Pug Ear Infections: Signs, Causes, Treatment, Prevention

The forward-folding ears on a pug are an unmissable feature of theirs. They’re thin, black, and irresistibly soft to touch! While cute, the floppy structure of their ears do make them more susceptible to health issues. Here’s why:

Pugs are prone to ear problems because their forward-folding ears closes off their ear canals. As a result, they easily trap dirt, debris, and moisture. It makes them a breeding ground for bacteria and fungus growth, which can lead to infections and a lot of discomfort.

There are many signs and symptoms that a dog will show when suffering from an ear infection. It’s imperative that you know what these are, so that you can immediately take your pug to the vet for treatment. Better yet, there are preventative techniques that owners can follow to significantly lower the chances of an ear infection.

Structure Of A Pug’s Ears

Before we get into the various ear medical problems a pug can face, it’s important to understand how their ear structure can play a part. As mentioned, they are forward-folding, thin, soft, and black in color. But pugs can have slight variations in the way they sit and look.

“Button” ears fold forward to the point where the outer ear canal is completely covered. They point downwards and will usually sit against the face. “Rose” ears are similar, but they will have a thin leather fold that flops backwards to expose the bumpy cartilage (burr) from the outer ear canal.

Additionally, all dogs have a long ‘L’ shaped ear canal that makes them great for hearing, but predisposes them to collect moisture, debris, and other foreign materials. While ear infections can occur amongst all breeds, dogs with floppy ears are more prone to it due to the way they close off the ear canals.

Pug Ear Development & Modification

Typically, a pug puppy’s ear shape and color will be a strong indicator of what they will set as in adulthood. However, there is the likelihood of these features changing as they develop. For example, the coloring of the ears are likely to see some changes when the pug reaches adulthood. It could either fade in color or darken. The changes will be much more prominent in lighter colored pugs, i.e. fawn coats.

Ears that are flatter (button) may slowly open up into rose ears, and vice-versa. The way the ear sits can be impacted during a puppy’s teething stage. This happens within the first nine months, and will be due to the connection from the muscles in the ear region with that of the nerves in the jaw. The overuse of their teeth and jaws can impact how the ear is positioned.

The way the ear sets will be determined by the dog’s genetics. There isn’t a way to mould it into a more desired position or look; nor should this matter. Each individual pug is unique and charming in their own ways. Some have tried taping their pug’s ears down in hopes of making it flatter, but this doesn’t seem to really do anything. Rather, it just becomes a big nuisance for your puppy.

Signs Of An Ear Infection

Healthy ears are normally pink, clean, and scent-free. When infected, there are several signs that your dog will show, including:

Milder SymptomsSevere Symptoms
Foul and pungent odorBalance loss
Itchiness and discomfortUnusual eye movements
Constant ear scratchingAnxiously walking in circles
WhimperingExcessive head tilting
Head shaking
(to alleviate the itch)
Hearing loss
Redness, swelling, and crustingPartial paralysis (e.g. facial)
Excessive ear wax and discharge
(yellow or black in color)

When these symptoms are noticed, it’s imperative that you get your dog’s ears examined by a vet. They will check for foreign materials and determine whether the ear drum is still intact, before getting a swab sample for diagnostics. From there, they can identify the problem and provide an appropriate treatment option.

Types Of Ear Infections

Parasites, fungi, bacteria, and foreign matter can lead to infections in the inner, middle, and outer ears. The deeper the issue goes into the ear canals, the more serious the consequences. Typically, these ear infections are classified and referred to as otitis externa (outer), otitis media (middle), and otitis interna (inner).

Otitis Externa: Outer Ear Infections

Inflammation of the external ear canal is referred to as “otitis externa” and is common amongst many small animals, such as cats and dogs. In fact, it is one of the biggest reasons why dogs are taken to see the vet. If your dog is suffering from this condition, they will likely exhibit the milder symptoms from the above table. Excessive scratching, head shaking, redness, black or yellow ear discharge, and an unpleasant odor will be common.

