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Forum DIET & CARE Head Tilt

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    • Meep
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        Hi there,

        I have a 10 year old (and 4 months) Netherland dwarf rabbit named Pepper. 2 weeks ago Pepper started listing to one side and had a pronounced head tilt. It was a sudden onset and I took her to the vet the next morning. The vet thinks she has an inner ear infection and prescribed baytril at a dose of 0.65cc every 24 hours for 3 weeks. However she has now been on the meds for 12 days and there has been no change. I have also been giving her oxbow critical care and metacam (0.2cc nightly indefinitely). She is quite small and only weighs about 850g. She is becoming more withdrawn and does not seem to be getting better. I am going to go back to the vet because I feel as though there should have been more of an improvement in 12 days on antibiotics. 

        Does anyone else have experience with head tilt? Should I keep her on Baytril longer? The vet hasn’t done any testing to figure out what exactly is causing the headtilt but as Pepper is quite old and small and gets very stressed when she goes to the vet we are trying to figure out a minimally invasive course.

        Any advice would be greatly appreciated as well as suggestions for greens that could get her appetite up (shes not losing weight but she isnt eating as much as she used to, the critical care is supporting her weight for now).

        Thanks!


      • jerseygirl
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          {{{Pepper}}}
          Poor little darling. I know it’s hard to see them dealing with tilt. My rabbit a Maple developed headtilt last November.
          It took a month of medicating and assistance before she really regained independence.

          She was on metacam, baytril and panacur. Panacur for if cause was the E.C. parasite.
          I believe it was the anti inflammatory meds that were most beneficial. After the vet tried a shot if cortisone I felt she turned a corner.

          Other members on here used meclizine (motion sickness med) and really found that was great for them. I think it helps with feeling of nausea and dizziness.
          Sorry, my memory is bit sketchy.

          ETA: vitamin b is supposed to help appetite. Maybe try a liquid form with water??
          Maples interests with food kept changing. In the beginning she ate very little . I was able to get her eating rose petals, leaves and willow first. Then parsley & curly endive. Eventually some mix lettuces and celery.


        • Meep
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            Thank you for your reply! I asked my vet about parasites when I first took her in and the vet said it was unlikely as she in as indoor bunny who does not have contact with other bunnies. I’m not sure how dizzy she is, she doesn’t fall over or anything and has enough balance to get up on her hind paws and clean her face and such. But she has restricted her territory to a few square feet (she normally has the run of the entire upstairs). Did your vet prescribe the cortisone because your Maple wasn’t making progress or is it a standard course for head tilt?
            Thanks again!


          • LittlePuffyTail
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              I’m sorry your bunny is unwell. Did your vet suggest the possibility of EC? A lot of head tilts are caused by this and the best remedy is a 30 day treatment of Fenbendazole. This worked well for my guy and after a week or so on the meds, he had straightened back up. The sooner the treatment starts for this, the more likely the positive results.

              There is a test for EC but most vets find it to be most often inconclusive.

              I hope you and your vet are able to get her straightened up asap. (((((Pepper))))


            • LongEaredLions
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                No advice here but (((((vibes))))) for your bun.


              • jerseygirl
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                  Did your vet prescribe the cortisone because your Maple wasn’t making progress or is it a standard course for head tilt?

                  It really depends on the vet as using steroids for rabbits is one of those things vets have mixed views on. Many who do use it will give cortisone shots at the beginning. I think 2-3 shots maximum and done couple days apart??? It’s a short acting drug.
                  Maple had her 1 and only shot a week or so after she developed tilt. She’s had 4 days not eating and by the weeks end was on her side all the time and frequently rolling. She also had dropped weight that 1st week. So I guess vet thought we had nothing to lose at that point.

                  I asked my vet about parasites when I first took her in and the vet said it was unlikely as she in as indoor bunny who does not have contact with other bunnies

                  The thing with EC is many rabbits contract it when babies. The spores are shed in the urine of infected rabbit (say the Mum) and then others eat pee’d on hay or get pee on feet then ingest when cleaning themselves.
                  It can stay dormant and never cause an issue. Or it can flare up various times.

                  Here’s list of other cause of head tilt if you have not yet seen it.
                  http://www.medirabbit.com/EN/Neurology/head_tilt.htm

                  Hopefully it’s just a matter of more time needed for antibiotic to have effect for her.
                  Is that her in your avatar picture? Maple is same colouring as that bunny.


                • BelarusianBunny
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                    Hi there,

                    I have an 11 year old Netherland Dwarf that developed two bad cases of head tilt.  The first case, he was around 8 years of age and the second case was last summer when he was 10.

