liffey has the dreaded head tilt (resolved)

[purplepeacock]

i get this call at work today from my husband saying liffey's head was tilted. he rushed him to the vet. literally in a matter of 3 hours he went from a slight tilt to a full-blown tilt.....it looks like his head is upside down. he's being treated and is on 2 meds. i know this is a topic that comes up frequently all the time on here. but i have to admit----i can't stop crying. he just looks so awful. i feel like a bad parent for letting this happen. the vet said he is doing wonderful. he is walking fine and hopping around. idk......i wish i knew how i could have prevented this.

 

[luvthempigs]

I'm sorry to hear about your bunny :hug:

I don't really know anything about head tilt in bunnies but there are members here who will be able to answer some questions for you. Hopefully they will be by soon and respond.

 

[purplepeacock]

luvthempigs wrote:

I'm sorry to hear about your bunny :hug:

I don't really know anything about head tilt in bunnies but there are members here who will be able to answer some questions for you. Hopefully they will be by soon and respond.

thanks!! i used to be pretty active on this site-----then i got married and took a new position at work and free time went down to zilch....lol....i remember other members having bunny's with this problem and thinking---oh i hope this doesnt happen to liffey. thank GOd my husband noticed it this morning since i was at work. i just want to hold liffey but it seems to make the tilt worse when i hold him.

 

[ra7751]

What meds is he on? Most vets either are far too conservative in treating this condition. Most tilt cases in a domestic rabbit is caused by a bacterial infection in the middle and/or inner ear. There is a lot of incorrect information about a parasite called E Cuniculi being a cause for tilt. In realiy, it's not the EC but the bacterial infection allowed by a compromised immune system that causes the tilt. This misinformation often causes an incorrect or delayed treatment.

Randy

 

[purplepeacock]

the vet said she couldn't say for sure if it was a parasite or and ear infection. she is treating both.

fenbendazole
SMZ_TMP
bene-bac

 

[Luvmyzoocrew]

oh no i hope he makes a full recovery!!!!!!! There are a few members with head tilt buns and they live fine with it and there are some that have had it and made full recoveries so hang in there

 

[purplepeacock]

Fran......hopefully he'll get better. the poor thing---he tries so hard to play. he likes to take stick and throw them up in the air and then hops over to where they land to do it again. he's just knawing on the sticks now. he hops around. one thing i noticed is that as much as he wants to be held....the more i hold him the worse the tilt gets. can't figure that out.

btw-----how's the baby doing? not much of a baby anymore i suppose. it's been too long since i've been on here.

 

[iluvdutchrabbbits90]

I had a5 year old rabbit get head tilt and after 2-3 rounds of meds it got a little better,but she lived to be 6.She lived like a perfect happy bun.

 

[tonyshuman]

I'm sorry this has happened to Liffey. I also want to know what meds he's on, so we can verify if the vet's doing what is appropriate for what is most likely an inner ear infection. Many bunnies that get a tilt like this can be cured and go back to "right-side-up" bunnies, if the treatment is appropriate, timely, and aggressive.

 

[Luvmyzoocrew]

purplepeacock wrote:

Fran......hopefully he'll get better. the poor thing---he tries so hard to play. he likes to take stick and throw them up in the air and then hops over to where they land to do it again. he's just knawing on the sticks now. he hops around. one thing i noticed is that as much as he wants to be held....the more i hold him the worse the tilt gets. can't figure that out.

btw-----how's the baby doing? not much of a baby anymore i suppose. it's been too long since i've been on here.

I am pretty sure with head tilt bunnies because of the tilt and i guess being off balance dont like to be picked up, they already feel unsteady and unbalanced so being off the ground just makes it worse.

The baby is doing good, and no not much of a baby anymore,lol. He is 16 months already. What vet are you taking him to?