The causes of outer ear infections can be broken down into primary and secondary causes. Primary reasons of otitis externa alters the conditions within the ear, which allows a secondary virus to fester. Usually, secondary causes are more severe and will likely be a recurrent problem unless the primary factors for this condition are addressed.

Primary CausesSecondary Causes
(related to food, atopic dermatitis, contact)
Bacteria (Staphylococcus, Streptococcus,
Enterococcus, Pseudomonas, Proteus, etc.)
ParasitesYeast (Malassezia)
Autoimmune & immune-mediated factorsReactions to medication
Epithelialization disorders
(related to wound healing)
Endocrine diseases
(hypothyroidism, hyperadrenocorticism)
Foreign bodies
Glandular disorders
(diabetes, pancreatic, thyroid, adrenal)
Fungal (Aspergillus)
Viral (distemper)

Additionally, there are also knock-on effects that can arise, as a result of chronic ear inflammation that may continue indefinitely. For example, epithelial changes can alter the mechanism for how the ear naturally cleans itself. The ear canal may narrow or swell up, and the eardrum can even rupture. Other perpetuating factors include glandular, middle ear disease, and pericartilaginous fibrosis or calcification.

As you can see, external ear infections can be quite dangerous and can even cause lifelong consequences for your pug. There are factors that can increase the risk of developing this condition, and you should be aware of what these are. Predisposing factors include:

  • Ear structure (floppy ears, narrow ear canals, and excessive hairs in the ear canals)
  • Excessive moisture
  • Obstructive ear disease
  • Primary otitis media (middle ear infections)
  • Systemic disease
  • Changes in gut flora and microbiome
  • Trauma

Diagnosis of otitis externa will involve a clinical examination, whereby a vet will examine your pug’s skin and eardrum, as well as taking a sample from inside the ear. This will help determine the cause and subsequent treatment. If the problem is severe, your pug likely won’t cooperate due to the pain, and that’s when anaesthesia or sedations may need to be administered.

Treatment will usually involve some sort of ear drops that can be applied to the affected ear(s). However, multiple medications may need to be prescribed if there is more than one type of infection present. If there is excessive discharge in the ear, it may also need to be flushed out of the ear canal by the vet. Additionally, they may trim any long hairs in the ear canal to help increase airflow and healing.

Recovery time will depend on how serious the infection is, but will take place at home. It will usually take 2-3 weeks of continual treatment before significant improvements are seen. During this time, you’ll need to clean your pugs ears. Because it’ll be sensitive, you’ll need to entice them with treats and other forms of positive reinforcements in order for them to oblige.

Otitis Media & Interna: Middle & Inner Ear Infections

As opposed to otitis externa being more common, middle and inner ear infections aren’t as prevalent and are considered much more of a serious problem. They’re usually bacterial infections but can also be related to fungus and yeast. It’s imperative that any outer ear problems are treated accordingly before there is a chance for it to develop into otitis media and interna.

The onset of this condition will likely see your pug showing severe symptoms from the above table. Middle and internal ear infections can impact the central nervous system and cause neurological symptoms. As stated, some of these will include partial paralysis, balance loss, and blinking issues. Hearing loss, smelly discharge, and depression are likely to be seen too.

There are several things that can cause otitis interna and media in dogs. Bacterial infections are the most likely reason due to the warm and moist environment of a pug’s ear. However, serious trauma to the region can lead to infections as well. Other factors that contribute to this condition include mites, yeast agents, foreign material, and tumor or polyp growth within the ear.

Diagnosis will initially be similar to otitis externa, whereby a clinical examination will be carried out and otoscope will be used to probe the ears. Again, sedation may be required if your pug is in too much pain to cooperate. From there, the vet will look to extract ear fluids from the middle ear region in order to put it under a microscope for analysis.

X-Rays, computing tomography (CT), and magnetic resonance imaging (MRI) scans will be used to diagnose changes within the inner ear. If signs of an infection is noticed, there will be a follow up of blood and urine tests to confirm it.

