Severe Head Tilt

[HarleyQuinn]

A couple months ago, my bunny started leaning his head to the left, nothing more. Vet diagnosed as head tilt/ear infection, prescribed 1 x daily injections of Baytril. These injections continued for two months, then, after a week of no antibiotics, he was perfectly fine and chipper for two days.

Then, suddenly, he began to lean to the other side. It wasn’t just a lean, however; He began to flail uncontrollably and was unable to get up or stand up. His ears were burning hot. I rushed him to the vet and he said the ear infection just moved to the other side and prescribed more Baytril and steroid to help with the hot ears. Steroid did not help ears. We put a cold pack in his carrier. He’s been getting progressively worse. He does show desire to eat and drink (through a dropper), and his stools are normal. He DID miss eating his caecos on his own this morning, but I coaxed him into eating most of it. I keep him either in a small carrier or beside me at all times. He shows resistance if I try to nudge him to one side or the other… Vet also gave him a shot of bicillin. I’ve been giving him small amounts of plain yogurt (at direction of vet) to counteract the antibiotics and prevent diarrhea. vet took x-rays to rule out broken bones. He has not taken blood tests and says that he cannot look in Wilbur’s ear (he’s a lop) because he won’t sit still and if the infection is in the middle/inner ear, he can’t even see it.

Then, just now, when I picked him up to put him in a clean carrier with new, clean towel, he uncontrollably urinated. It’s like when changing a baby boy’s diaper and the stream just happens. He’s never done that before… And, just now, he audibly urinated on the fresh towel. He’s never done that before. His ears are still warm and he doesn’t seem to want to even try to walk around. His breathing is fast.

My mom was a human nurse and says that being unable to control urination is a sign of impending death…

What else can I do? He’s not getting any better. This is the only vet around who takes both rabbits and payment arrangements… Do any of you have any information or experience with persistent head tilts?

[JackRabbit]

Bumping this thread to hopefully get responses

[jerseygirl]

I’d ask he also go on a daily dose of anti inflammatory pain reliever (important) and panacur in case this is related to E. Cuniculi. The urinating could be an indicator that it is. That said though, it might be in response to his discomfort & disorientation overall.

Anyway, it’s quite common to treat for suspected ear infection or suspected EC infection at the same time. It can be hard to determine 100% the cause of the tilt so a presumptive diagnosis is given.

It’s hard to see your rabbit dealing with this, I know. {{{healing vibes}}} sent your way.
It’s a pity you don’t have access to a more rabbit savvy vet.
Re yogurt, I’d look online about getting some benebac instead. Rabbits really should avoid dairy.

[jerseygirl]

Just another thought. Has he been checked for ear mite? An infestation can sometimes cause tilt. Possibly why he tilted one way, then the other. Thought cross infection of bacteria could easily happen too.

[jerseygirl]

Sorry for all my responses.
Just wanted to suggest you contact after Dr Dana Krempels about your rabbit.
She’s a biology professor & rabbit rescuer. Very knowledgeable on rabbits health.

You can submit questions to her here: http://www.allexperts.com/user.cgi?m=4&expID=35789&catID=703

I’ve not come across much about bilateral tilt. Only case & cause I’ve come across so far was due to herpes virus of all things.

[R0se]

I would look for a second vet in the area.
I had to take my bunny in to 4 different vets *the last one being at a exotic pet specialist* for them to find out what was wrong with my first bunny. *also had a tilt and wobbled about*

If the vet normally only sees cats and dogs *like my first two* they don’t seem to have full understanding of the bunny. The 3 vet was a bunny vet at an urgent care, but still didn’t think to check for the brain parasites that he had.

They always say when you get a bad prognosis, you should get a second option. Even if its a little bit of a drive.  

The 4th vet has become my bunnies main doctor. She is a rabbit specialists, and was able to tell something was wrong with him in less then 5 minutes, well the dog and cat vets were: He’s fine!
We were able to treat him just fine after finding someone who knew fully what they were doing.

Good luck!

EDIT: You could also try to find a good vet that dose online questions.  I know I can send a question into my vet (e-mail from there site) and they will call me back with an answer.  There might be some places that will allow that near you. 