                    In the first case, he had an ear infection that turned into a head tilt on a Friday night.  Worst possible timing!  No emergency vets, no vets on the weekend.  He was treated with Baytril ear drops twice a day and Metacam twice a day.  He recovered but he’s always been left with a bit of a slight wonky head tilt.  If I remember correctly, the Baytril ear drops were for 3 weeks.

                    Last summer, during his shedding, when his immune system was struggling, he must have got another infection because not only did he have a head tilt but it turned into hind end paralysis as well.  The vet said that because Baytril ear drops and Metacam worked the first time, that is was the first plan of action.  I tried it for 3 days and I saw there was no change so we went back to the vet.  He gave him oral Baytril and that made all the difference.  The oral Baytril was administered for 2 weeks but now, we have a standing prescription to follow the same regiment if we see early signs of it starting again.  That is, as long as the Baytril works …

                    The vet said the same thing that Metacam, or anti inflammatories in general, are key in treating head tilt.  They help take down the inflammation in the nervous system and that helps in taking things back to normal.  (If I remember correctly what the vet said … something like that …)  

                    The treatment regiment for my Dwarf has always been Baytril and Metacam.  I know that you said that it isn’t working so I would think the vet also needs to treat for EC.  This forum has been wonderful in that I have learned there should be dual treatment for infections and EC when there is a head tilt.  You may have to be firm with your vet but it is better to have it treated than not treated.  Antibiotics take time to work and it is best to finish out the regime.  However, in my personal opinion, I would consult with the vet to see what else can be done.  When the EC wasn’t treated, it always gnawed at the back of my mind that “what if that is the problem?  What if it gets worse?”

                    I just thought I would reply because I have a similar aged bunny that went through the same thing.  He’s doing well now.  I know it is stressful, especially to watch a bunny with a head tilt, but it can be treated and successfully done so.  Best of luck and care to you and your bunny!


                  • Meep
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                      We just got back from the vet and Pepper is now prescribed Zeniquil (in case it is a bacterial infection) and Fenbendazole (in case it is EC). However the vet said to stop the metacam so we are not overloading Pepper with meds. I am a little uneasy about that since I thought keeping down the imflammation was key. The vet seemed quite sure that we should stop so we’ll see how that goes.

                      But hopefully there will be improvement on the new meds. Thank you everyone for your support and responses and I will update if there is any changes in her condition.

                      And yes Jerseygirl that is Pepper in my avatar!

                      Thanks again!


                    • jerseygirl
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                        I haven’t heard of zeniquil before. A quick search tells me it’s an anti anxiety supplement. I’m a little confused.
                        Are you continuing with the course of baytril?

                        @BelarusianBunny, it’s great your little guy has recovered each time!


                      • Meep
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                          Sorry that was a typo, its Zeniquin and it’s a stronger anti-biotic to replace the Baytril.


                        • jerseygirl
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                            Thanks for clarifying. That makes much more sense.
                            More healing {{{vibes}}} for Pepper.


                          • MimzMum
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                              Hello Meep,
                              My bunny Mimzy is one bunny who used meclizine (Dramamine) for head tilt. It really helped him with his balance issues and he took it for at least six months. And yes, metacam is key to keeping inflammation down either from inner ear or central nervous system involvement in head tilt. My Mimzy has had to be taking it for years already due to early onset arthritis but it was one of the meds he needed throughout his therapy for the tilt. According to my vet, bunnies are able to take higher doses of this medication than cats or dogs because they excrete it so quickly from their systems. It should have no consequence to being used with the other medications your bunny is on but perhaps your vet is concerned about stomach, liver or kidney problems. Mimzy has taken high doses of metacam since he was three years old and he is now almost 8. He loves it and looks forward to when I come to give him his dose.

                              You’ve already received great advice here. I hope Pepper will recover completely from her tilt and be back to normal again. Mimzy’s was severe enough that his head is still wonky two years later. He is also deaf. It is a long process though and requires constant nursing at onset. If your bunny has any residual balance problems, hopefully over time she’ll relearn how to keep herself upright. Mimzy has and his head was once at a 90 degree angle to his body (he was quite literally always looking at the floor with his left eye, now he can raise his head better.) If Pepper should have residual tilt then something may need to be prescribed to help keep the downward facing eye clean and clear. Also be prepared for any rolling. If Pepper begins rolling she’ll need to be kept in a smaller area with rolled up towels or other safe bedding for her to use to steady herself.
                              Hopefully though it’s been caught early and she’ll be feeling better soon. Please ask again about the metacam, it’s pretty important. (Just speaking from experience, I am not a vet.)
                              ((((((((Healing vibes)))))))) coming your way.


