Head Tilt-Twinkles

[tonyshuman]

I really think that an anti-dizziness medication needs to be part of his treatment, especially since he's rolling. It's got to be terrible to feel that the world is oriented the wrong way and be falling over all the time.

Like Pipp and LittleBayPoo have said, you should go with whatever treatment has been doing the most to help. Every patient is different and will respond to treatment differently. Just like Ronnie needed a different treatment regimen, Twinkles may need a nonstandard treatment. The treatments written on the package don't always work for all patients. Being open-minded and willing to try new things (like Convenia) will help you and your vet beat this.

Good luck. :thumbup

 

[PixieStixxxx]

I know this is probably a dumb question.. but she is seeing one of Vancouver's rabbit savvy vets right? Maybe she can go to Upjohn for a second opinion?

Royce's ear problem was always being treated at West B. Two weeks ago, I had an uneasy feeling and took him to Upjohn for a second opinion and they discovered an impacting ball of pus located in his ear canal that West B. completely missed. If I hadn't brought him in, Royce's could've suffered from head tilt and potential deafness.

I learned the lesson that a good vet reputation doesn't mean that there are no imperfections.

 

[bpotter2]

Hi, have been unable to get on for the last few days. Thanks for all the information. Twinkles is no worse and is actually a little bit better. I have been giving him the oral Chlorpalm twice a day for 11 days. He has times during the day when his head is straight but then, when he moves his head to look, he reverts to full sideways tilt. He no longer hides under the sofa all the time and has been out lounging with Bon Bon allowing Bon Bon to groom him and give him a good licking. He only rolls when I give him his meds but one time, he did not roll at all. He is eating well and runs like the dickens when I enter the room! I am the monster that stuffs nasty stuff in his mouth without his permission.
Fortunately, the vet gave me more ChlorPalm but also gave me more injectable Baytril and Penicillin, just in case. Unfortunately, the needle size was increased. I had to practically stab him with the first lot and even then was not sure how deep the needle went. Which brings me to another problem. Twinkles now has a few lumps at the back of his neck and one larger, long one on his side. They seem to be just under the skin, not attached to muscle or anything. I am convinced, now, that these are where the injection sites were, including the one Convenia shot which the vet gave into the side. I have been watching them, just in case, and have seen them go from full. plump nodules to flat and hard. I hope they will clear up on their own.
Twinkles does seem to be slowly improving. I am worried that if I do give him the penicillin injection, it will sit in his skin. if that's what happened. Also, the vet did not dilute it to make it easier to inject. Is it possible to go to the pharmacy and ask for saline or something and dilute it myself? I would feel a lot easier giving the injection if I knew it would actually go in. The vet just offered to increase the needle size to 18 when I reminded her of the problem.
I also would like to know if I should put mineral oil or olive oil in his down ear. Months ago, when Twinkles went in due to his tearing eye, the vet checked inside his ears and found one ear was packed with very hard wax. I have to tell you, it was quite massive. He cleaned it out as well as the other ear, which was not so bad. My thoughts are, if the ear is impacted again, it might be adding to his problem. Actually, the second vet looked at them and said there was a bit of wax but did not bother to clean them.
I really appreciate everyone's help. This has been such an ordeal.
Kathy

 

[bpotter2]

I forgot to mention, no I am not at one of the bunny savvy vets, although I was directed to this vet by BlueRidge which is on the list. The vet there was unavailable and I was told she is a very good vet.
I just got the Meclizine and will give him some next med time. I stopped the Metacam after 4 days as he reduced his eating dramatically, therefore very little output. After a couple of days, he went back to eating quite well.
Thanks,
Kathy

 

[tonyshuman]

Thanks for giving us an update.  Unfortunately, the hard lumps on the side sound like sterile abscesses, which are a result of the injection not absorbing quickly enough.  This article mentions it on pg 6-7 (under the heading "Diluting the medicine before administration".
http://www.medirabbit.com/EN/Injection/Extracting_medication.pdf

Also this book excerpt mentions how one gets sterile abscesses: injection into the skin rather than below the skin into the peritoneal (body) cavity.  The way it works is that there is a layer of skin and muscle immediately at the surface of the body.  Once you go below that, it is called the peritoneal cavity, which is where the organs are.
Click Here For Book Link

That article also mentions that penicillin should be diluted, but it is in an oily solution as opposed to water-based, so you cannot dilute it with saline.