 

[ra7751]

You may want to talk with your vet about a better course of treatment. Sulfanomides (SMZ is one of these) is one of those old school drugs that are notvery effective these days with all of the resistant bacteria. I haven't used (or know of any exotic focus vets still use) this family of drugs in years. It can also be devastating to the beneficial bacteria in the GI. Fenbendazole (Panacur) is the long time "standard" treatment for E Cuniculi. Couple of things here....first, as I previously mentioned, it's not the EC causing the tilt....if EC is involved, the tilt is caused by opportunistic bacteria allowed to grow due to a compromised immune system. And it would be compromised by the EC. While Fenbendazole has been the standard for treatment....fact is that the parasite is in the brain and Fenbendazole has a difficult time penetrating the blood/brain barrier so it can easily reach the parasite. The initial presentation of an active EC infection are a paresis in the hind quarter (most often the left rear leg) and some degree of urinary contenance. Most vets have never actually seen a full blown case of EC. There is a test, called a titer, that can check for antibodies for EC....but nearly all domestic rabbits will titer positive since they have been exposed....a titer is used as part of the diagnosis along with clinical presentations.

Most of the time, the bacteria causing head tilt is some strain of pasteurella. But we have seen other bacteria (and even yeast) causing tilt. I don't like using the term "stronger" antibiotics because that wouldn't be technically correct, but in most cases, a more aggressive and targeted antibiotic is necessary....and sulfa isn't usually up to the task. In the case of most ear infections, drugs such as Zeniquin, Penicillin, Convenia or Chloramphenicol would be much better choices. Pain meds should be implemented. Keeping the eyes hydrated would be beneficial. While the Fenbendazole probably won't help if it's EC, it is beneficial in ridding the GI of general worms. Bene Bac is good to use in order to help stabilize the pH in the GI.

This type of situation has to be treated aggressively if there is to be hope of a favorable resolution and correction of the tilt.

Randy

 

[tonyshuman]

:yeahthat:

Several bunnies on here have had tilt and it only improved when they were put on zithromax, convenia, and/or penicillin G.

 

[AngelnSnuffy]

I just want to say how sorry I am...Give the bun a hug and squeeze from me.

Keep us updated! Aww....:sad:.

On a happy note, Happy Easter!:hug:

I have to look out for EC as well, as Snuff has a cataract. He's doing well, but you never know....

Thinking of you guys.

 

[purplepeacock]

fran---our vet in perkiomen was closed----along with practically every vet in our area. but doug found one here in bethlehem......Genevieve LaFerriere.....luckily she and her vet tech both have rabbits.

I think at least until tuesday liffey is gonna have to keep on the current meds. mostly b/c the vets are now all closed for the holiday. but also i'm a nurse and it's my weekend/holiday to work. in my contract calling off at any time on a holiday weekend is automatic dismissal. and when your husband is a full time student and you have a mortgage.....well...there really isn't much of an option until i'm off on tuesday.

as for liffey....the eye twitching has stopped. he is hopping around all over. the tilt only gets bad if i pick him up....which he wants all the time but we're limiting it. he always was a little love bug. if i walk by the cage he's trying to climb up the sides to get attention. he tries to throw his stick up in the air the play "catch". he's eating and drinking on his own now.

Randy--I would have thought bactrim would be stronger than PCN. In humans PCN is so generic. for really strong bacteria in adults we skip over the PCN and go straight to bactrim. who knew it would be different in rabbits. i know the healing process is slow but i'm hoping by the time the vets open on tuesday maybe he'll make some progress and he'll be ok on what he's taking. he was not like this at all on friday. he barely had it saturday morning when doug first took him out. it literally got bad in a few hours time (like from 12-3:30pm)

thank you everyone for your support!!! off to work for now =(

 

[elrohwen]

I don't have any experience with head tilt, but I just wanted to stop in and say good luck to your baby bun! I hope he's able to make a full recovery.

 

[JadeIcing]

:hug:I know it seems very scary but don't it is very treatable with the right course of meds. Key is finding to the exact cause and getting in the appropriate meds.

I also want to make very clear it isn't your fault. This can come on very suddenly and most time is extremely unexpected. It can happen to anyone so please please don't feel like a bad mommy.

Ali

Special Needs Bunnies: Working With Head-Tilt

 

[ra7751]

Well...as far as the sulfa....I hate to use the term "stronger" with antibiotics. What you are dealing with here are resistance issues from overuse (much like penicillin overuse in humans....and MRSA) along with the fact that the digestive system in a rabbit is quite sensitive to antibiotics and especially those that are harsh on gram positive bacteria. So the key to treating infections in rabbits is to find a drug that is rabbit safe and that has no resistance issues.....and that is effective against the pathogen. And there is an additional issue in rabbits....and that is the thickness of the pus found in infections. It is sometimes quite difficult for the drug to reach the core of the infection and that is especially true in "walled offed" infections such as deep ear, lower respiratory or abscesses. While I am not a vet, I have been doing very advanced medical treatments for years (I live near a major vet school and many of the local vets use my protocols) and I haven't used sulfa in mammals in years. The only time I use it in animals is once in a while in birds if I am out of Clavamox.