                            • bunnluff
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                                I’ve been going through this nightmare as well over the last year with my girl Pippin. So I feel your pain!! Three separate times I’ve been battling whatever infection/s have caused 2 tilts and several episodes of rolling/seizures. It’s so awful and stressful for not just the bunny, but for the owner too. I was bawling my eyes out watching my baby suffer. I’m not sure if these 2 items I used had any effect, but they definitely do not hurt to boost the immune system, and just to keep around in times of crisis. Bene-bac and Critical Care. Get those, keep them around and administer during treatment and even after. They can be used as daily supplements if you choose. Hang in there and hugs for Pepper!!!


                              • dutchmclovin
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                                  I adopted a bun with a head tilt. I wish I could give you advice on healing, but all I can say is long term watch for sore hocks! Mine has developed a small sore we’re working on because of her constant off balance. Vibes for your bun!


                                • Meep
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                                    Thanks for all the replies everyone!

                                    I talked to my vet again and Pepper is back on the metacam. Hopefully that will help her feel better and get her to eat more. Even with feeding her Critical Care 4 times a day she’s still losing weight

                                    Mimzmum, how long did it take for Mimzy’s head tilt to resolve? I’m wondering how long a head tilt can go for.
                                    Dutchmclovin, has your bun’s head tilt resolved?


                                  • Meep
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                                      Also I spoke with a rabbit specialist at a Veterinary University in a neighbouring town, and she recommended doing a CT or MRI, however Pepper does not like car rides and it would be a 3 hour round trip to get there. Has anyone else had their bunny CT’d or MRI’d? I’m trying to decide if it would be worth putting her though the stress of the car ride.


                                    • MimzMum
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                                        I was offered the CT/MRI option but my vet thought it would be more stress and motion and unless there’s an underlying issue like abscess or tumor that can’t be imaged by other means it seemed unnecessary.
                                        Mimzy still has a tilted head because the damage to his middle ear was severe. But as far as the length of treatment altogether I think our main fight lasted 4 to 6 months. You see this is a kind of one step forward and two steps back disease. Each bun is different too…some recover quickly and others take longer. Some have no further tilt and others stay tilted. I’m lucky that Mimzy’s tilt is not as bad as when he first got sick. He functions pretty normally but for his lack of good balance. I have to handle him very slowly and carefully to avoid him freaking out. But he’s still got spunk.


                                      • jerseygirl
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                                          Duration really varies case by case. A couple of members here saw improvement really set in after the month long medication regime. And as LPT said, she saw Bindi improve within a week or two.

                                          Some rabbits stay tilted but start to adjust to the angle and function really well. You might see that with Pepper yet.
                                          You can probably consider scans then when she’s more stable & adjusted?? If you’re still wanting to determine cause.

                                          I know the weightloss is worrying. For Maple, her regain happened over several months after recovery and was slow. Even now I still find her too slight. But she’s healthy at least.
                                          You’ll be amazed though how rabbits can survive so thin and recover.

                                          Just hold hope and keep on day by day. It’s just takes time.
                                          {{{Pepper}}}


                                        • Meep
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                                            You guys are right, it really is like one step forward 2 steps back.

                                            On monday night Pepper had a rolling episode where she couldnt stand up on her own without rolling over. I ended up holding her for 2 hours until the episode passed and then i barricaded her area with pillows and blankets so she cant hurt herself if it happens again. She was fine the past few days and didn’t roll at all and then last night she had another rolling episode. This one was less severe and lasted only 15 minutes or so and she wasnt constantly rolling but had a very pronounced nystagmus of the eyes. Then suddenly it stopped. I called my vet and she think this is probably just part of the head tilt symptomatology but she is unsure why the nystagmus would start and stop like that.

                                            Has anyone had a similar experience?

                                            Also I have a theory that at night (when the episodes happen) because its dark, she cant see and it exacerbates her dizziness. So last night I left her light on and she seemed fine with that. I’m contemplating leaving her with a night light every night now.


                                          • MimzMum
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                                              Yes the nystagmus will come and go. Every time a tilted rabbit moves, those balance centers go haywire. Mimzy has some nystagmus to this day but only when being handled or if he gets feeling frisky and moves too fast.

                                              The rolling can get quite bad at times. I was at a point a week or two in from the start of symptoms that I was certain I’d have to put Mimzy down. But my vet and I both decided we’d give him a chance and he did better so we added the meclizine to help steady him. He still rolled but in time we began to see improvement.
                                              This is a waiting game. I told Mimzy from the off that I wouldn’t give up unless he told me to. You can tell when an animal is tired of fighting. Well it’s going to be three years since he tilted on June 11. He’s not told me to give up yet.
                                              Thinking of you and Pepper.


                                            • Meep
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                                                Thank you. It means a lot to us. I’m always worried that I’d doing all these medical interventions for my own sake (since I can;t bear the thought of losing her) and it’s not really what’s best for her, considering how awful the rolling looks. But like you said, if its time to let go, she’ll tell me and until then its back to the trenches!


