# Head Pressing in Cats: Why It Happens and When to Worry Head pressing in cats means a cat stands facing a wall or solid object and pushes its head against it for no clear reason. It is a neurologic warning sign, not a behavior quirk, and it usually points to a problem in the brain or a metabolic condition affecting the brain. If you see it, your cat needs to be seen by a veterinarian the same day. This article is educational and is not a substitute for veterinary diagnosis or treatment. ## Quick Answer - Head pressing is different from head-butting (a friendly bunting behavior) and from a cat simply sleeping with its face tucked. - It often looks like a cat standing still and pushing its forehead or top of the head into a wall, corner, or piece of furniture. - Causes include liver shunts and hepatic encephalopathy, brain tumors or inflammation, infections, toxins, and head trauma. - Same-day veterinary assessment is needed because the underlying cause can worsen quickly. - Do not try to treat this at home. Keep your cat safe, quiet, and away from stairs or hazards until you reach the vet. ## What Does Head Pressing in Cats Look Like? Head pressing is a specific posture. The cat stands with its head pushed firmly against a vertical surface, such as a wall, door, cabinet, or the back of a couch. The cat may stay in that position for minutes at a time and may not respond normally when you call its name. It can look similar to a few normal cat behaviors, so it helps to know the differences. ### Head pressing vs. head-butting Head-butting, also called bunting, is a social behavior. Your cat walks up to you, a person, or another pet and bumps its head or cheek against the target. It is usually brief, directed at a living thing or a familiar object, and your cat looks relaxed and engaged. Head pressing is aimed at a flat surface, lasts longer, and your cat often seems dull, confused, or unaware of you. ### Head pressing vs. normal sleep positions Many cats sleep with their nose tucked into their paws or pressed against a cushion. That is normal. The difference is context. A sleeping cat in a tucked position wakes up normally, eats, plays, and interacts. A cat that is head pressing may do it while awake, may pace or circle, and may show other changes such as poor appetite, wobbling, or staring. ### Other signs that often come with it Owners often notice more than one change. A cat with a neurologic or metabolic problem may also: - Walk in circles or lean to one side - Have a head tilt that changes with head movement, called positioning head tilt [1][2] - Hold the neck bent downward, called cervical ventroflexion [3] - Tremor, especially in the head, which has been reported in cats with hepatic encephalopathy from congenital portosystemic shunts [4] - Seem blind or bump into things - Have seizures - Act withdrawn, hide more, or seem confused If your cat is hiding more than usual along with these signs, see [Cat Hiding: When to Worry and When It's Normal Cat Behavior](/knowledge/veterinary-medicine/vet-visit-decisions/cat-hiding). ## What Causes Head Pressing in Cats? Head pressing is a symptom, not a disease. The list of possible causes is long, and some are emergencies. The table below groups the main categories. | Cause | Typical clues | How urgent | |---|---|---| | Hepatic encephalopathy (often from a portosystemic shunt) | Young cat, poor growth, drooling, head tremor, dull mentation, worse after meals | Emergency or same-day | | Brain tumor or brain lesion | Older cat, gradual onset, circling, head tilt, vision loss, seizures | Same-day to urgent | | Brain inflammation or infection (meningoencephalitis) | Fever, neck pain, seizures, sudden behavior change | Emergency | | Toxins (lead, certain plants, human medications) | Known exposure, sudden onset, vomiting, wobbling | Emergency | | Head trauma | Recent fall, hit by car, or unknown injury | Emergency | | Metabolic problems (low potassium, thiamine deficiency, thyroid disease) | Weakness, neck ventroflexion, poor appetite | Same-day | | Severe dental or sinus infection spreading to the brain | Recent dental work, eye swelling, lethargy, seizures | Emergency | ### Hepatic encephalopathy and liver shunts The liver normally filters toxins