Concussions in Dogs: Signs, Symptoms, Treatments

We often think of concussions as happening to people while they’re working or playing competitive sports. But pets are also at risk of brain injury. Concussion in dogs is “a very serious medical problem that can become life-threatening,” says Dr. Dottie Hagler, DVM, DACVIM, board-certified veterinary neurologist and medical director at Pet Specialists of Austin. “The good news is that dogs are incredibly resilient, and many patients who suffer from this condition actually go on to survive and have a great quality of life, but early intervention is key.”

In This Article

If you suspect your dog has a concussion, seek veterinary care right away. If you suspect your dog has a concussion, seek veterinary care immediately to improve their chances of recovery and prevent complications. We asked veterinarians about the symptoms, causes, and treatment of concussion in dogs canine concussions.

What Is a Concussion in Dogs?

A concussion occurs “when the brain hits the skull and undergoes trauma,” says Dr. Veronica Villanueva, DVM, medical director at VEG Anaheim Hills. “A more severe concussion is when they get backlash, where the brain hits the front and back of the skull.” This kind of trauma can cause brain swelling and even seizures.

“In veterinary medicine, we refer to concussions as a traumatic brain injury or TBI,” Dr. Hagler says. “Statistically, about one out of every four dogs who have some type of blunt trauma to their head will have a significant traumatic brain injury.” Such injuries may include a skull fracture or a fracture that causes compression of the brain, and there may be pieces of skull in the brain.

“We can also see intracranial bleeding, and that can put additional pressure on or inside of the brain, and contusive injury where the brain comes in contact with the side of the skull during the trauma,” Dr. Hagler says. Dogs may also have polytrauma, meaning they have additional injuries to their body. “They may have been in some type of vehicular accident, or been dropped on their heads, or have had a heavy object fall on their heads,” she explains.

In less severe cases, concussions generally involve a functional disturbance rather thanas opposed to structural damage. With a functional disturbance, “a CT scan or an MRI would be completely normal, and the dogs would make a full recovery with rest and monitoring,” says Dr. Eliza O’Callaghan, DVM, managing veterinarian for Small Door Veterinary. She explains that a functional disturbance is a temporary neurologic disturbance, such as dizziness, that affects the dog’s functioning. In contrast, structural damage refers to a bruise or a bleed.

Symptoms of Canine Concussions

The most common symptom of concussion in dogs is diminished or dull mentation, meaning their level of awareness, Dr. Hagler says. They may be unable to walk or have difficulty maintaining their balance. “Patients can come in even worse than that, where they’re in a coma or having seizures,” she adds.

In a petit mal seizure, dogs may roll into a tight ball, stiff and shaking, Dr. Villanueva says. Other signs are a head tremor or seeming disoriented. In Conversely, dogs can have a grand mal seizure, dogs may flail their legs, vocalize, urinate, or defecate themselves,” she says.

The onset of symptoms tends to occur immediately following the trauma. “An exception would be patients who have an intracranial bleed that’s slow,” Dr. Hagler says. “In a patient like that, it may take a few hours for them to become symptomatic.”

Physical and behavioral symptoms of canine concussion include:

• Ataxia (loss of balance or coordination)
• Dizziness
• Lethargy
• Not responding to normal cues such as their name or treats
• Brief loss of consciousness
• Blurred vision
• Headache
• Pain
• Unequal pupil size
• Nystagmus (rapid eye movement)
• Drooping of the face
• Head tremor

“The symptoms we see are indicative of where in the brain the problem is,” Dr. Hagler says. Some parts of the brain require more nutrients than others, making them more susceptible to metabolic injuries, such as a disruption in nutrient processing or energy production. For example, an injury to the front of the brain is more likely to cause behavioral or personality changes.

Another example is an injury to the brain stem, which controls breathing. “Injuring that part of the brain is going to carry a much more guarded prognosis,” Dr. Hagler says. Fortunately, these injuries are less common because the brain stem is tucked away at the back of the brain. “When patients are exhibiting symptoms of a brain stem injury, often, it’s because the front of the brain has been injured and becomes swollen, causing pressure on the back of the brain,” she explains.

Causes of Concussion in Dogs

One of the most common causes of TBI in dogs is getting hit by a car, but it’s not the only one. “I’ve also had very small patients who jumped out of their owner’s arms and fell on their heads,” Dr. Hagler says. They can also have a heavy object fall on their head. “Some of these patients are so small that it really doesn’t take much to cause a serious brain injury,” she says.

