Slightly Tilt Head and Nystagmus Eyes

[the fluffies]

Hi JBun,
Thanks for the info.
At this moment, i just forget about the steroid and only give antibiotics and fenbendazole.

Sadly we have no oral Metacam in Malaysia. We only have the injectable, but my vet will never let me inject the bunny myself.

I think for now, let see if the antibiotics and fenbendazole work on Maxie without the anti-inflamatory. He doesnt look very sick. He eats by his own (he choose to eat vege and hays, and lost interest towards any pellets), drinks a lot, pee a lot but poop very little. I will encourage him to eat more.

 

[tonyshuman]

Will your vet consider ibuprofen instead? They usually make it for human babies as a liquid and dosing info can be found here:
http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

It must be taken with food in the belly but should be helpful for some pain relief. You can also look into giving aspirin if you are willing to crush up tablets and resuspend in water to give orally via syringe.

I agree on the steroids bit--usually not a good idea in rabbits.

 

[the fluffies]

Maxie is getting worse today. His tilted 90 degrees at his left side and also tilted backwards. When he tries to move, he flipped like a fish and it scared me because i am afraid he was having a stroke.

I called local pharmacy. They have human Meloxicam (Mobic brand) 7.5mg.
Can someone help me with the right dosage? How many times a day should i give, for how long and can i give at the same time i give antibiotics?

 

[the fluffies]

I read that [FONT=&quot]it should not be used in rabbits suffering from liver or kidney failure. [/FONT]
my Maxie is drink double/triple than normal and pee a lot. is it ok to try on him?

 

[JBun]

I'm sorry your rabbit is doing worse. You may want to consider changing the antibiotic to something like the Zithromax. If the head tilt is being caused by an ear infection, the baytril may not be working. Also to keep in consideration is using the steroids, but I'm a bit nervous about using steroids in rabbits, so I would only do it as a last resort. But at this point it may be something you may want to try.

The meloxicam is contraindicated in a case of kidney failure, but it's hard to know if your rabbit is experiencing this without additional testing. If you still want to try it, can the pharmacy make a suspension syrup with the tablets? That will be the easiest way to get the correct dosage and administer it to your rabbit. Usually for rabbits the dog dosage of metacam syrup is what is used, and the concentration in that is 1.5mg/ml. So if you were going to have the pharmacy compound that for you into a suspension using a 7.5mg tablet, you would mix about 5ml of the syrup with a crushed 7.5mg tablet to get the 1.5mg/ml suspension. Usually a cherry flavored syrup is used. Once you have the suspension, the dosage range for rabbits is 0.1-0.2mg/kg, but this is considered the low dose. I've read of a therapeutic dose of 0.6mg/kg being used in the UK for rabbits, with the frequency being twice a day. If it were me, that's probably the dosage that I would use. So to get a 0.6mg/kg dosage from a 1.5mg/ml suspension, you would give 0.4ml(cc)/kg. You can give at the same time as the antibiotics, and I've read accounts of meloxicam being used longterm, for rabbits with chronic health problems, so you should probably be able to use it as long as is needed for your rabbit to get better. But if you decide to give the steroids, you shouldn't give the meloxicam until, I think, a day or two after you have stopped the steroids. But I'm not exactly sure on the amount of time you have to wait after stopping the steroids, so check this with your vet. Keep in mind that I'm not a chemist or vet, and am just making these calculations and offering recommendations, from the little knowledge that I have. Double check the math, and if possible, check with your vet as well, to make sure all the dosage info is correct. You can check this link for the recommended dosage for meloxicam as well. http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

 

[woodlandbuns]

I have had several rabbits with this over the last few years it seems to come on so suddenly. I am sorry to say that some did not survive but recognizing that something is wrong and catching it early can be the key. I now worm my rabbits every three months with
Pancure and hopefully that is helping. Good luck, it's a very worrying time I know.

 

[the fluffies]

I gave Maxie 0.3mg/kg of Meloxicam starts last night.

