Why does my dog keep shaking his head and rubbing his ears?

By Mara Ratnofsky, DVM
angell.org/generalmedicine
617-522-7282

Table of Contents Show

Why might a cat or dog shake their head?
Should you be concerned?
Hearing is important
How do you tell what the problem is?
What to do next?
Treating ear problems
A note for cat owners
Other signs something is wrong with your dog’s ears
Causes of ear issues
How to stop your dog’s head shaking
Preventing future ear infections
Final advice

Otitis externa, otherwise known as inflammation of the ear canal, affects roughly 20% of dogs. A dog with otitis may scratch his ears, shake his head vigorously and frequently, hold his ears in an abnormal position, and/or have malodorous ear discharge. The ears are also usually painful when touched.

Dogs are more prone to ear infections than members of many other species, partially as a result of their conformation. The ear canal of a dog has a steep vertical portion and then a horizontal portion, almost creating the shape of the letter “L”. This shape makes it harder for wax, oil, and other debris to make their way out of the canal, and their presence creates an environment that promotes the growth of the small amount of yeast and bacteria that normally reside in the ear canal. An overgrowth of these yeast and bacteria create the ear infection. In addition to conformation, there are other factors that can cause a dog to have excess ear wax. Ear mites, allergies (to food, fleas, pollen, etc.), tumors of the ear canal, endocrine disorders (such as hypothyroidism), and foreign material in the canals can all cause ear canal swelling and increased waxy discharge, setting the stage for infection.

A simple external ear infection can often be treated with ear cleaner and an appropriate topical medication (ear drops). The medication is usually chosen by the veterinarian after he or she looks at a sample of the ear discharge under a microscope. The microscopic evaluation will allow the veterinarian to determine if the infection is caused by yeast or bacteria, and may give some clues as to the type of bacteria present, the severity of the condition, and the chronicity of the condition. If the ear infection doesn’t respond to treatment, or if the infection returns shortly after completion of the course of medication, the dog likely has chronic otitis. With a chronic infection, the veterinarian may culture the ear debris to determine which type of bacteria is growing. This information helps the vet choose an appropriate antibiotic with which to treat. The veterinarian may also recommend flushing the ear canal to rid it of debris and to allow visualization of the ear drum which may rupture as a result of infection. In addition to treating the current infection, it is important to try to identify the underlying cause of recurrent otitis. The veterinarian may run blood tests to check for endocrine diseases, prescribe a special prescription diet to rule out food allergy, or recommend skin testing to find out if the dog is allergic to something in the environment.

If untreated, chronic inflammation will lead to an overgrowth of the tissue in the ear canal. Protrusions of excess tissue allow more places for yeast and bacteria to grow and can make the infection extremely difficult to treat. The deeper structures in the ear, including the nerves, can become affected and result in a head tilt, facial paralysis, and severe dizziness. The ear canal can become mineralized and stiff, and sometimes surgery to remove the ear canal becomes the only viable treatment option.

Ear infections are common and, if chronic, can be difficult to treat. Make sure to have your dog evaluated if he or she is showing signs of an ear infection, and follow your vet’s treatment recommendations regarding length of treatment and recheck appointments. Effective treatment early in the disease process and identification of the underlying cause will provide the best outcome for your dog.

Related material:

To view a how-to video on cleaning your dog’s ears, visit: angell.org/video

Pets shake their heads for several reasons. The most common reason for head shaking in dogs is the one we all know - the head and coat shake after a swim at the beach or a soap-up at bath time. Regular or continuous head shaking in cats or dogs without reason is not normal and could be an ear of an issue!

Why might a cat or dog shake their head?

There are quite a few reasons, and most of them relate in some way to the ears.

Grass seed or other foreign body lodged within the ear canal
Ear infection (bacteria/ yeast or ear mites)
Allergies
Excessive amount of ear wax
Fly bites to the tips of the ears
Immune mediated disease
Polyps/ masses within the ear canal

Should you be concerned?

The answer is yes. If left untreated permanent ear damage can occur including a ruptured eardrum or even hearing loss. Problems such as Aural Haematomas can develop as a result of persistent or aggressive head shaking (for more information on Aural Haematomas in DOGS click here | for more information on Aural Haematomas in CATS click here). Any chronic inflammatory process (such as a bad infection) not treated is painful. If you have ever had a bad ear ache, you will no doubt remember the associated pain you felt before treatment.

Hearing is important

In the case of dogs, after the sense of smell, a dog's ability to hear is the next most important of its special senses. So investigating why a pet is shaking their head and treating any problems is vital to your pet's future quality of life.

How do you tell what the problem is?

As a pet owner it is extremely difficult to tell what the problem is. A dog or cat's ear canal is L shaped and problems are often hidden deep in the canal out of sight. The narrow ear tube/ canal is lined with an epithelium and ear problems can cause the epithelium to swell and subsequently reduce the size of the ear canal. This in turn (in combination with the shape of the ear canal) makes it very difficult for any discharge to make its way to the external ear.

