EMERGENCY - head tilt

[killertheturtle]

This morning I was leaving for work at 5:30 and my rabbit, Rocket, had extremley bad head tilit. When I got home from work, it was the same and she was hiding in her house (which she never does. Her eye was beginning to roll to the back of her head.
I called every vet in the phone book (I just moved here...and I was unprepared). The only place open that did rabbits is booked solid with emergencies.
I know I can get her somewhere tomorrow...but is it too late?
Also, is it contagious?

 

[naturestee]

Weekends suck.

Although sooner is better, tomorrow will not be too late to get Rocket treated. Head tilt usually isn't a fast killer unless there is something else major at work. It is not contagious, as the primary organisms that usually cause this (parasite called E. cuniculi and several types of bacteria) are in most rabbits anyway.

For now, keep her comfortable and you'll probably have to help her eat and drink, possibly by syringing it into his mouth. This site shows how make him comfy:
http://www.mohrskc.org/hrswebpg19.html

ray:

 

[killertheturtle]

Thank you so much.
I took her out of her cage to look at her and hold her. She is defiatley not herself and when I put her on the ground, she just walked in circles. It took her about a minute to walk almost normally.
Thank you for the website. I will take her first thing tomorrow.

 

[undergunfire]

I am sending thoughts your way ray:.


Headtilt is a very scary thing to go through.

 

[TinysMom]

Several of us here on the forum have dealt with head tilt bunnies. Definitely take your rabbit to the vet tomorrow ASAP.

One of the biggest things I can suggest is to keep your rabbit hydrated over night - lots of fluids - or give things like carrots and parsley (I like to soak them in water overnight).

While I do have suggestions to offer - I'd rather have you see a vet first. I'm going to send a private message to one of our mods who is really good at stuff like this and works in rescue as he can probably give good advice too (although you've already gotten good advice).

Peg

 

[Bunnicula]

Thinking of and praying for you and Rocket! ray:

Keep us posted.

-Mary Ellen

 

[killertheturtle]

Thanks guys...
My scheduel for the night is (and PLEASE give suggestions, tips or corrections)...
1 cc of water every 30 minutes.
1/2 cc of carrot baby food (organic, lowest sodium they had) every hour.
I'll check her tummy constantly to see is it is full or empty.
Palpate at least every hour.

I made her a bed with pillows, fleece blankets (pee pads under them) and I put hay and veggies (even though she wont eat them) to stimulate her.
I'm going to stay by her side as much as I can.

Actually...I have one more question. Rocket has never liked people. She is bonded with Sonic (who has free roam now to come and see her as he pleases) so I was wondering if me petting her and laying next to her will actually make her more nervous than comfortable?
She has NEVER let me pick her up, but she is now. She is also letting me pet her. I don't know if it is because she does not have the energy to care, or if it comforts her.

 

[Sealy]

Oh gosh! Hang in there and I'm keeping you in my prayers and thoughts and sending get well vibes.
Keep us updated.

Hugs,
~Sealy

 

[ra7751]

Hi,

Scary thing isn't it? Goes by several names dependingon where your experience is...wry neck, head tilt or torticollis. It can be caused by numerous things. Trauma, neurological issues, etc. The most likely cause is a bacterial infection in the inner and/or middle ear. Contrary to what is in print all over the internet.....E Cuniculi does not cause head tilt. Tilt in a EC bunny is still usually caused by a bacterial infection allowed in by a compromised immune system. The eye rolling is called nystagmus. The rabbit is searching for a focal point to orient itself. A rabbit can't see directly in front of their face so they can't focus on a fixed point like we can to establish orientation. They use the feel of their feet and the inner ear to establish their position.

A vestibular infection can be very difficult to diagnose especially if the doctor is not rabbit savvy. The absolute first thing the vet should do is closely examine the ears visually. In many cases, but not all, there will be a large amount of debris in the ear and it is sometimes possible to actually see some inflammation. But due to the way the ear canals are designed, it is not always possible to see the area in which the infection may be. There should be a "cytology" performed immediately. It is like a mini-culture. It won't be able to identify a pathogen, but it will show if there is bacteria, yeast or both in the ears....and lops are very prone to yeast infections especially in hot and humid weather conditions. If bacteria is noted in the cytology, a full culture and sensitivity should be performed. It takes several days to grow a culture. Most likely your doctor will initiate interim antibiotic treatments pending lab results on the pathogen.

We have dealt with tilt many times. When you catch things early like you have, the chance is much better to get correction. We have also noticed that once a rabbit has a vestibular infection, they seem to be prone to them afterwards. Here are a few suggestions based on our years of experience with this issue.