                                              • jerseygirl
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                                                  Also I have a theory that at night (when the episodes happen) because its dark, she cant see and it exacerbates her dizziness. So last night I left her light on and she seemed fine with that. I’m contemplating leaving her with a night light every night now.

                                                  Oh yes! This does seem to help. I’d forgotten that.

                                                  I know the rolling is hard to see. It’s tiring for the bunny too. But a little story for you…

                                                  I was hand feeding greens by the time Maple got to the rolling episodes. I still remember her going into a roll with a piece of lettuce hanging from her mouth, then resume chewing the instant she was still again. :shake head:


                                                • Velvet
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                                                    Velvet stays in a room in my basement. She has always had a kids nightlight on at night. Kinda keeps the furniture visible, so, if she has to run, at least she can see without hitting a piece of Furniture and hurting herself.


                                                  • Kokaneeandkahlua
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                                                      I’ve had two with head tilt.

                                                      I did a ton of research of academic journals on head tilt (and there aren’t many articles)-all concurred that metacam should only be given for at most a week. It’s not really effective after that.

                                                      Keep up the antibiotics a long time-4 weeks or even longer. Panacur is more of an in-case, as sometimes head tilt is caused by EC but it’s rare. It’s usually an inner ear infection in the tympanic bulla.

                                                      There was no sign of any improvement for the longest time with Kahlua and then boom-she started to mend. I’m going to see if I can upload my before and after video of her for you. It will give you hope-she was bad and for a long time.

                                                      Oh and if your vet can get their hands on it-see if you can get meclizine (anti-vert). It’s a can’t hurt might help drug that helps with nausea (obviously they don’t throw up!) but wow did it help. I decreased Kahlua’s dose one day so we could make it until refill -and she had a terrible night so I had to re-dose her. It was then obvious how much the drug was doing to help her quality (it does nothing for the infection, but helps them feel better so they eat).

                                                      Stay positive, see if friends or family can help you with the care, vent here-it’s a long road! *hugs*

                                                      PS-puppy pee pads are amazing if she’s not very continent


                                                    • Kokaneeandkahlua
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                                                        This one was less severe and lasted only 15 minutes or so and she wasnt constantly rolling but had a very pronounced nystagmus of the eyes. Then suddenly it stopped. I called my vet and she think this is probably just part of the head tilt symptomatology but she is unsure why the nystagmus would start and stop like that.

                                                        Has anyone had a similar experience?

                                                        Yes-sorry didn’t see this. When I decreased Kahlua’s dose of the meclizine one day (to stretch to refill time) she had a terrible episode of rolling and crazy nystagmus. I found the nystagmus was always worse during a rolling episode. Not sure which is causative-if the nystagmus acts up and they roll or vice versa. But definitely saw upswings and downswings of the nystagmus!


                                                      • Meep
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                                                          I’m going to ask my vet about meclizine today, hopefully she will prescribe it for us without seeing Pepper again because Pepper is in no fit state to travel She seemed to be stabilizing well for the past week and now this morning she has terrible nystagmus and she can stay still. She’s only rolled twice or so but she keeps circling in very tight circles and almost looks like a pretzel shape. It’s heart breaking to watch


                                                        • Meep
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                                                            Or not. Apparently Meclizine is not sold in Canada any more.
                                                            As for the pee-pads, how often do you change them? As soon as they have been peed on? Pepper is definitely struggling with using her litter area


                                                          • MimzMum
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                                                              Perhaps your vet could find somewhere in the U.S. to order it for you? I’ve ordered vet prescriptions by mail and they work pretty well. (Well my vet does the ordering and it comes right to my door. I think it’s Wedgewood Pharmacy in Arizona that he used last time.)
                                                              I changed Mimzy’s puppy pads when they got soiled and also kept a layer of hay or Carefresh bedding in with him in his Sterilite box. He can’t use a litterbox anymore because of his arthritis so he’s on towels in his xpen and I change/wash those at least once a day. I layer them on a large trash bag so cleanup is easy, after I shake all the hay/mess off the towels I just roll up the mess in the bag and toss it out.

                                                              It’s been a challenge making less work for me while still keeping him comfy but you get innovative after awhile. And of course I was manic those first months cleaning to be certain he didn’t reinfect himself. If it’s E.C. I think the spores remain active in the urine up to a month afterwards?


                                                            • Meep
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                                                                I’ve been going crazy trying to make sure everything is sterile around her. It’s getting to be a challenge since im in school full time and I work part time and the rest of my family is currently on vacation.

                                                                I talked to a specialist vet who thinks the best thing to do it to get the CT scan and if the CT shows that it is an inner ear infection, to remove the inner ear. I’m not too thrilled with this option because of the chances that she could die on the operating table or while recovering from surgery. The vet has performed 12 of these surgeries in the past 3 years and only lost one bun so they seem confident but I am not. Pepper is not spayed (the first vet I took her and her friend to when they were babies said it was unnecessary since they were both female, needless to say that wasn’t a very rabbit savy vet, but I was 13 and not very rabbit-savvy myself) so we have no precedent as to how she will react under anaesthetic.

