That head shake means something: ear infections 101
Written by Dr. Cassie Knapp, DVM
Co-Founder & Chief Medical Officer, UrgentPaws
Published August 11, 2026
The short version
- Ear infections are genuinely painful. Head shaking and scratching are not habits — they are your pet telling you something hurts.
- A veterinarian needs to look inside the ear before treating. Some medications are harmful if the eardrum is ruptured.
- Do not use leftover drops from a previous infection or a home remedy. The wrong treatment makes the next examination harder to interpret.
- A head tilt, loss of balance, or an eye flicking side to side suggests deeper involvement and should be seen promptly.
What you are seeing
- Head shaking, or tilting the head to one side
- Scratching at the ear, or rubbing it along furniture and carpet
- A noticeable odor
- Discharge — brown, yellow, or black — or visible redness inside the flap
- Flinching, pulling away, or crying when you touch the ear or the area beneath it
- A swollen, spongy ear flap, which can follow vigorous head shaking
Why they happen so often here
An ear infection is usually a symptom rather than the whole story. The overgrowth of yeast or bacteria that produces the discharge and the smell tends to be secondary to something else: allergies, moisture, ear anatomy, or occasionally a foreign body.
Allergies are the most common underlying driver we see, and Southern California’s long allergy season means we see a lot of them. Add swimming, beach trips, and dogs with heavy drop ears that hold moisture and warmth, and the conditions are close to ideal. Foxtails deserve a special mention — a grass awn in the ear canal causes sudden, intense, one-sided distress and needs removing.
What treatment looks like
Most ear infections are handled in a single visit: examination, a sample, a thorough cleaning, and medication chosen for what we actually find. Pain relief matters here more than people expect — inflamed ears hurt, and a comfortable pet is far easier to medicate at home.
Finish the full course even after the signs disappear. Stopping early is the most common reason an infection returns within weeks, and repeated cycles can cause the canal to thicken permanently, making every future infection harder to resolve.
When to be seen promptly
- A head tilt, stumbling, circling, or eyes flicking side to side — this suggests the middle or inner ear
- Sudden, severe, one-sided pain, particularly after a walk in dry grass
- An ear flap that has swollen up firm and fluid-filled
- Any discharge containing blood
- A pet in enough discomfort that they cannot settle or sleep
Preventing the next one
- Dry the ears gently after swimming or bathing
- Use a veterinary ear cleaner at the interval your vet recommends — not more, since over-cleaning irritates
- Never insert a cotton bud into the canal; it pushes debris deeper
- Treat the underlying allergy if there is one, as that is what stops the cycle
- Check ears after walks in dry grass during foxtail season
Dr. Cassie Knapp, DVM
Co-Founder & Chief Medical Officer
Dr. Cassie Knapp is a veterinarian with 17 years of clinical experience and extensive emergency room and urgent care experience. See full bio
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chivir
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Romeo B.
Jasmin , thank you for your help and making sure that Pua is well taken care of. You are awesome!!!
Teresa F.
My Dog had swallowed a ear from a toy she was playing with I took her in they were so nice and understanding and knowledgeable everyone was so great I had a really good experience they made me feel calm and made sure my baby was taken care of definitely recommend here ❤️🐶☺️
elle R.
Last night our puppy had a bad reaction to a vaccine and her face was swelling. When we got there they were dealing with another emergency but made sure we were taken care of exceptionally! They were so sweet and calmed our anxiety immediate. Within an hour she was back to her normal self:)
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I literally can’t say enough about the team at Urgent Paws. We unfortunately had to put down our cat. She was my daughter‘s cat who passed away 10 years ago. So she was really, really special to us. It’s like losing the last piece of my daughter. Sydney went above and beyond. She was so kind and empathetic, she made this process bearable. I received a lovely personal card. It meant everything to me. We will be bringing all of our pets to this establishment.
Andrea B.
I can’t say enough positive things about this animal urgent care! I called ahead because my cat was in respiratory distress, and they were ready and waiting for him the moment we arrived. They immediately took him back and made sure he received the care he needed during a very scary situation. What impressed me even more was the level of care after we left. They checked in on him the next day to see how he was doing. When we found out he had a bacterial infection and my other cat began showing symptoms, they were able to help with her as well. They even helped us figure out that our new rescue kitten was most likely the carrier of the infection. On top of all of that, the staff took the time to show me the best way to administer medication to my very sassy and uncooperative cats—which was incredibly helpful! From the moment I called, I felt like they genuinely cared about my cats and wanted to help our entire furry family. Their compassion, responsiveness, follow-up, and willingness to go above and beyond meant so much to us. I am incredibly grateful for the care they provided and would absolutely recommend them to anyone needing urgent care for their pet.