Unfortunately, the only solution I can find to sterile abscesses is surgical removal or draining of the abscess.  I also cannot find info on what you're supposed to dilute penicillin with, but I guess it would depend on what kind of penicillin it is.  For instance, Pen G/procaine solution is water-based and could be diluted with saline.   This site lists all the types of penicillin and if you click on each one, it will tell you if it's oil-based or water-based (aqueous).  http://www.drugs.com/vetp.html

This thread talks about ear wax buildup: http://www.rabbitsonline.net/view_topic.php?id=27814&forum_id=16
HRS recommends an ear cleaner: http://www.rabbit.org/faq/sections/groom.html#Ears

I would think a little oil in there to break it up couldn't hurt, but am not sure.  Some sites say never put anything in there, some say it's ok.  I would be more concerned about why he isn't cleaning it out himself.  Is his back leg on that side working ok?

Best of luck~~

 

[bpotter2]

Thanks! Twinkles legs seem to be fine, he kicks them up at me now when I let him go after his meds. His way of telling me he does not want anything to do with me. He absolutely hates his twice daily squirt in the mouth. He forgets about the nice massage he gets immediately after which he absolutely loves! He now makes these little contented sounds like he used to before he got sick.
He has improved a great deal since yesterday. He actually went out onto the porch today, something he could not have even considered a couple of days ago. This is really quite an improvement, if you could have seen him. I did give him his first squirt of oral Meclizine this morning but that was after his outing, so it could not be attributed to that. He also ate very well. I am just praying he will continue to improve!
Today was a good day!!!
Kathy

 

[Maureen Las]

Great!!!! hope the good days continue

 

[tonyshuman]

Yay! I'm glad the meclizine is helping him. I can't imagine how disorienting head tilt must be. Glad his legs are fine, the little sassy bun! Still strange that he's not able to clean out that ear by himself though. Did you put any oil on the wax in his ear?

 

[bpotter2]

No, I haven't done anything yet about the ear. I was reading about what I should use. I think I have to get something at the vets.
Twinkles was doing so well, then a few hours after I gave him the Meclizine, he had a bad bout of rolling. He rolled while under the sofa but managed to come out of it fairly quickly. When I gave him his evening Chlorpalm, he rolled so bad I could not get him on his feet for quite some time. It was terrible! Next morning, at med time, I decided not to give him the Meclizine as he had a soiled bottom. I wiped and cleaned it as best I could. He did not eat very much and the major worry was back on. He seems to be so sensitive to everything!
He has gotten better since I have not given him the Meclizine. Today, he was more animated and did not roll at med time, but his bottom was soiled, again. His appetite is better, he ate pretty well.
Hoping he will do well tomorrow.

 

[tonyshuman]

That's too bad he's been rolling. It's strange that he does better without Meclizine because it should make the rolling less frequent. In any case, it probably is better to get oil or something from the vet. When does he go in again?

 

[Little Bay Poo]

I remember when we took Ronnie to the vet for his tilt, and she told us that Meclizine doesn't work for every bunny, but it was worth a shot. It worked well for us (most notably stopping his eyes from darting back and forth) but maybe Twinkles is one of those bunnies that Meclizine doesn't work on.

We too had bouts of rolling and they were upsetting to watch. Head tilt bunnies have good days and bad days and it can be so unpredictable. I would just make sure to keep Twinkles on his rounds of antibiotics and Critical Care if he has a bad appetite. We had Ronnie on Critical Care, 2-3 times a day every day for at least two months. It seemed neverending but eventually he regained his appetite and has been eating on his own for a few months now, even putting on some weight.

 

[bpotter2]

Hi I am a bit wary of taking him in to see the vet unless absolutely neccesary. Last time he went, I thought he would not make it home. He convulsed and hyperventilated for close to 20 minutes on the drive home, even though I held him close to my chest. His heart was beating so fast, I thought he would have a heart attack.
Twinkles was no better, no worse the last 24 hours. I am a bit confused about the Meclizine and Metacam. I have not read of other bunnies getting soiled bottoms from these meds. Twinkles still had a poopy bum at midnight, when I gave him his Chlorpalm. I cleaned best I could with a wet cloth but it's been a couple of days since I gave him the Meclizine. He did not eat a lot but ate some.
He did not roll very much after his meds last night, was able to get up quite quickly and scampered off under the sofa.
Other news, I noticed Bon Bon has a wet patch under his right eye. This is a real blow to me. I am concerned that Bon Bon will now go through this. Twinkles fell over the first time Dec 26th. Bon Bon has not shown any signs of illness until now. Will be talking to the vet as soon as possible about him.
Kathy

 

[Flashy]

I'm sorry times are tough for you and Twinkles. Try to really appreciate the positive when it happens, like when he got up quickly after his meds and scampered off, because it will make the stress lessen, a little.