                                                                According to the vet, if it is an inner ear infection (and not a stroke, parasite or other problem) then the inner ear will fill with pus and that pus cannot be drained or cleared using antibiotics, which is why re-infection occurs and buns have a residual head tilt.

                                                                I’m not sure what to do now. Should I continue with regular treatment and just provide palliative care, or should I go for the aggressive treatment and do surgery.

                                                                I wish bunnies could talk and then Pepper could tell me what option she prefers


                                                              • bunnluff
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                                                                  When Pippin had tilt, I’m pretty sure hers was caused by an infection first and ear mites second. All the times I’ve dealt with this I’ve gone the antibiotic route to clear whatever may be there causing the problems and then followed up with home remedies to prevent recurrence. It’s definitely something I always have to stay on top of. I’m always inspecting her ears with a flashlight and putting drops in there and making sure the ears are always clean. Best of luck!!


                                                                • Kokaneeandkahlua
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                                                                    Meep
                                                                    Meclizine isn’t sold anymore in Canada but a compounding pharmacist can make it. Are you anywhere near the edmonton region? I can recommend the special pharamcy. Otherwise ask your vet about phoning pharmacies to ask them to make it. If your vet wants to talk to my vet, private message me and I’ll give you her details!


                                                                  • Kokaneeandkahlua
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                                                                      I just saw your post on the CT/MRI.

                                                                      I would avoid car rides with a tilted rabbit, they make it much worse.
                                                                      Ask your vet if the CT/MRI showed anything, what in your treatment plan would change? If something woudl change, why can’t you just do the change without the scans?
                                                                      Usually with head tilt you treat for EC and an inner ear infection. Traveling to get a better picture/scan of the infection in my opinion would not change the plan so I wouldn’t do it.


                                                                    • Kokaneeandkahlua
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                                                                        I should read all before I reply! Now onto the surgery option. My opinion is unless you are three-six months into treatment you have not given enough chance for it to resolve from treatment or on its own. It’s true the infection may not resolve with antibiotics-there can be bone involvement and it’s really thick and hard to fix. But it does happen.
                                                                        I would continue with the treatment you are currently doing, try to get meclizine and give it some time (find out what your bunny will eat and give her anything she wants so you can keep weight on)
                                                                        If after several months there is no improvement and you can afford the surgery easily then go for it. When it was quoted out to me it was astronomical but vet care varies by location-so if it’s not going to make you sell your car or remortgage your house I would go for it. My dog had the surgery (Teca bo-total ear canal ablation and bulla-ectomy -excuse the spelling!) for her similar issue and it went wonderfully. But my rabbit Kahlua responded after several months of antibiotics and we’re now one year from when she was first symptomatic and she’s doing well


                                                                      • Meep
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                                                                          Kokaneeandkahlua: I’m in Ontario so not really close to Edmonton.

                                                                          My vet gave Pepper Valium to calm her down and reduce the dizziness. However Pepper’s condition has deteriorated in the last week. She can no longer stand upright on her own at all and will not eat food that is not syringe fed to her. Im currently keeping her in a smaller enclosure where i can prop her up with towels so she doesn’t roll constantly but she wont drink from the water bottle i put in with her and i cant leave a bowl of water in with her because she cant balance enough to drink and falls in. She stopped breathing last time this happened as water went in her nose. (I had a towel on hand and she was breathing within a few seconds but that’s not an experience I ever want to repeat). So now the only way she gets water is with a syringe as well.

                                                                          My vet thinks that as Pepper can’t move around on her own at all any more and is dependant on me for all her basic functions I need to consider if her quality of life is worth the pain on her infection. She does not think a rabbit in Pepper’s condition would survive surgery and she thinks that since we haven’t even been able to stabilize Pepper with all the meds she’s on that it’s time to let go. Also she needs someone with her 24/7 to make sure she gets water at least every 2 hours. I have been off school and work for the past 4 days but I can’t keep that up forever. I’ve tried to find a competent rabbit-sitter but I’ve had no luck so far.

                                                                          Also her eye (that faces the floor) has become inflamed and sore and red so I have eye drops for that.

                                                                          We’re going to a veterinary hospital tomorrow morning to do the CT scan and get a second opinion for a surgical vet. According to my vet the fact that Pepper is declining so rapidly could mean that this is either a very bad aggressive inner ear infection or that it isn’t an inner ear infection at all but a brain tumour or something else entirely. Hopefully the CT will clear that up. As for the E.C. possibility, she’s been on drugs for that for almost a month so I doubt she has it.