Treatment will vary and depend on the underlying causes. Usually, the appropriate medication will be prescribed to fight against things like bacteria and parasites. The ears will need to be cleaned and flushed out before administering the treatment. If this isn’t effective, then a veterinarian will need to operate and drain ear fluids out in order to relieve pressure within the ear canal.

Regardless, it’s imperative for the issue to be addressed as early as possible for the treatment to be effective. Otherwise, neurological disorders can develop quickly, which may require surgery to correct. Not only will your dog’s health be impacted long-term, but it will also cause a lot of emotional and financial heartache for owners.

Recovery will generally take place at home, and involve ear cleaning, medication, and a lot of rest. If the dog’s diagnosis is severe, the vet may insist on an overnight stay to monitor how it would react to the medication. There will likely be follow up visitations to track your pug’s recovery progress as well.

Ear Mites

If your pug shakes their head uncontrollably and scratches its ears excessively, then there is a chance that they may be infected with ear mites. Ear mites are small, spider-like bugs, and hard to see with the naked eye. The mites feed on your pug’s ear wax and oil, making it quite uncomfortable.

The most common symptoms observed in dogs affected with this condition includes vigorous head shaking, twitching, scratching at the ears, and producing a dark, waxy discharge from the ear canal. If you observe these symptoms in your pug, you’ll need to take them to the vet as soon as you can.

Preventative actions include cleaning your pug’s ears often to prevent your pug from experiencing any discomfort. You can purchase ear cleansers over-the-counter at your local pet store. But it’s recommended that you take your pug to the vet as soon as you observe these symptoms, so that immediate relief can be provided. The professionals will be also provide a treatment plan to prevent the re-infestation of mites.

Treating Ear Infections

While treatment will vary depending on the type of infection and the severity of it, there are nuance details that you should be aware of. It’s vital that you follow best practices to give your pug the best possible chance to recover. For additional medical advice, we recommend that you set up a consultation with your vet.

Before applying medicated drops or ointments to the ear, you’ll need to thoroughly clean the affected area. A medicated ear cleanser will be recommended by your veterinarian to help flush out any debris. Minor ear infections like externa otitis should clear up after a few weeks.

More severe cases that involve otitis interna and media in dogs can take months to fully resolve. There may be lifelong impacts and surgery may be necessary. Treatment for ear infections are most effective during the early stages of it. It’s vital that they’re treated during this stage before developing into a more chronic infection that may reoccur.

Home Remedies & Natural Treatment Options

Why do some owners prefer natural remedies over conventional treatment options? They believe that ear problems are deeper than the surface level symptoms that are seen. So, the prescribed drugs only clear them up, making them much like a band-aid without addressing the underlying issue.

Antibiotics can disrupt a dog’s microbiome, which in some cases, can kill more good bacteria than bad. Steroid medication can also cause issues due to its affect on the immune system. While there is a point to be made about these statements, I would advise working with your vet in a holistic manner to avoid further complications.

While factors related to diet, grooming, and lifestyle can help manage ear infections as a preventative measure, there are natural remedies that can be applied to treat ear infections. These solutions may or may not work for every dog, and would be wise to consult with your vet beforehand.

  • Green tea – contains antioxidants to help reduce inflammations. Create a mixture by using two green tea bags and 8 oz of boiling water. Once cooled to lukewarm temperature, apply the solution to the ear canal with a syringe or sponge.
  • Grapefruit seed extract – another great antioxidant that’s also antiviral, antibacterial, and antifungal. To clean the ears topically, mix 10 drops of the extract with half an ounce of pure aloe vera juice to create the solution. Additionally, you can also add 3-5 drops of grapefruit seed extract to your dog’s food for internal ingestion.
  • Oregano oil – a natural form of antibiotic to be used to clean your pug’s ears. Soak a cotton ball in a mixture made up of 1 drop of the oil to half an ounce of pure aloe vera juice.
  • Vinegar & water – can be a great option to reduce itchiness with. Mix 1 part organic apple cider vinegar with water. Clean the ear with a cotton ball soaked with this mixture and ensure the solution is massaged gently into the ear canal.

