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Cats bob their heads for a variety of reasons—while it may be normal in sleepy cats, most of the time it is caused by something else. It can be something simple and easy to treat like an ear infection or complicated like a condition in the brain. 

Any change in your kitty’s behavior can be alarming, and you will want to know: when should I be concerned, and when should I reach out to my veterinarian? Here we describe when cat head bobbing is normal, the many causes, and when to talk to your veterinarian.

Cat Head Bobbing: Is It Normal? 

Cat head bobbing is it normal cat wide eyes being held

Head bobbing is normal when cats are very sleepy and are about to fall asleep. When cats are fighting sleep, they can sometimes bob their head as they begin to fall asleep but aren’t quite there yet! If your cat only experiences head bobbing when they are trying to sleep, and the bob is very subtle, this is likely not a cause for concern.

Also, blind cats may have a subtle head bob as they explore new surroundings—when their whiskers touch something, they may move their head back in an exaggerated way because they cannot see, and then immediately approach something again. This is a normal way of exploring new things.

However, cat head bobbing in other circumstances is rarely normal and almost always indicates other issues. Head bobbing can be very subtle or very obvious. Usually other symptoms are there too—like twitching of other parts of the body, increased urination or thirst, changes in your kitty’s fur coat, or changes in the way your cat walks.

Causes of Cat Head Bobbing

Cat head bobbing cat head tilted up and looking confused

There are many potential causes of head bobbing in cats. These include:

  • Ear infections
  • Brain inflammation or structural issues
  • Metabolic disease
  • Seizures
  • Skin Disease
  • Mouth Pain
  • Feline Hyperesthesia
  • Anesthesia

Cat head bobbing is often accompanied by other symptoms as well. Noting the other symptoms, along with the head bobbing, can help your veterinarian figure out what is wrong.

Ear Infections

Cat scratching ear outside cause of cat head bobbing

When cats develop ear infections, they often have inflammation of the inner or middle ear as well as the outer ear. The inner inflammation affects a nerve that connects to the brainstem (central brain) and can result in head bobbing. 

Usually other symptoms of ear infections in cats include:

  • Discharge of one or both ears
  • Redness of one or both ears
  • Scratching of the ear when rubbed, or vocalizing as if in pain
  • Walking in circles
  • Constantly tilting the head to one side
  • Stumbling a little during walking

Ear infections are frequently treated with medication externally in the ear, as well as antibiotics and possibly steroids to decrease inflammation. Deep ear infections can take 1 to 2 months to resolve.

Brain Inflammation or Structural Issues

Cat feeling woozy laying down on tiles outdoors

The brain contains the cerebellum, which controls movements of your cat’s body. When the cerebellum is affected by inflammation of any kind, head bobbing or tremors will likely be seen. The rest of the brain, called the cerebrum, doesn’t control movements quite the same way as the cerebellum. However, inflammation in this area of the brain can affect a variety of neurons, or electrical connections, that affect your cat’s behavior and reactions.

There are a multitude of conditions that can cause inflammation in the brain and lead to head bobbing. 

Examples include:

  • Congenital conditions (born with a slightly different brain structure)
  • Hydrocephalus (fluid buildup occurs in the center of the cerebrum, causing the brain to bulge, affecting the cerebellum and cerebrum)
  • Trauma (any accident that affects the head)
  • Vascular incident (stroke). This can occur secondary to trauma, systemic (full body) disease or congenital issue like an abnormal vessel in the brain.
  • Cancer. This is much more common in senior cats. Cancer that affects the brain usually starts in the brain itself, not spread to the brain from other parts of the body.
  • Infection. Infections can be caused by bacteria, parasites, viruses, or fungi.
  • Bacteria. Any systemic issue could cause a bacterial infection to spread to the brain, but it is rare. This may occur with severe inner ear infections.
  • Parasites: infection with Toxoplasma gondii or the spread of parasites to the brain such as Cuterebra spp. from the skin or Dirofilaria immitis from the blood.
  • Fungal infections. Cryptococcus neoformans, Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides spp., Aspergillus spp. and Candida spp. are fungi that could affect a cat’s brain. The most common is Cryptococcus, although in general fungal infection of the brain is rare.
  • Inflammatory disease. Meningitis or meningoencephalitis refer to inflammation of the brain or the outer layer of the brain and spinal cord. Infection (as listed above) or your cat’s immune system can cause this inflammation.
  • Degenerative conditions. Rarely, certain cells in a cat’s brain will prematurely degenerate (breakdown) and stop functioning
Cat spaced out

When your cat’s brain is affected, there will typically be other neurologic symptoms that occur along with the head bobbing, such as: 

  • Walking in circles
  • Stumbling during walking
  • Change in consciousness. Seems “spaced out” or less aware of his surroundings.
  • Increased aggression or increased passiveness
  • Change in size of the pupil (black central part of the eye) – bigger or smaller than usual, and may not change in the dark or bright light
  • Abnormal movement of the eyes, almost like twitching of the pupil, when not looking around
  • Seizures
  • Twitching or pain of any part of the body
  • Decreased activity and/or appetite

Treatment of these conditions varies widely depending on the cause. Infections are treated with specific medications and usually take a few months to resolve. Trauma and vascular incidents are usually treated with supportive care to keep your cat feeling generally healthy while allowing your cat’s body time to heal. Inflammatory or degenerative disease may be treated with medications that decrease the overactive immune system and are lifelong. There are not many treatment options for cancer, but it depends on which type of cancer your cat has.