[HarleyQuinn]

Posted By jerseygirl on 8/03/2014 11:43 AM

I’d ask he also go on a daily dose of anti inflammatory pain reliever (important) and panacur in case this is related to E. Cuniculi. The urinating could be an indicator that it is. That said though, it might be in response to his discomfort & disorientation overall.

Anyway, it’s quite common to treat for suspected ear infection or suspected EC infection at the same time. It can be hard to determine 100% the cause of the tilt so a presumptive diagnosis is given.

It’s hard to see your rabbit dealing with this, I know. {{{healing vibes}}} sent your way.
It’s a pity you don’t have access to a more rabbit savvy vet.
Re yogurt, I’d look online about getting some benebac instead. Rabbits really should avoid dairy.
Just another thought. Has he been checked for ear mite? An infestation can sometimes cause tilt. Possibly why he tilted one way, then the other. Thought cross infection of bacteria could easily happen too.

Yes, his ears were clean for mites… but again, the vet said he couldn’t use a scope. I was looking into some ProBios from Farm & Fleet (it worked well to treat another rabbits’ facial abscesses, along with Pen G Procaine) but it’s a 5 hour trip to and from the store on the bus…

Posted By R0se on 8/03/2014 2:27 PM

I would look for a second vet in the area.

I had to take my bunny in to 4 different vets *the last one being at a exotic pet specialist* for them to find out what was wrong with my first bunny. *also had a tilt and wobbled about*

If the vet normally only sees cats and dogs *like my first two* they don’t seem to have full understanding of the bunny. The 3 vet was a bunny vet at an urgent care, but still didn’t think to check for the brain parasites that he had.

They always say when you get a bad prognosis, you should get a second option. Even if its a little bit of a drive.  

The 4th vet has become my bunnies main doctor. She is a rabbit specialists, and was able to tell something was wrong with him in less then 5 minutes, well the dog and cat vets were: He’s fine!

We were able to treat him just fine after finding someone who knew fully what they were doing.

Good luck!

EDIT: You could also try to find a good vet that dose online questions.  I know I can send a question into my vet (e-mail from there site) and they will call me back with an answer.  There might be some places that will allow that near you. 

I have, and the other vet is exorbitantly expensive; $100 to step foot in the door, and the estimated culture/sensitivity test, bloodwork, and possible debriding of pus in the middle/inner ear (if it exists) is upwards of $1000 total. Hopefully our current vet will give me proper doses of Pen G Procaine or bicillin to try… That worked on a 1″ diameter hole left by a lanced/debrided forehead abscess and closed it within a week.

Now, he’s overproducing cecals. But that could be because I re-introduced pellets in a desperate attempt for him to eat and cilantro to make him feel better. Thanks for all the replies! *kisses* Please keep bumping if anyone gets more ideas or information!

[HarleyQuinn]

Update: vet has put Wilbur on Baytril ear drops for a couple days; if this doesn’t resolve, he’s to receive oral sulfa-something or other once a day. Again, this vet suggested giving plain yogurt to balance tummy flora.

but here’s a kicker: remember last post when I said he peed a TON, and all of a sudden when I picked him up? He hasn’t peed since. It’s been at least 2-3 days with no pee. His belly does feel a little swollen compared to the rest of him (he’s losing his weight slowly due to inactivity and decreased appetite). I researched and found that his favorite veg, kale, is high in calcium. Is it possible that he has sludge or a blockage? What’s the recourse to fix this if that is the case? My vet does not have a radiograph machine; I think all they have is an xray. Funny thing is, last time he ate kale was the last time he peed. He finished off his cilantro yesterday night.

I have tried massaging his lower belly and slightly agitating him to try and trigger another pee response. Nothing. I don’t want to stress him by scaring him, because he’s already stressed with being unable to stand and move on his own. What else can I do to help him pee here at home until 8 am when the vet opens?

[Roberta]

Damp sweet basil seems to work well with many bunnies… Do you have any fresh basil handy ? It will help hydrate him if you leave some water on when you rinse it.

[Roberta]

Also some fresh spearmint. The one with the longish leaves not the short round ones.

