SYMPTOM
Head shaking
Repeated, vigorous shaking of the head, often accompanied by flapping of the ears, that occurs more frequently than normal grooming behaviour.
Ear canal inflammation or infection
Head shaking is one of the most common behavioural responses to discomfort within the ear canal. Otitis externa produces irritation, pruritus, and pain that prompts the dog to shake its head in an attempt to dislodge the source of discomfort. The shaking may be intermittent in mild cases or near-continuous in severe inflammation, and is often accompanied by scratching at the affected ear or rubbing the head on surfaces.
Foreign body in the ear
Grass seeds, insects, or other foreign material that enters the ear canal can cause sudden, intense head shaking. The onset is typically abrupt and dramatic, contrasting with the more gradual onset seen in infectious otitis. Foreign bodies can migrate deeper into the canal with each head shake, potentially reaching and damaging the tympanic membrane if not identified and removed.
Ear mites and parasites
Ear mites (Otodectes cynotis) inhabit the ear canal and cause intense irritation. While more common in puppies and young dogs, they can affect any age. The mites produce a characteristic dark, crumbly discharge and drive persistent head shaking, ear scratching, and restlessness. They are highly contagious between animals in close contact.
Allergic ear disease
Allergic conditions frequently manifest with ear involvement, sometimes as the primary site of allergic inflammation. The ears may become inflamed, itchy, and prone to secondary infection, prompting head shaking that may follow seasonal patterns or be persistent year-round. In some dogs, recurrent head shaking is the earliest indicator of an underlying allergic condition.
Aural haematoma
A collection of blood between the layers of the ear flap cartilage can develop as a consequence of vigorous head shaking and can itself cause further shaking due to the weight and discomfort of the swollen pinna. This creates a cycle where the original cause produces a secondary condition that perpetuates the behaviour. The ear flap appears swollen, pillowy, and warm.
Vestibular dysfunction
Conditions affecting the vestibular system can cause head shaking along with head tilting, loss of balance, and disorientation. The head shaking in this context often differs from ear-related shaking in that it may be accompanied by nystagmus and a characteristic head tilt rather than ear scratching.
Why timing matters
Early observation
When head shaking first appears, it typically represents the initial response to an irritant or inflammatory process within the ear. At this early stage, the underlying cause may be relatively straightforward to identify and address. Early head shaking tends to be intermittent, with the dog returning to normal behaviour between episodes. The ear canal is usually still of normal diameter at this stage, allowing thorough examination and effective treatment delivery.
Later presentation
If head shaking persists over days to weeks, the underlying ear condition may progress. Chronic inflammation can lead to secondary infections, thickening and narrowing of the ear canal, and changes that make resolution more challenging. Prolonged vigorous shaking also carries the risk of aural haematoma formation. The transition from intermittent to persistent shaking often indicates worsening.
The trajectory depends on the underlying cause. Foreign body-related shaking has abrupt onset and will not resolve until the object is removed. Infectious otitis may produce shaking that waxes and wanes before becoming persistent. Allergic ear disease often follows seasonal or cyclical patterns. Understanding whether the shaking is acute or chronic, unilateral or bilateral, and its temporal pattern can help characterise the process.
Conditions commonly associated
Otitis Externa in Dogs
Head shaking is one of the most recognisable signs of otitis externa in dogs. The repetitive shaking motion often reflects discomfort or irritation within the ear canal, and may be among the earliest changes an owner observes.
Vestibular Disease in Dogs
Vestibular disease can cause head shaking as affected dogs attempt to cope with abnormal balance signals and disorientation, often accompanying the more characteristic head tilt.
Otitis Externa in Cats
Cats with otitis externa often shake their heads in response to ear discomfort, though some cats with significant ear disease show surprisingly subtle signs.
Nasopharyngeal Polyps
Head shaking in cats with nasopharyngeal polyps may indicate extension of the polyp into the ear canal.
Ear Mites
Ear mites cause intense irritation within the ear canal, prompting frequent and often violent head shaking as animals attempt to dislodge the parasites.
When to explore further
When head shaking begins suddenly and intensely after outdoor activity in grassy areas, the abrupt onset may suggest a foreign body has entered the ear canal. Grass awns can migrate deeper with each shake, so prompt attention to acute-onset ear shaking is valuable.
When head shaking is accompanied by visible discharge, unusual odour, or redness of the inner ear flap, these additional signs suggest active inflammation or infection within the ear canal that may warrant investigation.
When head shaking occurs repeatedly over weeks or returns after apparent resolution, this recurrent pattern often indicates an underlying predisposing factor that has not been addressed.
When head shaking is accompanied by a head tilt, loss of balance, or abnormal eye movements, these neurological signs suggest involvement beyond the external ear canal.
When the ear flap becomes swollen, warm, and pillow-like, an aural haematoma may have developed as a consequence of the mechanical trauma from vigorous shaking.
Observing the pattern of head shaking — whether it affects one ear or both, when it started, whether it is worsening, and what other signs accompany it — can help build a useful picture. Many owners find it helpful to look at the inside of the ear flap and visible canal entrance to note any redness, discharge, or odour. Tracking whether head shaking follows a seasonal pattern or correlates with activities like swimming can also provide valuable context.
Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS