Updated October 31, 2026. Fact-checked against veterinary sources; review by a licensed veterinarian is in progress. See our editorial policy.
If a puppy keeps shaking their head or scratching an ear, don’t assume it’s “just ear mites.” Mites are one possibility, especially after contact with affected animals, but inflamed ears can also reflect yeast, bacteria, allergies, trapped debris or an injury. The treatments differ, which is why a veterinarian should look into the ear before drops are used.
How ear mites and infections can look
Ear mites often cause intense itching and dark debris, sometimes described as looking like coffee grounds. They’re contagious between pets and are especially familiar in cats, though dogs can be affected too. An inflamed ear canal may also produce dark discharge without mites, so the appearance alone doesn’t confirm the diagnosis.
Otitis externa, or inflammation of the outer ear canal, can cause redness, odor, soreness, head shaking and discharge. Yeast or bacterial overgrowth may be present, but an underlying problem such as allergies or moisture exposure may be keeping the inflammation going.
How the veterinarian finds the cause
The examination usually includes looking into the canal with an otoscope and checking a sample of debris under the microscope. This helps identify mites, yeast and bacteria. In a very painful ear, your veterinarian may need to control discomfort before a complete examination. They also check whether the eardrum is intact, because certain cleaners and medications shouldn’t be used if it’s damaged.
When is it urgent?
Arrange a prompt examination if your puppy has head shaking, discharge, odor or a painful ear. Seek urgent care for a head tilt, loss of balance, marked swelling, severe pain or sudden neurological signs. These can indicate a deeper ear problem and should not be treated at home.
Safe care until the appointment
Keep the ear dry and don’t push cotton swabs into the canal. Avoid vinegar, peroxide, essential oils and leftover drops. If your veterinarian recommends a cleaner, ask for a demonstration and a frequency appropriate for your puppy. Treatment may involve a parasite medication or prescribed ear therapy, depending on the actual findings.
Read more about veterinary treatment of ear infections. If other household pets are scratching, tell your veterinarian because mite control may involve more than one animal.
Veterinary references
This article is for general education and is not a substitute for care from your own veterinarian. Learn about The Pet Vet and our editorial policy.