Dogs can also suffer falls from grooming tables and furniture. Another cause of brain injury is “really rough play, where two dogs have a collision, causing a minor concussion,” Dr. O’Callaghan says. Such injuries can also happen in working dogs, hunting dogs, and dogs who participate in sports such as agility. “They’re at a higher risk of exposure to high-impact environments and physical exertion,” Dr. Villanueva says.

Aside from blunt force trauma, Dr. O’Callaghan explains that sudden acceleration or deceleration of the head or neck, like in a car accident, can also cause concussions. This motion can cause the brain to collide with the inside of the skull, causing an injury. Dr. Villanueva agrees, adding that dogs can get whiplash and develop a concussion.

“We take our pets everywhere now, which is wonderful, but they don’t have a seatbelt,” she says. She sees this a lot with  small breed dogs. They can fly and hit the windshield and have permanent head trauma. In addition, small breed dogs like the Chihuahua and Pomeranian have what’s called an open fontanelle or a soft spot in the skull, which can put them at risk of a brain injury.

Immediate Actions and Emergency Care for Head Trauma

If you observe any type of head trauma, especially a car accident or high-speed collision, Dr. Hagler recommends taking your dog to the nearest veterinarian immediately. Even if they don’t show initial problems, dogs should be evaluated by a veterinarian. “Dogs are very good at hiding their injuries,” she says. “Often, patients have to be in a lot of pain before they start screaming or crying.”

A veterinarian can provide initial stabilization, often with medications that reduce pressure and swelling. Treatment typically also includes:

• Intravenous (IV) fluid therapy
• IV pain medication
• Anti-convulsant medications
• Intensive nursing care, in some cases
• Supportive care, such as oxygen therapy

“The initial neurologic presentation of the patients is just as important as the trend we observe over time,” adds Dr. Hagler. Veterinarians use a grading system called the modified Glasgow Coma Scale, or small animal coma scale, to assess whether a patient is getting better or worsening. These scales provide an objective assessment of the patient’s condition and are helpful in intensive care unit settings where multiple veterinarians treat patients.

“Often, in these patients, we also need some form of advanced imaging like a CAT scan or MRI,” Dr. Hagler says. These tests help determine whether patients need additional intervention, such as decompressive brain surgery. They may also need another procedure to stabilize injuries sustained during the initial accident.

Diagnosing Canine Concussion

Not all incidents occur on our watch. Dogs could be playing outside when an injury happens, or you may be out of the house when they slip and fall or run into a wall. If you notice any neurological symptoms, such as disorientation or a loss of coordination, Dr. Villanueva recommends taking your dog to a veterinarian right away for early assessment and treatment.

“You need to be vigilant within the first 24 to 48 hours following a head trauma because there can be life-threatening complications like brain bleeding or swelling, and they can develop very slowly,” she says. “A veterinarian can perform a neurologic exam to see if there are deficits that the owner may not be able to see.” Even if your dog seems okay, if you suspect they’ve had head trauma, bring them to see a veterinarian. Dogs can’t tell us what’s wrong, and symptoms aren’t always immediately visible.

In diagnosing concussions in dogs, the veterinarian will perform a full physical examination from nose to tail. They will take your dog’s history and perform a neurologic examination. “We’re going to watch them walk and see if they’re having any ataxia,” Dr. Villanueva says. “We’re also going to flip their paws upside down because the natural response is to correct it and put their foot the right way.”

The latter is called conscious proprioception, which is “a way of testing whether the dog knows where their feet are in space,” Dr. O’Callaghan explains. Other assessment tools include taking your dog’s blood pressure, having them balance on one leg, and checking their reflexes. For example, a dog should blink when you put your finger up to their eyes.

If the trauma is mild or the injury seems minor, “at minimum, we would want a pet parent to keep their dog with them for observation, for the rest of that day to make sure they didn’t take a turn for the worse,” Dr. Hagler says.

Treatment and Recovery from Canine Concussion

Treatment and prognosis depend on the location and severity of the dog’s injury, and the type of stabilization needed. “The real cornerstone of treatment is strict rest and observation and making sure they don’t deteriorate from the state they’re in,” Dr. O’Callaghan says. Crate rest is ideal, but you can have your dog confined to a small room or area where there’s no furniture or steps for them to climb and injure themselves further.

