Why does my pet shake her head and scratch her ears?

The most common cause of head shaking is otitis – inflammation of the ear.  Otitis can be due to infection, irritants, foreign objects, or allergic conditions.  Not a “normal” behavior, shaking is an indicator that it is time to seek medical attention.

Otitis is a common condition seen in veterinary practice.  During an exam, the veterinarian uses an otoscope to visualize the ear canal and be sure that the tympanum (ear drum) is intact.  This checks for objects lodged in the canal and also shows if it is safe to use certain cleansers and medications.  Cleaning products or drops should not be used prior to an exam as many can be toxic if the ear drum is damaged.  Please do not use Google concoctions such as alcohol, vinegar or essential oils to clean your pets’ ears before an exam. For sensitive and allergic pets or those with damaged tympanums, these products can further irritate the ears or even cause hearing loss.

If discharge is present your veterinarian will perform a cytology on a microscope.  This test allows the diagnosis of a bacterial, yeast, or mite infection.  Then comes a game plan for treatment and maintenance to help prevent frequent recurrence of the problem. Recurrence – you mean this is going to happen again? Unfortunately, otitis is often due to an underlying cause that will be present for life. That means you and your veterinarian are going to get to know each other well with multiple visits.  The more your veterinarian does diagnostically and the more you comply with treatment protocols and maintenance routines, the more you can reduce flare-ups.

What are the underlying causes for those recurrent infections?  The “big 4” are atopic dermatitis, adverse food reactions, inflammatory polyps, and Otodectes.   Atopic dermatitis pets suffer from symptoms due to IgE immunoglobulins in the body reacting to environmental allergens.  IgE reactions lead to itching which can be in the ears only, the paws (seen any licking of the feet lately?) or even the entire body including the inner ear skin.  This condition often shows up during adulthood as their body has been primed by previous exposure to the allergens and is now sensitive to them.  Exposure then causes the release of histamines leading to redness and itching of the skin (think ear lining).  So those pollens or dust mites that make you sneeze could be making your pet itch.

Pets with recurrent otitis can be suffering from adverse food reactions.  These are also linked to IgE, so the signs such as itching and redness appear just as with atopic dermatitis.  A colleague of mine liked to say that food allergies are the “rear and ear” disease!   He was right – food allergies cause gastrointestinal effects and, surprisingly, itchy ears.  If your veterinarian suspects food sensitivity, they may recommend an elimination diet trial.  Don’t run to the store now and buy a new popular food. This may or may not work.  An elimination diet trial must be strictly regimented and followed exactly for 4-8 weeks to see if the condition improves.  Treats and foods in any price range can all have ingredients that bother your pet’s ears.  Take time to consult your veterinarian to develop a trial that will be worth your time and money and hopefully help your pet!

Inflammatory polyps and Otodectes are more common as causes for cats with recurrent otitis.  Cats’ ears should always be clean. If they are greasy – please schedule an exam.  Many kittens start with terrible Otodectes (mites) and this damages the lining of the ears – setting up for a lifetime of otitis. Polyps (growths in the canals) can not only lead to otitis but also grow as a result of untreated otitis.  Cats are the masters at hiding symptoms so take a look at those ears!

The bottom line is clear – if your pet is shaking their head or rubbing their ears, please call your veterinarian. Pet store products are unlikely to help and could worsen the condition.  Your veterinarian can use diagnostics to determine the underlying cause and then use medicated gels, at-home medical cleaning products, specialized diets, allergy medications and even non-invasive laser treatments to help you manage those ears and stop that shaking!

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