As for Bon Bon, a wet patch under the eye is probably not anything related to head tilt, but it does need to be seen. Hopefully it is something easy to sort like conjunctivitis.

 

[tonyshuman]

I see why you don't want to take him to the vet. I did find a site that stated that diarrhea is a side effect of meclizine in humans, but it's a bit rare. I also have not heard of metacam causing poopy bum. I would suspect something else is causing the poopy bum. Is he having difficulty eating cecals? Is it mushy fecals? Were there any other changes in diet that accompanied the meclizine?

I do think Bon Bon should see the vet soon. Many of the bacteria that can cause bad ear infections are always found in the rabbit's system, but they can get out of control and cause an infection. Any stress can cause a bunny's immune system to let common bacteria get out of control. The introduction of antibiotics kills off the bacteria that are susceptible to them, but those that are resistant can cause more problems. Bon Bon may have picked up one of these resistant bacteria from Twinkles and gotten an eye infection. It would be good to get him on an antibiotic (either oral or eye salve).

Sorry all of this is happening to you at once! Big hugs to all three of you~~

 

[Flashy]

Flashy wrote:

As for Bon Bon, a wet patch under the eye is probably not anything related to head tilt, but it does need to be seen. Hopefully it is something easy to sort like conjunctivitis.

I just reread my response and wanted to clarify that what I meant was that having a potential eye infection/problem shouldn't really lead to head tilt, if treated appropriately. However, that's not quite what I said, lol, so sorry about that.

 

[Pipp]

Hey Kathy,

I sent you an email with the contact info for Dr. Martinez, I finally located him after he left the clinic I use. He's been the best rabbit vet I've used here in Vancouver, and the best news for you -- he does house calls!

He'll advise (and assist if need be) re: the antibiotics, but he also says he's has good luck using acupuncture on head tilt bunnies, so that may be another option.

Please give him a call.


sas :expressionless

 

[naturestee]

I wonder if Twinkles rolls more with the Meclizine because he has become used to balancing himself with the tilted head? Then the meclizine would disrupt that by making him feel more "normal."

I haven't heard of diarrhea from Metacam but it can cause stomach upsets/ulcers. If you want to try another pain med, Tramadol might be a good choice. It's stronger than Metacam but not strong enough to make him woozy, not an NSAID in case he is sensitive to those orally in general. It's an opiate and those do sometimes slow the gut a bit but then again so does pain and stress.

 

[bpotter2]

Thanks everyone! Twinkles seems to be better in the mornings. I caught him munching away on his greens this morning with such super speed, you could barely see his mouth move! I could not help but laugh!
He rolled after his evening meds. It seems to be a pattern, now. Not bad or even better in the mornings, then rolls and less active at night. He had a dry bottom this morning, so I am quite sure it was the Meclizine. His food is the same, his environment, no change. I cannot think what else it might be.
I will be calling Dr Martinez today, see what he can do. Hopefully, Bon Bon's wet eye is not serious, I am not taking any chances.
Thanks to you all, I would be an even worse basket case than I am if I didn't have you to talk to.
Kathy

 

[Maureen Las]

I'm glad that Twinkles is better ;I guess that it must have been the meclizine and his response to it.

Iwouldn't worry too much about Bon Bon's eye ; if you are taking him to the vet you will 'nip it in the bud' if it is a beginning infection.
Maureen

 

[tonyshuman]

Maybe what naturestee said is right--he had gotten used to the world being tilted and the Meclizine made it feel all wrong and upside down again. That could make a bunny stressed and cause mushy poos, or it could have been the medicine itself. Glad he loves his greens! I seem to remember other head-tilt bunnies doing better in the morning than the evening...Ringo and Ronnie perhaps? It could be because he's more tired in the evening, although bunnies seem to sleep all day so I'm not sure.

Good to hear things are going better, and that you're going to take Bon Bon in to get him looked at. I'm sure it's not a big deal, but you do want them at top form.