Ear Infections: Otitis externa is a disease of the outer ear and is generally manifested by head shaking, head tilt, ear scratching, and odor, which create significant quality-of-life problems. The infection may be caused by ear mites, foreign objects in the ear, swimming, water remaining in the ear after bathing, or may develop secondary to allergies or other diseases. Otitis occurs in cats, but is more common in spaniels and other dog breeds with heavy ears that hang down over the sides of the head. Diagnosis is by examining smear of swabs from the ears and bacterial cultures. Simple cases can be treated with drops or creams and daily ear flushing. Otitis must be followed closely until it is cleared as continuing cases become deeply entrenched and difficult to cure; therefore, we like to treat ear problems aggressively from the beginning and get them resolved. Advanced otitis, or otitis progressing to involvement of the middle or inner parts of the ear, may require x-ray, surgery, or other treatment methods.