Cat Keeps Licking His Lips & Shaking His Head (7 Diagnoses)

“My cat is licking his lips all of a sudden. He ate dinner a little while ago and started licking his lips and shaking his head repeatedly. Why is he doing that?”

–Terry B. 

These symptoms are somewhat unusual but not rare in veterinary practice. But since there are so many possible causes, I need to create a list when presented with a cat licking his lips and shaking his head.

Not every possible cause will be a real concern in every case, but the following list is a good outline of the major causes of lip licking and head shaking in cats. 

Upper Respiratory Viral Infections

Calicivirus and herpes viruses infections are extremely common in cats. These both cause symptoms involving a cat’s mouth, sinuses, and throat. 

While sneezing is a classic viral URI symptom, post-nasal drip is also common and can cause lip licking, head shaking and repeated swallowing.

Increased salivation and mouth sores are often seen with these viruses, especially Calicivirus. I’ve seen many cats lick their lips and shake their heads in response to these uncomfortable changes in their mouths. 

Gastritis and Nausea

Gastritis means stomach inflammation. It can come on suddenly or it may be a chronic problem. 

Common symptoms of gastritis include excessive salivation, poor appetite and vomiting. 

It’s also a common cause of lip-smacking behavior in cats. You may or may not see vomiting after they lick their lips. Some cats with gastritis show increased lip licking right after eating and others display the behavior when their stomach is empty. 

Nausea is a general term to describe the “feeling” of sickness, often with a desire to vomit. Nausea can be caused by gastritis, infection, drugs, toxins, liver disease, kidney disease and so many more diseases it’s impossible to list them all. 

black and white cat keeps licking lips and shaking head

Dental Disease

Dental disease is very common in pet cats. Resorptive lesions, tooth root abscesses and widespread gingivitis/stomatitis all cause discomfort. 

Symptoms of dental/gingival disease range from no obvious symptoms to severe changes in appetite, lip-smacking, lip-licking and excessive drooling. 

I’ve seen more than one cat with a loose tooth lick their lips and shake their heads. It seems very mysterious until the problem is found, then it’s pretty easy to understand this unusual cat behavior! 

Once the dental issue is treated, most cats stop licking and shaking. 

Feline Orofacial Pain Syndrome

The cause of Feline Orofacial Pain Syndrome (FORPS) is unknown. It is a disease most common in young to middle-aged Burmese cats. Symptoms include licking the licks, chewing while not eating and pawing at the mouth. 

Some cats seem to have extreme discomfort and vocalize loudly for several hours. This may happen only once or recur in episodes. 

Many cats with FORPS also have dental issues, so it’s not an easy diagnosis. 

Tumor/Polyp/Foreign Object

Cats may respond to an abnormal object in their mouth, nose or throat by smacking their lips, swallowing hard, shaking their head, etc. 

Getting a good look at a fully conscious cat’s throat or deep in their ears is challenging. Vets often need to sedate a cat to do a good exam of these body parts. Sometimes we find things that don’t belong there such as

  • Nasopharyngeal inflammatory polyps-these are benign inflammatory masses that grow in a cat’s ear and throat area.(1) They can lead to pain, dizziness, ear infections and changes in breathing.
  • Sinus or oropharyngeal tumor-cancerous and non-cancerous tumors can grow in a cat’s sinuses, throat and mouth. Anesthesia and endoscopic imaging is often required to find these tumors and collect samples for biopsy. 
  • Foreign object-I’ve seen cats with needle and thread lodged in their throat, plant thorns piercing their soft palate and foxtails in their ear canals. These things may be hard to find without sedation, x-rays and/or CT scans.

Mouth Trauma

There are many ways a cat can experience trauma to their mouth. One possibility is a dislocated jaw that may be caused by falling or being hit by a car. 

And some cats have just enough looseness to their temporomandibular joint that it can dislocate when they open their mouth wide to engage in normal grooming. (2)  

Lip lacerations (cuts) may be caused by blunt force trauma. But they can also happen when a cat has an abnormally positioned tooth. A common place to see this is the upper lip where it overlaps the lower canine.

Similarly, abnormally positioned teeth or missing teeth can lead to lip entrapment. This is most likely to occur when the upper canine tooth is missing and the lip gets trapped “inside” the lower canine. 

Toxins and Oral Irritants

Cats love to explore their world by sniffing and licking interesting things. Sometimes they get more than they bargained for and end up with a sore mouth. 

Many ornamental plants contain substances that cause oral irritation (dumb cane, Poinsettia, etc.). I’ve also seen cats who got household cleaning agents (like Mr. Clean liquid cleaner) on their fur and licked it off only to develop a very burned mouth. 

Poinsettia plant
Poinsettia plants can cause oral irritation when cats chew them

Focal Seizure

Focal seizures differ from grand mal seizures in that they are confined to only part of the brain. An affected cat typically doesn’t lose consciousness. Instead, they engage in repetitive behaviors like chewing, licking their lips and shaking their heads.

Focal seizures are often a challenge to diagnose. Your vet will have to rule out the many other possible causes of symptoms before concluding the cat is suffering from focal seizures. 

Diagnosing the Cause

Many cats require extensive testing in order to find the cause of their lip-licking/head shaking. Your vet will likely recommend a full blood panel including thyroid and viral testing.

Many cats also need to have a sedated examination with radiographs of the head, neck and chest as well as dental radiographs.

How to Help Your Cat Now 

I will assume you’ve found this article while trying to figure out why your cat is licking/shaking and what you should do next. Here is some general advice on how to assess the situation’s severity. When in doubt, it’s never wrong to call your vet or a 24-hour vet clinic for advice!

  • Wear latex gloves to protect your hands from potentially harmful substances.
  • Gently open and look in your cat’s mouth with a flashlight to see if there is anything obvious. Be cautious as a painful cat may inadvertently bite you. 
  • Keep track of when it happens, and what the cat was doing before the onset of symptoms
  • Note any diet changes made in the last couple of months including treats
  • Note any other symptoms like sneezing, runny eyes, change in appetite, ear infections
  • Go to an emergency clinic if trouble breathing or the cat seems weak, or very lethargic

Summary

When a cat keeps licking their lips and shaking their head your veterinarian needs to go through the list of possible causes to arrive at a diagnosis. You can help the process by noting any other unusual symptoms, medications, treats, supplements or events your cat has experienced recently. 

Most of the time these symptoms are relatively mild and don’t constitute an emergency situation. But changes in breathing, weakness or extreme lethargy should prompt you to take your cat to see a veterinarian immediately. 

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References

  1. Davidson, J. R. (2014). Otopharyngeal/otic polyps in cats. Current Techniques in Small Animal Surgery, 5th ed.; Bojrab, MJ, Waldron, DR, Toombs, JP, Eds, 232-235.
  2. Hsuan, L., Biller, D. S., & Tucker-Mohl, K. (2017). Open mouth jaw locking in a cat and a literature review. Isr. J. Vet. Med, 72, 54-59.
  3. Wong, V. M., & Jaffe, M. H. (2018). Pathology in Practice. Journal of the American Veterinary Medical Association, 252(3), 297-299.

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