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Dog Ear Infections: Signs, Treatment and Prevention

Ear infections (otitis externa) are one of the most common conditions seen in UK vet practices. They are painful, often recurring, and can become chronic without proper management. Recognising the early signs and understanding the treatment options can prevent a straightforward infection from becoming a serious, expensive problem.

Signs of an Ear Infection in Dogs

The signs of an ear infection in dogs are usually quite obvious once you know what to look for. The most common signs include: head shaking — often the first thing owners notice; scratching at the ear or rubbing the head against furniture or the floor; redness and swelling of the ear canal (visible if you gently lift the ear flap); a dark brown, yellow, or black discharge inside the ear; an unpleasant smell — often described as musty, yeasty, or foul; and pain when the ear is touched, which may cause the dog to flinch or cry out.

In more severe or chronic cases, the ear canal may become thickened and narrowed, and the dog may hold its head tilted to one side (head tilt), have difficulty with balance, or show other neurological signs if the infection has progressed to the middle or inner ear (otitis media or interna). At this stage, the condition is significantly more difficult to treat and may cause permanent damage.

Early treatment is therefore important — the sooner an ear infection is identified and treated, the easier and cheaper it is to resolve.

Common Causes of Dog Ear Infections

Dog ear infections are almost always secondary to an underlying condition that creates an environment in which bacteria or yeasts can thrive. The most common predisposing factors are: allergies (atopic dermatitis or food allergy), which cause inflammation of the ear canal lining; excessive moisture in the ear canal — particularly in dogs that swim regularly or have heavy, pendulous ear flaps; foreign bodies such as grass seeds, which are a common cause of sudden-onset ear pain in summer in the UK; and ear mites (Otodectes cynotis), which are particularly common in puppies and cause intense itching.

The most common infectious agents are bacteria (most commonly Pseudomonas, Staphylococcus, and Proteus species) and yeast (Malassezia pachydermatis). Mixed infections are common. Some infections are driven primarily by one organism, while others involve both — which is why proper diagnosis with an ear swab and cytology is important before choosing treatment.

Breeds with pendulous ears (Cocker Spaniels, Basset Hounds, Labradors) and those with hairy ear canals (Poodles, Schnauzers) are particularly prone to ear infections due to reduced air circulation.

How Ear Infections Are Treated

Your vet will examine the ear with an otoscope to assess the extent of infection and check that the eardrum is intact — this is essential before placing any ear drops, as some preparations can damage the inner ear if the eardrum is perforated. A swab for cytology (microscopic examination) and sometimes culture will identify the organisms involved.

Treatment typically involves prescription ear drops containing a combination of antibiotic, antifungal, and anti-inflammatory agents. Commonly prescribed products include Osurnia, Surolan, and Mometamax. Treatment duration ranges from 7–14 days for uncomplicated cases. Your vet may also perform an initial ear flush under sedation or general anaesthesia if the canal is very inflamed or full of discharge.

For chronic or recurrent ear infections, your vet may recommend allergy testing, a food elimination trial, or regular maintenance ear cleaning to address the underlying cause. Without addressing the root cause, ear infections will continue to recur regardless of how many courses of ear drops are given.

Preventing Ear Infections

Prevention focuses on controlling the predisposing factors. For dogs that swim, dry the ears thoroughly after every swim — gently swab the external ear canal with cotton wool (never insert cotton buds into the canal). For breeds prone to hairy ear canals, regular hair removal by a groomer or vet nurse can improve air circulation.

Regular ear cleaning with a vet-recommended ear cleaner helps maintain a healthy ear environment. Your vet or nurse can demonstrate the correct technique — you should never poke anything into the ear canal, but you can gently fill the canal with cleaner, massage the base of the ear to loosen debris, then allow the dog to shake its head and wipe away what emerges at the entrance.

For dogs with underlying allergies, long-term allergy management is the most effective way to reduce ear infection frequency. This may involve dietary management, allergy testing, immunotherapy, or long-term prescription medication — all of which are worth discussing with your vet.

Understanding Ear Infection Treatment Costs

A standard consultation to assess an ear infection typically costs £40–£65. Ear cytology adds approximately £20–£40. Prescription ear drops typically cost £25–£50 for a course of treatment, and if sedation or general anaesthesia is needed for an ear flush, costs can reach £200–£400. Chronic ear disease requiring specialist referral to a veterinary dermatologist may generate costs of £300 or more for the initial consultation alone.

For dogs on long-term ear medications or allergy management medication (such as Apoquel), using a written prescription to purchase from an online pharmacy can significantly reduce monthly costs. Under the March 2026 CMA reforms, your vet must offer you a written prescription and cannot charge more than £21 for the first medicine.

Visit app.comparemyvet.uk to compare local vet practices and find those that publish transparent pricing. CompareMyVet currently covers Brighton & Hove and is expanding UK-wide.