Head bobbing or head shaking is a common symptom which almost always has an underlying cause from mild to serious. In addition to head bobbing, additional symptoms may be present which can narrow down a probable cause.
Catnip exposure
Catnip is a perennial herb from the mint family which can induce a high in 2/3rds of cats. The active ingredient is nepetalactone which is found in the stems and leaves of the plant. Common signs of catnip exposure include sniffing, chewing, licking and head shaking, chin and cheek rubbing. Catnip exposure is not harmful and the high only lasts 5-10 minutes before the cat returns to normal.
Ear mites
Ear mites are tiny spider-like mites that inhabit the ear canal of affected cats. Infection causes intense irritation as well as increases the risk of bacterial or yeast infection that can lead to an ear hematoma, a collection of blood within the cartilage of the ear and the skin. The most common species of ear mite to infest cats is Otodectes cynotis. Ear mites are extremely contagious and cats can be infected via close contact with an infected animal as well as via bedding.
Clinical signs include head bobbing, ear twitching, intense itching, coffee grounds exudate in the ears.
Treatment includes cleaning the ears to remove exudates, veterinary insecticide to kill the mites (treat all cats and dogs in the household) and antibiotics or antifungals to treat secondary infection where necessary. As ear mite insecticide doesn’t kill eggs or pupae, it will be necessary to treat animals over several weeks.
Ear infection
Otitis externa refers to an inflammation or infection of the outer (external) ear canal. It is one of the most common medical conditions seen in cats. The most common causes of ear infections include ear mites, foreign body, allergies, scabies, tumours, Infection may start within the ear canal or the pinnae and is classed as primary or secondary.
- Primary otitis externa begins with irritation to the ear resulting in inflammation and a build-up of wax in response. This creates a perfect environment for bacteria and yeast to take hold.
- Secondary otitis externa is due to bacteria or fungi taking hold due to the above-mentioned inflammation. Incorrect ear medication administration can also contribute to secondary otitis externa.
Clinical signs include head shaking, ear twitching, head tilting, foul odour and ear debris.
Treatment for ear infections includes finding and addressing the underlying cause, administration of a solution to clean the ears followed by administration of topical ear drops. In some cases, oral antibiotics will be prescribed.
Nasal and nasopharyngeal polyps
Nasopharyngeal polyps are benign growths that arise from the mucous membranes of the nose (nasal) or the base of the eustachian tube (nasopharyngeal). Polyps can extend into the middle ear, external ear, pharynx (cavity behind the mouth) and nasal cavity.
The exact cause isn’t entirely understood but it is believed that they are the result of chronic inflammation or congenital (present at birth). Young cats are most commonly affected, with a mean age of 1.5 years.
Clinical signs include head shaking, sneezing, chronic nasal discharge and a head tilt.
The treatment for polyps is surgical removal under anesthesia. If the polyps are within the bulla (middle ear), a bulla osteotomy will be necessary. This procedure involves opening up the middle ear to remove the polyp(s).
Foreign object in the ear
Grass seeds or other foreign objects can become lodged in the ear, which can cause intense irritation to the cat. Common signs include pawing at the ear, head tilt, head shaking and redness. Trauma from scratching can lead to a secondary bacterial or fungal infection and trauma can rupture the eardrum.
Most cases of foreign bodies in the ear will need veterinary attention to remove the object due to pain. The veterinarian may need to administer a short-acting anesthetic to remove the object and clean the ear. Antibiotics may be prescribed if the cat has developed a secondary infection.
Gum disease
Gum (periodontal) disease is an inflammatory infection that leads to the destruction of the supporting gums and bones. It occurs when plaque, a sticky biofilm hardens to become tartar. Tartar collects under the gum line and forms pockets. Bacteria and inflammation in the affected area cause destruction of the surrounding tissue.
Clinical signs include bad breath, pawing at the mouth, dropping food, head shaking, loose or missing teeth and inflamed gums.
It is not possible to reverse damage from gum disease and the goal of treatment is to prevent further bone loss. The veterinarian will remove tartar from the teeth and under the gums under general anesthetic.
Dental hygiene is essential to prevent gum disease, this can be achieved by daily cleaning with a suitable pet toothbrush and toothpaste.
Allergies
Cats can develop allergies to almost any substance. The most common triggers include flea saliva and food. Allergies tend to manifest as skin irritation in cats. Clinical signs include miliary dermatitis, itching, head shaking, skin and ear infections.
The goal of treatment is to find and eliminate the cause where possible. A food elimination trial may be initiated in which the cat will eat a hypoallergenic diet for six weeks to see if symptoms resolve. After six weeks, the cat will return to his or her original diet to see if symptoms return. If a food allergy is not the cause, it may be necessary to continue investigations to determine the allergen.
Insects
Fly and mosquitos bites can be bothersome to cats, particularly in the summer months. The ears are a primary target due to the thin fur. Signs of insect bites include head shaking, swelling and scratching. If the cat experiences an allergic reaction, antihistamines can reduce clinical signs. Unfortunately, human insect repellant is toxic to cats, the best way to prevent bites is to screen windows and keep doors shut.
Hypoglycemia
Hypoglycemia is a life-threatening condition in which the blood sugar levels drop dangerously low. The liver and muscles store excess glucose in the form of glycogen when needed, enzymes release it back into the blood. Many cells of the body can use protein or fat as energy sources if blood sugar levels drop, however, the brain relies on glucose alone. If glucose levels drop, the brain can no longer function properly and neurologic dysfunction occurs. Severe cases can lead to brain damage or death.
The most common cause of hypoglycemia is due to insulin overdose, vomiting or a missed meal in the diabetic cat. Less common causes include an insulin-secreting tumour, liver disease, certain medications (beta-blockers), Addison’s disease, and glycogen storage disease.
Clinical signs of hypoglycemia include nausea, nervousness, rapid breathing, dilated pupils, lethargy, disorientation, weakness, head tilting, shakiness, seizures and coma.
Hypoglycemia is a medical emergency. Administer a sugar solution, maple syrup or honey onto the tongue, or gums if the cat is unable to swallow and take the cat to the veterinarian. It is important to determine the cause of hypoglycemia and treat it as necessary.
Vestibular disease
Vestibular disease is a condition in which the cat develops incoordination due to several disorders affecting the vestibular apparatus in the inner ear or brainstem. The vestibular system is responsible for providing the brain with vital information about orientation and direction relative to gravity. This information means your cat is aware if he is turning, upside down, right side up, walking, running or falling.
Causes of vestibular disease include ear infection, nasopharyngeal polyps, tumours, medications (metronidazole and aminoglycoside antibiotics), inflammation or infection of the brain stem, head trauma and lead poisoning.
Signs of vestibular disease include nystagmus (involuntary movement of the eyes), head tilt, circling, ataxia (wobbly gait), vomiting and unnatural limb position.
Treatment is based on supportive care as well as treating the underlying cause. Most cats with vestibular disease will improve within 2-3 days and full recovery by three weeks.