The cause may be an itch or a full-blown infection

Most dogs scratch at an ear occasionally. However, if you notice your dog scratching frequently, crying when they scratch, holding their head tilted sideways, or if they have ear redness or hair loss, then you need to investigate. 

The causes of ear problems are many — from parasites to foreign bodies, to a complicated case of allergies. When we asked Dr. Julia Miller, assistant clinical professor of dermatology, about causes for ear scratching, she immediately replied, “Allergies. Allergies. Allergies! Most dogs will scratch at their ears because there is a little allergic inflammation first, and then they develop infections as a secondary problem."

While you can treat for temporary relief from allergies, you need to determine the causes and take appropriate action to make sure they can be managed effectively. Allergies can be a complicated problem, but once you find the key allergens, treatment can be successful — although secondary yeast and bacterial infections are common and require medication. 

If your dog has seasonal allergies to certain plant pollens, you may control the itching with a short course of corticosteroids. For year-round allergies, the ideal strategy is to perform skin or blood testing to identify the allergens, followed by immunotherapy treatment. Dogs with serious allergies often benefit from a referral to a veterinary dermatologist.

Ear mites 

Ear mites cause intense scratching. If you look in your dog’s ears and see dark brown debris that resembles coffee grounds, then your dog most likely has ear mites. This parasite can be shared with cats, dogs and other animals (like the family ferret). Luckily, this mite does not take up residence in your house like fleas, so treating all the pets can eliminate it. 

In Miller’s experience, she says that over-the-counter products are not always effective, and they can sometimes cause more inflammation in the ear canal. However, your veterinarian can recommend a good cleaning solution and an appropriate medication to kill the mites. 

Foreign bodies such as insects, ticks and various plant materials, such as foxtail, may be flushed out by your veterinarian. Other things lodged in the ear might require sedation while your veterinarian carefully uses forceps to remove them. 

Infections 

An ear infection can be painful. If your dog has a lot of debris, if their ear is red, inflamed and moist, or if they have a pus-like discharge, then they may benefit from an exam and cleaning under anesthesia. 

An emergency visit to your veterinarian may be needed if the infection worsens and goes deeper into the middle ear. Symptoms of this severity include your dog keeping their head tilted to one side, walking with a drunken gait, vocalizing and scratching their ear so much that it causes secondary trauma to their face (by making visible scratch marks or open sores). 

Owners always want to know: What if it’s the weekend or if this happens when you're out of town? Can it wait? 

To keep a dog with ear problems comfortable over the weekend, Miller says that it’s important that the dog not scratch viciously at their ears and cause other issues. An Elizabethan cone collar or no-flap ear wrap may help prevent self-trauma. 

You can also try an over-the-counter ear cleaner to help decrease the bacterial or yeast population in the ear temporarily, but a visit to the veterinarian as soon as possible is still best. 

Ear hematoma  

A hematoma is caused when your dog’s vigorous ear scratching and head shaking bursts a blood vessel. Without medical attention, the ear will crinkle into a “cauliflower ear” as the hematoma regresses. 

If your dog has a soft swelling of their ear flap, contact your veterinarian. This swelling can be painful, and your dog may hold their ear slightly out from their head due to the discomfort. 

Ear hematomas can be seen in dogs with prick ears, but most of them occur in dogs with drop ears. Surgery is often recommended.

Take precautions when swimming 

Swimming in lakes, rivers and streams is a common cause of ear infections. Avoid getting water in your dog’s ears. Clean water shouldn’t cause a problem by itself, but if the ear canal stays warm and moist, then it becomes a perfect setup for growing yeast and bacteria. 

This is a bigger problem for dogs with drop ears, like Labradors and Golden Retrievers. Gently drying the ear and wiping out the canal with a cotton ball after swimming can help. 

Treatment 

At the veterinary visit, a swab of any ear discharge or debris will be taken for examination under the microscope. Parasites, bacteria and yeast can all be identified this way. Knowing the cause will guide your veterinarian’s choice of medications, which may be topical, oral or a combination of the two. 

Your veterinarian will also do an otoscopic exam, looking for foreign bodies and mites, plus checking to see if your dog’s tympanic membrane (ear drum) is intact. The state of the ear drum can influence which medications are safe to use. Dogs with a head tilt need a thorough otoscopic exam and may benefit from radiographs. Your veterinarian needs to rule out middle otitis (infection in the middle of the ear) and possible growths in that area. 

Without question, a dog scratching and digging at their ears is in misery. Getting to the cause quickly with appropriate treatment is wise. If secondary infections have time to set in, things get even worse. A trip to your veterinarian is time well spent.

This article has been reprinted with permission from the Cornell University College of Veterinary Medicine’s DogWatch newsletter, published by Belvoir Media Group. When you become a member of the Riney Canine Health Center, you will receive a free subscription to DogWatch.