Since you are a nurse, that gives youquite an advantage in treatment options. In this case, I would suggest either Pencillin (which can be purchased at farm supplies...Pen G is a cattle drug) or Convenia. Pencillins and cephalosporins are safe only when injected. Convenia is a new type of cephalosporin and is available only by script. Dosing on the Pen depends on which version you can find....a combination of Procaine and Benzathine is the best. Covneina is also quite effective but the label dosing must be modified.

Ear infections in a rabbit can be a long term deal even with much more aggressive drugs. It can also invade the brain stem and that brings on an entirely new set of long term problems and a lifetime of head tilt. I fire all the "big guns" with vestibular issues.

Randy

 

[purplepeacock]

Randy---if i were to switch to PCN and inject where do you inject? lif is like a bag of bones......he's a good eater but active so he never got any extra meat on him. it's funny---i inject people all the time and yet the thought of injecting lif makes me sick. i know i could and would do it if i had to. I want to switch his meds if pcn is better for him but afraid b/c he's doing so well in only a 24 hour time. part of me wants to continue with the bactrim since it seems to be working. or at least something is working. oh...one more question---why does oral pcn not work? also (yet another question) should he be on probiotics? last thing i want is a bun with c-diff!

Alicia---what did you use to treat Ringo? and did you do the PT exercises with him to help regain a straighter head? and thanks for the link....i'm going to check it out next!

Also......lif has always been perticular about his litter habbits. and i came home today and he peed on his blanket. even as a baby he never peed on his blanket. he pooped everywhere but that doesn't surprise me since he's in a smaller cage now that he's not in too often.....marking territory probably. but i'm wondering if something neurological is going on. He is better today. he's hopping all over the place and playing a lot. eating--pooping---voiding fine. was concerned about water intake and have tried all the "tricks" but he's voiding his normal amount. maybe just a little less. i worry with the bactrim since you need good fluid intake with bactrim.

 

[ra7751]

PCN is injected SQ.I useConvenia (an injectable cephalosporin) against PCN resistant bacteria. Oral pen is much like oralsulfanomides and oralcephalosporins....they disrupt the beneficial bacteria in the gut...and most of the bacteria that digest food is gram positive and that is what PCN and related drugs are most effective at containing. And as you already know, when you lose that bacteria, you get C Diff. Oddly enough, I just read a medical paper regarding the appearance of C Diff as the next "super bug" in hospitals...displacing MRSA is some places. And you probably know that C Diff is an obligate anaerobe andis difficult to treat. We use a combination of Metronidazole (Flagyl) and a drug called Di-Tri-Octahedral Smectite (marketed as a horse product called "BioSponge") to bind and filter the enterotoxins induced by C Diff. It is a standard part of our wildlife rescue and has been a life saver with both squirrels and rabbits. During In Vitro labs, the BioSponge managed to bind and filter99% of the Clostridium enterotoxins. It is also helpful to offer a probiotic in order to help stabilize and maintain the acidic pH required by the flora in the GI.

I will say this about drugs such as Sulfa or Baytril. Sometimes they will work a time or two in rabbits before the bacteria become resistant. Sulfa has been linked to a condition known as Tyzzer's Disease....and Tyzzer's is just a name for an overgrowth of C Diff. Just in my non-professional opinion, I have learned there are many more safe and effective options in lieu of drugs like Sulfa or Baytril....and when you have the skills to inject meds...that opens a lot of doors.

Randy

 

[JadeIcing]

purplepeacock wrote:

Alicia---what did you use to treat Ringo? and did you do the PT exercises with him to help regain a straighter head? and thanks for the link....i'm going to check it out next!

Ringo's final meds were zithromax/pen g combo with bonine for the rolling. I did do some pt exercise and still do some. I also just rub his neck and body.