Article: If you think fleas or sarcoptic mange mites are causing your dog's itchy ears, then speak to your veterinarian about an appropriate anti-parasite product to kill the infestation and relieve the itch. There are several highly effective spot-on products available that kill fleas and mange mites. Ask the veterinarian to recommend one and determine the proper dosage for your dog. Since it's difficult to look deep into your dog's ear, you may only notice the scratching and a thick brown wax that might also be crumbly. This wax is made by ear mites, an infection that's a common problem in dogs. Your vet will need to use magnification tools (like an auroscope or otoscope) to look for mites scurrying or by looking at microscopic slides for mites or eggs. In otodectic mange, or ear-mite infection, the ear mites feed off wax in your dog's ear canal. They infest both the vertical and horizontal ear canals. Your veterinarian will probably recommend that you start with non-prescription medication containing pyrethrin. Typically, you'll apply a pyrethroid ear medication to the ear canal once or twice daily, for ten to fourteen days. Pyrethrin applied topically is safe for your dog, since it doesn't pass into your dog's bloodstream easily.  While pyrethrin is effective against ear mites, it's not a successful treatment for bacterial infections. There is a theoretical risk of toxicity if your dog eats the medication or another dog licks your dog's medicated ear. The signs of poisoning include excessive salivation, muscle tremors, agitation and in extreme cases, seizures. If you notice any of these signs, keep the dog in a dark, quiet room to minimize stimulation, and get veterinary advice.

What is a summary?
Follow your vet's treatment plan. Look for signs of an internal parasite infection (ear mites). Follow the vet's treatment plan for ear mites.