Feeding Head Tilt Bunny

[Sabine]

To my surprise (and delight) Asha is still with us and there is even a slight improvement. She is still nibbling on greens and bits of hay and is moving around a small bit. I think I am getting a bit better with the syringe feeding and seem to be able to get more critical care into her. The vet noticed that she did not appear dehydrated anymore but the tilt is still really bad so that she lies on her side for most part of the day. We are continuing the baytril injections for another while and she also gets the penicillin shots and the fenbendazole of course. I am a bit more hopeful now as Asha seems to hang in there and I was wrong thinking she had given up already.
We are due back to the vets on Saturday. So fingers crossed that by then we'll see some improvement.
P.S. I put a tiny drop of pineapple juice in her drinking water bowl. I did find her with her head in it this morning and I think she must have drunk a bit by herself.

 

[Sabine]

Asha at her worst:

 

[Bunnylova4eva]

Hadn't seen the thread until now-praying for your sweet Asha. I've been through head tilt with one of my bunnies, so I know I how difficult it can be caring for them. One idea on syringing- what size syringe are you using? The vet gave me big ones (like 10 mL or something) and my bunny just wasn't taking it. I tried then filling a 1 mL syring and she took it SO much better-difference of night and day! But, the problem was that it was hard to get the Critical care into a 1 mL syringe. So, I'd fill the big one and use that to fill from the top of the 1 mL syringe (if that makes any sense..).

 

[tonyshuman]

The poor bun. I'm glad she's eating on her own and improving. You may want to put artificial tears in her eyes, as buns with severe tilt can often get problems with their up eyes (they don't close the lid as much so the eye gets dry) and their down eyes (they are closer to the ground and can get stuff in them. It sounds like she is getting better--the tilt may not be going away, which would be really difficult and sad for her to have to deal with for the rest of her life, but it is something that can be adapted to.

 

[Sabine]

Bunnylova4eva: Thanks for the advice with the syringe. I actually tried it last night but even the back end of my 1ml syringe is to small to syringe the food into. I am going to ask the vet for an inbetween size as I do find my syringe rather large for a 900g bunny.

tonyhuman: I actually bought those artificial tears yesterday and have used them a few times. I had the vet look at her eyes yesterday. Thankfully there are no injuries just the down eye looked a bit irritated.

Some good news: Asha is doing much better with the eating. She ate most of the fresh food I left in the gcage overnight and a good bit of hay. I even put a few pellets in front of her nose and she ate those too. I just went into the garden for some dandelions and she is munching them at the moment. I think I will still syringe her a small bit as her weight is still only 850g and I am not sure how much she is drinking.
I'll be giving her the fenbendazole and the baytril injection in a minute too.
Her actual condition hasn't improved much but she appears stronger and more alert. I do hope we'll see some improvement soon.

 

[tonyshuman]

So good to hear! Cmon Asha, keep eating!

 

[holtzchick]

Hoping for a speedy recovery!! Poor girl has been through a lot!

 

[HEM]

That is good news!!!
We are hoping that Asha continues to improve every day.
We will be thinking of you and Asha

 

[Sabine]

Thanks everyone. We are just back from the vet's. My vet thinks that she has improved slightly when she examined her but I can't really see it. The good thing is that she is eating herself for the most part and her poops look normal. She weed on me several times yesterday so I think there is enough water going through her system. I did syringe her once this morning as her weight was slightly down again but will watch her food intake over the day.
We will keep injecting the baytril and giving the fenbendazole. Our next appointment is scheduled for next Wednesday. I hope by then I can see some more improvement.

 

[Bunnylova4eva]

So glad to hear she is doing somehwat better! I have a special place in my heart for head tilt bunnies; today marks 2 years since I lost mine. :'(

 

[Sabine]

Asha spends a lot of time just lying on her side motionless but does move around occasionally to get some food:

I hate seeing her like this and hope she'll be able to regain some quality of life back.
Here are some pictures from last Autumn:

And Asha with her friends Lint and Snickers:

 

[Sabine]

It has been over two weeks now of treatment and there is absolutely no sign of improvement. The tilt is as bad as ever and she is hardly able to move around. In fact, she tends to lie in the same spot for most of the day. She does eat small amounts and I am still syringing her food to keep her weight up but I am really beginning to loose hope. Should there not be some sign of improvement after two weeks on baytril, penicillin and fenbendazole? Or is it the amount of medication that makes her so lethargic and unresponsive?
I know it can take a long time for head tilt to be cured but should the rabbit not show some signs of alertness after over two weeks?

