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Head Pain in Dogs

We all know that headaches and migraines can be extremely painful and debilitating. There’s almost nothing worse than a pounding, sharp pain in your head and temples that you can’t get rid of or pinpoint the actual cause. It’s even worse for dogs who can’t tell you that it’s their head that hurts. When they act strange, it may be normal practice to check things like their legs, stomach and back but dogs can still have head pain. All head pain in dogs should be taken seriously.

Common Symptoms:

  • Hyper reactive to or averse to touch (specific to head or poll or neck; from shoulder forward); generalized to the whole body in strong headache
  • Defensive behavior shown as cringing
  • Hyperactive: pacing in room or pen
  • Ataxia, clumsy, unresponsive
  • Lowered head or elevated head posture
  • Chiropractic misalignment of mainly scull/atlas and /or atlas/axis connection
  • Skittish, irritable, aggressive, spooky
  • Head shaking, head pressing, or staring
  • Furrowed brows, squinty eyes, worried look, frequent blinking, distressed or dull expression
  • Tight mouth/jaw
  • Full body shakes that are incomplete
  • Difficulty putting a collar on

Causes of Physical Head Pain

Brain injuries occur in two different ways: primary and secondary. Primary brain injuries develop as a result of a direct brain insult and secondary brain injuries occur after the primary brain injury. Bleeding from a brain blood vessel or swelling of brain tissue are examples of secondary brain trauma. Alterations of consciousness, which may indicate bleeding in the skull, reduced blood supply to the brain, or fluid-inducing swelling within the brain, are common symptoms of brain trauma/injury in dogs. Other signs may include seizures, injuries on other parts of the body or signs of injury to the brain/head area, bleeding from the eyes, nose, or even ears, trouble controlling their body temperature which results in fevers or low body temperature. The dog’s pupils may dilate unevenly or even respond to light abnormally. There are numerous causes for brain injury which include the following: trauma, continued lack of oxygen, prolonged seizure or multiple seizures in a period of time, toxins, cardiac arrest, blood clots, respiratory arrest, bleeding into the brain, and brain tumors. Treatment is based upon the initial cause of the brain injury and the exact injuries taken place. 

Treatments:

  • Intravenous fluids
  • Wound management
  • Oxygen support
  • Medication to help control swelling, decrease intracranial pressure, treat infection, or  address pain, nausea, or seizures

All tumors come in the form of primary and secondary. Primary brain tumors originate from the tissues of the brain or membranes while secondary brain tumors originate from other cells in a tumor elsewhere that then traveled to the train. Usually seizures are an indicator a dog might have a brain tumor and often diagnosed by an MRI or CAT scan. Dogs may also be hypersensitive to neck pain, have abnormal behavior, circling, wobbling when walking and a head tilt. Your primary vet may also refer to you a veterinary oncologist for further examination and treatment options.

Treatments:

  • Neurosurgery.
  • Radiation therapy.
  • Chemotherapy.
  • Steroids decrease fluid buildup.

Caudal Occipital malformation Syndrome (COMS) is a congenital disorder that causes a deformed skull in dogs. The back of the skull forms incorrectly, leading to compression to the back of the brain and abnormal fluid to flow from the skull to the vertebral column. This results in the dysfunction of neurons in the brain and spinal cord. Small breeds such as the Cavalier King Charles Spaniel are at the highest risk and can start showing signs years after birth. Signs include neck/head pain, dizziness or falling, scratching of the neck, and limb weakness. MRIs are used to appropriately diagnose COMS. 