Keep the bunny as quiet as possible. Being unstable is very stressful to a prey animal. I would suggest treating this like wildlife and keep her in a confined area and covered if possible. You might want to ask your vet about using meclizine....which is motion sickness medicine. It works in some rabbits but not all for some reason. It slows the reaction between senses but sometimes will make them very drowsy. Hydration is very important. This is another situation where sub-q fluids may play an important role. Most likely she will have a fever that might range as high as 105 degrees...well above normal. This will be very uncomfortable for her. Sub-q fluids will not only replenish the electrolytes and keep her hydrated, room temperature fluids will also help control body temp. If she is really fevered, a cold mist on her ears will be most welcome. I usually attack ear infections withmulitple antibiotics as indicated by the lab culture. I will usually administer two antibiotics...I prefer some of the injectable drugs....as well as some type of broad spectrum non-steroidal ear drops. An ear infection is also very painful. I will administer an anti-inflammatory drug for no longer than 5 days (and I have an idea what this drug will be...and it is the one considered "safe"....but should be limited in duration to no more than 4-5 days and hydration should be monitored in order to protect the liver). I have no problem using a narcotic especially in the first few days until things get under control. You will have to modify your husbandry protocols to assist with eating and drinking. But the hand feeding and extra TLC are a vital part of the overall treatment. And something that nobody ever thinks about...keep the "down" eye lubricated as it will tend to dry out and scar the cornea.I like the Refresh Gel as it is thicker and stays in the eye better than regular drops.

As far as being contagious....maybe or maybe not. Depends on exactly what iscausing the concern. But if you are concerned about your other rabbit, if it is contagious, it has already been exposed. That does not mean that your other rabbit will get sick. Same as with us, we can be with someone with a cold and we might or might not get infected.

Now, having said all of that....let's mention a few things that could cause this if it is not a vestibular infection. Rabbits can suffer from something similar to a stroke...a vascular accident...in which a damaged blood vessel in the brain can lead to neurological issues. A head abscess is also a possibility. I had a rabbit that suffered from that. It was quite difficult to diagnose and impossible to treat....at that time anyway. Some type of blood problem that is starving the brain for oxygen can also be a consideration. If your bun is an outside rabbit...or plays outside....there is a parasite carried by raccoons andleft in theirfeces that is a possibility. It is very rare to contract this parasite...but in thecases that have happened, there is absolutely no treatment for this invasion and these cases will self resolve in a short period of time (trying not to be too blunt with this one). And the bad boy...E Cuniculi. That is a protozoan infection that migrates to the brain. Normally, the first sign of anactive EC infection is a very slight neurological "tick" with the rear legs...maybe one drags once in a while....and seems to affect the leftrear leg first for somereason. Over the years, unsubstantiated reports have led many to believe that this particular parasite causes tilt. There is no clinical proof of that and our experience leads me to believe that EC in itself is not the primary cause of tilt in systemic EC bunnies. What appears to happen is that the immune system is so overwhelmed fighting the EC, that it allows the opportunistic bacteria....things like pasteurella and staph, to invade other parts of the body. Pasteurella is known to many as "snuffles"...and for those of you that have read my past posts...you will know by disdain for that term. Just for precaution, it might not be a bad idea to titer for EC. The titer is not perfect and is open to interpretation. This test should be done several times over several weeks. Your doctor will be watching for rising or falling titer levels. It is not a precise test and leaves a lot open to queston. The only sure way to test for EC is post mortem. Something we have noticed in EC positive rabbits is that it is a very reactive treatment protocol. This month, it's an ear infection, next month maybe urinary tract, then eyes, then upper respiratory. The immune system is so compromised that bacteria invades at will. There is not a really good treatment for EC although a promising drug is being used to treat a closely related horse issue called EPM.

This is another case with more questions than answers at this point. Just about every case of tilt like this one that I have been involved in has been an ear infection. It can be beaten but it can also be a long term deal. I have treated them for up to 8 months at a time. Recovery from this can be painfully slow. But it can be beaten. We have numerous rabbits here that have tilted over completely and recovered. We also have one that was not properly treated and did not correct completely although we do have him better than he was. Even if the tilt doesn't fully correct, with a few slight husbandry modifications, they can live very comfortable lives. While a vestibular infection is not fun to deal with and offers some challenges, it might be the lesser of the evils.

Sorry for the long post but this is a very complicated and misunderstood affliction. Based on my years of experience, I am betting this is an ear infection and that you have caught it early enough to treat it succesfully....and we wish Rocket a successful and speedy resolution. Please update us after your vet visit.

Randy

 

[killertheturtle]

Wow Randy I really wish I read your post before I just spent $150 dollars at an emergency clinic (finally) with a rabbit vet.
He did not look in her ears, he did not take her temp and he told me pretty much what you told me. He prescribed her baytril (which I already have from a prvious incident) and told me to continue watching how she is not using the bathroom.
He told me her not eating/drinking or using the bathroom is not linked with head tilt.
I'm going to give her the baytril twice a day for ten days...but I don't know what to do with her not going to the bathoom. The last time she went was 5:30 pm. I bought her 100% baby carrot food....but the vet told me to avoid that.
Randy, please tell me what to do. I realy appreciate your post.

 

[TinysMom]

I'm SO glad Randy stepped in - thanks so much! I PM'd him as soon as I wrote my earlier response because Randy has helped me deal with head tilt in bunnies.

I'm sure he'll be checking back in soon and he may be sending you pms (private messages)......

For now - I'd keep your rabbit hydrated until Randy checks back in.

