Dog Hot Spots and Shaking: What Could Be Happening?
When a dog with hot spots also begins shaking, trembling, or shivering, owners are often unsure whether the two signs are connected. While some overlap is possible, shaking can also point to a separate issue that needs attention.
Quick Answer
Hot spots (acute moist dermatitis) and shaking can be linked through several mechanisms: pain from the skin lesions, an ear infection causing both head shaking and localized skin irritation, fever from infection, generalized discomfort, or less commonly neurological issues. Because shaking can also be a sign of pain or systemic illness, a dog showing both signs — particularly if shaking is persistent or accompanied by lethargy — should be evaluated by a veterinarian.
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What Can This Combination Look Like?
Types of Shaking in Dogs
Not all shaking is the same. Observing the pattern and context can help narrow down possible causes.
- Whole-body trembling or shivering: Often associated with cold, pain, fever, or anxiety.
- Head shaking: Frequently linked to ear irritation or infection.
- Localized shaking (a single leg, the head, or the rear end): May indicate pain, muscle spasm, or neurological issues.
- Shaking episodes that come and go: Could suggest episodic conditions such as seizures or tremor syndromes.
Hot Spot Appearance
Hot spots typically appear as red, moist, inflamed patches with hair loss and sometimes oozing or crusting. The dog may lick, scratch, or chew at the lesions.
Distinguishing the Two
It is useful to observe whether the shaking is clearly related to the location of the hot spots (for example, head shaking with hot spots near the ears) or appears to be a separate, generalized sign.
What May Be Associated With Hot Spots and Shaking?
Several conditions and mechanisms may connect hot spots and shaking in dogs.
Pain
Hot spots can be painful, especially when they are large, deep, or located in sensitive areas. Dogs in pain may tremble or shake as a response to discomfort. This is particularly common when the lesions are around the ears, neck, armpits, or between the toes. If your dog becomes tense, whines, or resists being touched near a hot spot, pain is likely a contributing factor.
Ear Infections
Ear infections (otitis externa) are a common cause of both head shaking and skin irritation. A dog with an ear infection may shake their head frequently, scratch at the ear, and develop a hot spot on the ear flap (pinna) or just below the ear from self-trauma. The ear canal may appear red, swollen, or have discharge. Ear infections can be caused by bacteria, yeast, allergies, or foreign material (such as grass awns).
Fever
A fever raises the body's temperature set point, which can cause shivering or trembling as the body tries to generate heat. Fever may result from a bacterial skin infection that has spread from the hot spot, or from an unrelated infection. A rectal temperature above 102.5 degrees Fahrenheit (39.2 degrees Celsius) is generally considered elevated in dogs.
Generalized Allergic Reactions
Severe allergic reactions can cause shaking or trembling along with skin signs. Anaphylaxis may present with restlessness, panting, facial swelling, hives, and trembling. This is a medical emergency.
Cold or Hypothermia
Dogs with compromised skin (such as extensive hot spots that have been shaved or are weeping) may have more difficulty regulating body temperature. Small dogs, thin-coated breeds, and older dogs are particularly susceptible. Shaking in a cold environment, especially with skin lesions, may simply reflect difficulty staying warm.
Anxiety or Stress
Some dogs shake or tremble when anxious — for example during storms, car rides, or vet visits. The same stress can also trigger excessive licking that leads to hot spots. In these cases, the shaking and hot spots share an underlying emotional cause rather than a physical one.
Neurological Causes
Less commonly, shaking or trembling can be neurological in origin. Conditions such as idiopathic head tremors, seizures, or tremor syndromes (such as generalized tremor syndrome, more common in small white breeds) can produce shaking. These are not directly linked to hot spots, but their concurrent appearance warrants investigation.
Toxin Exposure
Certain toxins can cause trembling, shaking, or seizures along with other signs. If a dog has ingested something toxic, vomiting, drooling, or neurological signs may accompany the shaking. Hot spots in this context may be coincidental.