Metabolic Disease

Cat head tilting slightly sitting in the kitchen

There are many causes of systemic (i.e. full body) illness that can lead to head bobbing in cats, whether it affects the brain directly or not. This occurs with any imbalance of electrolytes (key elements in the body like sodium or potassium), blood sugar, or insulin. These imbalances affect nerves and muscles. 

Examples of metabolic disease in cats include:

Cats often have other symptoms of illness when they have metabolic disease, including:

  • Increased urination and thirst
  • Decreased or increased appetite
  • Decrease in weight
  • Vomiting and/or diarrhea

Treatment varies depending on the condition. Some conditions such as diabetes mellitus, hyperthyroidism, and hypertension are treated with specific lifelong medications. Chronic kidney disease typically involves special diets, hydration, and supplements to support your kitty for the rest of his life. Liver disease may require supportive care and supplements or possibly surgery if a shunt is present, and the condition is lifelong. Dietary insufficiency will resolve within weeks once your cat’s thiamine has been supplemented and his diet has been improved.

Seizures

Cat laying down staring into the distance

In general, seizures can be due to the causes listed above or they can be idiopathic, meaning no known cause can be found. Only about 2 percent of cats are diagnosed with seizures [1]. Epilepsy, seizures of unknown origin that happen with some frequency, occurs in 1 in 3 cats diagnosed with seizuresand typically begins between the ages of 1 and 4 years old.

Focal seizures are when only part of a cat’s body has abnormal movements or twitches, such as certain limbs, eyelids, or parts of the face. Many times, cats do not lose consciousness during these seizures. Head bobbing can be classified as a focal seizure, but not always.

Generalized seizures are when a cat loses consciousness, and their entire body dramatically twitches and moves for seconds to minutes. Head bobbing can be a neurologic symptom that eventually progresses to generalized seizures.

If there is a specific underlying cause of the seizures, treatment is dependent on the cause. If no cause is known, seizures are often treated with lifelong anti-seizure medications. If seizures are very frequent and uncontrolled, it can cause life threatening damage to the brain over time.

Skin Disease

Large cat laying down in the grass

When cats experience itchiness, it can look like head bobbing due to overstimulated nerves. Cats often hide when scratching or grooming themselves, so knowing your cat is itchy is challenging. 

Symptoms include:

  • Change in fur coat especially fur loss or shortened fur
  • Scaly skin
  • Redness to skin
  • Oily or bad smelling fur

Treatment involves addressing the underlying inflammation and infections, and frequently includes a special diet.       

Mouth Pain

Cat with their mouth open

Cats with severe dental problems can be seen head bobbing due to pain and overstimulated nerves in the mouth. Even cats with apparently normal looking teeth can have painful dental issues hidden under the surface that can only be diagnosed with X-rays. 

Other symptoms of mouth pain in cats include:

  • Foul breath
  • Discoloration of teeth i.e. brown or gray teeth
  • Severe redness of the gums or other tissue in the mouth
  • Excessive drooling
  • Pawing at the mouth
  • Vocalizing when eating
  • Preference to eat only soft (canned) food
  • Decreased appetite

Treatment involves a dental procedure under anesthesia at a veterinary clinic.

Feline Hyperesthesia Syndrome

Cat sitting looking at owner by a window

This is a complex behavior disorder that is triggered by fleas, stress, seizures, pain, or brain inflammation. Cats with this syndrome have overactive nerves, which results in twitching or head bobbing as well as many changes to behavior, including when brushing or petting your cat. Treatment is highly variable depending on cause, but often includes medications given lifelong to help your cat’s behavior.

Anesthesia

If your veterinarian had to anesthetize your cat (i.e. give medications to make your cat sleep while undergoing a medical procedure), he/she may have used ketamine. In rare cases for unknown reasons, cats begin head bobbing afterward but this should resolve completely within 48 hours.

When to Call Your Veterinarian 

Cat being examined in the vet

If you notice head bobbing in your cat that is not when your cat is falling asleep, take a video of the behavior and call your veterinarian right away. 

If it occurs while your cat is falling asleep, monitor your cat closely for an increase in how often it occurs or if it becomes more dramatic. If frequency increases or it becomes more dramatic, a call to your veterinarian is recommended.

Be prepared to answer your veterinarian’s questions that may target specific causes. Questions may include:

  • What if any other symptoms or changes you have noticed in your cat?
  • Does your cat have a history of trauma?
  • Did your cat eat anything toxic, such as human foods with xylitol, household cleaners, rodent poison, or antifreeze?
  • Was your cat recently anesthetized at another clinic?
  • What does your cat eat? Is it a well-balanced diet sold at pet stores, or do you make your cat’s food? (Home cooked diets are much more likely to cause issues.)
Cat being examined by vet

Your veterinarian will need to perform a wide variety of tests to rule out causes for the head bobbing. These may include:

  • Bloodwork including complete blood count (CBC), chemistry and thyroid levels
  • Urine testing, i.e. urinalysis and possibly culture
  • Blood pressure
  • FeLV and FIV testing

If these tests do not demonstrate anything, more advanced testing may be recommended including:

  • Parasite testing (Toxoplasma, Cryptococcus, Dirofilaria)
  • X-rays
  • Advanced imaging with a neurologist such as magnetic resonance imaging (MRI)

Cats may bob their head for a variety of reasons, and some can be serious issues that need veterinary intervention. By paying close attention to additional symptoms, your vet can start your cat on a treatment or management plan to address the cause of the head bobbing behavior.