Author: Representative Director Yeo Jae-seung (Chief Representative Director of 24H UN animal medical center, Director of Pet Cardiac and Renal Center, Chief of Internal Medicine at 24H UN animal medical center)
This content has been prepared in compliance with relevant laws including the Medical Law.
Where Should Dogs That Keep Scratching Their Ears and Shaking Their Heads Be Seen in Busan?
Q. My dog keeps scratching its ears and shaking its head. Is it otitis externa?
A. Ear scratching and head shaking are the most common signals of otitis externa. However, since the cause varies—including bacteria, yeast, allergies, and parasites—repeating only self-treatment without accurate diagnosis can lead to chronicity or otitis media. If symptoms persist for more than two days, a visit to an animal hospital is recommended.
According to Virbac Animal Medicine Veterinary Materials, otitis externa causes inflammation and pain inside the dog's ears, and this discomfort is expressed through behaviors such as ear scratching, head shaking, and rubbing around the ears. In other words, because companion animals cannot verbally express pain themselves, these behavioral signals are virtually the only initial warning that guardians can detect.
The important point is that the causes of otitis externa are diverse—including bacteria, yeast (Malassezia), ear mites, and allergies. If the cause differs, the medications used also differ; therefore, confirming the cause through otoscopic ear canal evaluation and cytological smear microscopy examination is the starting point of treatment. If self-treatment is repeated without diagnosis, it can worsen into chronicity and otitis media. Since the course varies depending on each individual's condition, treatment prognosis should be discussed with a veterinarian after diagnosis.
What Is Canine Otitis Externa? Causes, Symptoms, and Progression Path at a Glance
Otitis externa is a very common skin and ear condition in dogs. According to Health Kyunghyang (k-health) Pet Health Story, unlike humans, the dog's ear canal has an L-shaped bend that impairs air circulation. Breeds with drooping ears or those with abundant hair in the ears (Poodles, Cocker Spaniels, etc.) are prone to accumulation of earwax and moisture, creating conditions vulnerable to otitis externa.
The table below summarizes the characteristics and diagnostic approaches by major causative types of otitis externa.
| Causal Type | Main Symptom Characteristics | Diagnostic Approach |
|---|---|---|
| Bacterial infection | Yellow or green discharge, severe odor | Cytological smear microscopy examination |
| Yeast (Malassezia) | Brown or black earwax, musty odor | Cytological smear microscopy examination |
| Ear mites | Black discharge, extreme itching, contagious potential | Otoscopic and microscopy examination |
| Allergy and atopy | Repeated recurrence, bilateral ear involvement often | Allergy testing + medical history |
| Foreign body or trauma | Sudden onset, unilateral ear concentration | Otoscopic ear canal confirmation |
According to Health Kyunghyang (k-health), representative symptoms of otitis externa include ear erythema, ear scratching, head shaking, unpleasant odor, and discharge. The treatment direction is determined after otoscopic ear canal confirmation and microscopic cytological examination to identify the causative agent.
If otitis externa is left untreated, clinical data shows it can progress to otitis media and otitis interna, leading to serious neurological symptoms such as facial paralysis, balance disorders, and hearing loss. In chronic cases, thickening and hardening of the ear skin (lichenification) or ear canal stenosis may occur. Once this stage is reached, management through medication alone may become difficult; therefore, early diagnosis and response are more important than ever.
How Does the 24H UN animal medical center Approach Otitis Externa?
Since its establishment in 2016, 24H UN animal medical center, which operates a 365-day, 24-hour interdepartmental consultation system based in Dae-yeon-dong, Nam-gu, Busan, first confirms the causative organism through otoscopic ear canal evaluation and cytological smear examination when patients present with ear symptoms, and then provides treatment guidance through internal medicine and dermatology collaboration.
As emphasized in the clinical principles of the Seoul National University College of Veterinary Medicine Animal Hospital Dermatology Department, precise evaluation of the ear canal and eardrum through digital otoscopy is the crucial first step in diagnosing otitis externa. Without this process, if medication is prescribed immediately, treatment may not match the cause.
— Treatment Step Flow
— Step 1. Precise Ear Canal Evaluation: Confirm the condition of the external ear canal and eardrum with otoscopy
— Step 2. Cytological Smear Examination: Identify the specific cause—bacteria, yeast (Malassezia), ear mites, etc.
— Step 3. Underlying Cause Screening: For recurrent cases, internal medicine consultation to determine whether allergies or endocrine diseases (thyroid, Cushing's, etc.) are concurrent
— Step 4. Customized Treatment Plan Establishment: Prescribe cause-specific medications (antibiotics, antifungals, steroids) and ear cleaning methods
— Step 5. Follow-up Management Consultation: Manage recurrence intervals and provide guidance on environmental improvements
As mentioned in Health Kyunghyang (k-health), underlying conditions such as atopy, food allergies, hypothyroidism, and Cushing's disease often hide as fundamental causes of recurrent otitis externa. The Seoul National University College of Veterinary Medicine Animal Hospital Dermatology Department also explicitly states that emphasizing diagnosis and treatment of atopic dermatitis and food allergies in chronic intractable otitis externa is key to preventing recurrence. If only ear surface inflammation is repeatedly treated while the underlying cause is neglected, recurrence may continue; therefore, cause tracking through internal medicine consultation is important. However, all treatment outcomes may vary depending on each individual's condition.