Trust me though - your rabbit can continue to have a good life - even if the tilt stays for a while.

Peg

 

[pla725]

Your rabbit sounds like it is stressed out and is in GI statis. You need to start feeding. I believe there is info on that in forum. Others with more experience can tell you better what to do.

 

[Ivory]

If it is encephalitozoonosis (EC), fenbendazole has been shown to be effective, but many vets do not know of the treatment. I would suggest asking about it. Albendazole has also shown effectiveness in treating it.

The side effects associated with E. cuniculi (whether or not torticollis is actually caused directly by encephalitozoonosis or pasteurellosis) can come on very quickly if it's acute, and it is a scary thing to deal with. Still, the sooner the treatment, the better the chances of the rabbit getting it's straight-head back. (I just made up a term!)

Urinary incontenence can be a sign of encephalitozoonosis, as well as renal problems from mild to chronic renal failure.

Good luck treating this, whether it's EC or not.

 

[killertheturtle]

Ok...she has been eating a small amount of food. Both hay and pellets. I'm not sure if she is drinking, so I am still syringing her water. She peed some time in the middle of the night and when I took her to massage her abdomen, I saw she had some diahrea stuck to her. I have her her baytril this morning and about 1/2 cc of baby carrot food.
I read more info on rabbit.org. They said to give her pedialyte. I'm going to buy her some very shortly.

 

[~Bracon~]

I was reading about this a few days ago, in my book it says that the vet can offer medication and the bunny will heal within a few weeks, although its head may not go back completly normal and still may be left with a slight tilt.

 

[killertheturtle]

Thanks for all your help and suggestions.
She is doing better; she is eating a little and pooping a little. I took her temp and it is 102.1. She actually seems like shes resting; she is in a relaxed position (well i guess as relaxed as one can be with their head tilted) and she loves pedialyte.
I bought stuff to prepare for a bunny enema (as per rabbit.org), but when I picked her up to take her temp, she started having little poops, so i will hold off.

 

[ra7751]

Ummm...that is all the advice you got for that money? My first suggestion is to find a real rabbit vet. I am not here to flame anyone...vets in particular....but those that have never dealt with ear issues in a rabbit don't really understand the forces at work. I think www.rabbit.org may still have a listing of suggested vets.

I am not a big fan of Baytril in any situation. And there is a possibility, and we run into this a lot, that if it is a bacterial infection that the pathogen may be resistant to Baytril. I rarely use Baytril now due to resistant bacteria. And the not eating and pooping not related? With the pain and stress of head tilt....I think it's related. The pain and discomfort are quite high and we do see their appetite depressed. With ear infections, they are very tough to treat, they are long term treatment and require aggressive attacks from multiple fronts. Unless it is a very puny infection, which I doubt considering the sudden onset and degree of tilt, Baytril just ain't gonna do it. Some good pain meds will do wonders for this rabbit I'm sure.

As others have mentioned, hydration is essential. Sub-q is best but orally by Pedialtye is better than nothing. And if she will eat greens....dandelion greens are always around here for sick rabbits....they also help with hydration. Offer any bunny safe food in a buffet.

Keep in mind that I am not a vet, but I would really like to see this bunny on much more aggressive antibiotics and pain meds. Ear infections can penetrate the ear drum and cause deafness and can also invade the brain.

It might not hurt to treat for EC after the tilt clears up...dont' want to do too much at once. The most favored treatment is Fenbendazole (Panacur). It is the latest and greatest of the "bendazoles". It has to be administered every day and we have done so up to 60 consecutive days. However, despite the "success" stories you see all over the internet, truth is that this drug is not that effective. Has to do with penetrating a blood/brain barrier (odd that the parasite has no problems doing it). Our experience in treating with Fenbendazole has been limited in success and disappointing to say the least. We have even used a "cocktail" of different drugs with not so muchsuccess. I am in the process of working with a drug called Marquis that appears, on paper at least, to possibly be more effective. Amazing how one of the simplest organisms on earth can be such a pain to deal with. EC is quite a challenge.

But for now, until we get a handle on this...I am still thinking vestibular infection and I think further diagnosis is in order. I suggest a much more detailed look in those ears to see what is going on.

Feel free to PM me if you need more detailed info. I am somewhat limited in this since I am not a licensed vet but I will do what I can to guide you in the right direction.

Randy

 

[MsBinky]

:yeahthat:

You tell that vet to put his head sideways all day and see if he wants to eat :foreheadsmack:Lol. I hope your bun feels better soon. I would definitely seek a second opinion, especially if they didn't check for an ear infection and such. Some vets aren't so great with rabbits huh? I know that feeling.ink iris:

 

[killertheturtle]

I took her to a great rabbit vet a couple of hours ago. He thinks she has EC. I'll get the test results in a couple of days. I am very worried.
He sent me home with Ponazuril and Critical Care. He said since she is eating a little to give her 1/2 the dose of Critical Care for her weight. I have no idea how to dose this. Please help..
50 cc/kg body weight. She weighs 3.5 pounds.

 

[JadeIcing]

It is scary to see them like that. Sending get well vibes to your little one.