Head Tilt

[ValerieH]

Well, I hope I’m doing this new thread correctly. 

My Bugsy recently developed a dead tilt. The vet he’d seen the 6 years of his life is no longer practicing so I took him to a new vet. She is a sweet person. I’m not trying to bash anyone in this thread. I just want information that could be helpful to my little one. We didn’t do any blood tests and the ear looked clean but we started him on Baytril and Albendazole. His condition worsened and we took him back in. The vet ended up keeping him for the day so that she could rupture the ear drum and use a cam to see if there was an inner ear infection. Which his ears were too small to get the cam in. But they did the procedure anyway and I was told that during the flush, white matter came out which was pretty obvious that an infection had ben present. Baytril was put directly in the infected area. He started getting better after a couple of days. He was actually able to stand up on his own for short periods and even started grooming himself again. 

Yesterday though, the vet suggested we give him a 3 part series of Dexium injections subcutaneously every other day. He had the first yesterday. And today, he is laying down most of the time and less able to keep his balance. When yesterday before the injection seemed like such an improvement.  I called the vet today and updated her on his status.  She said not to bring him in for the 2nd injection and see how he does until Monday (the day he would’ve received the 3rd injection).  I have had him on Critical Care food but he hasn’t wanted to drink much water.  I will probably put him on Unflavored Pedialyte soon. I am feeling emotionally distressed to be honest. I got Bugsy when I first got out of the military and he helped me cope with being back home. He helped me deal with civilian life again. He is extremely special to me and I feel so helpless because I don’t think I know enough.  I suppose I’m just looking for advice and definitely some support.  Thanks.

[lillian]

well, Dexium is an anti inflammatory, so not 100% sure on how that is going to help his condition. The vet should have taken a sample of what came out of his ear, seen if it was an infection, and, if was, then to start him on antibiotics to solve the problem. I would suggest getting a different opinion from a different vet.

Heres a website with more info on head tilt in hopes that this may help you in your quest. I hope Bugsy gets to his usual self soon! http://www.rabbit.org/journal/3-8/head-tilt.html

[BarbaraC]

Hi ValerieH. I’m so glad you were able to figure out how to post this. Head tilt in rabbits is most commonly caused by either an inner ear infection or a parasite known as E Cuniculi. I had a bunny a few months ago who presented with acute head tilt. I am fortunate to live near one of the best animal hospitals in the world that has a full exotics staff. Unfortunately I had to learn very quickly about rabbit healthcare. When Lily was going through the diagnosis stage the first thing the vet did was draw blood and run and EC culture. One statistic I read said that 80 percent of domestic rabbits will test positive for the parasite but only 12% ever have any symptoms. Therefore, the test they run looks for a high titer. My vet recommended putting her on meds to treat both an ear infection and the EC. This involved 6 different medications. A pain med, GI motility drug, an antibiotic, anti-parasitic, something to help with her balance and one more that I am forgetting. He also prescribed Critical Care to make sure she was getting enough nutrients and to keep her digestive system working.

The blood work took a couple of days to come back and it was positive for EC so we didn’t test for the ear infection, however, the recommended diagnostic for this was a cat scan to look for an infection. I have never heard of anyone puncturing the ear drum but this may be a typical practice for vets who do not have access to a cat scan machine.

The anti inflammatory drug that your vet prescribed may be because she suspects that the infection is causing an inflammation in the tissue that is putting pressure on the part of the brain that controls balance. The reason for head tilt was explained to me that the rabbit can no longer judge what is up and what is down so they tilt their head trying to get their balance. It is definitely a neurological condition.

The most important thing to do is determine exactly what is causing the head tilt and start treatment as soon as possible. I would keep him on the antibiotics but ask for blood work to rule out EC. You might even want to ask that they start him on that treatment. However, there are risks with this as it can suppress bone marrow production in some rabbits, much like chemo in humans. So if he remains on it he will need follow up blood work.

If you can get the underlying cause of the head tilt under control there are other treatments you can do for the head tilt itself. Neck massages often help since the muscles can start to constrict. I also read an article written by a man who is also a physical therapist who used some of his human methods on his rabbit who had head tilt. For right now though focus on the cause.

Also, I would not recommend syringe feeding him liquids. Because rabbits cannot vomit they can aspirate very easily on even a small amount of water. My vet recommended that I instead make Lily’s Critical Care mixture with more water if I was concerned about her fluid intake. You can also ask your vet to show you how to administer subcutaneous fluids.

