engage in this behavior.)

Photo of Dr. Eric Barchas by Liz Acosta

Head pressing is something different altogether. Cats that engage in this behavior press their head against something — usually a wall or a piece of furniture, or in a veterinary setting a kennel wall — relentlessly. They often push continuously and will move along the item against which they are pressing until they reach a corner. At that point they become stuck, with their head pathologically pressed into the corner.

Head pressing often does not occur on its own. Abnormal vocalization may occur. Cats may be noted at other times to walk continuously in circles, usually only in one direction. They may suffer from disorientation and other abnormal behaviors. Their pupils may dilate and constrict at unpredictable intervals. Seizures may occur.

Head pressing is a manifestation of a neurological disorder. Specifically, head pressing and the symptoms that go along with it usually are caused by problems with the central nervous system. In other words, head pressing occurs when something goes wrong with the brain.

I am sorry to say that head pressing is serious business. Most of the causes of head pressing are big deals.

Drunk cat 2 by Mike Burns’>

Drunk cat 2 by Mike Burns

Some form of intoxication is best case scenario for a cat who engages in head pressing. When I say intoxication, I mean it both colloquially — I have seen cats engage in head pressing after exposure to alcohol, marijuana, and prescription or illicit drugs — and literally. Some cats will react to certain potential toxins such as cheap flea preventatives, lime-sulfur dips, and amitraz (an anti-parasitic drug that is used in dogs and to which cats are sometimes accidentally exposed) with disorientation and head pressing. Less perniciously, cats who have received tranquilizing medications or who are recovering from anesthesia in a veterinary office may exhibit temporary head pressing. Although fatal intoxications are possible, most such episodes can be treated with no long-term consequences.

Other causes of head pressing are more worrisome. Cats with encephalitis or neurological manifestations of FIV/feline AIDS, feline leukemia virus, and feline infectious peritonitis may suffer from head pressing. Brain infection with toxoplasmosis may lead to the condition as well. Hereditary brain anomalies also are common causes of head pressing.

Photo CC-BY Dwight Sipler‘>

Photo CC-BY Dwight Sipler

Certain metabolic and glandular conditions can affect the brain and cause head pressing in cats. Liver disease can lead to a condition called hepatic encephalopathy; head pressing is common among cats with the condition. Similarly, kidney disease can lead to renal encephalopathy. Unregulated diabetes can lead to a condition called ketoacidosis, or to another condition called nonketotic hyperosmolar syndrome. Either can affect the brain and lead to head pressing. Over-treatment for diabetes, in which cats receive overdoses of insulin, can lead to low blood sugar which also may trigger head pressing.

Finally, there is the 800-pound gorilla in the room that cannot be ignored. Cancer — in the form of brain tumors or brain infiltration with lymphoma — is one of the more common causes of head pressing in cats.

That’s a lot of scary information. If your cat is head pressing, you should go to the vet. But you should not panic. Although many of the conditions that cause head pressing are serious, not all of them progress rapidly (and some of them — the toxicities — may resolve completely). I have known many cats who intermittently head pressed for years without developing other symptoms that compromised their quality of life.

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