[Kokaneeandkahlua]

Hey HarleyQuin

My first concern is not urinating-is it possible you haven’t seen it? Is he drinking? This is the first order-if he’s not eating and drinking (and when they are tilting that’s common as they feel unwell) you’ll want to force feed him critical care -your vet can sell this to you, it’s a pellet mash and you syringe feed it. He should be peeing.

As for peeing uncontrollably-not an issue. Certainly incontinence in some humans can mean they are declining, but it’s very common in head tilt rabbits to become incontinent.

See if your vet can step up your meds, you want to run a full course of baytril (4 weeks or longer) and one or two other broad spectrum antibiotics. We’ve also treated with fenbendazole as a ‘can’t hurt might help’ as it treats worms (Head tilt was thought to be caused by E. Cuniculi, but now is thought to be caused by a severe middle ear infection-EC is treated with a wormer, like panacur/fenbendazole; ear infections are what the antibiotics are for). You need to treat for as long as it’s safe to-the longer course the better.

I’ve also had success with meclizine (anti-vert) though not available in many places, your vet may know of a compounding pharmacy which can make it. It doesn’t treat the illness, but helps with the symptoms so they feel better and can eat and drink.

Until your bunny is eating on his own and drinking you’ll need to syringe feed with critical care. Tempting with their favorite veggies is a good thing. No yogurt please-that could be disastrous. You can feed carrot juice and pure pumpkin as well, it will help keep him hydrated and feeling well.

The biggest concern with a flailing rolling bunny is they hurt themselves, so see if you can mock up a safe area. I always use a baby playpen, it’s soft sided and small. You can likely pick one up used, but they aren’t much new either. I use puppy pee pads to keep them dry (as they are incontinent during the acute phase).

Keep hope-Kahlua had the worst case I’ve ever seen, I was really considering putting her down and after about maybe, 6 weeks or so, she just started picking up. She has a slight downward orientation, but only I notice it; No one else notices, shes’ that improved; and it’s been over a year since she recovered.

Keep us posted, sending {{Vibes}}

[HarleyQuinn]

Thanks for the detailed reply!
Due to his head tilt and inability to walk without doing the alligator roll, he’s either in two places: my lap/directly in front of me on carpet, or in a pet taxi. Normally, he runs loose in the bunnyproofed bathroom, closed off from other pets.  I empty the hay and poops twice a day; there has been no wet hay or wetness on his bottom (when the head tilt began again, I had to wash his bum every time he wee’d because he couldn’t clean himself.) So, there’s no way I could miss the urine. The last time he peed was 8/2 when I posted the original question here. He is eating his hay on his own, and I’ve been syringe-watering him since he’s too disoriented to use a water dish or bottle, but even so, he is drinking willingly and with no force involved. His poops are nicely formed.

He’s been on Baytril for going on 3 months now with worsening symptoms instead of improvement. :/ I think it’s safe to say that Baytril is not an option. He has not been tested for EC but I’m starting to think that it may be EC; as I posted above, 

BREAKING NEWS: Wilbur was laying upside down in my lap while I was researching and typing this reply. He started to grind his teeth and grunted a couple times, so I put him right-side up (or as much as I could, considering his tilt )  He struggled to stand upright but couldn’t, and, surprise! He did a pee pee. He’s still kind of grinding his teeth, though… it could be in frustration of not being able to stand up, or maybe he has a urinary problem causing pain.

I’m rather paranoid about the calcium buildup possibility, though. He LOVES kale and parsley, and I’ve found that these are high in calcium.

[jerseygirl]

Glad to read he urinated. As I was reading I was becoming really worried. Perhaps he was dehydrated and his tissues completely took up what you’d been syringing him.

I’ve seen my vet feel the bladder before and they can get a fair idea just by doing that. Maybe you can ask your vet to do this. if they feel the bladder is sludgy, they can show you how to express it. Id also request they administer sub-cutaneous fluids. You can also do this at home.

I had a rabbit with tilt last year. There was a stage she was completely reliant on me for drinking. I know how much work this takes!
I think I would have felt better knowing she was hydrated with subQ fluids. Better then me bothering her to drink on top of all the medicating.