                                                                          As for the surgery, we’ll see after the scan if it is an option but I’m still wary of it because of Pepper’s fragile state and advanced age. The price I was quoted was 1500-2000$ (on top of the 600$ CT scan). I’m not really thinking about the money though because Pepper is more important than cash. But I’m worried that even if she survives the surgery the pain of the removal of her inner ear and her compromised state would result in her being in more pain than she probably is in now. It seems like she can never return to her pre-illness state of health.

                                                                          I’m not really sure what to do at this point. I’ve heard from quite a few members that it takes several months for this type of illness to resolve but seeing how fast Petter has deteriorated in a week I find it hard to know if she will even be alive in several months. Sometimes it seems like she is struggling to breathe and her heart rate is slower than normal. And sometimes she eats her syringe food with interest. Her last “good day” was the 19th of May. I don’t want to euthanize her but I also don’t want to drag her through a slow and painful death. There are really no good options anymore.


                                                                        • Kokaneeandkahlua
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                                                                            Just if it gives you any hope-that was all true for Kahlua too-I had her in a little play pen, changing puppy pee pads 5x a day to keep her as clean as possible, but she still needed to be cleaned (both her bum and her face) twice a day. her face was messy because of the syringe feeding. She had to be syringe fed for several weeks-in addition to critical care, I also gave her pumpkin mixed with carrot juice. She couldn’t stand or move around at all, she just fell down.

                                                                            She lost weight-normally 1.2 kg, she dropped to 0.91. (She’s now 1.4 heavier even than she was prior to the illness!)

                                                                            There was no steady improvement at all.

                                                                             

                                                                            Then one day I had her on the ground on a towel while I cleaned her pen and she started digging the towel-she fell down but got up and dug again. She made drastic improvement within a couple of weeks and very soon was able to run around. She told she was fully recovered and sick of the play pen when she started hopping out of it.

                                                                             

                                                                            For months she was still slightly oriented down -no one would notice but me and my vet, but that is now gone too.

                                                                            I can’t emphasize enough that Kahlua’s quality of life was terrible, but I gave her a chance and she pulled right through. My internet is really slow but I am working on uploading her before and after video


                                                                          • LongEaredLions
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                                                                              I don’t have much advice tat hasn’t already been given but I just want to send some (((comforting hugs))) to you and (((((huge healing vibes for Pepper)))))


                                                                            • MimzMum
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                                                                                I can confirm what K&K says about how much it gets worse before it gets better. I am hoping your bun will begin to rally soon but I am someone who has watched her bun go through a few months where we were constantly wondering about his QOL and if it was fair to keep him going. He made it through even though my own vet suggested PTS and brain tumors, which he obviously did not have.
                                                                                If your bunny is eating vegetables she is likely getting quite a bit of fluid into her. We also did subcutaneous fluids for a few months. After Mimzy began to steady a bit he didn’t need them. I also soaked haycakes in water for him and broke them into manageable pieces and he would gobble those up.
                                                                                The ear operation sounds extreme in any case to me, although I know it does work for some pets. It can cause a lot of pain to a bunny which is something they don’t live with well. However I’ve only read about it and not experienced it so I really can’t say.
                                                                                I am sorry that Pepper is feeling so poorly. I totally understand the need for keeping them happy and the massive drain it is on the carer as I spent many nights without sleep and after six months of wondering if Mimzy would make it I was thoroughly drained. He has held his own well ever since but had any of my other buns come down with head tilt as well I would have had some more serious decisions to make.
                                                                                I really hope things will improve and you will not be faced with having to let her go. It really does take time for them to do better. I understand your frustration and also the despair you can feel in this situation. I wish I had something more to offer that could be helpful but truly this is just one of those things that takes time and of course the bunny has to be willing to go on as well as you do. Generally I assessed on a daily basis that if Mimzy had input and output and seemed to be interested in fighting that I would fight with him till he told me to stop. Every bunny is different and each carer needs to make the call depending on their own viewpoint. For the most part even though he looked terrible a lot of the time, I think Mimzy was a lot better off than any of us thought he was.
                                                                                You’ve considered all these things though I am certain from what you’ve posted. I wish I could help make this an easier decision.
                                                                                I am thinking of you and sending healing vibes for Pepper. ((((((((hugs)))))))))) xx


                                                                              • Meep
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                                                                                  Thank you for your messages guys, I really appreciate it!

