Cat Shaking Head Repeatedly: Is It Ear Mites?

Your cat is shaking their head like they have water in their ears. They're scratching frantically at their neck or ears. Maybe you've noticed a funky smell.

Ear discomfort drives cats crazy. Because their ears are so sensitive—they use them for balance as well as hearing—any irritation feels like an emergency to them.

While everyone assumes "ear mites," there are actually three common culprits. Here's how to identify what's wrong and how to fix it.

The Big Three Causes

1. Ear Mites (Otodectes cynotis)

What they are: Microscopic spider-like parasites that live in the ear canal and feed on wax and skin oils.

Who gets them:

• Kittens (very common)
• Outdoor cats
• Cats in multi-pet households
• Rare in solitary indoor adult cats

The distinctive signs:

• "Coffee ground" debris: The ear is filled with dry, black, crumbly gunk. This is a mix of mite poop, blood, and wax.
• Intense itching: The cat scratches until they bleed.
• Contagious: If one pet has them, they all do.

2. Bacterial or Yeast Infection (Otitis Externa)

What it is: An overgrowth of yeast or bacteria in the moist, warm environment of the ear.

Who gets them:

• Cats with allergies (food or environmental)
• Cats with polyps
• Cats with small/floppy ears
• Any age (common in adults)

The distinctive signs:

• Odor: Smells like sourdough bread, old cheese, or dirty socks.
• Discharge: Moist, yellow, brown, or black gunk (yuckier and wetter than mite debris).
• Redness: The ear flap looks angry and inflamed.

3. Nasopharyngeal Polyps

What they are: Benign growths that originate in the middle ear or throat. They can grow into the ear canal.

Who gets them:

• Young cats (under 2 years) most commonly
• Can happen at any age

The distinctive signs:

• Head tilt: Cat holds head rotated to one side.
• Unbalance: Walking drunk or stumbling (vestibular signs).
• No response to regular meds: You treat for mites/infection, but it comes right back.
• Noisy breathing: If the polyp extends into the throat.

How to Check Your Cat's Ears

You need to look inside to know what's going on.

1. Wait for a calm moment: Don't try this when the cat is zooming.
2. Gently fold back the ear flap: Expose the canal opening.
3. Use a flashlight: Phone light works well.
4. Look for:
   • Pink and clean: Healthy.
   • Black crumbles: Likely mites.
   • Yellow/brown goo: Likely yeast/bacteria.
   • Redness/swelling: Inflammation.
   • Blood/scabs: Self-trauma from scratching.

Warning: If the ear is extremely painful (cat cries or fights), stop. You risk getting bitten, and the cat needs sedation for an exam.

Identifying Ear Mites vs. Ear Wax

Ear mites produce very specific debris.

Mites look like: Dark, dry coffee grounds. If you take a chunk out and put it on a dark paper under a bright light, you might actually see tiny white dots moving. Those are the mites.

Normal wax looks like: Pale yellow or light brown, usually minimal.

Dirty ears vs. Mites:

• "Just dirty" is rare in cats (they are self-cleaning).
• If there is SIGNIFICANT debris, it is almost always mites or infection.

Treatment Options

Treating Ear Mites

The Old Way: Oily drops used daily for weeks to smother the mites. Cats hated this.

The Modern Way (Better):

• Revolution / Bravecto / Advantage Multi: These are spot-on treatments (applied to the back of the neck) that kill ear mites systemically.
• One dose: Usually clears the infection completely.
• Bonus: Kills fleas too.

Cleaning: You still need to gently clean the dead mites out of the ear (see below).

Treating Infections (Yeast/Bacteria)

Requires medication prescribed by a vet.

• Tresaderm: Drops kept in the fridge; contains antibiotic, antifungal, and steroid (for itch).
• Mometamax: One-time lubricant packed into the ear by the vet (lasts 2 weeks).

Important: You cannot treat infection with over-the-counter mite drops. It won't work and may start stinging.

Treating Polyps

This requires surgery. The polyp must be plucked or surgically removed from the ear or throat.

How to Clean Dirty Cat Ears

If you are treating mites or infection, you need to remove the gunk so the medicine can reach the skin.

The Tools:

• Cotton balls (NOT Q-tips)
• Vet-approved ear cleaner (Epi-Otic, TrizULTRA, etc.)
• Towel

The Steps:

1. Wrap the cat (Burrito method).
2. Flood the ear: Squeeze liquid cleaner into the canal. Don't be shy.
3. Massage: Rub the base of the ear (below the opening) for 20-30 seconds. You want to hear a squishing sound. This breaks up the debris.
4. Let them shake: The cat will shake its head, flinging debris out. (Do this in a bathroom).
5. Wipe: Use the cotton ball to wipe out the visible gunk.
6. Repeat: Until clean.

The "No Hydrogen Peroxide" Rule: Never use hydrogen peroxide. It bubbles, which feels terrifying to a cat, and it damages delicate ear tissue. In an inflamed ear, it hurts.

Complications: Hematomas

If a cat shakes its head too violently, the blood vessels in the ear flap can burst, filling the ear flap with blood. It puffs up like a water balloon. This is an Aural Hematoma.

• Requires surgery: To drain and stitch the ear flat.
• Cauliflower ear: If left untreated, it scars down into a crinkled "cauliflower ear."

Preventing hematomas: Treat the itch EARLY so they stop shaking their head!

When to See a Vet

Go to the vet if:

• The cat is tilting its head (dizzy/balance issues).
• The ear is red, hot, or swollen.
• There is a bad smell.
• You see blood or pus.
• Over-the-counter cleaning hasn't worked after 2-3 days.

Prevention

For mites: Keep all pets on monthly flea prevention (Revolution/Bravecto) that also kills mites. This is the 100% cure for mites.

For yeast: Manage underlying allergies. If your cat gets recurring ear infections, they likely have a food allergy (chicken/beef) or environmental allergy.

Routine checks: Peek in your cat's ears once a week. Catching "coffee grounds" early prevents a massive infestation.

The Bottom Line

Head shaking means itch. And itch means something is living in or growing in that ear.

• Black crumbs = Mites (Use Revolution)
• Smelly goo = Yeast/Bacteria (Need Vet Drops)
• Head tilt = Deep inner ear issue (Need Vet ASAP)

Don't ignore it. An itching ear is torture for a cat, and treating it gives them instant relief.

Related: Cleaning Cat Ears Step-by-Step Related: Hidden Signs of Stress in Cats