Prevention Methods

Do you know what’s better than treating an ear infection? Simply put, it’s to prevent it from occurring in the first place! Regular grooming is essential for pugs due to their floppy ears. Both the outer and inner ear canals need to be maintained in order to prevent medical issues. Here are some ways to help you achieve this.

Outer ear canal: with a pet friendly wipe, clean the outer ear canal at least once per week. Try and get as much as you can without penetrating into the inner ear canal. If your pug is prone to ear infections, you should do it more frequently. Don’t forget to wipe the inner ear flaps in the process and remove any leftover moisture.

Inner ear canal: should be cleaned every 4-6 weeks, but can be done as often as weekly if the dog is susceptible to recurring issues. This will help flush the ear of dirt and fine debris that are trapped, while also helping to break up clumps of excess wax. Please follow the instructions below for best results:

  1. Pick up an appropriate ear cleanser, preferably one that is alcohol-free. Speak to your vet for recommendations if unsure.
  2. Lift the ear flap (one-side at a time).
  3. Squeeze a couple drops of the ear solution into the ear canal (as directed on the label).
  4. Once the solution has been administered, close the ear flap and gently massage it in from the outside.
  5. From there, you can let go of the ear, and let your pug shake their head to wring out any excess liquids.
  6. Wipe up any debris or ear wax that comes out, before wiping them dry.
  7. Repeat these steps on the other ear.

It’s also worth noting that you should try and keep your pug’s ears dry when exposed to water. Wipe them down and even use ear powders to completely dry them. Moisture creates a breeding ground for bacteria. But try and avoid overcleaning, as this can cause the ear canal to be irritated, which can lead to infections as well.

Hair can also build up inside the ears, and when they become too long, they will trap dirt and bacteria. Again, this can lead to an ear infection, so it would be wise to keep them trimmed. Lastly, don’t forget to take your pug for regular check ups with your veterinarian.

Hearing Loss

In the event where a pug has suffered from ear problems that are so chronic, there is a risk of them losing their hearing. But dogs are smart and may be choosing to ignore their owner, especially when there isn’t a treat for them. There are signs to look out for when a dog’s hearing has been impacted, and it’s important to be aware of what these are, so you can rule out general stubbornness.

A telling sign of hearing loss in dogs is when they become more vocal. Excessive barking can occur when they get a sudden fright because they couldn’t hear that someone or something was there. This leads onto the next point, which is being easily startled. If they’re struggling to hear, they’re more likely to be more tense, jumpy, and easier to sneak up on.

Most pugs like being part of the action and will immediately go to their owners when called. Although, you can’t completely rule this out as this breed can be stubborn at times. But if they’re not reacting at all to their name and other keywords that would indicate food, treats, fetch, etc. then there is likely to be a problem with their hearing.

When your pug isn’t paying attention to you, you can try and test their level of hearing at home. Aside from their favorite phrases, try and make different sounds that they would normally react to. If they don’t turn around as you’d expect them to, then it’s imperative that you take your pug to the vet for a clinical examination.

Related Questions

What kind of ears do pugs have? Pugs generally have button ears, which means they fold forward and sit against their face. When their floppy ears sit slightly higher and don’t completely cover their ear canals, this is known as rose ears.

Are you supposed to clean pugs ears? Yes, their floppy ears trap moisture and debris, which can lead to an infection. Pug’s need their ears cleaned at least weekly, and more frequently if your dog is more prone to ear problems.

Why do pugs ears get so dirty? Their forward-folding ears tend to trap dirt, debris, and other foreign matters. Combined with a moist environment, it can lead to different types of ear infections. Some common signs include excessive (black/yellow) earwax or discharge, and a foul smelling odor.


Greencross Vets, n.d. Pet Ear Infections.

Scott, D., 2020. Dog Ear Infections: Natural Remedies That Work.

Woodward, M., 2020. Otitis Externa in Animals.

Woodward, M., 2020. Otitis Media and Interna in Animals.

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