As a veterinarian with a focus on feline dermatology and internal medicine, one of the most frequent questions pet owners ask me is: “Why is my cat scratching its ears so much lately?” Occasional scratching is normal grooming behavior—but constant ear scratching, shaking of the head, or rubbing against walls or furniture often indicates an underlying medical problem.

Understanding Why Cats Scratch Their Ears

Cat ear scratching (also known as pruritus auris) is a symptom rather than a disease. It can result from irritation, infection, allergies, or infestations within the ear canal or surrounding skin. The intensity and duration of scratching provide important clinical clues. Mild, occasional scratching may stem from mild debris, while persistent or aggressive scratching may indicate pain, infection, or severe inflammation.

If untreated, excessive scratching can cause wounds, secondary infections, or even ear hematomas (blood-filled swellings of the ear flap).

Common Causes of Ear Scratching in Cats

1. Ear Mites (Otodectes cynotis)

Ear mites are microscopic parasites that feed on wax and oils in the ear canal. They are the leading cause of ear scratching in cats worldwide, particularly in kittens or outdoor cats.

Symptoms:

• Intense itching and scratching
• Head shaking or rubbing ears against surfaces
• Dark, crumbly debris resembling coffee grounds inside the ear
• Scabs or hair loss around the ears

Ear mites are highly contagious between cats (and sometimes dogs), so checking all pets in the household is essential.

2. Bacterial or Yeast Ear Infections (Otitis Externa)

Chronic scratching is frequently due to ear infections caused by bacteria or yeasts like Malassezia pachydermatis. These organisms thrive in moist, inflamed environments and often occur secondary to allergies or wax buildup.

Symptoms:

• Red, inflamed, or swollen ear canals
• Moderate-to-intense scratching and shaking
• Yellow-brown or waxy discharge
• Foul odor from the ears

3. Allergies (Food or Environmental)

Allergies are among the most common underlying causes of chronic ear disease in cats. Exposure to allergens—such as dust mites, pollen, or ingredients in cat food—can trigger inflammation of the ear canal.

Symptoms:

• Scratching both ears and body
• Recurrent ear infections
• Excessive grooming or overgrooming other body parts
• Seasonal or year-round itching
  

4. Foreign Bodies (e.g., Grass Seeds)

Foreign material lodged inside the ear canal causes immediate irritation and head shaking. Cats with outdoor access are particularly susceptible to grass awns and seeds entering their ears.

5. Ear Polyps or Tumors

Inflammatory polyps (benign growths) can develop inside the ear canal or nasopharynx, mainly in young cats. In older cats, tumor formation within the ear canal must also be ruled out when scratching persists despite standard treatments.

Symptoms:

• Recurrent infections
• Head tilt, balance problems, or abnormal eye movement (if middle ear is affected)
• Visible mass in the ear

6. Skin Diseases Surrounding the Ear

Conditions such as flea allergy dermatitis, mange, or ringworm can cause severe itching around the base of the ears. Even when the ear canal is healthy, the surrounding skin diseases may cause your cat to scratch excessively.

7. Otitis Media or Inner Ear Disease

Chronic untreated outer ear disease can spread deeper into the middle or inner ear, causing ongoing pain, scratching, and neurologic symptoms such as head tilt or loss of balance.

Diagnosis of Cat Ear Scratching (2026 Clinical Guidelines)

In 2026, improved diagnostic tools allow veterinarians to identify ear problems quickly and accurately. Here’s what to expect during your cat’s veterinary visit:

1. Detailed History and Physical Examination

Your veterinarian will ask about your cat’s age, environment, diet, other pets, and previous ear problems. Observation of scratching patterns, head shaking, and any odor helps direct the examination.

2. Otoscopic Examination

Using a modern digital otoscope, your vet visualizes the ear canal and eardrum. Structural damage, debris, inflammation, mites, or growths become immediately visible.

3. Ear Cytology (Microscopic Analysis)

A small swab of discharge is examined under a microscope to identify yeast, bacteria, and mite presence. Cytology remains the gold standard for differentiating infection types and tailoring treatment accordingly.

4. Culture and Sensitivity Tests

For recurrent or resistant bacterial infections, advanced culture testing identifies the exact pathogen and the most effective antibiotic.