Treatment:

Dogs have thicker skulls compared to humans but when inflicted with head trauma, the danger is just as severe. When damage to the head occurs, primary and secondary factors may influence the type and degree of trauma that’s been sustained. Swelling in the brain from injury can be fatal, so it’s important to watch for the following symptoms: confusion, disorientation, loss of consciousness, bleeding from the nose or ears, coma, facial weakness, paralysis, lethargy, pupil dilation, seizures, and stumbling. Along with lesions, bruises, or lumps, clinical symptoms are very much like human symptoms. The types of head trauma are categorized as:

  • Contusion: A direct impact to the head causes this condition, characterized by bleeding on the brain.
  • Concussion: The most common form of head trauma; a concussion is when the brain is violently traumatized from an impact and can cause temporary or permanent damage
  • Diffuse Axonal: This is caused by strong shaking or rotation, and is characterized by tearing of the nerve tissues; this condition can cause damage that is spread across several areas of the brain
  • Coup-Contrecoup: This occurs when there is a contusion at the site of impact and one on the opposite side from the brain hitting the inside of the skull

Diagnosing includes a physical exam, a complete blood count, and biochemistry profiles, along with diagnostic imaging to get a better internal view of the skull and brain (X-rays, CT scan, and possible MRI). 

Treatment:

Encephalitis is inflammation of the brain and can either be infectious or non-infectious. Encephalitis is triggered by a brain infection, which means that the body's immune system is malfunctioning which creates malnormal inflammation since we don't recognize it completely. This may be due to the fact that the bacteria, the viral, the fungal and the parasites are manifestations of infective encephalitis. Immune-mediated encephalitis is more frequent in dogs than infection-related encephalitis. In dogs, the causes of immune-mediated encephalitis are unknown. If clinical symptoms including exhaustion, head tilting, circling, and seizures are shown, they may signify a variety of disorders or conditions; however, when a number of neurological signs appear at the same time, it could suggest encephalitis, or brain inflammation. Treatment is dependent on whether the cause of Encephalitis is bacterial, viral, parasitic or immune related and should be administered immediately.

Treatments:

  • Bacterial related: broad-spectrum antibiotics
  • Viral related: antiviral medication
  • Immune-related: immunosuppressive doses of corticosteroid

Epilepsy is the most common neurological condition in dogs and is a disorder in which dogs have seizures, which is when a dog may collapse and flail uncontrollably, often instead of a one-off incidence. It’s believed that epilepsy affects about .75% of the canine population. There are three types of epilepsy. One is idiopathic epilepsy is inherited after there is no evidence of structural damage or cause in the brain. Because of this, it’s assumed that it’s genetic. Idiopathic epilepsy is most common in border collies, Australian shepherds, Labrador retrievers, beagles, Belgian Tervurens, collies, and German shepherds.

  • Structural epilepsy is due to observable damage to the brain that can be brought on by a number of causes. Some causes of structural epilepsy include inflammatory disease of the brain, growth of an intracranial tumor, or after trauma to the head.
  • The third type of epilepsy is where there is no known cause and no structural damage is seen but it’s assumed to exist.

Epilepsy itself is not a painful condition but it can be a sign of another disorder such as liver disease, kidney failure, brain tumors (link to brain tumors), brain trauma, or toxins. To diagnose Epilepsy, owners should keep a detailed diary or journal of their dog’s seizures including the date/time of day, the affected body parts, and how long they last. The vet will do a physical exam and blood work to try and determine the cause of epilepsy.

Treatments:

Glaucoma affects dogs just as much as it affects humans. Glaucoma is a painful disorder of the eye in which an increasing pressure behind the eye, called intraocular pressure (IOP), causes damage to the optic nerve. Signs to look for include hazy or cloudy eyes, redness in the white of the eye, dilated pupils that do not constrict when light hits them, showing signs of pain that include avoiding touching of the head, eyes watering and sleeping more, and also sudden blindness. There are two types of glaucoma:

  • Primary in which the cause is inherited and there are genetic abnormalities in the drainage pathway.
  • Secondary which can be caused by inflammation (uveitis), lens luxation, retinal detachment, tumors, cataracts, or damage to the eye from a ruptured lense.

The type of treatment is dependent on the pain level in the dog, the extent of glaucoma, and whether the dog has fully lost their vision in that eye or not. Certain breeds are predisposed to Glaucoma including (but not limited to) beagle, basset hound, Boston terrier, cocker spaniel, and shar-pei.