 

[tonyshuman]

If the dosing is right, the meds shouldn't make her lethargic/out of it. You may want to ask the vet to be sure the doses are right, and that they're correctly determining her body composition. I read this recently about bunnies being assumed to be overweight due to their breed, and the vets subsequently overdosing them with fat-soluble medicine. Fatty tissue often serves as a storage site for medicines--most drugs go into fatty tissue and don't come out as rapidly as they would for tissue that is more heavily supplied with blood. Some vets will see a round little nethie and assume that the bun is obese, having a lot of fatty tissue, when in fact the bunny is normal for the breed and it is not fat that makes them that shape. They subsequently change the dose to be higher to account for partitioning of the drug into the fat. If you think the meds are making her lethargic, for instance if she seems better right before you give her a dose, it's worth asking the vet. Overdoses of Baytril and penicillin seem to be first GI-related, then increased CNS activity, i.e. seizures, tremor, etc, instead of lethargy, from what I have read. Fenbendazole could cause depression like you note, but it is very hard to overdose (high doses are tolerated).
http://www.medirabbit.com/Safe_medication/Body_shape/Type_rabbit_en.htm

I would think that you would see at least some improvement in 2 weeks if there was going to be improvement. Some bunnies that get a head tilt will become cured of the infection/parasite that caused the initial injury to the inner ear, but will not resume a head upright position because the damage to the inner ear could not be repaired. Depending on the severity of the infection and how long it takes to get it under control, the tilt can become permanent. I don't know if you remember JadeIcing and her bunnies Ringo and Gabriel. They both had ear infections that didn't get treated thoroughly enough in time, and subsequently had permanent head tilts. They weren't as bad off as Asha is, though.

 

[Sabine]

I seem to remember that my vet calculated the dosage just by weighing her. She just had a conversion chart then to calculate the dosage. I don't think body fat came into it.
Asha is off the baytril now as 2 weeks seems to be the maximum recommended dosage. She is just getting the penicillin a injections and the fenbendazole. She is eating by herself, even pellets but I still syringe her a bit to get some extra probiotics into her. Her weight is still rather low and I am wondering should I change to a different pellet like the junior/dwarf variety of the pellets she is already eating?

 

[tonyshuman]

That may help. Would you say she's in good spirits?

 

[Sabine]

It is hard to say. I reckon it doesn't help that she hasn't got her friends with her anymore. She is just very very quiet and lies in her cage. She does eat a decent amount for her size and this morning I didn't even find any cecals in her cage. As there were alot of other poops around and a good amount of food missing I assume she has started eating them again which is great. I still syringed her a small bit to get a few more probiotics into her. I never see her drinking from her bowl but as there is pee about I assume she must be doing it at some stage.
I am just wondering if this is as good as it gets and she'll just be a severely disabled bunny for the rest of her life? She is still rolling and can't hop. She moves by just shuffling about.

 

[Azerane]

Aww, at least she is eating of her own will, that's a really good sign. If you're concerned about her drinking, you could always syringe some water into her mouth as well. Or measure out the amount that you give her and then re-measure it a bit later in the day.

 

[tonyshuman]

It is good that her appetite is there. You can probably put her back with her friends if you think they'll treat her ok. I don't think whatever is going on medically can make them sick--they've probably already been exposed to it, be it EC or an ear infection bacteria. Maybe that would help her cheer up? I hate to say that I do think at this point, it's unlikely that she'll get a lot better in terms of being tilted. It seems that once the tilt has persisted this long, it usually doesn't go away. I have heard of longer-term improvements with panacur, around the time frame of 4 weeks or so, but not much longer. Does your vet have access to ponazuril? You might consider trying one of the less commonly used treatments for EC, like pyrimethamine.
http://www.medirabbit.com/EN/Neurology/cuniculi/pyrimethamine.htm
http://www.medirabbit.com/EN/Neurology/Signs/Cuniculi_signs.html
http://www.medirabbit.com/EN/Neurology/cuniculi/Starsky.htm

I am still not sure EC is the culprit here, since she had the horizontal nystagmus, which usually indicates an inner ear infection instead of EC-related head tilt. However, if everything else (ie the long-term tilt that didn't respond to aggressive antibiotic treatment) points to EC instead of an ear infection, maybe the nystagmus was just a red herring. The only other antibiotic that might help would be chloramphenicol, which has good blood-brain bioavailability.
http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm

 

[adamjai]

I have a head tilt bunny who gets around and seems very happy. She's had a couple of rough patches that Panacur has helped her through, and I nearly lost her a couple of years ago but with a lot of syringe feeding was able to get weight on her and she pulled through. I would definitely put her with her bond mates, som rabbits can get very depressed when split up. I've heard of bond mates cuddling and propping up head tilt bunnies before.

 

[LoisBunnies]

Hey, just wanted to give you some hope! My Poppy had what looks to be a similar degree of head tilt (I haven't read the whole thread though) I will attach a picture of her so you can decide for yourself. She was like that for three weeks, and didn't actually stand upright for two weeks. Over the space of about 8 weeks in total, her neck did straighten. She passed away in November, but I really don't know if it was head tilt or something else - what I do know is that we had six months of happy, healthy bunny We got there with painkillers, antibiotics, panacur, pellets dissolved in water with added baby food syringe fed, and lots of water by syringe.