Often, the first sign of illness in dogs is abnormal behavior. Lethargy, weakness, or personality changes can indicate something is wrong before other signs begin to show. One of these abnormal behaviors is “head pressing,” during which the animal stands near a wall or corner, hanging its head low, and not moving. The animal need not actually press its head against the wall to exhibit “head pressing,” but this often occurs as well. Head pressing often indicates that something is wrong with the nervous system. This could be a nervous-system specific ailment, or an existing condition that has progressed to neurological involvement. This behavior is not normal. Schedule a visit with a local veterinarian as soon as possible if your dog exhibits abnormal behavior like head pressing or general personality changes. You know your dog best, which means when you notice something off, you're the only one that is able to correct it.

Head pressing is a behavior exhibited by animals experiencing neurologic damage or under the influence of certain toxins. An affected animal will often stand in a corner or near a wall with its head hung low, or physically press the head against objects.

If you notice your dog pressing its head against walls, pacing or standing facing a corner for extended periods of time, contact the veterinarian immediately. If your pet has a neurological disease, it will need immediate treatment in the hope of avoiding permanent damage. Be prepared to give a detailed medical history of your pet, including any medications, surgical procedures, or recent visits at a kennel or pet hotel. Be sure to let the veterinarian know if you suspect poisoning. This may include mentioning any known poisonous plants in a neighbor’s yard, if your dog has vomited recently, or if the dog came to you with plant material on lips or stuck to teeth), as lifesaving action must be taken immediately.

A veterinarian will make a physical examination of your dog to distinguish signs of poisoning from illness. Poisoned dogs will often exhibit greatly increased or reduced heart rate, dilation/constriction of the eyes, muscle tremors or lethargy, and may vomit. This usually, but not always, is differentiated from sickness by the absence of a fever.

If the dog appears to be sick, and not poisoned, there are a number of tests that the veterinarian may order. A CBC (complete blood count) is often the first line of investigation, and will reveal abnormalities in the amounts of different blood cells. Increased white blood cell count, for example, often means the dog is fighting an infection. Other signs, like fever, sneezing, and fluid in the lungs can be signs of illnesses like Canine Distemper Virus or meningitis. Liver damage can cause a condition known as hepatic encephalopathy, resulting in neurological signs like head pressing from the toxins released by the liver.

If no obvious disease or poisoning presents itself, the veterinarian may refer your dog to an animal hospital for medical imaging, such as MRI (Magnetic Resonance Imaging), X-ray or CT (Computed Tomography) scan. These are larger machines that may require your dog to be sedated to keep them still during the imaging. Results from these tests provide veterinarians with high-resolution images that may show evidence of a brain tumor or mass pressing on the nervous system.

Head pressing can only be resolved by treatment of the underlying condition. If your dog has been poisoned, the veterinarian will attempt to identify the toxin and counter it. This can include a variety of methods, such as providing fluids to combat dehydration, activated charcoal to absorb toxins, chelation therapy, or drugs that keep the body from processing the substance into its toxic by-products, such as in the case of antifreeze poisoning. Providing the veterinarian with information about toxic hazard in and near your home is often key to saving your dog’s life. These treatments are administered as soon as possible and stopped once the animal recovers.

Neurological diseases like meningitis can be identified by culturing the cerebrospinal fluid and choosing an appropriate antibiotic. The antibiotic administration must be given as directed until the entire course of medicine has been used up, even after symptoms improve. This ensures that your dog will not relapse or develop antibiotic-resistant strains of the infection. Antibiotics are usually safe, but in some pets may irritate their stomach.

Cancers will be treated according to their location, type and progression. Radiation therapy, chemotherapy or surgery may be required.

The recovery of your pet will depend on the cause of the head pressing. As neurological symptoms are serious, the veterinarian will more than likely request follow-up appointments to monitor your dog’s condition. Let your pet rest as much as possible and provide food, water, and medication as directed. Try not to overexcite or stress your pet (e.g. by vacuuming) if possible. Neurological symptoms brought about by poisoning or infection usually resolve quickly once proper treatment is found. Head pressing caused by degenerative diseases and cancers often take much longer to resolve, or in some cases, not at all.

Head pressing can be a sign of poisoning, a neurological disorder or even cancer. The cost of treatment can vary greatly based on the cause.