Initial Monitoring and Hospitalization

Out of an abundance of caution, a veterinarian may recommend hospitalization for initial monitoring. Among patients requiring hospitalization, “some dogs improve very rapidly and are discharged in 24 or 48 hours,” Dr. Hagler says. Other patients require a longer hospitalization. For example, a patient who undergoes a decompressive brain surgery may need to stay in the hospital for a longer period than one with a less severe injury.

“If we see a neurologic deficit, we’re going to treat and would hospitalize them, because we want to prevent permanent damage,” Dr. Villanueva says. “The sooner we can start, the better.” Permanent damage can result from brain pressure or bleeding. For example, if the brain hits the front and back of the skull, this can result in a severe injury. “There’s a French term for it called contrecoup brain injury,” Dr. Villanueva says. In addition, the veterinarian will monitor the dog’s vital signs, including their blood pressure.

Managing Pain and Swelling

“If we’re seeing neurologic signs, we’re probably going to give them an opioid such as hydromorphone or gabapentin for neuropathic pain,” Dr. Villanueva says. A vet may also prescribe diuretics like mannitol to help reduce brain swelling and anti-seizure medications to treat seizures.

“If your dog is in pain, please don’t give any human medications to them,” she says, adding that “Tylenol and Ibuprofen are toxic to dogs.” In cases where the vet doesn’t observe neurologic symptoms, but the dog is experiencing pain, they may suggest treating the dog on an outpatient basis.

Brain Imaging and Prognosis

If the amount of brain trauma is severe, a veterinary neurologist can request an MRI or CT scan to assess the brain further and detect any bleeding or swelling, Dr. Villanueva says. “If there’s any form of brain trauma or thoughts of a concussion, we would recommend doing an MRI or CT scan right away,” she says. Knowing the severity of the injury will help determine the prognosis.

“In general, once a patient starts improving, the prognosis tends to be good,” Dr. Hagler says. Many patients go on to have a good quality of life. That said, “it’s not uncommon for dogs who have survived severe head injury to have some type of permanent neurologic deficit, like difficulty seeing out of one eye, having seizures, or walking with an uncoordinated gait,” she says.

Recovery and Rehabilitation

As your dog is recovering, you can take them outside on a short leash for toileting. All three experts agree that you should use a harness instead of a collar to avoid pulling on their head or neck. Dogs generally recover from a concussion within 24 to 72 hours. Dr. O’Callaghan recommends a week of rest to be on the safe side. Once neurologic signs resolve, dogs can gradually return to normal activity.

Dr. Villanueva stresses the importance of not overexerting your dog as they’re recovering. Avoid taking them to the park or allowing them to run around. “Just keep them calm and have them rest,” she says. Although infrequent, some patients may require physical rehabilitation. Full rehabilitation, whenever possible, may take a long time, Dr. Hagler says.

The Importance of Prevention and Early Intervention

There are several things you can do to prevent TBI in dogs or reduce the risk of permanent damage. “One of the most important things is to invest in some type of restraint device for inside a vehicle,” Dr. Hagler says. A patient of hers, who was in a car accident, wasn’t restrained and developed a compressive skull fracture that required surgery. Despite having a good quality of life, this patient developed seizures.

Dr. Villanueva has seen similar accidents in her practice. She recommends not allowing your dog to sit in the back of your truck. Your dog could get excited and jump out of the vehicle or get injured if you slam on the brakes.

Another way to prevent concussions is to take precautions at home and outdoors. Indoors, remove any heavy furniture or objects your dog might run into, Dr. Villanueva says. When you’re outdoors, keep your dog on a leash or in a fenced-in area. With working dogs, make sure you’re in an open area with no trees or obstructions in their path.

If you take your dog to a groomer, inquire about safety protocols to keep your dog secure, Dr. O’Callaghan says. Dogs should never be left unattended on a grooming table or high surface. Likewise, if your dog tends to play rough, monitor their play with other dogs. The same vigilance is needed for sports, where dogs are at risk of falling or bumping their heads.

Because early intervention is critical to preventing permanent damage, take note of the nearest emergency veterinary hospital. Accidents can happen at any time. Your regular veterinarian may not be available.

“Dogs are absolutely amazing,” Dr. Hagler says. “I don’t think I could overemphasize their resilience.” Her advice is not to give up. “Some of these patients just need a little bit of time.”

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