Cat Head Bobbing: Why It Happens

Cats bob their heads for several reasons. While it may be normal in sleepy cats, most of the time it something else causes cat head bobbing. It can be something simple and easy to treat like an ear infection or complicated like a condition in the brain. 

Still, any change in your kitty’s behavior can be alarming. You will want to know: when should I be concerned, and when should I reach out to my veterinarian? Here we describe when cat head bobbing is normal, the many causes, and when to talk to your veterinarian.

Cat Head Bobbing: Is It Normal? 

Head bobbing is normal when cats are very sleepy and are about to fall asleep. When cats are fighting sleep, they can sometimes bob their head as they begin to doze off. If your cat only experiences head bobbing when trying to sleep, and the bob is very subtle, there’s likely no cause for concern.

Blind cats may have a subtle head bob as they explore new surroundings. When their whiskers touch something, they may move their head back in an exaggerated way because they cannot see. This is a normal way of exploring new things.

Otherwise, cat head bobbing in other circumstances is rarely normal. It almost always indicates other issues. Head bobbing can be very subtle or very obvious. Cats usually present other symptoms at the same time. These symptoms include twitching of other parts of the body, increased urination or thirst, changes in fur coat, or changes in how they walk.

Causes of Cat Head Bobbing

There are many potential causes of head bobbing in cats. These include:

• Ear infections
• Brain inflammation or structural issues
• Metabolic disease
• Seizures
• Skin Disease
• Mouth Pain
• Feline Hyperesthesia
• Anesthesia

Cat head bobbing is often accompanied by other symptoms as well. Noting these other symptoms can help your veterinarian figure out what is wrong.

Ear Infections

When cats develop ear infections, they often experience inflammation of the inner or middle ear. This inflammation affects a nerve that connects to the brainstem and can cause head bobbing. 

Usually other symptoms of ear infections in cats include:

• Discharge of one or both ears
• Redness of one or both ears
• Scratching of the ear when rubbed, or vocalizing as if in pain
• Walking in circles
• Tilting the head to one side
• Stumbling a little during walking

Veterinarians treat ear infections with topical medication, antibiotics, and sometimes steroids. Deep ear infections can take 1 to 2 months to resolve.

Brain Inflammation or Structural Issues

The brain contains the cerebellum, which controls movements of your cat’s body. When inflammation affects this part of the brain, cats can experience head bobbing or tremors. The rest of the brain, called the cerebrum, doesn’t control movements quite the same way as the cerebellum.

Examples of conditions that can cause inflammation in the brain and lead to head bobbing include: 

• Congenital conditions – born with a slightly different brain structure

• Hydrocephalus – fluid buildup occuring in the center of the cerebrum

• Trauma – any accident that affects the head

• Vascular incident (stroke) – can happen after trauma, systemic disease, or congenital issues like an abnormal vessel in the brain

• Cancer – more common in senior cats, can cause harmful inflammation

• Bacteria – though rare, any systemic issue could cause a bacterial infection to spread to the brain (e.g., severe inner ear infection)

• Parasites – infection with Toxoplasma gondii or the spread of skin parasites like Cuterebra spp. or blood parasites like Dirofilaria immitis to the brain

• Viruses – such as Feline Infectious Peritonitis (FIP), Feline Leukemia Virus (FeLV), and Feline Immunodeficiency Virus (FIV) can cause inflammation in the brain

• Fungal infections – in general, fungal infections of the brain are rare; however, some fungi can affect cat brain functions, including Cryptococcus neoformans, Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides spp., Aspergillus spp. and Candida spp.

• Inflammatory disease – meningitis or meningoencephalitis refer to inflammation of the brain or the outer layer of the brain and spinal cord, often stemming from immune system infections

• Degenerative conditions – rarely, certain cells in a cat’s brain will break down and stop functioning prematurely

Symptoms of brain inflammation to watch out for

With brain conditions, cats often experience other neurologic symptoms alongside head bobbing. These symptoms include:  

• Walking in circles
• Stumbling during walking
• Change in consciousness. Seems “spaced out” or less aware of his surroundings.
• Increased aggression or increased passiveness
• Change in pupil size – bigger or smaller than usual, and may not change in the dark or bright light
• Abnormal movement of the eyes, almost like twitching of the pupil, when not looking around
• Seizures
• Twitching or pain of any part of the body
• Decreased activity and/or appetite

Metabolic Disease

There are many causes of systemic (i.e. full body) illness that can lead to head bobbing in cats. These conditions occur with any imbalance of electrolytes, blood sugar, or insulin, affecting nerves and muscles.

