Help! rabbit has bad head tilt and closed eye

[Bunnylover*]

Hi everyone I am new to this site just joined.... I am in desperate help for my poor rabbit boo boo who has a severe head tilt and closed eye. He developed this over a month ago. I have been going back to the vet many times only to be given Baytril his whole life for every abscess he has developed. It seems to take a long time to work and doesn't get rid of them all the way. The abscesses always come back. He has had one in his chin just under his teeth and I have been keeping it drained and cleaning it regularly and giving Baytril. All of a sudden pus stuff started coming out of his one ear and his eye on the same side one day.

Went back to vet given more Baytril. Now he has a severe head tilt and closed eye. His head is completely turned sideways. It's so so sad. He falls often and even rolled trying to get up. But like right now he's standing normal with his head tilted completely sideways and he's eating just fine. He has not lost any weight and eats/drinks still.

I went back to vet today, his usual vet is on vacation so we had to see a different vet in the same office we have never seen before. This vet told me I need to think about when to put him down!!! I was hysterical. I asked why haven't we tried any other medicines only baytril? He then prescribed sulfa. It's some pink liquid I am suppose to give him twice a day. Also I forgot he's on cipro eye drops for the one eye. That has not helped at all for several weeks now that he's been on it. Is there anyone out there who has had similar issues with their rabbits? If so what did you use or do. I have been reading online there are some natural plants they can eat to help this! But I don't want to try these unless someone knows they work. I think enchanthia is one of them. I prob spelled that wrong.

I am just so sad and don't want to loose my little man. He's the coolest rabbit ever and has such a personality like a human I swear! Hes about 3.5 years old. My kids are so sad too they keep asking why boos head is sideways and why he's not better. I want him better but at same time don't want him to suffer. Like I said he eats and drinks normal still and doesn't seem like he's in any pain. He walks around fine even other then if he falls over he starts flipping around trying to get up. But I'm sure his neck hurts from his head being sideways!

Please if anyone can help give me some advice or tell me what worked or did not work for your rabbit please let me know.

 

[JBun]

First thing is if at all possible, find a different rabbit savvy vet. Your rabbit needs to be on something besides baytril at this point. Something like pen g injections, azithromycin, chloramphenicol. I would probably opt for both pen g procaine/benzathine injections every other day and oral azithromycin daily. There is some risk with using these, though generally for most rabbits there doesn't seem to be a problem. But at this point the infection is severe and you need to hit it hard with 'heavy duty' antibiotics. Azithromycin in particular, seems to have a more rapid affect on infection.

I would also want my bun on high dose meloxicam to begin with, at 0.6mg/kg twice a day, to help with pain and bring down any inflammation. This could help alleviate some of the head tilt.

If your bun hasn't had a thorough dental exam with xrays, you will want to ensure your new vet does this as it sounds like there could be a dental infection that is spreading, and you may need surgical removal of teeth and cleaning out of infection.

As long as my bun was continuing to eat and drink, and if I felt there was still hope of him getting better, I would give it a chance as long as any pain could be managed and I felt he still had a decent quality of life. But you need to be treating with better meds to have any chance of getting this infection under control at this point, and these vets don't seem to be experienced enough with treating this kind of thing in rabbits. Just to emphasize the seriousness of this(which I'm sure you are aware of), a member just recently lost a rabbit to a similar infection, and the same thing occurred, the vet was unwilling to treat with anything besides baytril.

If you don't already have some, it may be useful to have a bag of Oxbow critical care food mix(apple banana flavor) on hand in case your bun needs help with eating and you need to start syringe feeding him. You can get it from the vet but it will cost more.

For the meds, any that you can get online will save you money as vets usually double or triple the price, though you may need to get a few days worth to start with, from the vet. And the vet will need to instruct you on how to give sub q injections if you do the pen g.