                                                                                  I have a most confusing update:

                                                                                  I took Pepper yesterday to the Small Animal Hospital to get the CT scan done and she did surprisingly well in the car. She was sedated a bit and mostly just slept through it. The results of the CT showed that Pepper does not have an inner ear infection. At all. Nor could they see a brain tumour. So surgery is off the table since there is nothing to remove. The vet said that other, less common, possibilities are that she has very advanced EC (something the vet of 15 years has never seen to such a degree with such a fast progression considering Pepper has no outer ear mites or infection). Or she could be having multiple ischemic events (mini strokes). The also did blood tests and the results showed that she has no underlying kidney disease, liver disease or heart disease (which would be potential causes of strokes). They did a test for EC and the results of that are not back yet but even if they come back positive it doesn’t mean much since 50% of rabbits without symptoms test positive for it. Our course of meds will not change since she is already on meds for EC.

                                                                                  I am baffled and so it seems are the vets. This small animal hospital is the best in Ontario and they are on the forefront of rabbit medicine. I met a bunny while I was there who is the first in Canada to be treated for bone-marrow cancer. I spoke to several vets who have treated domestic and wild rabbits with EC and none of them had seen a rabbit who is on EC meds continue to deteriorate so rapidly.

                                                                                  If it is mini strokes there nothing really that we can do but provide palliative care and make her comfortable as she will not improve.

                                                                                  I’m going to do more research on EC treatment, in case it is a weird EC case. She’s currently on Fenbendaloze for the EC but maybe they could up the dose or something. The results should be back by the end of the week.


                                                                                • LongEaredLions
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                                                                                    That is so puzzling. I am leaning towards the EC, but like I said I am very inexperienced in this area. Just sending more positive vibes, I hope you can figure this out.


                                                                                  • MimzMum
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                                                                                      If it is E.C., which is most likely, then the treatment you are giving will hopefully show improvement eventually. But I would think if she is having strokes you’d be seeing other forms of impairment. Complete loss of motor control of the legs for instance and inability to sit, stand or walk.
                                                                                      I’m keeping prayers going that Pepper will begin to turn a corner soon. Amazing that she took the car ride well, Mimzy to this day gets pretty disoriented in the car, but he finally just sits in a corner of his carrier and gets on with it. Then the minute we stop to take him into the clinic he begins turning circles again.


                                                                                    • LongEaredLions
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                                                                                        How is Pepper doing today? Any improvement?


                                                                                      • Meep
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                                                                                          She’s the same. There’s been no improvement but also no further deterioration. She’s been sleeping a lot though, the past few days. She’s also still very very rolly. I’m trying to figure out the best way to house her. Currently she lives in a big plastic tub that is lined with pillows on the sides and peepads and towels on the bottom. However when she flips over she can’t always pick herself back up so I have a fear that she will suffocate herself against a pillow or towel. She’s never left alone so someone is always there to pick her up if you falls over.

                                                                                          I managed to procure some Meclizine from the States. And she’s been on it for a few days but so far I see no difference.


                                                                                        • Kokaneeandkahlua
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                                                                                            Awesome!! I didn’t see improvement really from the meclizine-but when I stopped it I saw an escalation in the nystagmus and rolling. I think you’ll see a difference soon

                                                                                            I use a playpen for my rolling bunnies-soft sides I was kicking myself as I threw out the playpen I bought for Chuck when he had head tilt, because a few years later Kahlua got head tilt. And I had to buy another one.

                                                                                            I did find my first one used on Kijiji -and the second one I needed FAST so I bought it new-wasn’t bad, I think $60 This is basically what I bought http://www.asia.ru/en/ProductInfo/1213448.html (And it’s not unused now! When my bunnies have to go to the vet, I bring the playpen for them to hang in)

                                                                                            It’s perfect because it’s soft sided, they can see out and it’s moveable and folds up-I would definitely recommend it

                                                                                            Are you doing puppy pads? I found those worked great for keeping her clean. Also if you take a big towel and roll each side up, in sort of a ‘U’ shape you can make a bunny corral.

                                                                                            If your handy with a sewing machine you could sew it in the fashion-with two rolls and a dip in the middle -it makes a nice rest for them to lay in and lean on. Let me try to find a picture.

                                                                                            {{Healing Vibes}}


                                                                                          • Meep
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                                                                                              The vet called with the results of the EC test and we have bad news. Pepper tested positive and with a high titer (or something like that) level. This leads the vet to conclude that the fenbendazole is not working as she’s been on it for over 3 weeks now, so we might try new meds. Also she said that the neurologist and the radiologist met to discuss Pepper’s CT scan and while they agree there are no obvious tumours she does have some lesions around the part of her brain that controls vestibular functions (such as balance). The vets think that the EC has infected her brain and is basically making holes in it. She thinks Pepper’s prognosis is poor because the damage may already be irreversible and if we can’t control the EC there will be more brain damage. She’s going to do a literature review for me and see if there are any other drugs to try as Pepper can’t stay on fenbendazole forever.


                                                                                            • Kokaneeandkahlua
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                                                                                                Awesome-here’s what you are looking to make
                                                                                                http://www.etsy.com/listing/151520929/large-lambswool-bunny-hugger-side-by?ref=shop_home_active

                                                                                                I was going to order one or have one made, and Kahlua just started recovering, but I often fashioned one out of towels and she rested on it.


