Why Are My Dog’s Ears Red & Hot? The Most Common Diagnosis

Dog ear infections are rarely caused by viruses as we see in humans. And contrary to what internet pundits tell you, swimming and bathing are not likely to cause ear infections unless a dog has underlying allergies. 

When your dog’s ears are red and hot, it’s important to understand that ear infection or inflammation is not the primary disease itself. Instead, it often indicates an underlying issue that requires attention.

Numerous factors can contribute to the redness and warmth in your dog’s ears, including:

Environmental allergies 

The most common cause of allergies in dogs is pollen from plants. Other environmental allergens that occasionally affect dogs include dust mites, wool and even dander from other animals.

Most dogs with environmental allergies have other symptoms such as excessive foot licking, reverse sneeze and eye discharge. 

Food allergy/sensitivity

Food allergies are much less common than pollen allergies in dogs. But some dogs seem to have more skin problems when they eat certain proteins in spite of not truly having a food allergy per se.  

Parasites

Parasites are more common in dogs who spend a lot of time outdoors and/or socializing with other animals. Ear mites cause tremendous itchiness and inflammation in the ear canal and may lead to secondary bacterial infection.

Foreign objects 

We occasionally find surprises deep in a dog’s ear canal in the form of foreign objects. Grass seeds or “fox tails” are probably the most common object found in dog’s ears. They cause irritation, inflammation and secondary infection if not promptly removed.

Hypothyroidism

Hypothyroidism is a common disease in dogs that occurs when the thyroid gland can’t produce enough hormones to regulate metabolism. One of the most common symptoms of hypothyroidism is skin disease. You might see chronic ear problems, hair loss and abnormally dry skin.

Other Causes

Dogs’ ears have a lot of blood vessels and help cool the body. If a dog is overheated or has a fever you might notice their ears are especially hot and even flushed in color. These dogs will usually show other symptoms that can clue you in to these causes. 

How do allergies cause ear infections in dogs?

It’s normal for dogs to have a small number of yeast and bacteria in their ears. But when their allergies flare up, the ear skin becomes inflamed and moist. 

Changes in pH, increased wax production and decreased airflow allow microorganisms to overgrow. These secondary bacterial and yeast infections make the inflammation even worse. 

Symptoms

While ear infections are not always obvious, there are some signs that your dog might have an ear problem.

If your dog has any of these symptoms, it is important to seek veterinary care as soon as possible. Ear infections can be painful and uncomfortable for your dog and can lead to more serious problems if left untreated.

Behavioral

• Dog is shaking their head a lot
• Head is tilted to one side
• Sound of liquid in the ear canal when the ear is scratched
• Dog avoids having ears touched
• Scratching the ear or side of the face with the foot
• Dog licks paw after scratching his ear
• Increased licking/sniffing of the ear from other dogs 
• Dog rubs face on furniture or the ground
• Ear drooping on one side

Physical

• Ear is warm or hot and red or dark pink
• Red bumps or scabs on the inside of the ear flap
• Crusty debris in the ear canal
• Red spot on the inside of the ear flap where it ear folds in floppy-eared dogs
• Increased ear discharge and wax (brown, gold or greenish)
• Noticeable odor from the ear canal

Should my dog see a veterinarian about an ear problem?

Consulting a veterinarian is the fastest, most effective way to help your dog recover from an ear problem. However, some cases require more immediate attention than others. 

• Observe and monitor: your dog’s ears are pink inside but the dog has no other symptoms, you can simply monitor the situation and take action if things worsen.
• Make an appointment soon: the dog has multiple symptoms such as redness, heat, discharge and itchiness. Make an appointment to see your vet within the next day or two. 
• Seek veterinary care immediately: your dog’s ear is red and hot, they’re constantly shaking or pawing the ear, whining and acting in distress. Seek emergency care. While an inflamed ear is rarely fatal, it can cause so much pain a dog might injure themself trying to find relief. 

