Head turn, not tilt

[ta240]

Our 13 year old male rabbit is partially blind in his right eye and mostly blind in his left (not sure if that has anything to do with it) and has been that way for several months. He just recently started laying with his head curled back around to his left. All his life he would sleep laying or sitting straight. Now he sometimes tightly wraps back to the left, always the left. Sometimes when he is awake and sitting his head will slowly turn an inch or two to the left and then he will correct it back to center and it will then just go left again. He will sit and repeat that like he is scanning something.
He can sit straight at times and can move in a straight line; although he does tend to veer in that direction when he is in a hurry now.

Any ideas what would cause this change?

 

[ta240]

 

[ta240]

Something we just noticed is his eyes move slightly before his head moves. So I can't tell if he is seeing something move in his eyes and is trying to follow it with his head.

Took him to a nearby vet today that prescribed antibiotics, pain killer and anti-nausea medicine. Their guess was an inner ear issue.

I'm going to try to get him into a known Bunny vet that is about an hour away. I hate to stress him with that drive but he did pretty good with his cage on the passenger seat and getting his nosed rubbed on this trip.

 

[JBun]

I would have said maybe it has something to do with his eyes. If his left eye is painful for some reason (eg glaucoma, infected eye, abscess), this could cause the reaction of turning his head in the direction the pain is coming from.

An ear infection would be the next most likely cause, so it's good you got treatment going for that just in case. If it does end up being an ear infection, you'll want to make sure that treatment is long enough. Rabbits usually need a much longer treatment for infections. Usually 4-6 weeks minimum. And if you aren't seeing any improvement after the first week on antibiotics, it can mean that antibiotic may not be effective and a different one is needed. Also, if the pain relief isn't a NSAID like meloxicam, it's something I would suggest requesting, as it helps reduce inflammation as well.

Getting him seen by a very knowledgeable rabbit vet if at all possible, can sometimes make all the difference in getting the correct diagnosis and treatment. Might be a good idea to have his eyes checked too. It's still possible that could be the cause and not an ear infection. There's a good chance the vet may want to take xrays as well

www.medirabbit.com/EN/Neurology/Otit/otitis.htm

www.disabledrabbits.com/blindness.html

https://wabbitwiki.com/wiki/California

 

[ta240]

Thank you for the reply. He does turn in the direction of his worst eye. The vet put him on Metacam (meloxicam) and Baytril and Meclizine.

His eye movement is definitely horizontal. I haven't been able to get a video of it, he acts differently as soon as I get close enough with the camera.

Tomorrow I will call the two vets recommended by the rescue. We also have UC Davis's small animal clinic at their school of veterinary medicine not too far away, I'm not sure about their level of bunny expertise.


The Vet today said his ears looked clean but after a fair amount of struggling tonight I got these pictures The one that looks the cleanest (but still has a chunk of wax) is his left ear and that is the side he turns towards. The right ear is the other two shots, the one dark area in the right ear doesn't look good to me.


This is a very subtle version of his head movement. He always moves less when I'm recording.
View attachment vid1.mp4

 

[JBun]

That looks more like the eye scanning rabbits with poor vision do when they're trying to get a better look at something. It's very common in red eyed rabbits. With an ear infection or painful eye condition, I'd expect more of a consistent head tilt and/or circling going on. Where the rabbit is more inclined to keep the head turned or tilted towards the pain and doesn't immediately return back to center. And there will often be other signs of pain and movement problems.

Not that an ear infection or eye pain is completely ruled out, but I'd hate for you to go spend a bunch of money on expensive tests, only to find out it's just a common reaction that rabbits with poor vision have. It can also explain why your rabbit is turning mostly to the left, to get the one right eye with some vision, out front to try and see to the other side better.

I'd suggest doing some research into red eyed rabbits eye scanning. Especially watch some videos. Then decide if this is what you're seeing with your rabbit or not. If it's an ear thing or a painful eye condition (and not normal eye scanning), you should see a change and at least some improvement on the antibiotic and pain meds. But if you don't see any change at all, I'd be inclined to believe it's this eye scanning due to your rabbit having decreased vision. Though it's certainly possible both could be going on as well, an ear infection and eye scanning.

https://wabbitwiki.com/wiki/Eyes

https://vgr1.com/vision/

But if it isn't scanning but happening from ear or eye pain, UC Davis is a good place to go for more advance treatment and scans, if you need a better rabbit vet to see. Though cost wise, they're likely to be expensive, but will also likely provide better diagnosis and treatment.

 

[ta240]

He is now receiving IV antibiotics for an ear infection and meningitis. He will be in their ICU for at 2-3 nights

Bunnies don't make much noise but it is so quiet in the house without him.

 

[JBun]

I hope your little guy will be alright What were the vets findings, if you don't mind sharing?

 

[ta240]

The CT scan showed an ear infection and the early stages of brain infection. They weren't certain they were connected but wanted to get him on IV antibiotics quickly. Unfortunately, after he is done with those he will need surgery for the ear.
I forget what they called it but animals have a natural resistance to having their head moved and he only has that in one direction, which pointed them towards a neurological issue.

