Head Pressing in Dogs

Have you ever noticed if your dog is pressing their head into a corner, wall, or against furniture? It could be a sign of head pressing, an abnormal neurological condition in dogs that causes them to press their head against something firm. This isn’t the same behavior as when your dog pushes their head against you for love and attention. This is a compulsive disorder that dogs cannot control and indicates an underlying disease. 

Read on to find out what head pressing looks like, what causes head pressing in dogs, how it is diagnosed by a veterinarian, and how it is treated.

What Is Head Pressing in Dogs?

Dog head pressing refers to an abnormal behavior when a dog compulsively pushes or presses their head against something vertical, stationary, and firm: a wall, a corner, a piece of furniture, etc. The most common places pet parents see their dog head pressing is against a wall or corner of the room. Dogs are typically standing on all four legs and stationary when they exhibit this behavior.

Head pressing in dogs isn’t a common symptom reported by pet parents, but it is considered an emergency. If you notice your dog head pressing, take them to the veterinary clinic or the veterinary emergency clinic immediately. 

What Causes Head Pressing in Dogs?

While we know what head pressing looks like in dogs and what diseases are associated with it, we don’t really know what the dog is thinking or feeling when they are head pressing. One theory is that it is uncomfortable, like a headache, and pressing takes away the pain. Another theory is that dogs who are head pressing have altered mental activity (mentation) and don’t really know what is going on. Some dogs will respond to their name while head pressing, others will not. What we do know is that head pressing is usually a sign of serious illness in dogs. 

Head pressing is usually a symptom of neurological disease. It has multiple causes, and it can occur in any dog of any breed and at any age. The following are some of the known causes of head pressing in dogs.

Liver Disease

Dogs with liver disorders can develop liver-related brain disease (hepatic encephalopathy) due to a buildup of toxins in the blood. The liver normally removes toxins. If the liver is sick, toxins build up, and brain cells are very sensitive to toxins. Dogs with liver shunts often exhibit head pressing after they eat a meal. Liver shunts are most commonly seen in puppies, and affected breeds include Yorkshire Terriers, Labrador Retrievers, Golden Retrievers, and Maltese.

Brain Tumor

Brain tumors in dogs cause inflammation in the brain and impact normal structures. The presence of brain tumors can cause head pressing and are more common in older dogs.

Hydrocephalus

Hydrocephalus is commonly referred to as “water on the brain,” and causes brain swelling due to the buildup of cerebrospinal fluid (CSF) inside the skull. This is more common in toy breeds with dome-like heads, such as Chihuahuas.

Traumatic Brain Injury

Head trauma can cause head pressing in dogs, but it is less common.

Stroke

Brain cells are very sensitive to damage, and require constant blood flow. A stroke refers to ischemic damage to the brain when blood flow to brain cells is blocked or a blood vessel bursts inside the brain. Stroke symptoms have a rapid onset and are typically severe. 

Encephalitis

Encephalitis refers to inflammation of the brain, which can cause dog head pressing. 

Brain Infection

Bacterial, viral, or fungal infections and tick-borne diseases can cause inflammation in the brain, resulting in head pressing or seizures.

Low Sodium (Hyponatremia)

Hyponatremia refers to the body having abnormally low sodium levels which causes brain cells to swell and can cause head pressing in dogs. Hyponatremia can be caused by severe vomiting, diarrhea, certain medications, Addison’s disease, kidney disease, and other metabolic disorders.

Toxin Exposure

Any toxin that causes damage to brain cells, such as lead, can cause head pressing. 

Other Dog Head Pressing Symptoms

Head pressing is typically associated with dysfunction of the part of the brain known as the forebrain. The forebrain is responsible for thinking, behavior, and integrating sensory information that comes into the brain. It is also where sight is processed. If a dog is head pressing because their forebrain is dysfunctional, then they may also develop acute blindness and behavioral abnormalities. Other symptoms that may be associated with head pressing include: 

• Loss of potty training or other training
• Changes in appetite
• Pacing or circling
• Loss of vision or other senses on one side of the body, bumping into things only on one side
• Abnormal vocalization
• Seizures
• Acting depressed or unusually grouchy
• Pupils are different sizes
• Neck pain
• Fever
• Vomiting
• Incoordination or “acting drunk”
• Yellow skin or eyes (indicates jaundice in liver disease)

If your dog exhibits any of these signs in conjunction with head pressing, take them to a veterinarian for evaluation immediately. If you can, take a video of the behavior to show your vet.

Diagnosis of Dog Head Pressing

Head pressing can be caused by many things. Your veterinarian will use a combination of oral history from you, medical records, physical examination, neurological examination, and diagnostic testing to determine the cause of dog head pressing. They will also take your dog’s vitals, including weight, temperature, heart rate, respiratory rate, and sometimes blood pressure. 

Diagnostic testing depends on what your vet thinks is causing the problem. Most dogs will receive baseline diagnostics that include blood work and urinalysis. From there, testing can often include:

• Liver function tests if your vet suspects liver disease
• Abdominal ultrasound to evaluate abdominal organs
• Chest or abdominal radiographs (x-rays)

The cost of getting a diagnosis of the cause of head pressing with a regular veterinarian can run $750-$1,500.

If the problem is determined to be primary brain disease, such as a brain tumor or encephalitis, then your veterinarian will refer you to a veterinary neurologist for further evaluation. At this point, testing can include:

• MRI
• Testing the cerebral spinal fluid
• Electroencephalogram to measure brain activity

The cost of diagnostics with a veterinary neurologist run $1,500-$2,000.

Head Pressing in Dogs Treatment

Treatment of head pressing in dogs depends on the cause. If it is liver disease or an operable brain tumor, then surgery is indicated. If it is a brain infection, then antimicrobials are prescribed. Whether treatment is inpatient or outpatient is dependent on the cause, how sick your dog is, and your veterinarian’s preference. 

The outcome of treatment depends on the cause as well. Many dogs with head pressing due to brain infections and liver disease can be successfully treated and live normal lives. Dogs with brain tumors or stroke have a more guarded prognosis. Your veterinarian will be your best resource for learning and understanding your dog’s prognosis. 

The cost of treatment depends on the cause. Generally speaking, treating neurological disease in dogs is expensive, running into multiple thousands of dollars. 

Management of Head Pressing in Dogs

After your dog has been treated, then head pressing should decrease over time. Head pressing usually disappears altogether once a dog has been treated. If your dog still has neurological problems:

• Make sure areas where your dog has access are free of hazards
• Prevent them from going up or down stairs or going around pools or bodies of water by using baby gates or other structures to bar access
• Use a non-slip rug to help them get up
• Work with your veterinarian to ensure that you have all the medications and tools you need to provide a safe and comfortable home for your dog, including anti-seizure medication if indicated