Tremors in Cats: Causes, Locations, and When to Worry

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-10-03

Tremors in cats are rhythmic, repeated muscle movements that can affect the head, legs, or whole body. Some tremors are harmless, like the twitching you see during sleep, but others point to serious problems such as kidney disease, low blood sugar, or a nervous system disorder. Where and when the tremor happens gives your veterinarian the first big clue about the cause.

This article is educational and is not a substitute for veterinary diagnosis or treatment.

Quick Answer

• A tremor that only happens during sleep or right as your cat drifts off is usually normal and needs no treatment.
• A tremor that happens while your cat is awake, standing, eating, or walking deserves a veterinary visit.
• Head tremors in older cats can be a specific condition called late-onset myoclonic epilepsy, which is manageable but needs a diagnosis [1].
• Tremors in the back legs that appear only when standing can occur in young cats with an otherwise normal exam [2].
• Any tremor with weakness, collapse, vomiting, drooling, or trouble breathing is an emergency.

What Tremors in Cats Look Like and What Is Normal

A tremor is a rhythmic, oscillating movement. It repeats at a fairly steady rate and stops when the underlying trigger stops. This separates a tremor from a seizure, which is usually a one-time event with a distinct start and finish, and from a twitch, which is a single quick jerk.

Normal twitching during sleep

Cats twitch in their sleep. Paws paddle, whiskers flick, and the whole body may shudder for a second or two. This happens during dreaming and is not a tremor in the medical sense. If your cat is asleep, easy to wake, and completely normal when awake, there is nothing to treat.

Tremors in cats while sleeping versus awake

The timing matters more than the look. A tremor that only appears at rest or during sleep is often benign or linked to a specific diagnosis that is not an emergency [3]. A tremor that appears when your cat is awake and trying to do something, such as eat, walk, or jump, is more likely to reflect a real neurologic or metabolic problem.

Where the tremor shows up

Tremors in cats can be generalized (the whole body), or focal to the head, a limb, or the tail. In one review of cats with liver-related tremors, the tremor was generalized in about half the cats and limited to the head in most of the rest [3]. Location helps your veterinarian narrow the list of causes, but it does not confirm a diagnosis on its own.

Main Causes of Tremors in Cats

Tremors are a common neurologic presentation in cats, but the underlying causes are varied and sometimes surprising. A large review of 105 cats with tremors found the most common diagnoses were degenerative brain disease, feline infectious peritonitis (FIP), congenital portosystemic shunt, intoxication, and polyneuropathy [4]. Here is how those and other causes tend to show up.

Tremors in cats with kidney disease

Kidney disease does not usually cause tremors by itself. The link is often the medication used to manage it. Two cats with chronic kidney disease developed short jerks of the head after receiving gabapentin at doses of 11.8 to 16.4 mg/kg, and these jerks were different from their usual seizures [5]. Both cats had a history of seizures and were in stage 2 kidney disease. If your cat has kidney disease and starts jerking after a dose of gabapentin, tell your veterinarian before the next dose.

Tremors in cats with liver disease

A congenital portosystemic shunt is a blood vessel that bypasses the liver. It showed up in 17 of 105 cats with tremors in one review [4]. In a separate group of 19 cats with this condition, tremors were the only neurologic sign in six cats, and most tremors were episodic and happened at rest [3]. After surgical or medical treatment, tremors stopped in nine of the 14 cats with follow-up information [3]. This is one of the more treatable causes, which is why early diagnosis matters.

Tremors in cats with back legs

A tremor that only affects the back legs while standing has been described in a young cat. An 11-month-old cat had a low-frequency tremor in both pelvic limbs that appeared only when standing or extending the knee, and it disappeared when the limb was lifted [2]. The cat was diagnosed with pseudo-orthostatic tremor. The cat stayed playful and able to walk but had trouble jumping. Treatment with gabapentin at 10 to 20 mg/kg every 8 hours for three weeks, followed by clonazepam at 0.1 mg/kg every 12 hours for one day, did not help, and the clonazepam caused unacceptable side effects [2]. This is a reminder that not every tremor responds to medication.

Tremors in cats with front legs

Front leg tremors often point to a problem in the nerves that supply the limb. The spinal nerves that extend into the front and hindlimbs come from the spinal cord, and they branch into smaller nerves that cover the body [6]. Damage anywhere along that path, from the neck to the paw, can produce a tremor. Causes include nerve inflammation, injury, and metabolic disease.