So, here are some references and info on treating this kind of illness, as well as recommended meds to use. It may be useful to print out and bring with you to the vet in case you need to prove your point. Also some info on helping buns with head tilt.
http://www.medirabbit.com/EN/Dental_diseases/Treatment/Facial/abs_dental.htm
http://www.medirabbit.com/EN/Skin_diseases/Bacterial/Abscess/skin_abscess.htm
http://www.medirabbit.com/EN/Skin_diseases/Bacterial/Absc_treat/abscess_treat.htm
http://www.bio.miami.edu/hare/jawabscess.html
http://people.umass.edu/~jwmoore/bicillin/bicillin.htm
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Abscessation_rabbits.htm
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/FacialAbscessesRabbits.htm
From above link:
'A study published in 2002 found that the bacteria involved in rabbit tooth-associated mandibular and maxillary abscesses included anaerobic gram-negative rods (particularly Fusobacterium nucleatum), anaerobic gram-positive spore-forming rods (especially Actinomyces spp.) and aerobic cocci, particularly from the Streptococcus milleri group. Pasteurella multocida was not isolated. All of the isolates tested were susceptible to chloramphenicol and to clindamycin, and most (96%) to penicillin, ceftriaxone and cefazolin, with 86% susceptible to azithromycin and tetracycline. However only 54% were susceptible to metronidazole and ciprofloxacin and only 7% to trimethoprim-sulfamethoxole. Clinically, 97 of 104 such abscesses (97%) had not recurred following treatment involving AIPMMA (antibiotic-impregnated polymethyl methacrolate) beads of clindamycin and/or ceftiofur. (J93.40.w5)'

http://vgr1.com/metacam/
http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
http://www.medirabbit.com/Safe_medication/Safe_drugs_main.htm

http://www.disabledrabbits.com/head-tilt.html
https://rabbit.org/vet-listings/

If I find any other important links I'll share them.

 

[JBun]

It's also important to be aware that some antibiotics are dangerous to give to rabbits at all, and some are dangerous to give orally(like pen g, which should only be given by injection).
http://www.medirabbit.com/Unsafe_medication/Unsafe_drugs_main.htm

 

[Bunnylover*]

Thank you sooooo much Jenny! We have the same name
By the way and both love rabbits
I really appreciate your reply And I agree with you about me finding another vet! I have called and went to so many around my house to find no luck. The one we go to now is one of the only vets I know that care for rabbits! I even went to another one because the office desk girl said yes we see rabbits. When I got back into see the vet the dr said oh I don't see rabbits and don't know much about them at all! I was so upset! But I'm going to try looking even further if I have to drive an hour or more I will to take him to a knowledgeable Bunny dr. I agree with you the vet should be giving him more then Baytril because he's been on it his whole life for the abscesses. And now they want me to put him down instead of trying other medinces. I do feel he has it in him to survive, he's strong and has been dealing with stuff since he was a little bunny. Plus he's eating/drinking.

Thank you again for your reply. So do you think I could go to a vet and ask for those medicines for him they should be ok with it? I was going to ask you if you knew a good bunny dr but I assume we prob aren't even in the same state.

 

[Bunnylover*]

I feel so bad someone else on here lost their bunny to this. I do know how time sensitve it is to get meds going. I don't want to loose my little guy and that's why I am lookin everywhere I can for help evening posting on here. I have never been in a forum before. I want him to make it so badly. In your opinion is the sulfa not good to give him then? Or not strong enough prob is my opinion. He just got it prescribed by that new vet today. I'm going to try to find another vet and ask for the stuff you suggested.

 

[JBun]

I posted a link with recommended rabbit vets in my previous post, if you haven't looked at it already. I would suggest looking at that link, and I'll post this other one that has recommendations from other rabbit owners, you just need to look up your state. The only thing is, a lot of the recommendations are several years old, so may not still be valid.
https://www.rabbitsonline.net/forums/rabbit-veterinarian-list.21/

So when you find some names of vets you think may be possibilities, I would call tomorrow and tell them(making sure that this info is going to be passed to the vet or vets assistant) that you are looking for an experienced rabbit vet as your current one isn't very experienced. That your rabbit has been on baytril and sulfa for ongoing facial infections that are getting worse and you feel like the antibiotics aren't helping at all, and your rabbit needs to be on better antibiotics, and may have dental issues related to the infections which may need treatment. Tell them this is time sensitive and that you feel your bun will need to be seen immediately. Tell them where you are seeing pus(ears, eyes, etc) and that he has now developed a very bad head tilt. Ask if you were to see the vet, if your bun will be put on a different antibiotic besides baytril or a sulfa antibiotic, as you don't want to go through the effort of seeing a new vet just to be put on the same ineffective antibiotic.

