Head Pressing in Dogs

Summary

Head pressing is a behavior demonstrated when a dog compulsively faces a wall or corner and remains there without moving or appearing engaged in any kind of activity for a period of time. Head pressing indicates a dysfunction of the central nervous system and results from a variety of illnesses and injuries. It is not common, but affects dogs of any size, age, or breed.

Diagnosis of the underlying cause of head pressing can be difficult. A physical examination and basic blood work may suggest the underlying cause, or advanced diagnostics like an MRI scan may be necessary. Common causes of head pressing include canine cognitive dysfunction, liver disease, and tumors. Treatment and prognosis for head pressing varies widely depending on the underlying cause.

Guidelines

Head pressing is not commonly observed, and is a secondary symptom of a wide range of ailments. Since head pressing commonly results from serious disorders like canine cognitive dysfunction, liver disease, and tumors, veterinary attention is recommended. Head pressing itself is not an emergency unless present with other symptoms indicating more urgency like seizures, collapse, or labored breathing.

Possible Causes

Head pressing is frequently associated with cognitive dysfunction, but it also occurs with:

• Forebrain damage or disease • Poisoning • Liver diseases • Electrolyte imbalances • Head injuries

• Hypothyroidism • Kidney disease or damage • Diabetes mellitus • Tumors and cancer • Epilepsy

• Adrenal gland disorders (hyper- or hypoadrenocorticism) • Fluid buildup in the brain, known as hydrocephalus

• Viral diseases like rabies and distemper • Fungal and protozoal infections affecting the nervous system

Risk Factors

Head pressing doesn’t present identically in each instance; one bout can involve the dog’s head fully in contact with a wall, while the second instance can involve them standing idly with their head hung low in front of a solid obstruction. The dog can be called out of this stance with or without clear disorientation presenting afterwards, but they will resume the behavior at some point when idle.

Testing and Diagnosis

In addition to physical exam and complete health history, further diagnostics may be recommended for a dog presenting with head pressing. Useful diagnostic tests include; 

• Eye exam • Blood pressure measurement • Urinalysis • Blood work • Diagnostic imaging

Treatment is dependent on the underlying condition.

Similar symptoms

Head pressing may be confused with head tilting or head turning, or a dog simply getting stuck in corners. When pressing, the dog’s head won’t be tilted to one side or alternating back and forth; the dog will be facing straight-on, unmoving, and not searching for a route around the obstruction.

Associated Symptoms

The accompanying symptoms will vary depending on the underlying condition. Head pressing is often present in combination with other symptoms such as; 

• Compulsive pacing, can be accompanied by sores on the feet • Seizures • Vomiting • Vision problems

• Injuries to the face and head as a result of prolonged head pressing

• Behavior changes • Muscle tremors • Lethargy • Fever • Sneezing • Trouble breathing

• Dilation or constriction of pupils