Hypoglycemia (Low Blood Sugar)
Small breed dogs and puppies are prone to low blood sugar, which can cause trembling, weakness, and sometimes seizures. This is usually unrelated to hot spots but may occur concurrently.
What Should the Pet Owner Monitor?
Shaking Pattern
- Note when the shaking occurs (at rest, during activity, after eating, during sleep).
- Observe which body parts are affected.
- Track how long episodes last and whether they are increasing in frequency.
Hot Spot Progression
- Record the size, location, and appearance of each hot spot.
- Note whether shaking is more pronounced when a particular hot spot is touched.
Associated Signs
- Ear appearance: Check for redness, swelling, discharge, or odor in the ear canals.
- Body temperature: If possible, take a rectal temperature.
- Behavior: Is the dog anxious, hiding, panting, or reluctant to move?
- Appetite and water intake: Note any changes.
Video Documentation
Recording a short video of the shaking episodes can be very helpful for the veterinarian, especially if the episodes are intermittent or do not occur during the examination.
What Can the Owner Safely Do Next?
Comfort and Warmth
- Ensure the dog is in a warm, dry, quiet environment.
- Provide soft bedding and avoid drafts.
- If the dog is anxious, gentle reassurance may help reduce stress-related trembling.
Ear Inspection
Gently examine the ears for redness, discharge, or odor. Do not insert anything into the ear canal. If signs of infection are present, a veterinary visit is needed.
Skin Care
- Prevent self-trauma with an Elizabethan collar or recovery cone.
- Keep hot spots clean and dry using a veterinarian-approved antiseptic.
Avoid Medications
Do not give human pain relievers, anti-inflammatory drugs, or anti-nausea medications. Many are toxic to dogs, and some can worsen certain conditions.
When to Contact a Veterinarian
Seek Emergency or Same-Day Care If:
- The shaking is continuous, severe, or accompanied by inability to stand.
- There are signs of seizure activity (loss of consciousness, paddling limbs, drooling, unresponsiveness).
- The dog has a high fever (above 103.5 degrees Fahrenheit / 39.7 degrees Celsius).
- There is facial swelling, hives, or difficulty breathing (possible anaphylaxis).
- The dog is lethargic, weak, or not eating.
- Hot spots are spreading rapidly or have a foul odor.
Schedule a Non-Urgent Visit If:
- Shaking is intermittent and mild, and the dog is otherwise bright and eating normally.
- Ear shaking is occasional and there is no obvious discharge or swelling.
- Hot spots are localized and stable.
- The dog has a known history of anxiety that may explain the shaking.
Frequently Asked Questions
Why is my dog shaking their head along with hot spots?
Head shaking is most commonly associated with ear irritation or infection. Hot spots near the ears can develop from the constant scratching and shaking associated with otitis. An ear exam by a veterinarian can determine whether an infection is present.
Can pain from hot spots cause a dog to shake?
Yes. Pain is a common cause of trembling or shaking in dogs. Hot spots can be quite uncomfortable, particularly when located in sensitive areas. If shaking seems to be linked to touching or moving near a hot spot, pain is a likely contributor.
Should I be worried if my dog shakes while sleeping?
Brief muscle twitching during sleep is normal in many dogs and is not usually a concern. However, shaking that occurs while the dog is awake, persistent trembling, or episodes that resemble seizures should be evaluated by a veterinarian.
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Disclaimer
"This article and the PawAI Symptom Triage tool provide general information and cannot diagnose conditions or replace examination, diagnosis, or treatment by a licensed veterinarian. If you are concerned about your pet's health, contact a veterinarian promptly."
SYMPTOM TRIAGE
Shaking alongside hot spots may point to pain, ear infection, or fever. Use our symptom checker to assess how urgently your dog should be seen by a veterinarian.
This tool does not diagnose conditions or replace a veterinarian.