Just so you are aware, this could very likely be pretty expensive. If your bun has infected teeth that need to be removed or any other surgical procedures, that's going to cost quite a bit. If you can't go the route of surgery, in the very least get him on a different antibiotic. If you get him on the right antibiotic and for a long enough period of time(usually minimum of one month to several months treatment), it could very well clear up the infection. I think I would go with azithromycin(possibly with the pen g injections) even though there's a small chance of gut problems occurring. If it works, it seems to work quickly and well, which is what you want. Pen g and chloramphenicol are the others I would consider. There's some info in this old thread about using the combination of those antibiotics. You can also search old threads by ra7751 as he talks about using the combo to treat infections in rabbits.
https://www.rabbitsonline.net/threads/pen-g-vs-bicillin.29133/page-2

I'm doubtful the sulfa antibiotic is going to help much, if at all. You've already been giving it a while haven't you, without really any improvement?

 

[Bunnylover*]

Thank you for those links. I am in process of calling around. Much appreciated. The Baytril yes he has been on for years on and off. But the sulfa he just was given it yesterday for first time ever by the vet that told me to put him down. I said why haven't we tried other medicine and that's when he gave me the pink sulfa. So my little guy has only taken 1 dose of it so far

 

[JBun]

It's possible the sulfa could help some, but it's usually not the most effective antibiotic for this type of thing, according to that quote I posted above, and there's also this info in the link below about it.
'Trimethoprim sulfate is sometimes advised, but appears to bring poor improvement in rabbits. This could relate to the fact that half-life of this drug is about 40 min in rabbits'
This link also describes what is causing your bun to have the head tilt(middle ear infection).
http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm

For now at least he's not still on baytril, which the bacteria is likely completely resistant to now. But I would still want to change to a more effective antibiotic besides the sulfa, especially since the infection is progressing so badly.

 

[Bunnylover*]

Thank you for your help. I called vets today. I could only make an apt with one who then called me back an hour later and told me because he sounds so bad they can't treat him and advised me to go to pet emergency room. I also called back his vet he saw yesterday and asked if he can give us azeithromyicin and some pain medication. He told me absolutely not and that that antibiotic would kill him! I was like no I have researched it . He said no this sulfa is the last chance he gets ! I am so sad. I guess I'll go to the emergency room and pray they give me stronger stuff and not turn me away like the vet did!

 

[Bunnylover*]

I swear this vet wants my boo to die! He told me right away yesterday when I saw him that I need to put him down. Didn't even offer the sulfa until I said why havent you guys given him other meds to try ? Why only Baytril? And they only gave him a short course of Baytril every time. So he really hasn't been given a chance because I know rabbits need to be on these meds a long time to help

 

[Bunnylover*]

You know what I just thought of something. I wonder if I could give him the sulfa every couple hours since it has such a short half life. I don't understand why the vet thinks this will help and not the baytril when the Baytril stayed in his system longer! He told me to give the sulfa twice a day only.

 

[JBun]

The biggest problem with the sulfa abx is that it usually isn't effective due to the types of bacteria involved. I would just continue to give according to the instructions for now and you never know, it's possible it could help some.

If you are looking at emergency vets, you will still need to find one that has experience with rabbits and is willing to treat with a different antibiotic, but it's actually usually more difficult to find an emergency vet that knows anything about rabbits. I would suggest to still try and find a good rabbit vet, even if you have to travel a bit(if you are able to do this) to find one. If there is no good vet to be found, there is another possibility for treatment, but I would only do it as a last resort.

 

[JBun]

One other possibility that I thought of is if you can at least find a reasonable vet that will work with you and will consult with a rabbit 'specialist' in another part of the state, even in a different state, or at a vet school(like UC Davis). I would even go as far as consulting with one of the rabbit specialists in the UK, like Molly Varga(if it's even possible). It will increase costs, but it might be a way to ensure your bun is getting the correct treatment.