Holly H.
Truly the best vet experience I’ve had (and my dog has been to the vet A LOT). Chloe , the VTA, helped me from the time I called through the end of my visit. She was incredibly kind, attentive, empathetic, and understanding and made sure both my dog and me were comfortable. The doctor and vet tech, Sydney and Dr. Colon were both knowledgeable, thorough, answered all of my questions and took great care of my dog and were able to successfully treat him . They were also both incredibly kind. Communication was clear and they were upfront about the cost, which was an absolutely reasonable price . If your pet needs urgent care, come here! Thank you team!
Lauren R.
The best urgent veterinary experience I have had in a very long time. My dog had a suspected infection, but my vet couldn’t get her in and they recommended urgent paws. Since it wasn’t life-threatening, I felt like I could wait until 3 PM to get in. I was able to reserve my appointment time at 3 PM. Walked right in as soon as they opened and they took me immediately to a room no waiting whatsoever. The facility was very clean and modern and I liked that I could see them pulling my dogs blood work since the patient room doors have a window to see the technician area. The staff was all really friendly. You could tell they really love the dogs they were working on. I was kept informed of the progress and it all went very quickly, believe it or not I was in and out in under two hours. That never happens at an Emergency vet! Prices were about what you can expect to see an Emergency Vet. I don’t hope to be back, but I take great comfort in knowing this practice is available in the community and will be there when I need it. Thank you to the staff for taking great care of my Birdie girl!
Charlene C.
The last time we had to take one of our dogs in for urgent care, we waited literally 4 hours. My husband found UrgentPaws and we said we would come here instead for the next time something happened. Well that day came this past Sunday. We took our 15 year old Shih Tzu in at 10AM as soon as they opened. We got a room right away and were in and out within an hour . The following day, we even received a follow up in to ask how she was doing. That was the most amazing experience we’ve ever had. So glad they opened so close to us.
Erin V.
I took my 17-year-old cat to UrgentPaws for constipation, and the staff was so friendly and kind to all of us. Dr. Lauren Banales was really sweet and understanding about his situation. She put together a treatment plan just for him, and thankfully he’s doing better since we went. The office is super clean and well-equipped. We got his blood work and ultrasound results the same day. Thanks to everyone at UrgentPaws for making a stressful situation a bit easier.
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Ava T.
I took my cat to Urgent Paws to be seen for an eye and ear concern. I was immediately greeted by Christine (VT) and taken to an exam room. Christine was friendly and welcoming while explaining the services offered, including fees. Dr. Colon examined my sweet boy and was just as friendly and welcoming as Christine. My cat has been known to be slightly skittish during vet visits, but he was calm as could be during the whole process. I appreciated Christine and Dr. Colon explaining each step and answering all of my questions. Amazing service by staff who made it apparent they love their jobs.
Cori S.
Dr Grenus and the team at this urgent care were amazing with my dog Renee. They made me and my dog comfortable and explained everything so clearly and we're very helpful. I 100% would recommend anyone to take there pet to this urgent care.
Crystal Z.
BEST VET CARE EVER!!! I'm extremely ashamed that it's taken me so long to write this, but I have been thinking about UrgentPaws for months. They set the standard for exemplary care! Pros: *Quick service: I came during the holiday season and waited barely 5 minutes to get into a room *Caring staff: My cat didn't want to leave! Everyone was cuddling him and giving him treats. *Transparent care: all the work is done in a room surrounded by windows, owners can see exactly what's happening and more importantly how their pets are being treated! *Rational doctors: yes that's right! The vet doesn't push unnecessary products or services. They talk through your concerns and recommend what's right for you and your situation. It's not a big sales pitch; it's genuine concern! Cons: I wish they were my primary care vets instead of only an urgent care. I would exclusively go to them. This is the best experience I've had in over 20 years of bringing my dogs or cats for vet care. My little ones are all healthy right now (fingers crossed), but it's a huge relief for me to know that if something happens, I can get care at UrgentPaws. It's one less thing to stress about during the anxiety of sickness or injury.
Marisa M.
We took our pup to Urgent Paws for a paw injury, and we couldn't have asked for a better experience. The entire staff was wonderful. From the vet techs to Dr. Sweitzer, everyone was patient, gentle, and genuinely attuned to our pup's needs. They followed our lead on what would keep her calm while they wrapped her injury, which made all the difference for our anxious pup. Dr. Sweitzer was especially fantastic. She encouraged all our questions and took the time to answer each one thoroughly and clearly. Her explanations were so educational, and you could tell she genuinely cared about our pup's wellbeing. It's so rare to find a vet's office that combines this level of compassion with thoroughness. If we lived nearby, Dr. Sweitzer would absolutely be our go-to vet. Highly recommend!