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.