 

[TreasuredFriend]

@ta240, hoping your boy will recover smoothly.

You are getting the best care to address the medical maladies.

Lots of love and healing vibes are sent,

 

[TreasuredFriend]

Our special needs' hind-limb paralysis girl resists having her head turned. She favors only one side. She was diagnosed with degenerative neurological over a year ago. She's a hospice-care bun.

@ta240 , I understand the quiet comment. Treasure each day with your senior boy.

 

[ta240]

Anyone have any tips on getting him to take the critical care food? He has discovered that he doesn't have to swallow the food. I use a tiny syringe to help avoid pushing too much in but he just basically blocks it and lets it flow back out of his mouth. Sometimes if I put the syringe between his front teeth he kind of chews on it and that seems to trigger him to eat the food but not always.
He really didn't like the anise flavor but isn't a fan of the apple-banana either.

 

[JBun]

When I syringe feed, I come through the corner of the mouth (the side) to get behind the front teeth. Then I'll sometimes wiggle the tip around in there a little, to try and stimulate tongue licking and chewing, which will usually be followed with swallowing as well. If that still doesn't get him to swallow, you'll have to try something else, because there's no safe way to force swallowing, as it risks aspiration, which is very dangerous.

https://wabbitwiki.com/wiki/Medicating_your_rabbit

One thing you could try is making a pellet mush from his usual pellets soaked in warm water. You can try offering it in a shallow dish or on a spoon. But if that won't work and you have to syringe feed it, a large tip syringe is needed as it's more chunky than the critical care and can clog the syringe tip.

If none of these work to get him safely swallowing, it's best to talk to your vet about what to do next.

 

[ta240]

Thanks for the reply. Sometimes I just have to be more stubborn than him and wait it out and he will finally swallow what he has. I'm sticking with a 1ml syringe to make it harder to give him too much at once. And it gives him a small pause in-between. Although it does take awhile to get 20ml into him that way.
It is a good sign though that today he was much stronger in trying to get away. And it is nice that after he doesn't hold a grudge.

 

[ta240]

The medication has helped. He doesn't wrap up as tight as in the photo above, he sometimes even lays out straight and can move in straight line. He does still only turn left and he does still turn his head fairly often when he sleeps and even when he eats.

The Vet wants to operate on his ear to remove the fluid from it. They have said there is risk that it could make things worse. Damage to the nerves might cause his head turn to worsen and could even cause him to lose feeling in part of his face.

I'd love to help him feel even better but am so afraid that he could end up worse after the trauma of the surgery.

Does anyone have any experience with that sort of surgery?

 

[JBun]

I haven't, but I have read of very difficult experiences from some that had it done. I'm sure there are success stories, but I can't forget this one where there just seemed to always be complications for the rabbit following surgery, where the rabbit was always in pain and still had the infection reoccurring. So I would be reluctant to go that route unless every other less invasive option was tried first, including using more risky but more potent antibiotics like azithromycin.

But the decision is an individual choice. Sometimes we just have to proceed based on a gut feeling. So surgery may feel like the right choice to you, even if it might not be what I would choose first. And if you are seeing the vet at UC Davis, at least you're going to one of the best places when surgery is necessary.

If you still aren't sure what's best, I'd suggest doing some very thorough research on it, including reading first hand accounts, so you can make a more informed decision.

https://wabbitwiki.com/wiki/Otitis

 

[ta240]

Thank you for the reply and the link. I've been doing a lot of reading on it now and will do more. Some of the stats are definitely worrying.
Knowing that surgery isn't an absolute fix makes it so much more difficult, but every time I see him curled around having trouble eating because his head keeps moving way away from his dish it is hard to not want to try something. But doing something to make me feel better isn't the right decision, doing something to make him feel better is.

 

[ta240]

We've got him scheduled for a second opinion at a recommended bunny vet about an hour away.
I'm a bit worried at this point that with his head to the side so much it may be hard to tell if he's doing because of the infection or just because his muscles have gotten so used to doing it. I know when I've adjusted my posture because of an injury I've ended up with things messed up more from that. I have him a massage a bit ago and he is laying straighter now. But I'm sure when he eats again it will wrap back around next to him as he chews.

 

[JBun]

There can be residual head tilt even when the infection is gone. A scan or blood test might help tell if there's still an active infection going on.

Regular gentle massage certainly can help.

www.disabledrabbits.com/massage.html

Is he still on daily meloxicam?

 

[ta240]

Yes, he is still on the meloxicam, 1.3ml once a day. Recently they upped his Metronidazole up to .75ml from .2 and that made him very lethargic. We dropped it back down to .4

On the last visit they noticed some areas on the surface of his eyes so they added Optixcare Eye Lube 2-3 times a day. Even just doing one drop each time it was getting into the fur around his eyes, clumping it up and it started to fall out. His left eye drains a bit and so it spread it more on that eye and made a real mess. It wouldn't rinse out with warm water and a soft towel so we stopped using it.

He is also on .75ml Gabapentin, Enrofloxacin .8ml and meclizine 25mg