Treatments:

  • Drug therapy in the form of osmotic agents, carbonic anhydrase inhibitors, beta-blockers, and prostaglandin analogues.
  • Surgical treatment for dogs with vision include laser ciliary body cyclophotocoagulation and gonioimplants.
  • Surgical treatments for dogs with lost vision include enucleation, cyclocryotherapy, chemical ciliary body ablation or intrascleral prosthesis surgery to control pain, therefore improving the quality of life.  

Granulomatous meningoencephalitis (GME) is a central nervous system (CNS) inflammatory disorder that affects both dogs and cats. Meningoencephalitis is a form of meningitis and the most frequent cause of inflammatory disease of the canine central nervous system is GME, which is likely second only to encephalitis caused by the canine distemper virus. GME causes an inflammation that acts much like cancer in the way that it spreads. The inflammation process includes immune system cells infiltrating natural tissues. Small breed, middle-aged to young dogs are the most commonly affected but it can happen in any dog of any size and age. Symptoms include seizures (link to epilepsy blog), pacing in circles, tilted head, neck pain, stumbling, blindness, listlessness, facial anomalies, and exhaustion. All of the listed symptoms can be either chronic or acute in their onset. GME is currently not curable and a lifelong ailment that requires medication to manage. 

There are three types of GME:

  • Focal has a slower onset of 3-6 months 
  • Disseminated/multifocal has a more rapid onset of 2-6 months and has a wider variety of symptoms. Dogs without treatment have a poor prognosis and an estimated survival time of 8 to 30 days from the time of diagnosis.
  • Ocular involves the eye/optic nerve, and shows up suddenly has blindness which can affect both or just one eye but is not life-threatening as the other two forms.

Treatments:

Hydrocephalus in dogs is a disease in which cerebrospinal fluid leaks into the dog’s skull which then causes brain swelling. Hydrocephalus is also more commonly known as water on the brain. The swelling and increased pressure on the brain can lead to permanent brain damage or even death depending on the severity and how it’s treated. Small dog breeds, especially toy and mini sizes, are much more prone to this disease. Hydrocephalus can be either congenital or acquired. When congenital, the dogs are born with a skull that is a dome or apple-shaped with a large open fontanel on the top of the skull. But it is still hard to notice if a puppy has this until they are up walking and eating on their own.

 

When Hydrocephalus is acquired, it’s due to the cerebrospinal fluid being blocked or altered by either swelling, infection, or tumor with brain tumor being the most common cause. There are multiple clinical signs of a dog having Hydrocephalus aside from the dome or apple-shaped skull. Signs related to physical appearance include wide-set eyes and being smaller than their littermates. Dogs may also have seizures, be blind, bumping into things due to lack of coordination, weak back legs, standing with legs crossed or weak hind legs, kicking legs out when walking and difficulty with house training, drinking or eating. If this disease goes untreated, the increased swelling can become painful. When diagnosing, vets will observe the physical features such as the head shape and the large open fontanel and lack of coordination when walking are also major signs. An ultrasound of the fontanel will show dilation of the brain ventricles and either a CT or MRI can determine the actual source of the build-up as well as any other abnormalities.

Treatments:

  • Mild cases caught early may be treated with medication, usually corticosteroids.
  • surgery to place a ventriculoperitoneal shunt 
  • Treatment of the underlying cause for acquired Hydrocephalus.

Ear infections are one of the most common ailments in dogs which is often caused by bacteria, yeast, or a combination of both but ear mites can also be the culprit in puppies. There are three types of ear infections based on the three sections of the ear canal. Otitis interna is an infection of the inner ear, otitis media is an infection of the middle ear and otitis externa is an infection of the external ear canal. Ear infections are more common in dogs with floppy ears such as Basset Hounds, BloodHounds, and Cocker Spaniels. Otitis interna and media are often a result of the spread of infection from the external ear. Inner and middle ear infections are quite serious and can possibly result in deafness, facial paralysis, and vestibular signs.