Diagnosis

It’s easy to identify that a dog has ear inflammation. But it’s also important to identify secondary infections as well as the underlying cause. 

• Physical exam: Your vet will examine the ear, looking for parasites, swelling, tumors and foreign objects. They’ll also check to see if the eardrum is normal since it can rupture in severe cases.   
• Cytology: Secondary infections are identified with a microscopic examination of ear debris. In some cases, a bacterial culture is needed if your vet suspects an unusual organism is present. 
• Other tests: Dogs with chronic, recurring ear infections can have allergy testing and desensitization treatment. These dogs may also need a blood test to check for hypothyroidism or a food allergy trial.

Treatment for dogs with ear infections

The main goals of treating otitis externa in dogs are to remove debris, quell inflammation, decrease excessive wax production and eliminate secondary infections. 

Basic ear treatments usually include ear cleaners and medicated ear drops. Some dogs also benefit from systemic anti-allergy treatments such as Apoquel® and Cytopoint®.

Ear cleaners

Ear cleaners are liquids designed to flush debris out of an infected ear. Many cleaners also contain salicylic acid, which has a mild antimicrobial effect. Additional ingredients may include substances to break up wax, antibacterial agents, acidifiers, and antifungals.

Some common brands of veterinary ear cleaners are EpiOtic® and Duoxo Micellar®. I’ve also used the ear cleaner made by Zymox® and seen successful outcomes in milder cases.

Topical ear medication

There are many topical ear medications for dogs and most contain multiple drugs to treat inflammation and infection. Prescription products vets commonly use include Otomax®, Mometamax®, Posatex®, and Claro®. 

Short-term home remedies

For mild ear inflammation, there are some home remedies that can help alleviate discomfort until you can seek more specific help from a veterinarian.

Clean out debris

1. EpiOtic Advanced® ear flush. You must flood the ear canal for the best results. Lift the flap of the dog’s ear and direct the nozzle down toward the canal opening. Squeeze the bottle until you see liquid almost overflowing from the ear canal. Massage the base of the ear for a few seconds. Wipe out the excess with soft cotton. Do not use swabs or wipe vigorously. Stop if you see blood as it indicates excessive skin irritation.
2. Saline Solution. If you can’t get EpiOtic, you can use sterile saline solution over the counter from a pharmacy. Don’t use contact lens solutions or solutions with any additives! Apply according to the directions for EpiOtic.

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Soothing topicals

1. Zymox Otic® Ear Solutions. Zymox Otic contains enzymes with an antimicrobial effect. They offer a cleaning solution and a therapeutic ear drop. Follow the directions on the label. 
2. Coconut Oil. Topical coconut oil is moisturizing and soothing. It also has mild antimicrobial properties. It can help dissolve the greasy excess wax in an infected ear. Place 4-6 drops into the ear canal. Massage the base of the ear and blot the excess oil gently with soft cotton.

These remedies are meant for short-term use and should not be considered as a targeted treatment. Consult with a veterinarian for proper diagnosis and guidance in treating your dog’s ear issues.

Prevention and maintenance

Most of the suggestions below are affordable and don’t require a prescription. They are beneficial for dogs with mild ear infections to prevent future flare-ups.

Identify allergens and desensitize

Identify and avoid the triggers that cause your dog’s ear inflammation. Allergy testing by a veterinary dermatologist can determine the specific allergens affecting your dog. Allergy desensitization therapy is available in the form of home injections or oral drops.

Check for food allergies

Your veterinarian can prescribe a hypoallergenic diet to help in the case of food allergies. A food allergy trial involves feeding only the hypoallergenic diet for a period of a few months to see if the symptoms improve. 

Limit exposure to allergens

Helping your dog avoid exposure to allergens can go a long way toward improving their ear health.  Minimize outdoor activities during high pollen times and use frequent bathing to remove dust and pollen from their body. 

Keep windows and doors closed during allergy season and use a HEPA air filter to remove dust and pollen in your home. Wash your dog’s bedding at least once a week.