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Key takeaways


Head shaking is a common symptom in dogs with multiple underlying causes. Low grade, occasional head shaking is normal but excessive, persistent, or recurrent shaking requires veterinary attention.

  • Underlying diseases that result in head shaking vary, but irritation or itchiness of the ears is the primary cause
  • Triggers are categorized into disease of the inner, middle or outer ear, toxicity, and neurological causes
  • Investigation involves physical examination, including physical and microscopic examination of the ear canals
  • Diagnostic imaging involves X-rays or CT scans of the head and ear canals
  • Treatment options depend on the underlying cause but include topical or systemic medication including antibiotics, antifungals, and anti inflammatories
  • Some conditions have surgical treatment options such as ear polyps or tumors
  • Prognosis varies, most cases of head shaking involve an itchy underlying condition and respond well to treatment, but many triggers of head shaking are recurrent
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A closer look: Head Shaking in Dogs


Head shaking is a common symptom in dogs. Low grade, occasional shaking is a normal process in dogs and is not a cause for concern. Even cases where head shaking becomes persistent, recurrent, or severe are rarely emergencies. It is important to note recurring head shaking is often uncomfortable and benefits from prompt veterinary attention. Head shaking that is associated with other symptoms such as ataxia or seizures, or when associated with a traumatic incident, require urgent treatment.

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Possible causes


Head shaking has many possible underlying disease processes.

Ear problems make up a large percentage of cases of head shaking in dogs, and itchiness is one of the most common triggers.

Risk factors


Head shaking varies by severity, response to treatment, and prognosis.

Symptoms relating to itchiness such as ear infections or allergies usually result in mild to moderate head shaking. These causes normally respond well to treatment initially but often recur if the underlying cause is not addressed.

Foreign bodies in the ears often result in severe head shaking which resolves quickly once the foreign material is removed.

Some neurologic conditions may present with mild to moderate head shaking and may be difficult to resolve.

Testing and diagnosis


Investigation of head shaking involves:

  • Physical examination
  • Otoscopic examination of the ear canal (may require sedation)
  • Microscopic examination of the ear canal (ear cytology)
  • Neurological examination
  • Blood work
  • Diagnostic imaging

Treatment options depend on the underlying cause but may include:

  • Antibiotics
  • Antifungals
  • Anti-inflammatories
  • Surgical removal of tumors and polyps
  • Foreign body retrieval
  • Anti seizure medication
  • Management of head trauma cases

Similar symptoms


Head tremors or bobbing are different to head shaking but sometimes appear similar.

Associated symptoms


Other symptoms observed alongside head shaking depend on the underlying cause.

References


"Head Shaking in Dogs: When to Worry "
Jennifer Coates, DVM. - Writing for PetMD
"Idiopathic Head Tremors in Dogs "
Michele K. - Writing for Wag!
"Why is my dog shaking his head? "
No Author - Writing for FirstVet
Itchy ear problems
No Author - Writing for Cornell University College of Veterinary Medicine
DOG HEAD SHAKING: CAUSES AND WHAT TO DO
No Author - Writing for Southeast Veterinary Neurology
Disorders of the Outer Ear in Dogs
Sheila M. F. Torres , DVM, MS, PhD, DACVD - Writing for Merck Veterinary Manual
Hematoma of the Ear in Dogs
Krista Williams, BSc, DVM, CCRP; Ryan Llera, BSc, DVM; Ernest Ward, DVM - Writing for VCA Animal Hospitals

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