But since last night and this morning, Maxie was suddenly throwing and rolling as his side. I tried to hold him with a towel, but his head was turning and pushing his body to turn too. After a few times rolling, he was lying quietly on his side. i slowly picked him up and helped him stand, but i only made him roll again

I reduced his cage size and tried to prevent him from throwing or rolling himself again. I fed him meds (antibiotics, and metacam) and left to work. I will check on him in one hour (during my lunch time).

He becomes deteriorated. Will call the vet today and ask her what other treatment available. and maybe we should consider the steroid ***

 

[the fluffies]

throwing and rolling, is it seizure???

 

[JBun]

You may need to make the area a little more confining and put rolled up towels right on each side to support your rabbit and try and prevent any rolling. I don't know if you feed hay, but it's good to put hay under and around the head area so that they can more easily eat and snack on the hay. Also try and minimize picking up your rabbit as much as possible, as it makes them feel dizzy and disoriented, and can throw them into a fit. If you can give meds by leaving your rabbit where it is, that is probably the best way to do it, but I know that some handling is necessary to make sure your rabbit is staying dry and clean.

Unfortunately when a rabbit gets to this point it can take some time to start seeing progress. I agree that steroids may need to be considered now, as there is probably significant inflammation causing the extreme tilt and rolling. Of course it's a bit of a risk to use them, but you just have to decide if at this point it is necessary and worth the risk. You may want to check this link out. There is some helpful information and also some other peoples personal experiences with their head tilt rabbits, and what medications seemed to help them recover.
http://www.onthewonk.com/?p=1%2EHome&trk=menu:Home

 

[Maureen Las]

My previous post was out of sync with the thread due to the fact that I accidentally skipped a page while reading the thread...so sorry about that.


The rolling behavior is cause by the inflammation/infection having entered the brain causing your bun to have a total loss of a sense of balance. This is an extremely uncomfortable sensation for bun /human /whatever. This is one of the reasons why meclizine is prescribed
I agree with JBun that the baytril is probably not going to cut it if this is a deep inner ear infection. Zithromax, injectable penicillin and/or oral chloramphenical would be much better options. Chloramphenical is especially useful in that it is able to pass through the blood/brain barrier thus reaching deep infections.
I would try to talk with the vet re. another antibiotic.
So sorry that you and your bun are going through this :-(
Maybe this article will help you in someway ( sorry if it has already been posted)
It is very important to distinguish the cause whether EC or inner ear..... maybe a head x-ray?
I also agree that the fenbendazole will not be harmful.


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

 

[the fluffies]

Maxie today

http://www.youtube.com/watch?v=o79WWJKOn_E&feature=youtu.be

My vet said i have to wait another 2-3 days to see his progress and if only he get slightly better, then Maxie can start his prednisone. But at this moment, my vet asked me to keep giving Baytril and Methycobalamine B12.

 

[JBun]

Oh, it just breaks my heart Poor little bun. I hope he starts to improve soon. I think I would be insisting on changing the antibiotics NOW, and also giving the steroids. Waiting with this illness, can have horrible results. Waiting means continued inflammation in the brain and continued damage from the inflammation.

A few other things I forgot to mention is that stimulation and light can also set them off. So you'll want to minimize contact some, if it seems to set him off, and also try and keep his area somewhat dark, at least just while he is bad like this.

 

[the fluffies]

I tried the Meclozine HCl + Pyridoxine HCl i bought from the counter and diluted it. I gave quarter tablets (it is 25mg) but it doesnt seem helping with the vertigo.
How long should i administer the Meclozine? Once a day? For how many days? I read it should be give up to 5 days, but i also saw on other thread said he can have Meclozine as long as he needs it.

Can someone advice me on this?

His poops somehow look much better. I feed him Critical Care 12cc x 5 times a day. And he munch on bok choy leaf just now. I will call my vet again if it is ok to give the steroid since his gut looks promising.

