Soothe a Dog's Itchy Ears

While all dogs scratch their ears to some extent, if you notice your dog constantly scratching or irritation of the ear, you might need to determine what's causing the itching. Once you've determined the cause of your dog's discomfort, you can treat the underlying cause. Most itchiness is caused by a parasitic infection, ear infections (bacterial or yeast), allergies, or a foreign body in the ear (like a grass awn).

Steps

Relieving the Itch Immediately

1. Know when to see a veterinarian. If you've noticed your dog constantly scratching his ears, get him examined. The vet will use a tool (otoscope) to examine deep inside the ear canal and check if the eardrum (tympanum) is intact. The vet will also look for other causes of itchy ears. For example, the vet may swab your dog's ears to diagnose an infection.
   • If your dog is in so much pain that an examination is difficult, the vet may choose to sedate him and clean out the ear. This allows the vet to see the eardrum and helps topical treatments be absorbed by the skin.
   • Don't attempt giving topical ear treatments to your dog without seeing the vet first. If the eardrum is damaged, medication could cross into the middle or inner ear, causing permanent balance and hearing problems (possibly even deafness).
2. Be cautious about using tea tree oil. While some may recommend using this essential oil to calm inflamed or infected skin, know that it contains terpenes, which are toxic to dogs. Animals can tolerate tea tree oil that has been diluted to 0.1 to 1.0%, but most shampoos, disinfectants, and skin treatments sold by pet shops contain stronger amounts which could harm your dog. If you do use a tea tree oil product, make sure it's very diluted.
   • Watch for signs of terpene toxicity if you choose to use tea tree oil. Toxic signs include nausea, vomiting, and, commonly in both cats and dogs, paralysis. Serious cases of paralysis, seizures, and even death have also been associated with tea tree oil.
3. Try giving your dog antihistamines. If you're unsure what's causing your dog's itchy ears, you'll want to get him some relief until you can determine the problem. Contact your vet to confirm that the antihistamine is safe for your dog, especially if they are on other medication. Then you can give your dog 2 mg of a common antihistamine, like diphenhydramine, for every kilogram of body weight. Usually these are tablets given orally, three times a day. Antihistamines work by histamine release to prevent inflammation.
   • Note that even once you've started treatment, your dog will probably continue to scratch. Also, antihistamines are not widely effective in treating canine itchiness. You can try it to see if it brings your dog any relief, but know that only 10 to 15% of dogs benefit from them.
4. Give your dog temporary relief. The veterinarian may prescribe a short course of corticosteroids to provide temporary itch relief until a course of medication kicks in. Corticosteroids are potent anti-inflammatories which are excellent at relieving itchiness. Or, ask your vet about using over-the-counter (OTC) creams that contain 0.5 to 1% hydrocortisone. Applying these creams to the skin of the ear flap and around the base of the ear could soothe inflamed skin.
   • Be aware that steroids should not be used with certain medications, like if your dog is taking NSAIDs (non-steroidal anti-inflammatories) which are typically prescribed for arthritis. Taking the two drugs together can result in catastrophic gastric ulceration leading to hemorrhage and death.

Recognizing and Treating an Ear Infection

1. Look for symptoms of an ear infection. Ear infections are painful and cause lots of irritation, so you'll notice your dog rubbing and scratching his ears a lot. You may also notice the ear is red, swollen, hot to the touch, smells bad, or discharge coming from the ear (like a thick wax or pus). Ear infections can be caused by a variety of things (ear mites, bacteria, or yeast), so it's important that the vet diagnose your dog.
   • If you are unsure if your dog has an ear infection, compare one ear with the other. They should both look the same. If one ear looks different or irritated, it's likely infected.
2. Have the veterinarian examine your dog. Since many things could cause an ear infection, your dog should be diagnosed by a vet who can prescribe medicated prescription ear drops that contain antibiotics. If your dog has had ear infections before, the vet may swab his ears to get samples of pus to send for a culture. This will precisely identify the bacteria causing the infection and which antibiotic will kill them. Severe infections may require a combination of topical drops into the ear and oral systemic antibiotics.
   • There are many medications available. Your vet will select the best one for your dog and give you instructions on how often to apply it and for how long. Treatment will be largely determined by your dog's size and condition.
3. Clean your dog's ears. Choose a mild, pH balanced, emollient (moisturizing), and quickly evaporating ear cleaning product. Choose a liquid instead of a wipe, since the liquid can penetrate into the ear canal to clean away deep seated pus and infection. Place the nozzle of the bottle over your dog's ear canal and squeeze generously. Plug the ear canal with a ball of cotton and massage the side of his head. Remove the cotton and wipe up the ear cleaner that comes out. Repeat this until the ear cleaner comes out clean.
   • If you later notice your dog tilting his head to the side, it could be a sign that he's ruptured an eardrum and the cleaner has touched the delicate middle or inner ear. Stop using the cleaner and get veterinary attention.
   • Cleaning the pus from the ears can decrease the amount of bacteria and give your dog some relief from the itch. However, if cleaning the ear upsets your dog or if his ears are too sore, stop cleaning and take him to the vet.
4. Recognize possible allergies. In some dogs, recurrent and unexplained ear infections may be linked to an allergic reaction. The dog may be allergic to something in the environment (pollen or dust mites) or an ingredient in their food. Talk to your vet about this possibility if your dog continues to get ear infections — they may recommend putting the dog on a hypoallergenic diet as a trial to see if things improve.

