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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raquel R.
Highly recommend this place staff Kloe and all nurses and doctor were very caring, informative and most of all patient with my shihtzu he amazed me how well he let them care for him he was treated for an ear infection which today is doing very well.
sabrina
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Courtney E.
Dr. Martinez and his staff are angels are earth. We had experiences with both of our cats about a month apart, where in each instance, Dr. Martinez quickly identified significant health issues, walked us through all of the options, answered every question clearly, and ultimately helped us with "making the decision" (when the time came). Dr. Martinez quite literally held our hand through it all and took as much time with us as we needed in every decision. Everyone we interacted with was extremely knowledgeable, treated our cats as if they were their own, and had amazing sympathy and compassion. My gratitude far exceeds any rating system, and I will recommend Urgent Paws to anyone that will listen.
david P.
I recommend without hesitation Urgent Paws for your pet’s urgent care needs. It’s wonderful to have a facility that’s a step down in care from a full-on pet hospital - and it’s staffed by extremely dedicated people. I had returned from work to find my cat limping and Urgent Paws quickly got to the source of the injury. @grateful
Virginia A.
I took my dog, Dior, to Urgent Paws yesterday, and I’m so glad I did! The staff took great care of her and treated her with so much kindness and attention. One of the nurses was especially attentive to Dior, which made me feel reassured throughout the visit. They regularly checked in with us to see how everything was going, and I really appreciated that they even followed up the next day to see how Dior was doing. It’s clear that the team genuinely cares about their patients and their owners. I’m very grateful for the care Dior received and would absolutely recommend Urgent Paws to anyone who needs urgent veterinary care for their dogs or cats. Thank you to the entire team for taking such good care of my girl! ❤️🐾
Erin W.
We took our cat, Dante, here after he went potty outside of his litter box where I discovered he had a parasite. We made an appointment for 10:00 pm. Sam helped us get settled into the exam room. She was so good with Dante. Dr. Wells saw Dante, and provided us with some treatment options and testing. (I did call my friend who is also a vet and explained to her the situation and she said everything that the Dr. Wells suggested is what she would she would suggest for treatment.) We ended up taking Dante back the next day after my boyfriend and I could not get Dante to take his pill. Dante was seen by a vet tech, Victoria, and she got him to take that pill in under 10 seconds. Dr. Wells, Sam, and Victoria all had an excellent bedside manner. All of them were so professional and caring. Dante is doing much better now. I would take my pets here anytime. 10/10.
Shelley R.
I truly enjoyed our experience here this evening. I wasn't quite sure how it worked and never heard of this place but we gave it a go because our vet was closed until Monday. We signed in online before we got there. When we arrived there was only one other family ahead of us. We were greeted and we signed into the kiosks and began to fill out our forms. Before we could start we were directed to a room. All the rooms were very clean and mostly windows so you can see everywhere. Kelsie was our RVT and was so sweet. She took vitals and was very gentle with our dachshund. She explained how everything would go and shortly after she saw us the vet came and examined our baby. He had a double ear infection and they help clean and show us how to administer medication at home. They even allowed me to hold him and participate when we were called into the main examination room for cleansing his ears. We felt so comfortable and my weiner dog did so well. I've never been able to be with our pet when they get taken into the back for a procedure. It was a wonderful experience. I would definitely recommend and go back to. It was also not overly priced for it being urgent.
Karinatiscareno K.
The nurses Jasmine and Christine were so nice, caring and attentive with my cat. The entire staff went about and beyond to make sure my cat was comfortable during his exam and hospital stay.
Carmen G.
They are absolutely amazing. They educate on what they would like to provide and why. I didn’t feel rushed or pressured into anything. Thank you Dr. Ramirez and Lauren for your kindness!
Elsa T.
The veterinarian and staff were so compassionate and patient with my dog. They truly listened to my concerns and took the time to help ease my dog’s nerves, which meant so much to me. Their kindness made a stressful visit feel much more comfortable for both of us. I’m grateful for the care we received and highly recommend this wonderful team!
Brooke L.
The veterinarian and vet staff were wonderful, kind, and practical with their recommendations and treatment plan. They took very good care of our pet!
Lily N.
Staff was super quick and everyone we got to work with was super knowledgeable! Chloe was amazing, we always knew what was happening and she was really attentive! I would definitely recommend urgentpaws if your pet needs help right away, thanks to their help, our kitten Noodle feels a lot better 😌
Jordyn S.
This vet is amazing! We came in here last min needing to get stitches removed and we were met with Jasmine, Sydney, Christine, Chloe and dr. Franco. These veterinarians/ Dr were so sweet and they all cared so much!! They made us so comfortable! Great Place I definitely recommend taking your dog here !
Alicia R.
Chloe & Jasmin and all the staff here was amazing. I will definitely be recommending this place to friends and family.
Nicole S.
Great service from start to finish. The communication and timeliness of our visit was outstanding. Highly recommend bringing your pet here!
Ron C.
This place is really good! Yesterday was my first time there. Here are some highlights: 1) Scheduling - I got in the same day, no waiting - the website let me choose an available appointment time, down to the half hour. 2) Modern and clean facility - I got a feline specific room with bird noises playing to help distract my new cat. The treatment area was open for me to see, not hidden behind a wall. 3) Very friendly and incredible attention to the customer - I just lost another cat of 16 years and dreaded having to go back to a vet. So much of this was made easier and painless because I wasn't waiting for hours. That's Rex, my newly adopted cat, in their cat room. The plant is not real, and just like the rest of the room, was made safe in case he was scared and ran.
Paige R.
I made an appointment for UrgentPaws but arrived 15 minutes early. I was helped right away and was brought into a private room. The environment was very calm and the whole staff was very knowledgeable and caring towards my dog. I was helped by an RVT named Jasmine who was kind, personable, and professional. While I hope my dogs will not need urgent care visits soon, I am so happy to be near such a wonderful clinic.
Danica V.
Christine was amazing and the doctor was amazing. Made me feel very comfortable and my baby Teddy highly recommend this place.
Jessica F.
This place was AMAZING! Everyone was so kind. Jasmine was the best!!!!!
Alexandria S.
Very nice facility, prompt evaluation, kind and personable staff. Happy to know such a wonderful urgent care is in our community with hours that accommodate many.