“My Senior Dog Keeps Shaking Their Head”: what it could mean and what to do

Watching a senior dog repeatedly shake their head can feel alarming, especially when it comes out of nowhere or starts happening daily. Sometimes it is something minor, like a bit of water trapped after a bath. Other times it is a clue that your dog is uncomfortable, in pain, or dealing with a problem deeper in the ear or nervous system.

Because head shaking is a symptom and not a diagnosis, the safest approach is to treat it like a useful signal: notice the pattern, look for other clues, and involve your veterinarian early, especially for older dogs who may have more than one issue happening at the same time.

This article is for education, not diagnosis. Always check with your dog’s veterinarian, particularly before putting anything in the ear or giving any medication.

What “head shaking” usually means in dogs

Most of the time, frequent head shaking is a response to irritation, itchiness, or pain in or around the ear canal. Ear inflammation and infection (often grouped under “otitis externa”) are very common and classically show up as head shaking and ear scratching.

That said, not all head movement is ear related. Some dogs have tremors or neurological episodes that look like “shaking,” and some balance disorders include a head tilt or disorientation that owners may describe as “head shaking.”

A helpful first step is to ask: does my dog look like they are trying to clear or relieve an ear, or does the movement look more like an involuntary tremor?

The most common causes in senior dogs

Ear infection or ear inflammation (otitis externa)

This is the big one. Ear infections and inflammatory ear disease often cause head shaking, scratching, odor, redness, and discharge.

In senior dogs, ear issues can become more frequent when there is an underlying driver such as allergies, chronic moisture, changes in skin health, or anatomy that traps debris and humidity (for example, some floppy-eared dogs). The ear canal can also become thickened over time with chronic inflammation, which can make problems more stubborn.

Why it matters: untreated ear inflammation can be intensely painful, and recurring disease is common without identifying the underlying cause. Veterinary manuals emphasize that diagnosis depends on examining the ear and often using otoscopy and cytology to see what is actually present in the canal.

Allergies (environmental or food related)

Allergies can make the ears itchy and inflamed, setting the stage for infections or yeast and bacterial overgrowth. Industry and veterinary references commonly list allergies as a frequent underlying cause of otitis externa.

Where evidence can be limited: the exact “main cause” can vary widely by dog, region, and study population. In real life, allergies often act as a long-term contributor rather than a single, simple trigger.

Foreign material in the ear (grass seed, foxtail, burr, tick)

A stuck piece of plant material can cause sudden, persistent head shaking and discomfort. This is especially likely after yard time, hikes, or romps through tall grass. Pet health references highlight grass seeds, burrs, and foxtails as common foreign bodies that can lodge in the ear.

Why it matters: some foreign bodies can migrate and cause infection or tissue damage if not removed properly.

Ear mites (less common in many adult dogs, but possible)

Ear mites are more common in puppies and in multi-pet environments, but they can occur in adult and senior dogs too, especially with exposure to infected animals. Head shaking plus intense itchiness and dark debris can fit this picture. Because the presentation can overlap with yeast or bacterial infections, confirmation by your veterinarian is important.

Aural hematoma (a swollen “puffy” ear flap after vigorous shaking)

If your dog’s ear flap suddenly looks swollen, thick, or fluid-filled, head shaking may have ruptured a blood vessel in the ear flap. VCA notes that most dogs with aural hematomas have an underlying ear problem (infection, allergy, irritation) that led to repeated scratching and head shaking.

Aural hematomas are painful and usually need veterinary treatment, not watchful waiting.

Causes that are more common or more serious in older dogs

Vestibular disease (balance system problems)

Vestibular disorders can cause head tilt, loss of balance, nausea, odd eye movements (nystagmus), and disorientation. In older dogs, idiopathic vestibular syndrome is well recognized, and resources describe it as appearing most commonly in senior dogs.

Owners sometimes describe vestibular episodes as “shaking,” but the giveaway is usually the balance component: stumbling, leaning, falling, circling, or a dramatic head tilt.

When research is limited: “old dog vestibular disease” is a syndrome label, not a single cause. In many cases the cause remains unknown, and guidance is based on clinical patterns and ruling out more serious disease, not on one definitive test that explains every case.

Pain outside the ear (dental disease, neck pain, skin disease)

Senior dogs commonly develop dental disease and arthritis. Pain around the jaw, neck, or skin near the ear can make a dog shake their head or rub their face. These cases are easy to miss because the ears may look “fine” at first glance.

This is one reason vets often do a full physical exam even when the complaint sounds ear-specific.

Neurological tremors or episodic head movements

Not all head movement is an ear problem. Idiopathic head tremor syndrome is described by specialists as a benign condition of unknown cause that results in focal head tremors.

However, in a senior dog, new tremors also raise a bigger question: is this truly a benign syndrome, or is there something else going on (metabolic disease, toxin exposure, brain disease, or seizures)? A veterinarian, and sometimes a veterinary neurologist, is the right next step if the movement looks involuntary rather than scratch-and-relieve.