The signs of ear infections are quite easy to spot and include crusting/scabs in ears, head shaking, dark discharge, scratching the affected ear, odor, redness, and swelling of the canal, and pain. Your dog may be predisposed to ear infections if they have an autoimmune disorder, ear canal injury, excessive cleaning of the ear, and allergies. It’s important to stay on top of the infection and have it diagnosed quickly by your vet where they conduct a visual examination, using an otoscope to evaluate the ear canal and eardrum, culture samples, and possibly biopsies or X-rays in severe or chronic cases.

Treatments: 

Also known as sinus congestion or infection, sinusitis is when inflammation and mucus cannot drain out of the body. Sinus infections can be caused by a number of things including, but not limited to, weakened immune system, cancer, polyp, foreign body in the sinuses or nasal cavity, dental problems, oronasal fistula, or parasites. Symptoms that your dog is struggling with a sinus infection include sneezing/coughing, watery eyes, gaging, pain due to the pressure in the forehead and around the eyes, sits with head hung and eyes partially closed, and swelling below the eyes. To determine whether your dog has sinusitis, the vet will usually start with a physical exam in which they will look for signs of tooth root abscess and ulcers. A dental test, a blood examination, imaging and a physical examination may be carried out to assess the root cause of the inflammation and establish a successful recovery course. 

Treatments: 

  • Humidifier to loosen mucus
  • Antibiotics for a bacterial infection 
  • Medication as appropriate to treat the underlying cause  

Causes of Emotional Pain

Just like humans, dogs can easily go through bouts of depression or have persistent depression. Dogs may go through depression when they loose an owner, are rehomed or another dog in the family passes away. When dogs are going through depression, they might not eat or drink, want to go on walks and spend a lot of time in a hidden part of your home. They’re sleeping habits might also change. Depression might also be a sign of a medical problem and dogs should be seen by the veterinarian if depression is seen.

Treatments:

  • Rule out medical causes.
  • Natural remedies and supplements that include omega-3s and omega-6s, or probiotics.
  • Engage in fun activities with your dog, like games, fun tricks, and general training.
  • Take the time to bond with your dog.
  • Consider getting another dog if your dog is a single dog
  • Antidepressants.

Dogs can easily have PTSD. It’s crucial to know the signs, especially for recently adopted dogs that were recently rescued from traumatizing situations like hoarding. Other causes for PTSD include being abandoned, loss of their human, experience of being a working canine in the military or police, emotional or physical abuse, natural disasters, major accidents like car accidents, dog fights, and anything else that would be deemed traumatizing. If you’re not sure if your dog has PTSD, warning signs include tucked tail, sudden aggression, depression, being hyper-alert, excessive panting, and any other signs of stress.

Treatments:

  • A veterinary behaviorist can create a treatment plan
  • Combination of behavioral therapy and medication

Separation anxiety occurs from the physical separation of a dog from their owner for any period of time. Some dogs show signs immediately while some may develop separation anxiety after hours apart. When separated, dogs may display extreme actions in a desperate attempt to escape and find their owner. The most frequent symptoms of separation anxiety are vocalizing, salivation, disruptive behaviour, particularly near exits such as doors and windows, urination or defecation indoors/in undesirable places, loss of appetite while alone, self-trauma such as licking or chewing when alone, and attempted or active escapes. Action such as attempting to escape can be very dangerous and result in injury. 

Treatments:

Seasonal Affective Disorder (SAD) is a form of depression that occurs in late autumn and winter and is thought to be brought about by a lack of sun and more colder, grayer days. It affects both humans and animals alike. SAD in animals has only been a fairly recent diagnosis as it wasn’t thought to have affected them before. It’s possible they are also directly affected by the lack of sunlight and the darker days but it could also be an indirect response to their human’s SAD symptoms. Signs your dog has SAD are very similar to humans and may include lethargy, weight loss or gain, accidents, not wanting to move or exercise and possibly even hair loss in more extreme cases.

Treatments:

  • Increase sunshine exposure

  • 30-minute walk outside each day

  • Spend some more one on one time with your dog

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