Vet Guide 2025: Traumatic Brain Injury (TBI) in Dogs and Cats – Signs, Treatment & Recovery 🧠🐾

Hi pet parents—I'm Dr Duncan Houston. When your dog or cat suffers head trauma—like being hit by a car, falling from a height, or enduring a bite—it can result in a traumatic brain injury (TBI). These injuries range from mild concussions to severe, life-threatening damage. This guide explains how to spot TBI, what diagnostics and treatments are necessary, and how to support your pup or kitty through recovery.

📌 What is TBI?

TBI occurs when a sudden force impacts the skull and brain—causing bruising, bleeding, swelling, or structural damage. In mild TBI (concussion), changes are temporary. More severe cases involve skull fractures, brain swelling, bleeding (hematomas), and raised intracranial pressure—requiring rapid emergency intervention.

🏥 Causes and High-Risk Situations

• Traffic accidents (being struck or thrown from a vehicle)
• Fall from height (trees, balconies, furniture)
• Blunt trauma (being kicked, stepped on)
• Animal fights or kicks
• Shaking injuries (especially in small dogs/cats)

Pets with outdoor access or ADHD-like behavior fall into higher risk categories.

🧩 Recognizing TBI: Physical and Neuro Signs

• Altered mental state: disorientation, confusion, restlessness
• Unusual eye signs: pupil size difference, rhythmic movement (nystagmus), or head tilt
• Head/neck position changes (decerebrate posture—a bad sign)
• Motor issues: circling, weakness, ataxia, paralysis
• Seizures—either sudden or post-trauma
• Bleeding, fluid leakage from ears or nose, skull fractures
• Unstable vital signs: shock, abnormal breathing, low blood pressure

🔬 Diagnosis & Emergency Stabilization

Immediate attention at an emergency clinic is vital. A typical assessment includes:

• Stabilizing airway, breathing, and circulation (ABC)
• Neurological exam using Glasgow Coma Score adapted for pets
• Lab work: CBC, chemistry, blood gases, to detect shock or infection
• Diagnostic imaging: skull X-rays for fractures; CT is ideal for identifying hematomas; MRI for brain tissue damage
• Continuous respiratory and cardiac monitoring
• Blood pressure and intracranial pressure support

🛠️ Treatment of Primary & Secondary Injuries

Primary Injury Care

• Control hemorrhage—surgical removal of acute hemorrhage or skull fragments
• Skull fracture management—depending on severity, surgery might be needed

Secondary Injury Management

• Reduce brain swelling: elevate head, administer mannitol/hypertonic saline
• Maintain oxygenation: oxygen therapy, possibly ventilation
• Avoid hypercapnia/hypoxia—close ICU monitoring required
• Prevent seizures—administer anticonvulsants like levetiracetam or phenobarbital
• Antibiotics for wounds or risk of infection
• Pain and anti-inflammatory treatment
• Supportive bedside care: fluids, temperature control, and repositioning to prevent bed sores

🧠 Long-Term Recovery and Monitoring

• Survivors of the first 48 hours have good recovery chances
• Watch for persistent seizures—concussive epilepsy may require ongoing meds
• Rehab therapy: physical rehab, hydrotherapy, cognitive enrichment
• Regular check‑ups, repeat imaging for complications (e.g., rising intracranial pressure)
• Helping owners manage expectations and quality‑of‑life decisions

🔍 Prognosis: What to Expect

Outcome depends on injury severity:

• Mild TBI → rapid, full recovery is common
• Moderate TBI → may require weeks of intensive care, but many regain good function
• Severe TBI → risk of permanent neurological deficits, chronic seizures, or euthanasia decisions

Working closely with a neurologist or critical care team significantly improves outcomes.

📝 Key Takeaways

• Any head trauma is a veterinary emergency—don’t wait.
• Signs: altered mentation, seizures, bleeding, abnormal posture—act fast.
• TBI treatment is time‑sensitive—stabilization and diagnostics rule immediate care.
• Long‑term commitment: seizure control, rehab, pet-owner education.
• With prompt care, many pets bounce back; severe cases need realistic quality-of-life planning.

📚 I hope this in-depth guide supports you, your team, and your clients. Want client‑facing handouts, printable recovery plans, or infographic summaries? I can pack those in too!

Dr Duncan Houston, BVSc | Veterinary Neurology & Neurocritical Care Specialist