Vestibular Vertigo

[morgano]

Hello!  I apologize if this has been brought up before–couldn’t search, and went back about 5 pages worth and did not see anything…

So, it was around mid-September when I noticed my bun Morgan’s head was slightly tilting to the side.  It was only a slight tilt, and not nowhere as bad as pictures I had seen when I googled head tilt, plus, this had happened earlier this year, and after a while his head straightened out again, so I wasn’t too worried.  I just kept an eye on him.

By the end of September, his tilt was much more noticeable–again, not as bad as the pictures I’d seen, but there was a definite angle to his head now.  So I called the VCA hospital near my home and they told me that their rabbit doctor was in that afternoon and to bring him in.  So we do; the doctor examines him and asks about him.  She said she could find nothing wrong physically, besides the tilt, and he was still very alert.  I told her that yes, he still acts normal–he eats, drinks, poops, hops around (just at a diagonal now) — it’s just his head.  She asked if I noticed his eyes twitching–I hadn’t.  She asked if he rolls, and I told her I hadn’t seen it.  She tells me that it could be a parasite, it could be an ear infection, or it could be a tumor in his brain, however, she didn’t have the equipment to do the tests that would be needed, so my options were to take him to another animal hospital, about an hour away, on her referral, or I could just go ahead and treat him for the parasite.  I decided to treat him with the meds first, and if it didn’t work, then we could go to the other hospital for the scans to see what was wrong.  She gave me a 28-day supply of fenbendazole (.55ml dose) and a 10-day supply of meloxicam (.37 cc dose) to give to him once a day, told me to clear this environment so that nothing could scratch him, to keep an eye on his down eye, and we made an appt to come back in two weeks to see how he was doing.  If at any time he stopped eating, we needed to bring him in right away, and he would have to be put down.  

We took him back in 2 weeks, the head tilt was worse and he had lost .2 lbs, but he was still alert and curious, still eating and drinking, still no eye twitching, and he was still hopping around fine.  She was a little disappointed that the medicine was not working, but she said to keep it up because it takes a long time with these little guys, and she gave me another 10-day supply of meloxicam (I still had 14 days left on the fenbendazole).  We made another appointment in 2 weeks to see his progress, and she again told me that if he stopped eating, to bring him in to be put down .

The next week, I noticed the rolling.  It’s only really when you have been carrying him, which we do to administer his medicine.  Once you put him down, he will roll onto his back and stay there for about 10 seconds, before flipping over and righting himself (if you try to gently nudge him to his feet, he will continue the roll so he’s back on his back again).  Still no rapid eye movements that the doctor warned us about, no infected down eye, and he was still eating and drinking, but the rolling freaked me out.  Plus, his head tilt was looking more and more like those that I saw online.  So I decided to just take a drive over to the other animal hospital one evening.

The vet there did a thorough exam and we saw he had lost another .1 lb but she commented on how “feisty” he was, and after she had finished with him, he immediately started grooming himself so she was saying that’s a good sign.  She had to get a special scope to look into his ears to see his ear drum (different from the one the other vet used), and she said there was a lot of gunk in there, so she cleaned out his up ear (which she said surprisingly had more gunk than the down ear) and partially cleaned out the down ear (only enough for her to see the eardrum, because by then Morgan was NOT having it–my usually calm bunny was MAD).  When she left to do a cytology on the ear debris, he could not stop stomping!  I had to stand there and pet him over and over and talk to him quietly before he finally calmed down.  The cytology showed that he had yeast in his ears, so the vet prescribed Baytril (1ml orally 2x a day).  She did not tell me he would have to be put down, but did say that it’s good he’s still showing his personality, he’s still showing interest in grooming himself (which he did again once she came back in with the results–I guess he thought he better get ready haha), but that this could just be what is known as “vestibular vertigo.”  They don’t exactly know the cause, but that rabbits can continue living with it–they just adjust.  She said to use the Baytril (30 day supply) to get rid of the yeast.  

So the following week was the scheduled 2-week appt of the other vet.  I took him back and told her what the other vet told me.  She said it was good to continue with the Baytril and to continue to watch him, but that she was disappointed that he had not gotten any better even with the medicines he’s been taking.  She wanted to see him in another 2 weeks.

Two weeks later, and he was still the same, still head tilted, but still eating/drinking/pooping/hopping.  He was still taking the Baytril, so I decided not to take him in because she was just going to tell me the same thing.  I just hoped the Baytril would work.

It’s been three weeks since then, he has finished his Baytril (ended up being for 35 days, with the sample she gave from her office and the 30-day supply from the pharmacy), his fenbendazole, and his meloxicam, and still looks exactly the same.  Is this just the vestibular vertigo that the other vet told me, where there’s nothing they can really do about it?  I tried researching it online but it did sound like it was an ear infection, and shouldn’t that have cleared up with the Baytril?    I’m not sure whether to take him in for more meds or to just adjust to this, as he obviously has.  

Anyone heard of vestibular vertigo before?

Thanks!

sorry for the length 

[Bam]

Vestibular vertigo just means vertigo caused by something affecting the vestibular system, I e the balance organs in the inner ear. The cause can be anything from sth very harmless like benign paroxysmal positional vertigo to something really bad like a tumor on the vestibular nerve.

In rabbits, the most common causes are the parasite e cuniculi or a middle/inner ear infection. Fenbendazole is the most commonly prescribed drug for e cuniculi, Baytril is often first choice for an ear infection. You can’t get a sample from the ear behind the tympanic membrane without piercing that membrane (the eardrum), so you can’t do an antibiotics sensitivity test. You can test for e cuniculi, but the test is notoriously unreliable. Fenbendazole is a mild drug though, so vets often choose to treat with it on suspicion only. Metacam is both an antiinflammatory med and a painkiller, so that’s commonly prescribed together with fenbendazole/Baytril.

Nowadays some vets say e cuniculi should be treated with fenbendazole for st least 6 weeks. Its a very slow acting drug that doesn’t penetrate the blood brain barrier.

There is a website called disabled rabbits that have tips for owners of headrilt buns. They also have a Facebook page, and there are other e cuniculi/head tilt bunny Facebook groups where you might be able to connect with other people that are/have been in a similar situation to yours.

http://www.disabledrabbits.com/

Buns can live very good lives with a permanent residual head tilt. The brain is amazingly good at adjusting.

[morgano]

Thank you for the response and the information! I wasn’t sure whether to keep up with the meds or not–I know both vets said the meds are slow-working but I didn’t know if it was helping him any. I will visit the site and join the FB group. Thank you!

What’s funny is that I also, around the same time, had a severe earache and dizziness–I was diagnosed with an ear infection and positional vertigo. My friend thought it was so cute that I shared the same diagnosis with my rabbit.

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