With my cat Java’s recent visit to the Vet, I’ve had to research why a cat might be shaking their head and scratching their ears. Cats don’t do this normally, so it was a sign that something was incredibly irritating.

According to the vet, head shaking and ear scratching can be signs of a variety of medical conditions that range from minor to serious. Thankfully Java only had a minor ear infection.
However, this got me looking into ALL of the other things it could have been and how to be prepared for the next time she shows signs of displeasure. You can read all of my findings below, but long story short – check their ears for issues, take them to the vet, and get that head-shaking figured out for your cat’s sake!
Five Common Reasons Your Cat Is Shaking Their Head and Scratching Their Ears
Since cats can’t speak there are very few ways for them to communicate that something is wrong with their ears. The most common signs of ear irritation – head shaking and ear scratching – could be caused by a few different things, but of all the causes ear infections are the most common.
Ear Infections
Cats can get an ear infection for plenty of reasons, such as water getting trapped in their ears or an excessive buildup of wax or dirt. Much like human ear infections, if you’re not cleaning their ears EVENTUALLY ear infections will happen. If your cat’s been shaking their head, the first thing you should do is use a flashlight to examine the inside of their ears. Ear infections can cause your cat’s ears to become red and inflamed, as well as produce a dark, waxy discharge. If you see this, that only confirms your cat has an issue in their ears and needs to see a vet.
Outer Ear Infections
Outer ear infections can involve bacteria and/or yeast, but could also be a result of an ear mite infestation. I’ll talk about ear mites later, but the symptoms of all three look extremely similar. They can all cause your cat to persistently shake their head and scratch at the infected area to relieve their discomfort. To determine what exactly is plaguing your cat, your vet will give them an ear cytology test, which is an examination of the discharge from their ear under a microscope. They use a cotton swab to collect some of the black stuff, roll it onto a microscope slide, and then look for signs of mites, bacteria, and yeast. Once they’ve determined which specific infection your cat is dealing with, your vet will clean out their ears, examine them for any damage, and then prescribe an ear cleanser and topical medicine to help clear it up. They may also prescribe them with antibiotics, pain relievers, and/or anti-inflammatories, depending on the severity of your cat’s ear infection and her ear’s specific needs.
Middle and Inner Ear Infections
If an outer ear infection progresses deep enough into the cat’s ear, the middle and inner portions can also become infected. This can also be caused by bacteria spread through a cat’s bloodstream or Eustachian tube, which is just the tube that connects the back of a cat’s nose to their middle ear (we have one too).

These infections in cats can be extremely uncomfortable, and there are a number of signs your cat could be showing that indicate they have one:
- Head shaking
- Ear scratching
- Head tilting
- Diminished appetite
- Lethargy
- Drooping of the face
- Eye squinting
- Raised third eyelids
- Unequal pupil sizes
- Abnormal eye movements
- Difficulty walking
- Poor hearing
Middle and inner ear infections are more severe than an outer infection, so if you see any of these symptoms it’s critical that you take your cat to the vet ASAP. Beyond the ear cytology, your vet may have to perform additional diagnostic tests, such as CT scans, MRIs, and/or X-rays. This is when it pays to have pet insurance, as all of these tests can add up to several thousands of dollars. A CT scan alone can cost upwards of $2000 when factoring in the consultation, anesthesia, scan itself, and follow up.
Ear Mites
Ear mites are another common reason your cat could be shaking her head and scratching her ears. These are little bugs that get all up in cat ears and annoy the hell out of them. Although they’re most common in kittens, they are highly contagious among cats of all ages, so adult cats definitely can get them too. If you’re using a parasiticide like Revolution, your cat likely doesn’t have these guys and it’s probably a different ear problem. BUT if you’re not, and you have an outdoor cat or kittens, there’s a good chance your cat has ear mites.
The symptoms are very similar to ear infections, including head shaking, ear scratching, dark wax/discharge that looks like coffee grounds. You may be able to diagnose it yourself by examining the black discharge for small, white moving specks. However, it’s still recommended you take your feline to the vet since they’ll be able to prescribe more effective treatment than you could get over-the-counter. They’ll also confirm the diagnosis with an ear cytology exam, and can let you know if there are any other problems going on. Imagine if you treated your cat for ear mites only to realize she also had a bacterial ear infection (tsk tsk).
Polyps
Polyps are benign (non-cancerous) growths that can develop inside your cat’s outer or middle ear. Though not malignant, because they continue to grow they can cause significant discomfort. If they eventually extend into the eustachian tube, they can even impact your cat’s breathing. The ear blockage can also lead to a buildup of bacteria and result in ear infections, tacking onto your cat’s ear problem.