Examples of metabolic disease in cats include:

• Chronic kidney disease
• Diabetes mellitus
• Liver disease like portosystemic shunts
• Hyperthyroidism
• Dietary insufficiency (i.e. lack of thiamine)
• Hypertension i.e. high blood pressure
• Congenital myasthenia gravis (in Sphynx and Devon Rex breeds only)

Cats often have other symptoms of illness when they have metabolic disease, including:

• Increased urination and thirst
• Decreased or increased appetite
• Decrease in weight
• Vomiting and/or diarrhea

Treatment varies depending on the condition. Some conditions such as diabetes mellitus, hyperthyroidism, and hypertension need lifelong medications. Chronic kidney disease often involves special diets, hydration, and supplements to support your kitty for the rest of his life. Liver disease may call for supportive care and supplements, or sometimes surgery.

Seizures

Seizures in cats can be due to the causes listed above, or they can be idiopathic, meaning they have no known cause. Only about 2 percent of cats are diagnosed with seizures. Epilepsy can occur in up to 60 percent of cats diagnosed with seizures.

Focal seizures present as abnormal movements or twitches in only one area of the body, such as certain limbs, eyelids, or parts of the face. Many times, cats do not lose consciousness during these seizures. Head bobbing can be traced to a focal seizure, but not always.

With generalized seizures, cats lose consciousness, and their entire body convulses for up to minutes. Head bobbing can be a neurologic symptom that can progress to generalized seizures

If there is a specific underlying cause of the seizures, treatment is dependent on the cause. With no known cause, seizures are often treated with lifelong anti-seizure medications. Over time, frequent, uncontrolled seizures can cause life threatening damage to the brain.

Skin Disease

When cats feel itchy, it can look like head bobbing due to overstimulated nerves. Cats often hide when scratching or grooming themselves, so it can be hard to know when your cat is itchy. Itchiness can be caused by dry skin, allergies, or even parasites like ear mites.

Symptoms include:

• Change in fur coat especially fur loss or shortened fur
• Scaly skin
• Redness to skin
• Oily or bad smelling fur

Treatment involves addressing the underlying inflammation and infections. Sometimes, veterinarians will prescribe a special diet.  

Mouth Pain

Cats with severe dental problems may bob their heads from pain and overstimulated nerves in the mouth. Even cats with normal looking teeth can have painful dental issues hidden under the surface, diagnosable only via X-rays. 

Other symptoms of mouth pain in cats include:

• Foul breath
• Discoloration of teeth i.e. brown or gray teeth
• Severe redness of the gums or other tissue in the mouth
• Excessive drooling
• Pawing at the mouth
• Vocalizing when eating
• Preference to eat only soft (canned) food
• Decreased appetite

Treatment involves a dental procedure under anesthesia at a veterinary clinic.

Feline Hyperesthesia Syndrome

This complex syndrome is triggered by fleas, stress, seizures, pain, or brain inflammation. Cats with this syndrome have overactive nerves, resulting in twitching, head bobbing and changes to behavior. Treatment varies depending on cause, but often includes lifelong medications to help your cat’s behavior.

Anesthesia

If your veterinarian had to anesthetize your cat, he/she may have used ketamine. In rare cases for unknown reasons, cats begin head bobbing afterward but this should resolve completely within 48 hours.

When to Call Your Veterinarian 

If you notice head bobbing unrelated to sleep, take a video of the behavior and call your veterinarian right away. 

If it occurs while your cat is falling asleep, watch your cat for signs it is getting worse or more frequent. And if frequency increases or it becomes more dramatic, call your veterinarian.

Be prepared to answer your veterinarian’s questions that may target specific causes. Questions may include:

• What if any other symptoms or changes you have noticed in your cat?

• Does your cat have a history of trauma?

• Did your cat eat anything toxic, such as human foods with xylitol, household cleaners, rodent poison, or antifreeze?

• Was your cat recently anesthetized at another clinic?

• What does your cat eat? Is it a well-balanced diet sold at pet stores, or do you make your cat’s food? (Home cooked diets are much more likely to cause issues.)

Your veterinarian will need to perform a wide variety of tests to rule out causes for the head bobbing. These may include:

• Bloodwork including complete blood count (CBC), chemistry and thyroid levels
• Urine testing, i.e. urinalysis and possibly culture
• Blood pressure
• FeLV and FIV testing

If these tests don’t show anything, your vet may recommend other tests, including:

• Parasite testing (Toxoplasma, Cryptococcus, Dirofilaria)
• X-rays
• Advanced imaging with a neurologist such as magnetic resonance imaging (MRI)

Cats may bob their head for several reasons, sometimes requiring veterinary intervention. Your vet will help you assess the right treatment plan for you.