Re the ProBios, do you have option to pay over the phone and have it mailed out?

Sending many {{{vibes}}} for your rabbit.

He’s still kind of grinding his teeth, though… it could be in frustration of not being able to stand up, or maybe he has a urinary problem causing pain.

I really feel something like metacam would be beneficial. It not only gives pain relief but its anti inflammatory properties will help battle infection. Rabbits do well on metacam.

[Sarita]

I do wonder if he has some sludge – many times rabbits who cannot posture perfectly to urinate seem to get sludgy urine. I agree about sub-q fluids and expressing the bladder – neither are difficult and sometimes just holding him up can help him express his bladder.

[jerseygirl]

Just wanted to link this article in case you haven’t come across it, HarleyQuinn

http://www.bio.miami.edu/hare/tilt.html

[khrisangel]

So sad for you;( Sending positive vibes your way and wishing you the best

[HarleyQuinn]

UPDATE!!! AND A GOOD ONE!

I was so frustrated with my vet and paying out the wazoo for treatments that weren’t doing diddly. So, I took to the internet.
I found an old article which I’d used when Harley (R.I.P.) had abscesses on his head: Bicillin. I’ll post it once I find it again, since I wrote the info down and didn’t bookmark. I bought a bottle of cattle bicillin from Farm and Fleet; pen-G is short acting and pen-benzathine is long acting. Money spent at clueless vet: $200+. Money spent at farm and fleet for medicine and needles? Less than $40.

Site Recommends
Under 5lb = .25mL every 48 hours
Over 5lb = .5mL every 48 hours
Supplement with pea-sized drop of ProBios (labeled equine) to balance gut flora.
The site added that they had administered up to full 1mL with no adverse effects.

However, since Wilbur’s headtilt was so severe and had been going on so long, I decided to give the .25mL every 24 hours.

By the next morning, IT WAS LIKE NIGHT AND DAY! He became able to stand up on his own, still crooked. He became slightly mobile again, but still stumbled since he wasn’t used to using his right legs. I had an IV kit and gave him subQ fluids for the first 3 days.
It’s been a week now, and he is fully mobile!!! Head still crooked, but I know that will take time. He is able to groom, drink out of a bowl on his own, and has his big appetite back. Feeding him both timothy and alfalfa to help him gain weight. He’s even having an attitude with the cat and digging angrily in his cage at night!

I hope this helps someone!!! Obviously I am not a vet, but this treatment worked almost IMMEDIATELY. Spread this among your bunbun vets and see if they will recommend this treatment for future headtilt cases.

[jerseygirl]

Such a rapid turn around!
Many rabbits can tolerate subQ penicillin quite well and with good results.
I also used it for a rabbit with jaw abscess. I was nervous too in the beginning but he didnt have any adverse effects from it.

Great to hear Wilbur is doing better.

[LittlePuffyTail]

Glad to hear he is doing better!

[ValerieH]

Did you ever find the website?  I’m a little desperate.  My little one is just laying on his side.  I’ve got him on Albendazole and Baytril but no improvement after one week.

[Bam]

Hi ValerieH!
Please start a new thread on the subject of head tilt! You’re more likely to get answers if you do. This is an old thread and we ask members not to reply to old threads.
To start a new thread you click the Add Topic-button. If you need help starting a new thread, PM me.

[ashley & palmer!]

My bunny had severe head tilt– we woke up one morning to find his head completely upside down, with his poor little eyes going crazy trying to correct it! I almost died watching him go through the whole ordeal. He was placed on two medications (I can find out what they were, if it would be helpful), but the odd thing that I believe made him show improvements was shots of antibiotics. Such a simple thing (2 shots I believe), and he started to get better. He had to stay on medicine for a month, but his head is 100% corrected now!

[LBJ10]

Hello bunbun – Welcome to BB! Thank you for sharing your experience with this topic. Unfortunately, this is an old thread and we ask everyone to avoid bringing up old threads because it causes confusion. Someone sees the thread and thinks it’s a new problem that needs to be addressed, which draws attention away from current topics. If you have a question, you are more than welcome to start a new thread. I will lock this now.

[Author]

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