Head Tilt Questions

[Stacy]

So, on Dec 5th my lop Pepper was diagnosed with EC. He was sick with a cold and then got to where he had no balance. After taking him to the vet on the 5th and 8th, getting Sub Q Fluids both times and a couple of injections the first time as well as giving him the meds prescribed and a feeding suplement he seemed to get over this and got his balance back and started eating and drinking and pooping again. Then he developed head tilt. It started at when I would pick him up he would tilt it sharply but then when I would put him down he would struggle to get to his feet. This was at about 2 weeks so I took him to the vet again and kept him on meds. Another two weeks and he’d been what I found online to be called circling especially when I would give him his meds twice a day. It was always a struggle to get him back on his feet and his head has been consistently tilted whether he is sitting, walking, or laying down. She gave him a low dose of steroid and eye drops and kept him on one of his meds. So, we are going to be at 5 weeks tomorrow and he has gotten worse to where me and my husband were talking last night about his quality of life. He is constantly falling and his head is tilted the worse I have seen it. I’ve read where this can be a lengthy battle but any info from those that have gone through this themselves will be very much appreciated. It is to where I feel like if he doesn’t improve or declines more by Monday evening I will probably have to let him go. He is constantly falling and having a hard time getting up and his downward eye is looking extremely bad where it is barely open and very red.

I am very bad at remembering names of things and the paperwork I have isn’t very good. Some things my vet doesn’t charge me for and aren’t on my invoices. Here is what he’s been given though I’m really not sure of the names.

He did get a Baytril Injection on Dec 5th. And Dexamethasone. He got a white substance for once a day I think either .4mg or .5mg and pink substance for twice a day 1.5 mg. Then on the 19th he was kept on the white substance for once a day I think either .4mg or .5mg and was put on 1.8mg of the pink substance twice a day. On the 2nd he was kept on the white substance once a day either .4mg or .5mg so he is on that now (they pre-did it and I’m not at home so I can’t see) and on .4mg of a steroid once a day. He also has an antibiotic eye drop he can have every 12-24 hours but just do once a day because it is so hard on him when I put him back in his cage. On the invoices I have Panacur Suspension and TMS for his medications so I think that is the white and the pink meds he is on.

Any advise or any experiences those have had will be greatly appreciated. I’m not ready to let him go but I don’t want him to suffer and since he is falling down so often it is hard to watch. I will take him back to the vet every two weeks until he’s better if I have to and I will give him the meds he needs for as long as needed if I feel like he can get better.

[Bam]

I’m bumping this so as many people as possible see it.

Panacur for 28 days and antibiotics are standard protocol for EC. Steroids can be used in really severe cases.

You can also be given an anti-emetic (against nausea) f ex metoclopramide, and an anti-inflammatory (Metacam, meloxicam).

I haven’t had a head-tilt bunny. I know it can need prolonged treatment and that 28 days of Panacur is the minimum required lenght of trreatment – longer can be needed. Some bunnies retain the tilted head all the rest of their lives but still live good quality lives (the vertigo goes away by the wry neck remains).

Disabled rabbits has some tips about how to make life more comfortable for a head-tilt bunny:
http://www.disabledrabbits.com/ 

http://www.disabledrabbits.com/head-tilt.html

[Stacy]

Thank you for that info. Last night I spent a lot of time observing him. He seems fine when he’s sitting up even though his head is probably the most extreme form of tilted. He gets to where he wants to act like himself and then he falls down. I don’t know if he’s losing his balance because of his head or vertigo. Then if he falls down he will either try to get himself up to the extent that I’m afraid he’s going to break his back or he will just lay there on his side in a ball. He has always been a bunny that lays on his side to sleep (he looks like a dead rabbit when he does this, always has). Now with his head tilt he will lay on his side but seems to favor laying his face on his food bowl or lays on his belly with his head tilted at a very severe angle usually also on his food bowl. Then when he tries to get up he goes through the falling down. He eats, drinks, and acts like himself in every other respect.