from the blood. When a cat has a portosystemic shunt, blood bypasses the liver, and toxins build up in the bloodstream and reach the brain. This is called hepatic encephalopathy. Head pressing is a classic sign. Tremors are also common. In one review of 19 cats with hepatic encephalopathy from congenital portosystemic shunts, tremors were the only neurologic sign in 6 of the 19 cats, and most tremors were episodic and happened at rest [4]. Head pressing can appear alongside these tremors. If you have seen your cat pressing its head against a wall, this related article explains the liver and brain link in more detail: [Why Is My Cat pressing head against wall? Hepatic Encephalopathy and Brain Lesion](/knowledge/veterinary-medicine/symptom-guides/why-is-my-cat-pressing-head-against-wall-hepatic-encephalopathy-and-brain-lesion). ### Brain tumors and other brain lesions A mass in the brain can raise pressure inside the skull and cause head pressing, circling, seizures, and behavior changes. Brain inflammation, called meningoencephalitis, can do the same. One case report described a 12-year-old cat that developed bacterial meningoencephalitis and a suspected intracranial abscess after a routine tooth extraction. The cat's mental status declined and it had a generalized seizure [5]. This shows how quickly an infection near the head can spread to the brain. ### Infections Bacterial, viral, fungal, and parasitic infections can all affect the brain. Feline infectious peritonitis can cause meningoencephalomyelitis, and it was one of the diagnoses linked to cervical ventroflexion in a study of 86 cats [3]. Any infection that reaches the nervous system is serious and needs prompt treatment. ### Toxins Lead, antifreeze, certain houseplants, and some human medications can poison the nervous system. If you suspect exposure, call your veterinarian or a pet poison hotline right away. Do not wait for symptoms to get worse. ### Metabolic and muscle problems Low potassium can cause a condition called hypokalemic myopathy. In 14 cats with this condition, researchers observed positioning head tilt, where the head tilts to the opposite side of a voluntary head turn. The sign resolved after electrolyte correction in all 14 cats [2]. Cervical ventroflexion, a downward bend of the neck, is also common with low potassium and was the most frequent finding in a study of 86 cats with that sign [3]. These cats may also press their heads. ### Head trauma A fall, a car accident, or a blow to the head can cause bleeding or swelling in the brain. Head pressing may appear hours or days later. Any cat with a known or suspected head injury needs emergency care. ## Red Flags That Make Head Pressing an Emergency Go to an emergency clinic now if your cat has any of these: - A seizure, especially a first seizure or one lasting more than a minute - Sudden blindness or pupils that do not respond to light - Collapse, inability to stand, or severe wobbling - Repeated vomiting with head pressing - Known or suspected toxin exposure - Known or suspected head trauma - A sudden change in breathing, such as heavy or noisy breathing - Extreme lethargy or unresponsiveness If your cat is choking, gasping, or has something stuck in its throat, see [Why Was My Cat Choking](/knowledge/veterinary-medicine/clinical-methods/why-was-my-cat-choking). Coughing that comes with neurologic signs can also be a clue to a serious problem, so read [Cat Coughing: When Should You Worry?](/knowledge/veterinary-medicine/parasitic-diseases/cat-coughing-when-to-worry). ## What You Can Do at Home While You Wait You cannot treat head pressing at home. Your job is to keep your cat safe and get to the vet. - Remove hazards. Block stairs, put away sharp objects, and keep your cat away from hot stoves or open windows. - Confine your cat. Use a carrier or a small, quiet room with soft bedding. This prevents falls and makes it easier to watch for new signs. - Do not give any medication. Do not give human pain relievers, sedatives, or supplements. Many are toxic to cats. - Note the time. Write down when the head pressing started, how long it lasts, and what else you see. This helps your vet. - Take a video. A short phone video of the behavior can help your veterinarian