Where evidence is limited: idiopathic head tremor syndrome is still “idiopathic,” meaning the cause is not known, and much of what we know comes from clinical observation and retrospective reports rather than controlled trials.

What you can check at home safely (and what to avoid)

Here is a practical, low-risk way to gather clues without making the situation worse.

What to do now

• Note the pattern. Is it after eating, after walks, after waking up, after grooming, or random?
• Look, do not probe. Gently lift the ear flap and look for redness, swelling, discharge, crusting, or a strong odor. Compare both ears.
• Observe your dog’s body language. Flinching, whining, pulling away, or guarding the ear suggests pain.
• Check for balance signs. Stumbling, head tilt, vomiting, rapid eye flicking, or sudden disorientation can point toward vestibular disease and needs prompt veterinary guidance.
• Take a short video. This is incredibly helpful for your veterinarian, especially if episodes are brief or happen at night.

What not to do

• Do not insert cotton swabs or tools into the ear canal. You can push debris deeper or injure the ear.
• Avoid home “recipes” (vinegar, peroxide, oils) unless your veterinarian specifically recommends something for your dog’s confirmed diagnosis. When the ear canal is inflamed or the eardrum status is unknown, the wrong substance can worsen pain or complications.
• Do not use leftover ear medications from another pet or an old infection. Ear problems can look similar but require different treatments based on what is seen on exam and cytology.

When to call the vet urgently

Call your veterinarian the same day, or seek urgent care, if you notice:

• A swollen, puffy ear flap (possible aural hematoma)
• Severe pain, crying, or your dog will not let you touch near the ear
• Head tilt, loss of balance, vomiting, or rapid eye movements
• Bleeding from the ear, a bad smell with thick discharge, or visible foreign material
• Sudden onset after a walk in tall grass, especially with nonstop shaking (possible foxtail or seed)
• Any new or rapidly worsening neurological signs (confusion, collapse, weakness)

For senior dogs, it is worth being conservative. Older dogs have less “buffer” when something painful or destabilizing is happening, and prompt treatment can prevent complications.

What your veterinarian may do (so you know what to expect)

A good ear and head-shaking workup often includes:

• Full exam of both ears, including otoscopy (looking down the ear canal)
• Cytology (examining ear debris under a microscope) to check for yeast, bacteria, and inflammation
• Discussion of underlying causes such as allergies, moisture, or anatomy
• If a vestibular problem is suspected, a neurological exam and, if needed, referral or advanced imaging depending on severity and progression

Treatment varies a lot depending on the cause: cleaning protocols, topical medications, systemic medications, foreign body removal, allergy management, or hematoma treatment.

Prevention and “making it less likely to come back”

You cannot prevent every case, but you can lower the odds of repeat flare-ups:

• Keep ears dry after bathing or swimming if your veterinarian agrees your dog is prone to ear issues.
• Ask your vet whether routine ear cleaning is appropriate for your dog. Over-cleaning can irritate some dogs, while targeted cleaning helps others.
• Manage underlying allergies if they are part of your dog’s pattern. Recurring otitis often does not fully resolve long-term without addressing the driver.
• For dogs who romp in tall grass, do quick post-walk checks and consider avoiding foxtail-heavy areas in season.

Bottom line

Head shaking in a senior dog is often an ear problem, but not always. The safest approach is to treat it as a meaningful symptom, look for accompanying clues, avoid risky home interventions, and involve your veterinarian early.

If your dog seems painful, off-balance, or the ear flap is swelling, treat it as urgent. And regardless of what you suspect, always check with your dog’s veterinarian for an accurate diagnosis and a treatment plan tailored to your dog’s age, history, and overall health.

Sources

• Merck Veterinary Manual, “Ear Infections and Otitis Externa in Dogs.” (Merck Veterinary Manual)
• MSD Veterinary Manual, “Otitis Externa in Animals” and “Ear Infections and Otitis Externa in Dogs.” (MSD Veterinary Manual)
• VCA Animal Hospitals, “Ear Infections in Dogs (Otitis Externa)” and “Vestibular Disease in Dogs” and “Hematoma of the Ear in Dogs.” (Vca)
• American Kennel Club (AKC), “Dog Ear Infections: Symptoms, Causes, Treatment, and Prevention” and “Vestibular disease in dogs.” (American Kennel Club)
• PetMD, “Signs of Ear Infections in Dogs” and “Foreign Bodies in Dog Ears.” (PetMD)
• MSPCA-Angell, “Ear Scratching, Head Shaking, and Ear Discharge: Does Your Dog Have Otitis?” and “Idiopathic Head Tremor Syndrome” and “Approach to Vestibular Syndrome in Old Dogs.” (MSPCA-Angell)
• UC Davis School of Veterinary Medicine, “Foxtails and Dogs.” (healthtopics.vetmed.ucdavis.edu)
• Veterinary Partner (VIN), “Aural Hematoma” and “Tremoring or Shivering in Dogs” and “Vestibular Disease in Dogs and Cats.” (Veterinary Partner)