Eirevet is a veterinarian specialized in canine and feline internal medicine
who owns a small animal veterinary hospital in Ireland.

Is your dog shaking its head? If so, it's best to figure out why and fast.

Is your dog shaking its head? If so, it’s best to figure out why and fast.


Reasons Why Your Dog Is Shaking Its Head

Head shaking in dogs is a common presenting problem for veterinarians. Most
dogs will shake their heads in response to pain or irritation affecting one or
both ears. There are several potential causes which can affect either the
external ear flap (pinna) or the internal canals of the ears.

It is important to identify and correct whatever the problem happens to be as
untreated ear disease will cause irreversible changes to the anatomy of the
ear, making future problems more likely and more severe.

4 Common Causes of Head Shaking in Dogs

  1. Ear Parasites
  2. Foreign Bodies
  3. Ear Allergies or Skin Disease
  4. Ear Infections

1. Ear Parasites

There are a range of common parasites which may cause inflammation of your
dog’s ears. The two most commonly encountered are ear mites ( Otodectes ),
which infest the ear canals, and fleas ( Ctenocephalides canis/felis ),
which irritate the pinnae or ear flaps. While ear mites are unlikely to cause
any skin problems elsewhere, dogs with flea infestations will usually
demonstrate more widespread itching and potentially scaling and crusting of
the skin along the back. Fleas will also be visible on a flea comb or against
light-coloured hair coats.

Ear mite infestation may be diagnosed by your veterinarian on otoscopic
examination of the ears. These parasites are tiny, and they’re not usually
visible to the naked eye. However, they cause an accumulation of
characteristic dry, flakey wax in the dog’s ears, which may be obvious when
you yourself examine them.

Less commonly, pet dogs may be affected by sarcoptic mange. The early stages
of the infestation may be most severe around the pinnae, although the problem
very quickly spreads to the rest of the body, causing diffuse itching, hair
loss, and scabbing.

All of these infestations can potentially cause skin disease in pet owners,
but they are usually self-limiting in individuals in good health.

Otodectes cynotis colonises the ear canals.

Otodectes cynotis colonises the ear canals.

2. Foreign Bodies in the Ear

Occasionally, a foreign body such as a grass awn may become lodged in a dog’s
ear. The irritation this causes is usually severe and begins very suddenly. It
is not uncommon for a dog with a foreign body to require sedation or
anesthesia to allow a veterinarian to identify and remove the problem. Dogs
with ‘floppy’ ears and those that run through thick undergrowth are most at
risk of developing this problem.

3. Ear Allergies or Skin Diseases

Allergic skin disease is an incredibly common cause of ear disease in pets,
particularly dogs. In much the same way as in human medicine, allergies in
pets are becoming an ever more common complaint in veterinary practice. This
presents difficulties both in diagnosis and management of these patients.
Allergic ear disease is likely at best to be recurrent, and at worst may
require lifelong medication. Your dog’s head shaking may or may not be part of
more generalised itch and skin irritation.

The range of potential allergy-causing agents is endless, and the pet may
often be allergic to more than one allergen. For example, many dogs with an
allergy to house dust mites may also be allergic to fleas. Of all the types of
allergies we identify, food allergy is the ‘easiest’ to deal with, because we
do at least have control of most of what our pets eat. By identifying and
eliminating the culprit from the diet (commonly proteins such as
chicken/beef/gluten), we can hope to control the pet’s symptoms.

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If your dog has a skin allergy, the head-shaking will usually have gradually
worsened to the point where you realise there is a problem, although sudden
flare-ups can occur (see below) with particular types of bacteria colonising
the damaged ear canal.

Bacterial ear infection in a spaniel

Bacterial ear infection in a spaniel

4. Ear Infections

Ear infections in dogs are rarely a primary problem. They usually occur as a
result of inflammation or damage to the ear canal caused by parasites, foreign
bodies or skin allergies as descried above. Anatomical defects, like scarring
from previous ear problems, may impair ventilation and drainage of the ear and
can also predispose to infection.

Infection may be due to yeasts, most often Malessezia species, or bacteria
such as Staphylococcus pseudointermedius. Both of these groups are normal
inhabitants of the dogs’s ear canal, which proliferate when the skin’s normal
defenses are damaged. More severe infections with coliform (faecal) bacteria
or Pseudomonas species results in more severe signs, may be more sudden in
onset, and are commonly resistant to many first-line antibiotics. In these
cases, laboratory culture and sensitivity testing is an important step in the
veterinary diagnostic investigation to ensure the correct treatment is chosen.

Treatments for a Dog’s Ear Problems

The choice of treatment for your dog’s ear condition will obviously depend on
his underlying problem. Many readily available over-the-counter products are
available for treating parasitic infestations. Consultation with a
veterinarian competent or specialising in dermatology is essential for
managing many of the other conditions discussed above, as incorrect or
inappropriate treatments can genuinely cause harm to the sensitive ear canal.

In my daily practice, I commonly encounter animals which have become
permanently deaf as a result of owners administrating ear drops to ears with
perforated eardrums. Only otoscopic examination of your dog’s ears can confirm
the presence of an intact eardrum, and the safety of administrating topical

Otoscopy is simply the process of inserting a light source with a small
‘nozzle’ into the ear to allow magnification of the ear canal and any ojects
such as ear mites within it. It is usually quite painless, although if your
dog has a severely inflamed and painful ear, he may need to be sedated for the

What Happens If You Don’t Treat a Dog’s Ear Disease

Here are some problems that can occur if your dog’s ears are not treated.

Aural Hematoma

If not managed correctly, ear infection and inflammation can lead on to a
number of problems. In the short term, an aural hematoma may develop. This
occurs when severe head shaking or scratching of the pinna causes rupture of a
blood vessel under the skin of the ear flap. Blood then accumulates under the
skin, causing the pinna to swell dramatically. This accumulation of blood
needs to be drained by your vet to relieve pain and discomfort. Recurrent
hematomas or those that are not drained will cause a ‘cauliflower ear’ to
develop as a result of scarring.

Rupture of the Tympanic Membrane

Rupture of the tympanic membrane (eardrum) is commonly seen in infected ears.
The membrane will regrow quickly in the ear once the inciting problem is
settled, but as long as it is not intact it makes a middle ear infection more
likely, and makes it unsafe to use topical medications within the ear itself.

Middle Ear Infection

Middle ear infection involves the bony area at the base of the ear normally
protected by the ear drum. Signs of middle ear disease may be similar to those
involving the ear canals, but also include a loss of balance, deafness, and
possibly facial nerve paralysis. Successful treatment of middle ear infection
may be challenging, and can require months of antibiotic treatment.

This article is accurate and true to the best of the author’s knowledge. It
is not meant to substitute for diagnosis, prognosis, treatment, prescription,
or formal and individualized advice from a veterinary medical professional.
Animals exhibiting signs and symptoms of distress should be seen by a
veterinarian immediately.