                                                                                              • Kokaneeandkahlua
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                                                                                                  Oh dear-we must have posted at the same time-I’m so sorry for your news!! {{Vibes}}

                                                                                                  Let us know what your vet discovers in her literature review-and don’t despair yet


                                                                                                • MimzMum
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                                                                                                    The thing about E.C. is it can go dormant for a period of time and then resurface and reinfect. That’s why particular attention needs to be paid to cleaning the bunny’s area and anything coming into contact with the urine especially about the first weeks and around day 28 into the fenbendazole.
                                                                                                    The lesion may be damage from the parasite that has already occured. Not necessarily new lesions.
                                                                                                    Is Pepper still taking metacam? This helps reduce inflammatory response especially in the central nervous system where the E.C. parasite does it’s dirty work.
                                                                                                    Thinking of you and Pepper and hoping things will be better soon. xx


                                                                                                  • Meep
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                                                                                                      Yes, MimzMum, Pepper is still on Metacam (and Fendbendazole, Zeniquin, Meclizine and Critical Care). Hopefully there will be some improvement soon. And hopefully the lesions are ones that she can eventually improve from.

                                                                                                      Pepper is eating a lot of food lately. About 2 packs of critical care a week (5 tbsp CC mixed with 10 tbsp water per day) as well as as much pellets and hay (mixed timothy, alfalfa and medow) as she will eat. But she is still losing weight. I’ve taken to giving her a bit of banana a day in addition to her greens and veggies to try and fatten her up. She eats (with assistance) for most of the time she is awake but it just seems to pass right through her.

                                                                                                      I’m trying to keep everything extra sanitary because I also have a cat and I don’t want her to get EC either. My cat vet is on vacation for a few days but when she gets back I’m going to take Ginger (the cat) in to see if they can do a EC blood test on her. Just in case.

                                                                                                      The vet’s literature review did not come up with anything useful. The only thing she did find was that some rabbits just do not respond to treatment for EC. Or rather some EC varieties do not get killed off by traditional therapies. There are some more experimental drugs but the vet does not have confidence in them.

                                                                                                      Currently I’m just trying to solve the problem of her weight loss. Because if she gets too thin and her heart stops, the EC treatment doesn’t even matter. It’s hard to figure out though because she eats everything that I try to feed her and she eats high quantities of it. But she is very bony. I can feel all of her ribs, hips, spine etc.

                                                                                                      In other forums people have suggested oats as a way to fatten up bunnies. Would these be whole oats, rolled oats or quick oats? also do I have to pre-soak them in water? I know oats expand in the body and I don’t want to give Pepper GI problems.

                                                                                                      Ps: @ Kokaneeandkahlua the Meclizine I have is in tablet form (the same kind as is given to people). I dissolve a quarter tablet per day in water. But some particles don’t fully dissolve. They still end up in the syringe and then in Pepper. Do you think that affects its effectiveness? I still haven’t noticed any decrease in rolling from that drug.

                                                                                                      Pps: Thanks again to everyone who commented on my tread for all your support and encouragement! We are hanging in there and hopefully this story will have a happy ending.


                                                                                                    • Meep
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                                                                                                        Hey guys, I have bad news. Pepper passed away yesterday evening. I wanted to thank everyone for their support during this ordeal. I wish you all the best.


                                                                                                      • LongEaredLions
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                                                                                                          I am so sorry. You did your very best, and that’s all Pepper would ever have asked for. He knew he was loved.
                                                                                                          (((((Binky Free sweet one))))))
                                                                                                          Feel free to make a rainbow bridge thread if you would like.


                                                                                                        • MimzMum
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                                                                                                            Oh my gosh, Meep, I’m so sorry. I was really hoping Pepper would pull through. You did all the right things and gave her every chance.
                                                                                                            I’m really devastated for you. So very, very sorry.
                                                                                                            Binky free Pepper <3
                                                                                                            Sending you ((((((hugs)))))) at this very sad time.


                                                                                                          • jerseygirl
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                                                                                                              Meep, please accept my belated condolences. I’ve had very limited Internet access and am terribly behind in the forums. I am saddened to learn of your loss.

                                                                                                              If your care and dedication to her over the last few months is any indicator, I think Pepper must have had a great home & human companion for her 10 years.
                                                                                                              ***Binky Free Sweet Girl***
                                                                                                              Thinking of you Meep.


                                                                                                            • LittlePuffyTail
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                                                                                                                I’m so sorry I’m late seeing this. My most very sincere condolences on the loss of your very beloved bunny. What a lucky bunny to have you in her life.

                                                                                                                (((((Binky Free Pepper)))))

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