Recognizing and Treating Parasites

1. Look for signs of an external parasite infection. If you've looked at your dog's ears and the both look healthy, then your dog may be scratching because there's an external parasite infection (like fleas or sarcoptic mange mites). Check your dog's coat for fleas and their droppings (flea dirt) pushing back the hair on his ears in the wrong direction.
   • Fleas move quickly so you don't always see them. Flea dirt looks like specks of brown dust and when you place the dust on damp cotton wool you get an orange halo where dried blood from the flea bite reconstitutes.
   • Sarcoptic mange mites are too small to see with the naked eye, but the dog's fur typically gets a moth-eaten appearance, especially on the ear flaps and legs.
2. Follow your vet's treatment plan. If you think fleas or sarcoptic mange mites are causing your dog's itchy ears, then speak to your veterinarian about an appropriate anti-parasite product to kill the infestation and relieve the itch.
   • There are several highly effective spot-on products available that kill fleas and mange mites. Ask the veterinarian to recommend one and determine the proper dosage for your dog.
3. Look for signs of an internal parasite infection (ear mites). Since it's difficult to look deep into your dog's ear, you may only notice the scratching and a thick brown wax that might also be crumbly. This wax is made by ear mites, an infection that's a common problem in dogs. Your vet will need to use magnification tools (like an auroscope or otoscope) to look for mites scurrying or by looking at microscopic slides for mites or eggs.
   • In otodectic mange, or ear-mite infection, the ear mites feed off wax in your dog's ear canal. They infest both the vertical and horizontal ear canals.
4. Follow the vet's treatment plan for ear mites. Your veterinarian will probably recommend that you start with non-prescription medication containing pyrethrin. Typically, you'll apply a pyrethroid ear medication to the ear canal once or twice daily, for ten to fourteen days. Pyrethrin applied topically is safe for your dog, since it doesn't pass into your dog's bloodstream easily.
   • While pyrethrin is effective against ear mites, it's not a successful treatment for bacterial infections.
   • There is a theoretical risk of toxicity if your dog eats the medication or another dog licks your dog's medicated ear. The signs of poisoning include excessive salivation, muscle tremors, agitation and in extreme cases, seizures. If you notice any of these signs, keep the dog in a dark, quiet room to minimize stimulation, and get veterinary advice.

Recognizing and Removing a Foreign Body

1. Watch your dog for scratching and head-tilting. One common problem is a foreign body such as a grass awn or foxtail getting into the ear canal. You may notice the sudden onset itchiness after your dog went for a walk. Or, he might have been fine, gone for a walk and come back tilting his head to one side, frantically scratching his ear.
   • A foreign body, like a grass awn can migrate down your dog's ear canal, causing intense irritation. Your dog will tip his head to the side which has the foreign body.
2. Have the vet remove any foreign body. You probably won't be able to see deep enough into your dog's ear to find the foreign body. This is because the ear canal is "L" shaped and foreign bodies worm their way deep down. The vet will need to look deep into the ear using an otoscope (which is an instrument that is part magnifier and part light). The vet will remove the irritating object using special long graspers called alligator forceps.
   • Removing the foreign objects shouldn't take long or cause your dog any pain.

Tips

• Don't use standard over-the-counter (OTC) treatments for infections without asking your vet. When infection is present, a substance with anti-microbial activity is needed to kill the bacteria or yeast. But, because antibiotic use must be controlled, no over-the-counter, or pet shop product is allowed to contain antibiotics. So, OTC treatments will be ineffective or could cause further irritation.

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Sources and Citations

See also

• Care for a Dog's Torn Ear
• Heal Ear Infections in Dogs