Head tremors in cats

Head tremors deserve their own category. Older cats can develop spontaneous late-onset myoclonic epilepsy, a condition where the head jerks without a sound trigger. In a study of 15 cats, the median age at presentation was 13.2 years, and all cats had head myoclonus, with some also involving the front legs or the whole body [1]. Episodes became more frequent over time in about half the cats, and two cats also had generalized seizures [1]. This condition is not the same as the harmless head bobbing some cats do when they are focused.

Tremors from toxins and medications

Intoxication was the cause in 16 of 105 cats with tremors in one review [4]. Common household toxins include certain plants, human medications, and insecticides. If you suspect your cat ate something toxic, call your veterinarian or a pet poison hotline right away. Do not wait for a tremor to start.

Tremors from paroxysmal dyskinesia

Paroxysmal dyskinesia causes episodes of abnormal movement that can look like a tremor. In 25 cats, the most common signs were shifting limb dystonia, slow movement, abnormal gait, and a dystonic head tremor in three cats [7]. The neurologic exam was normal in all cats between episodes [7]. These episodes can be mistaken for seizures, so video recording them is very helpful.

Red Flags That Make Tremors an Emergency

Some tremors can wait for a routine visit. Others cannot. Go to an emergency clinic now if your cat has any of these:

• Tremor with collapse, inability to stand, or loss of consciousness
• Tremor with vomiting, drooling, or diarrhea that will not stop
• Tremor after known or suspected exposure to a toxin or human medication
• Tremor with trouble breathing, pale gums, or a racing heart
• Tremor that starts suddenly and gets worse over minutes
• Tremor with a fever, especially in a young cat
• Tremor with a head tilt, circling, or eyes that move back and forth on their own

If your cat is shaking and vomiting, see Cat Shaking and Vomiting: When to Rush to the Vet. If the shaking is more general and you are not sure whether it is an emergency, Cat Shaking or Trembling: Is It an Emergency? walks through the decision step by step.

What You Can Safely Do at Home While You Wait

You cannot diagnose a tremor at home, but you can gather information that makes your veterinary visit faster and more useful.

Record the tremor

Use your phone to film the tremor. Capture the whole cat, not just the shaking part. Note whether the cat is asleep, resting, standing, walking, or eating. Note how long it lasts and how often it happens. A video is often more valuable than a written description because it lets your veterinarian see the rate and pattern.

Note the timing

Write down when the tremor happens. Does it happen only at rest? Only when standing? Only after meals? Only after a dose of medication? Timing is one of the strongest clues for conditions such as liver shunt and medication-related jerks [3][5].

Keep your cat safe

Clear the area of hard objects if your cat is having a tremor. Do not put your hands in or near your cat's mouth during an episode. Do not try to hold your cat still, because restraint can make some tremors worse and can lead to a bite.

Do not give medication on your own

Do not give your cat any human medication, including antihistamines or pain relievers, for a tremor. Some common human drugs are toxic to cats. Do not change the dose of a medication your veterinarian prescribed without calling first.

Keep a log

Track food intake, water intake, urination, and bowel movements. Changes in these can point toward kidney or liver disease. Bring the log to your appointment.

What Your Veterinarian Will Check and Test

Your veterinarian will start with a full physical and neurologic exam. The neurologic exam checks how your cat walks, how the pupils respond to light, how the limbs respond to being placed in different positions, and whether the tremor changes with movement or rest.

Questions your veterinarian will ask

• When did the tremor start?
• Does it happen during sleep, rest, or activity?
• Has your cat eaten anything unusual or had access to medication?
• Is your cat drinking or urinating more than usual?
• Has your cat lost weight?
• Is your cat on any medication, including gabapentin?

Tests your veterinarian may recommend

• Blood work to check blood sugar, kidney values, liver values, and electrolytes
• Urinalysis
• Bile acids test if a liver shunt is suspected
• Infectious disease testing, including for FIP
• Imaging such as X-rays or ultrasound
• Advanced imaging such as MRI if a brain or spinal cord problem is suspected

The nervous system can be affected by birth defects, inherited disorders, infections, inflammation, poisoning, metabolic disorders, nutritional disorders, injuries, degenerative diseases, cancer, or unknown causes [8]. Because the list is long, your veterinarian may need several tests to reach an answer. Some neurologic diseases are more common in a particular breed, sex, or age group, which helps narrow the search [8].