I hope Bugsy starts to feel better soon. There are few things more worrisome than a sick bunny. Please keep us updated on his progress.

[bunnluff]

I know how you must be feeling with this head tilt struggle. My rabbit Pippin scared me numerous times with her ear problems. Because I didn’t do tests I wasn’t sure if her infections were caused by ear mites, but she had all the tell tale signs. Baytril cleared it up the first time. The second time she didn’t have tilt but was “rolling” (losing her balance and flailing around on her back) which was pretty scary. After that I got her on 30 days of Fenbendazole (Panacur) and she was great after that. No more tilting or rolling but still had mites in the ears so now she’s permanently on Revolution. After all of this, her poor ears have now become lopped indefinitely (they used to stand up straight). I hope that’s helpful information and hang in there!!

[jerseygirl]

From what happened with the ear, it seems ear infection is the cause of the head tilt. Is that your vets consensus?

It wouldn’t be a bad idea for your bun to be on an oral anti inflammatory (like metacam) after the Dexium has cleared the system. The use of steriodal anti inflamms is up for debate with vets it seems. Some see results, some view it as too risk. Its short acting and can only be given a few times from what I remember. It can be good to get on top on acute inflammation and the beginning of head tilt but not used continually.

{{{Vibes}}} for Bugsy!

[Roberta]

Ditto on the anti inflams, my vet only ever prescribes short dose to make bunny comfortable in the early stages of treatment. The only prolonged prescription was my bun Pascal with scholiosis and it had to be a lifetime (all too short) thing at need.

[ValerieH]

[ValerieH]

Yes, that is my vet’s consensus.  How long do you suppose the Dexium takes to clear the system?

[ValerieH]

Thank you everyone for your advice and support. Update on Bugsy: He has started to get better since I wrote this post and skipped the second dose of Dexium. He’s up on his feet more, wreaking havoc in his basket, eating hay, even grooming himself, and just now managed to eat some of his cecotropes. Of course he tires easily, but digs around angrily in bouts (active longer and longer each time). He had some diarrhea yesterday, but I managed to get more water into him and a little bit of unflavored Pedialyte and that resolved itself almost right away. Thank you again everyone from the bottom of my heart. It is a great comfort to receive advice from fellow bunny lovers.

[jerseygirl]

That’s great! I love to read a positive update.

[ValerieH]

Posted By jerseygirl on 8/31/2015 12:33 AM

That’s great! I love to read a positive update.

I believe I spoke too soon jerseygirl.  He started losing his balance not too long after.  The vet called to check up on him today and now she suspects he may have Pasteurella because he’s gotten better and then fallen back twice thus far.  She asked me to think about taking him to Texas A&M and have them evaluate him (likely have an MRI).  It’s the only veterinary college in the state

[Bam]

I’m so sorry to hear it. Sending him good vibes. (((((((Bugsy)))))))

[jerseygirl]

More {{{vibes}}}!

Going back and forth is part of the process with head tilt I’m afraid. With ear infections, you’ll probably need do antibiotics for minimum of 4 weeks. It’s a challenge trying to get on top of infection and keeping inflammation down.

Keep us posted.

[ValerieH]

Posted By jerseygirl on 9/01/2015 6:36 AM

More {{{vibes}}}!

Going back and forth is part of the process with head tilt I’m afraid. With ear infections, you’ll probably need do antibiotics for minimum of 4 weeks. It’s a challenge trying to get on top of infection and keeping inflammation down.

Keep us posted.

jerseygirl I would really appreciate if you (and anyone else) could just tell me what it’s like.  I don’t know what to expect out of this time that he is going through treatment.  His vet called and she suggested that I take him to Texas A&M because she suspects he may have Pasteurella since he has fallen back on his recovery twice now and it’s only been 2 weeks.

[jerseygirl]

I’ll try come on tomorrow and elaborate on my experience with my bunny Maple. It’s late here and my brain is tired. Lol

I do want to quickly pass on this link to a facebook group though.

http://www.facebook.com/groups/HelpforHeadTiltHoppers/

 HTH

[ValerieH]

Thank you JG

[jerseygirl]

Hi Valerie

How is Mr Bugsy doing?

[Author]

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