Things to Check Before the Procedure
If you check and record the following items in advance before your visit, it will help increase cause identification and diagnostic accuracy. According to Virbac Animal Medicine Veterinary Materials, otitis externa often develops due to multiple factors and has a high recurrence rate; therefore, accurate medical history information is the starting point of diagnosis.
| Item to Check | Check Points |
|---|---|
| Discharge color and odor | Yellow / Brown or black / Presence of odor |
| Scratching frequency and intensity | How many times per day? More severe at night? |
| Affected ear | One ear only / Both ears simultaneously |
| Onset time | Since when? After bathing? Related to seasonal changes? |
| Past ear disease history | Previous otitis externa treatment frequency and medications used |
| Dietary and environmental changes | Food change, changes in indoor environment |
| Concurrent skin symptoms | Presence of concurrent skin symptoms such as scratching, scaling, or hair loss |
— Visit immediately in these cases
According to Health Kyunghyang (k-health), in chronic cases, lichenification (thickening and hardening) of the ear skin or ear canal stenosis may occur, and in severely progressed cases, swelling may be so severe that the ear opening is invisible and assessment of conditions within the ear canal becomes difficult. At this stage, surgical intervention may be necessary; if such signs are observed, it is advisable to visit promptly without delay.
— Precautions when caring for ears at home
— Vigorously cleaning the inside of the ear with cotton swabs can irritate the ear canal or worsen infection and should be avoided.
— After bathing or swimming, it is important to keep the inside of the ears completely dry.
— Self-ear cleaning solutions should be used under veterinary guidance only after the cause has been confirmed.
— Guidance for Guardians Throughout Busan and Adjacent Areas
Guardians throughout Busan—including Nam-gu, Suyeong-gu, Haeundae-gu, Yeonje-gu, Busanjin-gu, Dongnae-gu, Geumjeong-gu, and Saha-gu—considering animal hospitals in Busan Nam-gu, those seeking dog ear treatment in Suyeong-gu, otitis externa animal hospitals in Haeundae, skin and ear animal hospitals in Yeonje-gu, and dog otitis externa treatment in Busanjin-gu, as well as those from nearby areas such as Yangsan, Gimhae, Changwon, and Ulsan can visit.
Frequently Asked Questions
Q1. How do you distinguish whether ear scratching is otitis externa or just itching?
The key to distinguishing simple itching from otitis externa signals is whether concurrent symptoms are present. If erythema and swelling around the ears, unpleasant odor, discharge (brown or yellow), and head shaking appear together with ear scratching, the possibility of otitis externa is high. If repeated scratching persists several times throughout the day, veterinary confirmation through otoscopic examination is recommended.
Q2. Why does otitis externa keep recurring?
If only ear surface inflammation is treated while the underlying cause is neglected, recurrence repeats. Often, internal medical conditions such as atopy, food allergies, hypothyroidism, and Cushing's disease act as fundamental causes of otitis externa. In recurrent otitis externa, it is important to confirm and manage underlying causes together through internal medicine consultation.
Q3. Is it okay to use ear cleaning solutions at home?
Ear cleaning helps reduce earwax and discharge and aids in management, but self-cleaning without confirming whether the cause is bacterial, yeast, or mite infection may only be a temporary measure. Since the cleaning method varies by cause, it is safer to use it under veterinary guidance after diagnosis.
Q4. How long does it take to treat canine otitis externa?
It varies by individual depending on cause and severity. In cases of early simple infection, improvement may occur with 1-2 weeks of medication, but in cases of chronicity or concurrent underlying disease, the treatment period may be longer. It is difficult to state a definitive timeframe; it is recommended to establish an individualized treatment plan through consultation with a veterinarian.
Book a Consultation Now — We Will Consult with You Step by Step from the Beginning
The 24H UN animal medical center will consult with you step by step from the beginning. Located in Dae-yeon-dong, Nam-gu, Busan, visits are available 365 days, 24 hours a day, including emergency and nighttime services on holidays.
While otitis externa is a common condition, if left untreated, it can progress to otitis media and otitis interna, leading to serious neurological symptoms such as facial paralysis and balance disorders. Health Kyunghyang (k-health) also mentions that chronic otitis externa can progress to a stage requiring surgical intervention such as lateral ear canal ablation if it worsens. Confirming and managing the cause early is ultimately a more manageable path.
If ear scratching and head shaking persist for more than two days, or if odor, discharge, or erythema are present, accurate veterinary diagnosis should come before self-judgment.
— Otoscopic ear canal evaluation → cytological smear cause confirmation → internal medicine consultation → customized treatment plan establishment—we will manage together while communicating sufficiently with the guardian.
📍 24H UN animal medical center
Nam-gu, Busan, Dae-yeon-dong | 365 days, 24 hours year-round | Emergency, nighttime, and holiday treatment available
This content has been prepared in compliance with Article 32 of the Veterinary Medicine Law. Please consult with a specialist for specific matters.