Too many times inexperienced vets don't understand head tilt and just want to give up on the bun, not understanding that a rabbit with head tilt isn't always a death sentence. Many times once these rabbits get the correct treatment, they go on to recover and live a happy life, even the ones that might have a residual tilt left. Usually it is the buns that stop eating and not responding, that pts should be a more serious consideration as there's less of a chance for recovery, but your bun is still eating.

 

[Bunnylover*]

Yes I agree with you. Thank you I will try those suggestions. My husband is at the livestock store and Said he found pen g but there are 2 kinds. Fast acting or long acting! Does it matter what one ? He asked the worker there and they have no clue

 

[JBun]

The pen g procaine/benzathine is the combination short plus long acting penicillin, which is the one used in the bicillin study I posted above. Injections are given every other day in the study, and in a severe case was given every day for a short time. There seem to be a lot of success stories using it. A member here was able to successfully treat her bun that had a retrobulbar abscess.

 

[JBun]

If you do use it I just have a few suggestions of what I would do and things I look out for.

It's usually easier to use a 20g needle to draw from the bottle, then remove and replace with a 22-23g 3/4-1 inch needle for injection. Let the syringe sit for about 10 minutes to get to room temp to make it easier to inject as the liquid is thick, but put the bottle back in the fridge after drawing the needed meds into the syringe, as it's important to keep the bottle itself refrigerated.

If inexperienced with giving injections , make sure to swab the bottle top with an alcohol wipe before drawing up the med, don't touch the syringe tip or needle top to anything but each other as to keep it all sterile, keep the needle covered until ready to inject. I would look on you tube to find an instructional video on giving sub q injections in rabbits, though having a vet show how to is best as giving incorrectly could be harmful. If there is any leakage at the injection site, it's important to clean it off thoroughly as any liquid ingested from a rabbit grooming it off, poses a risk of fatal enterotoxemia developing. Here's info on drawing up to give a sub q injection.
http://www.medirabbit.com/Safe_medication/Inject/inject_en.htm

It's important to make sure bun is eating lots of good quality(not moldy) grass hay, no sugary/starchy foods/treats, and giving the probiotic benebac may be helpful. Watch for loss of appetite, be ready to syringe feed if bun isn't eating well. At the first sign of a loud gurgling stomach, and/or watery or pudding like diarrhea(which is different from there being mushy cecotropes and normal fecal balls), stop the antibiotic. It's an emergency situation and the sooner the bun gets on metronidazole and questran(with plenty of fluids), the better chance of survival. Usually pen g injections don't cause problems, but there is always some chance that a rabbit can react to it negatively. So best to be aware of the possibility and potential signs of a problem.
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm

 

[JBun]

Here's another link on giving these injections.
https://www.rabbitsonline.net/threads/abscesses.10252/#post-434352

It's important to take note from the info in the links above, of making sure to draw back on the plunger to ensure there isn't a flash of blood, before the final sub q injection of the med. Otherwise there's the risk of hitting a vein, which injecting into would be fatal.

 

[Bunnylover*]

Thank you for all this info it is hwlping tremendously. My husband couldn't find the combi pen g like you said so he brought home penicillin injectable ( penicillin G procaine injectable suspension) 300,000 units per ML. Aqueous suspension antibiotic it says. For intra-muscular use only. It's a 100 ml bottle. It's by Durvet and has pictures of horses on it.

 

[Bunnylover*]

Also the guy that worked there owns 15 horses so he was helping my husband a little but said he didn't know about rabbits but did have him buy 20gx 1/2in needles. And a 6ml disposable luer lock syringe

 

[Bunnylover*]

I did find a vet that used to be a zoo vet and on her website has lots of pics of rabbits and other small exotic animals . Her next available appointment is not till this coming up Thursday later in the day. I'm hoping he can hang in there till then. Otherwise I might try the emergency vet but like u said most won't know what to do with rabbits and I don't want to waist money for them to tell me just to put him down like the other vet did. So I'm stuck right now with just sulfa and my decision to try this pen g or wait till Thursday ugh so stressful