see the posture and any head tilt or tremor. Teleneurology video review has been shown to help veterinarians localize neurologic lesions in dogs and cats with strong agreement compared to in-person exams [6]. - Offer water but do not force food. If your cat is dull or vomiting, food may not be safe right now. - Call ahead. Tell the clinic you are coming and that your cat is showing a neurologic sign. ## What Your Veterinarian Will Check and Test Your vet will start with a full physical and neurologic exam. They will check your cat's mental status, pupils, eye movements, facial symmetry, gait, reflexes, and response to touch. They will also look for a head tilt, neck ventroflexion, or tremor [3][4]. ### Common tests - Blood work. A complete blood count and chemistry panel can show liver values, electrolytes like potassium, glucose, and signs of infection. - Bile acids test. This checks liver function and can point to a portosystemic shunt. - Thyroid testing. Hyperthyroidism was a common diagnosis in cats with cervical ventroflexion [3]. - Infectious disease testing. Tests for feline leukemia virus, feline immunodeficiency virus, and feline infectious peritonitis may be recommended. - Imaging. X-rays, ultrasound, CT, or MRI can look for a liver shunt, brain mass, or fluid buildup. - Cerebrospinal fluid analysis. This can detect inflammation or infection in the nervous system. - Toxin screening. If exposure is suspected, your vet may send samples to a lab. ### Treatment depends on the cause There is no single treatment for head pressing. The plan depends on what is found. - Liver shunt: surgery or a special diet and medication to reduce toxins. - Brain tumor: surgery, radiation, or medication to reduce swelling. - Infection: antibiotics, antivirals, or antifungals. - Toxin: decontamination and supportive care. - Low potassium: electrolyte correction. In the 14 cats with hypokalemic myopathy, the positioning head tilt resolved after electrolytes were corrected [2]. - Tremors from liver disease: in the 19 cats studied, tremors stopped in 9 of the 14 cats with one-month follow-up after surgical or medical management [4]. Your veterinarian will calculate any medication dose based on your cat's weight and health. Never give a dose on your own. ## Prevention and Monitoring Some causes of head pressing cannot be prevented, but you can lower the risk. - Keep your cat indoors. This reduces trauma, toxin exposure, and infectious disease risk. - Store medications and chemicals safely. Never leave human pills, antifreeze, or cleaning products where a cat can reach them. - Feed a balanced diet. Thiamine deficiency can cause neurologic signs, and it is preventable with proper nutrition [3]. - Schedule routine vet visits. Early detection of liver, thyroid, and dental problems can prevent serious complications. - Watch for early signs. A cat that starts hiding more, eating less, or acting confused may be showing the first hint of a problem. See [Cat Hiding: When to Worry and When It's Normal Cat Behavior](/knowledge/veterinary-medicine/vet-visit-decisions/cat-hiding). - If your cat has a known liver shunt, follow your vet's diet and medication plan closely. Report any new tremor, drooling, or dull behavior right away. ## Limitations and When to Contact a Veterinarian This article cannot tell you what is wrong with your cat. Only a veterinarian can do that after an exam and testing. Individual cases need a veterinarian. Contact your veterinarian the same day if you see head pressing, even if your cat seems fine otherwise. Head pressing is never normal. Go to an emergency clinic now if your cat has a seizure, collapses, goes blind suddenly, vomits repeatedly, or you suspect poisoning or head trauma. Call for a routine visit if your cat has a known liver or thyroid condition and you notice a small change in behavior, appetite, or energy. Early monitoring can catch problems before they become emergencies. ## Frequently Asked Questions ### Is head pressing in cats always a sign of a brain problem? No, but it always points to a problem that affects the brain. The brain can be affected directly by a tumor, infection, or trauma, or indirectly by toxins, liver disease, or electrolyte problems. All of these