If he wasn’t always falling down so much I would be fine with the head tilt. Any advise on medicines I can ask my vet about? I’m taking him back next Monday. I’ve decided we will wait another week at least to see where he’s at as long as I feel like he’s not in any pain.

He’s on Pancur Suspension .5ml since Dec 5th once a day. He’s been on Oral Prednisolone .4ml once a day since Monday. And will start every 48 hours for 7 more days starting today. And has Tobramycin Ophthalmic eye drops that I can give every 12-24 hours but I do 24 as to not mess him up any more than I have to during the day – I do two drops in his bad eye. I also introduced GenTeal eye drops last night per the vet’s instructions that I could use these also and his eye looks so bad – 2 drops… His good eye is starting to form some discharge and look red so I gave him a drop of each last night too.

[Bam]

Molly Varga (British rabbit vet and author of the 2nd edition of the Textbook of Rabbit Medicine) says Baytril can help together with the Panacur. She also says albendazole can be tried if fenbendazole (panacur) doesn’t give result. Albendazole has some side-effects that makes it unsuitable as a first-choice med, so it’s for cases where fenbendazole doesn’t work. I listened to a webinar she held a year ago, it’s still available to listen to, but you have to register for it. It’s completely free though: Webbinars

Look under “archived” for all the webinars, the EC webinar was on Jan 17 2016.

Anyway, here’s a slide from that webinar: 

Lufenuron has been suggested but not strongly tested. 

By “treat the disease” she means the malfunction of the affected organ/s. EC attacks organs with a high blood-supply, typically the heart, the kidneys and/or the brain and will give symptoms accordingly. Your bunny obviously seems mostly affected brain-wise. 

Since he’s eating normally, it’s unlikely that he has nausea. It’s really, really great that he’s eating. He obviously needs all nutrients he can get in order to fight this, but it also says a lot about quality of life – a bunny that feels really sick loses its appetite. His brain and body can learn to keep his balance with time (an adaptation process called habituation) if the infection and inflammation goes away and it’s “just” his head that’s at a really weird angle.  

My bunny Yohio also slept on his side, looking like a dead bunny. Some buns like to do that, so that’s of course perfectly normal. 

[Stacy]

Thank you. I am feeling much better. I was physically ill yesterday at work thinking of letting him go. We will continue to treat him and I will discuss with my vet anything that others have had help them or that might work. I go to a pet clinic that has 3 outlets in our area. The one is 10 min away, there is another about 30 min away, and the other is 45min away. I have taken bunnies to the 30min away one way in the past because at the time they were the only ones that would deal with rabbits. More recently the one I go to near home had one vet a year ago that would fix them but not do anything medically. I haven’t had to go back until recently for one that needs to have his teeth trimmed every 8 weeks. There is one vet there that can deal with rabbits medically but I’m not as fond of her. The other one that can that trims my Thumpers teeth is good with medical issues but not very hands-on experienced. She will usually look at him, hear what I say, and then go consult her rabbit book. I don’t like to read too much online but last time I told her I saw where a steroid sometimes helped so she looked through her book and gave me a low dose for him. I really do love her and trust her completely to do her best by him. With that said…

We haven’t actually done any tests on him. The EC was diagnosed based on his unbalance and rapid eye movements. Are there any tests that can verify if the infection and inflammation are still there or gone? I’m planning on having a list of things others have had work when I go see her next week with him. It sounds like a lot of this is just wait and see. 

I currently have 7 bunnies but will admit he has been my favorite for a long time. He’s two years old and the only one that has lop ears. (4 of the others are his kids from a surprise litter because we thought he was a female before it was too late

[Bam]

Tests for EC often produce false negatives, so it’s only a positive that you can trust. I’ve PMed you.

Head-tilt can, as you know, result from a bad middle/inner ear-infection. Treatment for that is antibiotics + symptom-relieving meds like Metacam. Ear infections can be stubborn too, so it’s very difficult to diff-diagnose. Fenbendazole is refgarded as very bunny safe though, so you often treat empirically with that. 

[Author]

Messages