Canine ear diagram

Head shaking on its own is enough to warrant further investigation, ie. a veterinary health check-up. However, the following signs could also indicate problems:-

Foul odour or discharge coming from the ear
Ear scratching
Holding the head in an unusual position
Tenderness, irritability when you touch the ear
Redness or swelling of the ear pinna/ flap
Hearing loss

Please do not use cotton buds or try to poke anything in your pet's ears unless you have been instructed to do so.

What to do next?

The first step is to consult your veterinarian. Your vet will examine the ear with an instrument called an otoscope. If they detect an infection they will take a swab from the ear to conduct cytology (look at a sample of the discharge under the microscope). This is important to assess what organisms are present in the ear canal and in what numbers to assist with accurate treatment choice. Cytology will usually be conducted at each recheck as well to evaluate whether the infection is clearing with the chosen treatment or whether further investigation is required. (eg. culture and sensitivity testing).

Treating ear problems

Your veterinarian may prescribe any of the following treatments:

Antibiotics or anti-inflammatory tablets
Topical ear drops/ medication
Ear wash/ flush
Ear mite treatment
Dietary changes
An anaesthetic to thoroughly clean out the ear canal (it can be too painful to do awake) and
Occasionally surgery will be required

It is very important to follow their directions for treatment and revisit for a check-up when advised.

A note for cat owners

Whilst head shaking related problems is more common in dogs, cats can have very similar problems and veterinary assessment is essential in finding out the cause in order to determine the most appropriate treatment.

Have you caught your dog shaking his head a lot? Do you often see him tilting his head to one side? Is he constantly doing this even though his ears seem clean?

Unfortunately you won’t always be able to see what’s irritating your dog’s ears with the naked eye, but if he’s shaking his head frequently it means something is causing him discomfort. Most of the time this will either be an ear infection or an allergy, although there are other possible causes.

Other signs something is wrong with your dog’s ears

There are several other behaviour changes that can let you know your dog is having issues with his ears: • Rubbing their ears on furniture or the floor • Scratching their ears • Loss of balance • Walking in circles

• Erratic eye movements

You may also notice swelling around the ears, brown or bloody discharge leaking out of the ears, or an unpleasant smell from the ears.

Causes of ear issues

Ear infections can be caused by several underlying conditions. For starters, dog’s ears are warm, moist chambers with total darkness—in other words, the perfect place for all kinds of infections and parasites to thrive. This is particularly true for floppy eared dogs because their ears tend to have a lot more fur and be exposed to less outside air, giving bacteria free reign to grow.

If your dog’s ears appear to be clean there are only a few things it could be:
Bacteria – As mentioned above, your dog’s ears are the perfect home for bacteria of all kinds, especially if they have floppy, fur filled ears. Your dog is also more likely to develop a bacterial ear infection if they spend a lot of time swimming.
Fungus – There are a few types of fungal ear infection your dog can get but by far the most common is a yeast infection. Once these progress past a certain point you’ll be able to see them but the first sign of a fungal infection is usually a bad smell coming from the ears.
Allergies –Dog Allergies are far more common and varied than you might think. Many dogs have skin allergies which can cause severe irritation and repeated ear infections. If allergies are the underlying problem you will notice that your dog frequently gets ear infections and you may also see small reddish brown spots on the inside of their ears. You may have to start your dog on allergy medication at the same time as their ear infection treatment.
Parasites – These aren’t particularly common but there are a few types of parasites which often live inside dog ears.

How to stop your dog’s head shaking

If you want to stop your dog from constantly shaking their head you need to deal with the underlying infection or allergy. This means a trip to the vet to figure out exactly what is going on. If your dog is constantly shaking or scratching even though their ears are clean you should call the vet immediately. Ear infections can get worse quickly and can cause severe hearing loss.
The vet will thoroughly clean your dog’s ears, cut away any excess fur, and give you some antibiotics, usually an antibiotic rinse to be applied directly to the ears immediately after cleaning. If your dog has had repeated ear infections you should also ask for an allergy test.

Preventing future ear infections

Ear infections are unpleasant for everyone but the majority of them can be avoided if you take the time to properly care for your dog’s ears. This means regularly trimming any excess fur that grows in or around their ears and using a special ear cleanser once a week. Dogs who swim frequently may need to have their ears cleaned more often.

You should also always check your dog’s ears for dirt and debris after you go for a big walk through the park, especially if the park you usually go to is highly wooded. Dogs can easily injure themselves trying to get debris out on their own and these wounds are highly susceptible to infection.

If you’re nervous about trimming your dog’s fur or cleaning their ears yourself you can ask the vet to show you how to do it while you’re treating the ear infection.

Final advice

Whatever the cause of your dog’s irritation may be, you’re right to be concerned about their constant head shaking. Call your vet right away and get the infection dealt with before it can get any worse.

BIO
Dianna is the resident dog expert over at Pro Pooch, who produce pet health supplies for the more discerning canine.

Image Credit: https://stocksnap.io/author/471

This story is a guest submission and does not reflect the views of Dogs Monthly Magazine, always consult a qualified expert.

If you have a story you’d like to post, just click here