Like most ear problems, your best course of action is to get your cat to the vet. Unless it’s visible from the outer ear, they’ll likely have to do some x-rays to diagnose the polyp. If they do have a polyp, the only effective treatment is surgical removal.
Insect Bites
Just because you keep your cat indoors it doesn’t mean they’re safe from insect bites. Cats are natural-born predators, so all it takes is one mishap with a spider or scorpion for them to be scratching at a bite or sting on their head. Much like humans, an insect bite usually is just a small localized reaction that shows up as swelling, inflammation, and/or itching at the site of the bite. In less common instances, your pet could have an allergic response which would require you to see a vet ASAP.
Allergies
Just like humans, cats can develop allergies to all sorts of things and usually result in scratching and irritation. If your cat is scratching at their head and ears and shaking their head, but there’s no obvious cause or signs of ear infection, it could be allergies. The allergy could be from contact with a certain species of plant, a reaction to an insect bite, certain foods, or even chemicals as seemingly benign as the laundry detergent you use.
A vet will be able to help you confirm that it is in fact allergies or some other issue. In the event it is allergies, your vet may try a number of things to identify the specific allergen that’s affecting your cat. For example, if they think your cat may be allergic to a certain kind of food, they may suggest a hypoallergenic or elimination diet. They may also recommend skin and/or blood tests to help identify other kinds of allergens. Apparently, cat allergies are tricky to identify because there is such a huge variety of triggers. Try to be patient with your vet, since cat allergies can take months to diagnose.
Once the allergen trigger is identified, you should do your best to adjust you and your cat’s lifestyle to eliminate the allergen. The change will certainly be worth it so that your cat can live a more comfortable lifestyle.
Head Shaking Vs. Head Tremors – An Important Distinction
It’s important to know the difference between a head shake and a head tremor. A head shake is when your cat shakes their head on purpose whereas, a head tremor is when they develop a shake that they can’t control. Head tremors can be a symptom of much more severe issues, such as neurological diseases or infections, infections of the nervous system, spinal cord damage, or metabolic imbalances. Given the severity, any sign of head tremors should warrant an emergency visit to your vet. You can expect them to do some more extensive imaging on top of standard testing, such as a CT scan, MRI scan, X-rays, and/or ultrasounds. Again, this is when pet insurance comes in handy because all of these tests can be pretty damn expensive!
How do you find out what is causing your cat’s head shaking?
Among other less likely causes, any of the reasons above could be the cause for your cat shaking their head and scratching their ears. Sure ear infections are the most common culprit, but even if that turned out to be the case, over the counter ear drops may not be effective at targeting the specific bacterial or yeast infection your cat has, and could even make things worse depending on how deep the infection goes.

Cats can develop other problems that affect their ears and cause head shaking too, such as inflammatory disorders, immune-mediated conditions, and even tumors, so it is so not worth trying to diagnose your cat yourself. I’d recommend getting your cat checked out by a vet if they display any of the symptoms I mentioned above. Also, try to keep track of all the different symptoms your cat has and how long she has had them, as this could help your vet make a faster and more accurate diagnosis.
Has Your Cat Had Ear Problems? What Was It and How Was She Treated?
- Have you ever taken your cat to the vet because of excessive head shaking or ear scratching?
- Has your cat ever had an ear infection? How did the vet treat it?
- Are your kitty’s ears bothering them and you’re wondering why?
These suggestions and my advice are based on personal experience, extensive research and secondhand accounts, but I am by no means a professional cat expert or licensed in any way. I would love to hear if you have any opinions on cat ear problems, and I’m sure other cat parents would appreciate learning from your experience as well, in the comments below!
Leave a Reply