5. Allergy Testing

If infection keeps returning, intradermal or serum allergy testing helps determine whether food or environmental allergens are the root cause.

6. Imaging (for chronic or deep ear problems)

High-resolution CT or MRI scans (standardized in the 2026 veterinary toolkit) detect polyps, tumors, or middle ear infections with unparalleled precision.

Treatment for Ear Scratching in Cats

Treatment always targets the underlying cause and relief of itch, inflammation, and pain.

1. Cleaning and Ear Care

Before applying medication, veterinarians clean the ear canal using feline-safe ear cleansers. Deep cleaning should only be done by professionals to avoid eardrum injury.

2. Specific Therapies by Cause:

a. Ear Mites:

• Topical parasiticides (such as selamectin, moxidectin, or fluralaner) are highly effective with a single or monthly dose.
• Treat all pets in the household to prevent reinfestation.

b. Bacterial or Yeast Infections:

• Prescription ear drops containing appropriate antibiotic or antifungal agents (e.g., gentamicin, marbofloxacin, or miconazole) based on culture results.
• Corticosteroids relieve inflammation and itching.
• Duration typically lasts 7–14 days, depending on severity.

c. Allergies:

• Elimination diet trials with novel or hydrolyzed protein diets (minimum 8 weeks).
• Antihistamines or immunotherapy for environmental allergies.
• Regular ear cleaning to prevent secondary infections.

d. Foreign Bodies:

• Removed under sedation; antibiotics and pain relief may follow if trauma occurred.

e. Polyps or Tumors:

• Surgical extraction using endoscopic tools or laser ablation (2026 minimally invasive techniques).
• Histopathology confirms diagnosis and guides ongoing management.

f. Skin Disease Around the Ear:

• Flea and mite control: monthly prevention with modern isoxazoline-based products.
• Antifungal or anti-parasitic shampoos for ringworm or mange.

3. Pain and Itch Management

New generation antipruritic drugs developed by 2026—such as feline-approved Janus kinase (JAK) inhibitors—help reduce itching and inflammation without steroid side effects when long-term management is required.

Prevention of Ear Scratching (2026 Best Practices)

Preventing ear problems in cats relies on proactive hygiene, nutrition, and environmental management:

1. Routine Ear Checks

Inspect your cat’s ears weekly at home. Clean gently using a vet-approved solution only if wax or debris is visible. Never use alcohol, hydrogen peroxide, or cotton swabs deep inside the ear.

2. Regular Parasite Prevention

Administer monthly broad-spectrum parasite control, particularly if your cat goes outdoors or lives with other animals.

3. Nutritional Support

Feed a balanced diet enriched with omega-3 fatty acids, vitamin E, and antioxidants to maintain healthy skin and reduce allergic sensitivity.

4. Allergy Management and Environmental Control

Keep indoor air clean with air purifiers, minimize dust, and maintain low humidity if your cat has known atopic or environmental allergies.

5. Grooming and Hygiene

Regular brushing removes excess oils and prevents debris accumulation around the ear canal, especially in long-haired breeds.

6. Veterinary Checkups

Schedule annual wellness exams (biannual for seniors). Early detection of wax buildup, infection, or inflammation prevents serious complications.

When to See a Veterinarian Immediately

Seek veterinary care promptly if:

• Your cat scratches its ears constantly or cries when touched.
• You notice dark debris, pus, odor, or swelling.
• The ear canal appears red, crusted, or moist.
• Your cat tilts its head, loses balance, or stops eating.

Delaying treatment can transform a minor ear issue into chronic inflammation or permanent hearing damage.

Final Thoughts

Persistent ear scratching is a clear sign that something’s wrong—whether it’s mites, allergy, infection, or deeper ear disease. The good news is that with modern 2026 diagnostic and treatment options, most cases can be accurately diagnosed and resolved quickly, ensuring long-term comfort for your cat.

Maintaining clean ears, applying regular parasite prevention, and conducting periodic veterinary checkups remain the cornerstones of prevention. As always, early veterinary intervention saves your cat from unnecessary discomfort—and prevents minor irritations from turning into chronic ear disease.