 

[JBun]

I have no experience using meclizine, but in this link it mentions that if it isn't effective helping with the dizziness, the corticosteroids to bring down the inflammation, may be. I would think that if you aren't seeing any positive effect after a couple doses of the meclizine, then it probably won't help.

http://www.bio.miami.edu/hare/tilt.html

 

[the fluffies]

I keep him in dark, but this morning, Maxie keeps struggling, throwing and rolling himself with his neck twisted at his back. I have tried my best to reduce his space as much as can but he keeps rolling and throwing every 5-10 minutes. The more i tried to help him stand on his feet, the more he twisting and rolling.

He still can eats by himself, but i have to hold the hay/vege for him. He cant drink from his bowl because he cant put his head on bowl without makes the bowl turn upside down on his head. So i have to syringe feed water for him. He takes the syringe feed nicely without i have to hold his head or force him to swallow.

I administered the prednisone tablet gaven by the vet, together with baytril this morning (an hour ago). That is the last thing i can do now.

I put more pillows around him to restrict him from rolling, but i am not sure if it helps. I have to rush to the office and can only see him in the next 2 hours but i hope he is doing well and doesnt injured himself.

If his condition show no change compared to this morning, i will rush him to other vet nearby (who prescribed 4 days baytril earlier). This vet might not a rabbit savvy vet, but he is a veteran vet so i hope he might have some experiences in this.

The vet who prescribed prednisone+28 days baytril for Maxie is too far away (6 hours driving) for us to reach in this condition. Plus, the vet seems cant help/advice much. She asked me to keep giving the baytril and B12 as long as Maxie can takes them, and wait.

 

[tonyshuman]

I have also heard of using diazepam (valium) to help with the vertigo, if you're not seeing an effect from the meclizine. I think meclizine is given daily or twice daily, based on the drug's half-life but I have no experience with it. She looks pretty poorly, I hope that you can convince your vet to change antibiotics sooner if possible, or that she starts to feel better soon. JBun is correct that the swelling needs to go down. In fact, prolonged swelling in the inner ear can cause permanent damage, and thus permanent tilt. That's why some bunnies are always tilted, even if their ear infection has been treated. I'd try Baytril for just 4-5 days before saying it's not working. Some permanently tilted bunnies do take meclizine on a regular basis, for the rest of their lives.

 

[JBun]

I hope the prednisone helps. Are you still giving the fenbendazole? I think it would be a really good idea to talk to this vet near you, about prescribing a different antibiotic like Zithromax or chloramphenicol. If there is an infection causing this, it doesn't seem like the baytril is doing any good, which would just leave the infection to get worse. It would be good to do this and change the antibiotics right away, as soon as you can get into this vet.

It sounds like you are doing all you can for him. The fact is that this is just a horrible illness for rabbits to get, and can be really hard to nurse a rabbit through.

 

[tonyshuman]

If the other vet can recommend a rabbit-safe antibiotic, maybe the closer vet can give it to you.

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

Here are some safe antibiotics:
http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm

And unsafe ones:
http://www.medirabbit.com/Unsafe_medication/dangerous_antibiotics.htm

 

[the fluffies]

We went to another vet today. He was a vet in Singapore Zoo and said had treated many rabbits, esp headtilt cases.

He asked me to stop all the meds we currently taken including Baytril, Meloxicam and Fenben.

Unfortunately, he is not the person who will tell the drugs he prescribed. He gave 3 injections.
- Trixone antibiotic (i dont know if it is safe to rabbit. He mentioned something about Meningitis).
- Antihistamine (cant see the bottle).
- Anti-inflamatory (tylanol??? i forgot. will check the bottle tomorrow)

He said this jabs will reduce the swollen or inflamation in the head tissues. The jabs has to be taken daily until Maxie shows some progress and he said he will reduce the dose to weekly. 3 jabs is USD 65 perday.

It has been 4 hours after maxie taken the jabs. He is still rolling. But i feel he is slightly better than before he taken the jabs. Appetite still good, but i have to offer the food infront of his face. Drink a lot from syringe, pee and poo well so far.

 

[carlysoup]

How is Maxie doing today?