Prevention and Monitoring

You cannot prevent every cause of tremors, but you can lower the risk and catch problems earlier.

• Keep all human medications, including gabapentin, out of reach.
• Store household chemicals and insecticides where your cat cannot get to them.
• Feed a complete and balanced diet. Nutritional disorders can affect the nervous system [8].
• Schedule routine wellness visits, especially for cats over 8 years old.
• If your cat has kidney disease, ask your veterinarian about the risk of medication-related jerks before starting gabapentin [5].
• If your cat has a portosystemic shunt, keep follow-up appointments. Tremors stopped in most cats after treatment in one group [3].
• If your cat has late-onset myoclonic epilepsy, track how often episodes happen. Frequency can increase over time [1].

If your cat's tremor changes in location, frequency, or intensity, call your veterinarian. A tremor that was stable for months and then suddenly worsens is a reason to be seen sooner.

Limitations and When to Contact a Veterinarian

This article gives general guidance, but every cat is different. A tremor that looks harmless in one cat can be the first sign of a serious disease in another. Your veterinarian needs to examine your cat to know which situation you are in.

Call your veterinarian the same day if your cat has a new tremor while awake, a tremor that is getting more frequent, or a tremor with weight loss, increased drinking, or increased urination.

Go to an emergency clinic now if your cat has a tremor with collapse, trouble breathing, repeated vomiting, suspected toxin exposure, or a seizure that lasts more than a few minutes.

Schedule a routine visit if your cat has a stable tremor that only happens during sleep or rest and your cat is otherwise acting normal. Bring a video and a written log to that visit.

Frequently Asked Questions

Should I worry about my cat twitching in its sleep?

No, sleep twitching is normal and does not need treatment. Cats twitch during dreaming, and the movement stops when they wake. If your cat also twitches while awake, that is a different situation and worth a veterinary visit.

Can kidney disease cause tremors in cats?

Kidney disease itself is not a common direct cause of tremors. The link is usually a medication used to treat the cat, such as gabapentin, which has been reported to cause head jerks in cats with chronic kidney disease. Tell your veterinarian if jerking starts after a dose.

What does a head tremor in an older cat mean?

A head tremor in an older cat can be a condition called spontaneous late-onset myoclonic epilepsy. It typically starts in cats around 13 years old and may become more frequent over time. Some cats also develop generalized seizures, so a veterinary evaluation is recommended.

Are tremors in cats painful?

Tremors themselves are not usually painful. The underlying cause can be painful, such as an injury or nerve inflammation. If your cat is hiding, not eating, or reacting when touched, that points toward pain and needs a same-day visit.

Can a tremor in my cat go away on its own?

Some tremors do resolve, especially those linked to a treatable cause such as a liver shunt or a toxin that is removed. In one group of cats with liver-related tremors, tremors stopped in most cats after treatment. Other tremors, such as those from degenerative brain disease, tend to persist or worsen.

Related Articles

• Cat Shaking or Trembling: Is It an Emergency?
• Cat Shaking Head and Scratching Ears: Causes and Urgency
• Cat Shaking Head: When to Call the Vet and When to Monitor
• Cat Scooting: Causes and When to Worry
• Cat Shaking and Vomiting: When to Rush to the Vet
• Cat Vomiting: When to Worry and What to Do

References

1. Spontaneous late-onset myoclonic epilepsy in cats: 15 cases (2015-2023). Journal of feline medicine and surgery, 2025.
2. Pseudo-orthostatic tremor in a cat. Journal of veterinary internal medicine, 2025.
3. Tremors in cats with hepatic encephalopathy-congenital portosystemic shunts or postattenuation neurological syndrome. The Veterinary record, 2025.
4. Tremors in cats: 105 cases (2004-2023). Veterinary journal (London, England : 1997), 2025.
5. Presumed gabapentin-induced myoclonus in two cats. JFMS open reports, 2024.
6. Parts of the Nervous System in Cats - Cat Owners. Merck Veterinary Manual.
7. Phenotypic characteristics of paroxysmal dyskinesia in 25 cats. The Journal of small animal practice, 2026.
8. The Nervous System in Cats - Cat Owners. Merck Veterinary Manual.

Further Reading

• Merck Veterinary Manual: Cat Owners
• Cornell Feline Health Center: Health Information
• American Veterinary Medical Association: Pet Care