Bunny Rolling and head tilt

[Korednic]

I want to start by saying I have looked up bunny questions before and have always been directed to this site. Thank you for your advice and support even though you were not posting directly to me.
my bunnies are 2 years 6 months. I work at a vet clinic that does not see bunnies but one of the vets used to for years so she did the neutering and has even helped heal one bunny through severe GI stasis. My one bunny Ramen has developed a head tilt overnight. It’s been one week. We are treating with Baytril, metacam, buprenorphine, and once a day I give metroclopramide. I also do watered down critical care and will be taking in for fluids every other day beginningMonday. I’m prepared to do anything even if it means he will never be back to his old self again. I lovemy bunnies but ramen is just so fun and loves people or at least he did. Now he’s depressed. However my question is.
how do I adapt life for a head tilt bunny? He can’t go in his hutch at night because he falls over so he is out in there already blocked off room. Today he has toppled over twice and he panicked. I can take him to work with me but how do I make life easier and safer for him. Any tips Or tricks. His brother Miso, helps some by propping him up and grooming but I know there has to be some way I can support him. I’m trying also to find a bunny neurologist and may have a lead out of state which I can take him to but I’m the meantime how can I make life safe. I will never get rid of this bunny and he does eat and tries to hop around. If it comes to his quality of life being poor I will euthanize but not after I have tried everything and been to every doctor. My heart is breaking but I’m holding on to hope it’s an inner ear infection. However it keeps getting worse. Please help.

 

[dogwoodblossoms]

I had a bunny about two years ago who developed a head tilt (caused by a parasite which activated due to ear mites).
It helps when you set them on their back and cradle them (like a baby) and relieve the weight on the side the tilt is on. Massaging his neck will also help with the weight relief.
For his confusion and rolling, try keeping him in a smaller space that he’s comfortable in, it’ll help the panic. Make sure to keep his brother with him, he’ll also sooth him.
Besides that, all I can recommend is giving him lots of cuddles and attention for his depressed state.
Before you leave for work, all you can really do is make sure he’s comfortable, calm, in a safe space and has his brother.

 

[JBun]

Did your vet determine that your rabbit definitely has an ear infection, with having found evidence of infection in the inner ear or pus in the ear canal? Reason I ask is that with rabbits the parasite e. cuniculi is also a very common cause for head tilt. If your vet didn't definitely determine an ear infection, often rabbit vets will treat for both possibilities by giving a rabbit safe antibiotic(like baytril), meloxicam to reduce inflammation, and fenbendazole(Panacur- liquid or rabbit paste, not the large animal paste). Your vet should also rule out a secondary ear mite infection as that can contribute to the head tilt, though not a primary cause for severe head tilt(treated with ivermectin or Revolution/selamectin).

If it is determined that there is an ear infection(shows on scans or pus in the ear canal), or if once panacur is started he continues to worsen and it could be there's a chance that it's due to an inner ear infection, you may want to consider a different antibiotic. Baytril isn't always the most effective when it comes to rabbits and infections. One that seems to be very effective for head infections in rabbits is azithromycin(50mg/kg). It has good tissue penetration and usually starts working pretty quickly, which isn't the case with some other antibiotics. Pen g procaine/benzathine injections(NEVER orally) might be another option, but azithromycin would be my first choice. Though do be aware that rarely some rabbits will have a severe digestive reaction to it, but I've only encountered some minimal stomach cramping initially with it in one rabbit.

So I would get Panacur started(20mg/kg for a minimum of 30 days), continue with meloxicam/metacam (dosed minimum 0.3mg/kg twice a day, but up to 0.5mg/kg twice a day), and either switch antibiotics later if the condition continues to worsen or switch antibiotics now. In severe cases, sometimes vets will opt to use corticosteroids for a few days instead of the meloxicam, but that's only as a last resort due to it affecting the rabbits immune system, and especially in the case of a possible ear infection.

Medirabbit: ear infection clinical signs and treatment

https://wabbitwiki.com/wiki/Head_tilt
E. cuniculi in rabbits

https://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
https://www.vgr1.com/metacam/
For now you do have to have special living accommodations for him. Head tilt bunnies need to be indoors in a warm environment, in a smaller area with towel rolls, bumpers, etc to help keep their body supported. It can also help them to do some physical therapy to help them learn how to adjust to the head tilt, though this is more when they start recovering. Doing it while they still have vertigo can spark rolling. Also gentle massage of the neck muscles can be helpful. There's also a FB group called 'head tilt hoppers' that might prove helpful to you. But be aware that even if the medications do work and your rabbit stabilizes, sometimes there's permanent cell damage that leaves the rabbit with a residual head tilt. Head tilt rabbits can still go on to live happy lives, but special accommodations and help will need to continue to be provided.

http://www.disabledrabbits.com/head-tilt.html
Rabbit vet list if needed.

https://rabbit.org/vet-listings/

 

[Blue eyes]

When one of my rabbits got head tilt, I found the following site to be quite informative. It explains the different treatments and prognosis based on cause.

https://rabbit.org/health/tilt.html
Not only are there a variety of diseases that can cause head tilt, but it is important to determine if it is an issue with the inner ear (more common) or the brain stem. Knowing whether it is peripheral or central is key to proper treatment.

 

[Korednic]

Thank you everyone. My vet has also suggested Dramamine non drowsy as well which I just gave. On Tuesday she will run more tests to determine if it truly is an inner ear or something else. I will tell her about the panache that drug we have not done. Any med I can get compounded so it’s easier for him to take. The suggestions on towels as bumpers was very helpful. Simple but I never thought of it so thank you. Also we pick him up for meds and after he can not right himself for a while do I am going to try the towels as bumpers to do meds instead.
My vet is also talking to other specialists through VIN for others ideas and thoughts. I do think you are right I need to get a confirmed diagnosis. Since my work does not see bunnies the owner is willing to get whatever tools are needed as well as run any tests we can. He already gave me this medication and ordered me critical care. I’m very fortunate. I can’t express how much this means to me. The Facebook group suggestion as well. I had no idea. Thank you everyone. I look forward to returning the favor to you all.