need veterinary attention. ### Can head pressing in kittens be normal? No. Kittens may bump their heads while playing or exploring, but true head pressing is not normal at any age. In young cats, a liver shunt is a common cause, and it can cause poor growth, drooling, and tremors along with head pressing [4]. ### What is the difference between head pressing and head-butting? Head-butting is a friendly social behavior directed at people or other pets. It is brief and your cat looks relaxed. Head pressing is directed at a flat surface, lasts longer, and your cat often seems confused or unaware of you. ### Can head pressing go away on its own? The sign may come and go, but the underlying cause will not go away without treatment. In cats with low potassium, the head tilt and weakness resolved after electrolyte correction [2]. In cats with liver-related tremors, signs stopped in some cats after surgery or medical management [4]. Treatment is needed. ### What should I do if my cat is head pressing right now? Call your veterinarian or an emergency clinic immediately. Keep your cat confined and quiet, remove hazards, and do not give any medication. Take a video of the behavior if you can, and bring it with you to the visit. ## Related Articles - [Why Is My Cat pressing head against wall? Hepatic Encephalopathy and Brain Lesion](/knowledge/veterinary-medicine/symptom-guides/why-is-my-cat-pressing-head-against-wall-hepatic-encephalopathy-and-brain-lesion) - [Cat Hissing at Nothing: When to Worry About Hallucinations or Medical Issues](/knowledge/veterinary-medicine/anxiety-and-behavior-support/cat-hissing-at-nothing-causes) - [Cat Coughing: When Should You Worry?](/knowledge/veterinary-medicine/parasitic-diseases/cat-coughing-when-to-worry) - [Cat Hiding: When to Worry and When It's Normal Cat Behavior](/knowledge/veterinary-medicine/vet-visit-decisions/cat-hiding) - [Why Was My Cat Choking](/knowledge/veterinary-medicine/clinical-methods/why-was-my-cat-choking) - [Cat Lethargy: When to Worry and What to Do](/knowledge/veterinary-medicine/online-vet-and-care-costs/cat-lethargy-when-to-worry) - [Tremors in Cats: Causes, Locations, and When to Worry](/knowledge/veterinary-medicine/symptom-guides/tremors-in-cats-causes) - [Facial Paralysis in Cats: Causes and What It Means](/knowledge/veterinary-medicine/symptom-guides/facial-paralysis-in-cats) - [Labored Breathing in Cats: Causes, Treatment, and When to Worry](/knowledge/veterinary-medicine/emergency-and-first-aid/labored-breathing-in-cats-causes-treatment) - [Toxoplasmosis in Cats: Neurological Symptoms, Cytology, Pregnancy Risks, and Veterinary Care](/knowledge/parasites/pet-parasites/toxoplasmosis-cats-neurological-symptoms-cytology-pregnancy-veterinary-care) ## References 1. [Case Report: Positioning head tilt observed in six dogs with meningoencephalitis of unknown origin](https://pubmed.ncbi.nlm.nih.gov/41810408/). Frontiers in veterinary science, 2026. 2. [Reversible positioning head tilt observed in 14 cats with hypokalaemic myopathy](https://pubmed.ncbi.nlm.nih.gov/37318332/). Journal of feline medicine and surgery, 2023. 3. [Cervical ventroflexion in cats: 86 cases (2003-2024)](https://pubmed.ncbi.nlm.nih.gov/40692342/). Journal of feline medicine and surgery, 2025. 4. [Tremors in cats with hepatic encephalopathy-congenital portosystemic shunts or postattenuation neurological syndrome](https://pubmed.ncbi.nlm.nih.gov/39539156/). The Veterinary record, 2025. 5. [Ascending bacterial optic neuritis and meningoencephalitis following tooth extraction in a cat](https://pubmed.ncbi.nlm.nih.gov/41398265/). BMC veterinary research, 2025. 6. [Teleneurology video recordings and live streams provide reliable neuroanatomic lesion localization in dogs and cats](https://pubmed.ncbi.nlm.nih.gov/42526502/). Journal of the American Veterinary Medical Association, 2026. ## Further Reading - [American Veterinary Medical Association: First Aid Tips for Pet Owners](https://www.avma.org/resources-tools/pet-owners/emergencycare/first-aid-tips-pet-owners) - [Merck Veterinary Manual: Cat Owners](https://www.merckvetmanual.com/cat-owners) - [Cornell Feline Health Center: Health Information](https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information)