Head tilt in a bunny is exactly what it sounds like, their head turns sideways. It is also sometimes called Wry Neck. It can be caused by a severe ear infection.

​

Symptoms: A rabbit with Head Tilt can be perfectly fine one second and falling down the next. Or, it may start slowly with a slight cock of the head and some balance troubles. The important thing is to get the rabbit to the vet A.S.A.P. It can be a very scary condition and may be mistaken for injury or even seizures. A rabbit in severe head tilt can spin, literally flopping over and over on their sides. They are trying to make their world upright again. Anyone who has ever experienced vertigo can understand why. Their world is literally upside down. The extreme bend in their neck is their way of dealing with it.

​

What the Vet may do: There are two usual causes of Head Tilt. One is an ear infection. This is typically a middle or inner ear infection. It may be the result of a missed outer ear infection or an U.R.I. that migrated to the ear from the throat. It is much less likely to be something such as a brain tumor, but it is possible. Your vet will check their ears. They may do a skull x-ray to check for middle ear involvement. They might treat the rabbit for 2 disorders at once: E. Cuniculi and an ear infection. For the ear infection, a vet will usually prescribe injectable penicillin, which is typically given at home daily. An injectable is needed because the area of infection is much deeper than what a drop or even an oral antibiotic can reach. Sometimes, a rabbit will also be prescribed Panacur, a low-cost dewormer used for horses, in case the rabbit has E.C. Testing for E.C. may be done at some vets, but many rabbits will test positive when they are asymptomatic and it can be hard to tell whether the infection is active. The drug is safe and well-tolerated by most rabbits. Meloxicam will also be used for pain and inflammation. Meclizine might be prescribed for dizziness, they may also be prescribed appetite stimulants.

​

Treatment: Even if you are following the treatment schedule, it may take awhile to see improvement. Many people report improvement after the second or third injection of penicillin. It is important to complete the treatment prescribed by the vet, stopping too soon will cause a relapse. Until the spinning stops, it may be necessary to syringe feed your rabbit with Critical Care. Your vet will tell you how much they need per day. Many rabbits will try and eat as soon as they feel under control, even if they are still "crooked". Make sure they can reach their water bowl. Also, if they are spinning, you may want to line their cage with extra padding. Place some towels under the area where they prefer to sit. Line the edges of their cage to prevent them from injuring themselves on the metal. They will likely not have bladder or bowel control until the spinning ceases, so change their cage pad often to prevent urine scald. It is also important to note that some rabbits do not recover from Head tilt. Some retain a slight cock to their neck. Others remain in full tilt permanently.

​

E. Cuniculi is a disease that most rabbits have been exposed to. It was long thought to be a protozoal infection, but has just recently been determined to be a fungal infection. Regardless, treatment has not changed. Rabbits are only contagious for a few weeks after they have been exposed. It is present in their urine during this time. E.C. is most commonly associated with Head Tilt but also can cause damage to nerves throughout the body. It can cause liver disease, hind leg paralysis, incontinence, difficulty swallowing and even cataracts. Once thought to be a disease of only older rabbits, it can actually strike at any age and tends to occur after other major health issues.

​

What You vet may do: If your rabbit has Head tilt, the treatment is listed above. For other E.C. complications such as hind leg paralysis, the vet will still likely treat them with Panacur and meloxicam. It is important to get to the vet A.S.A.P after noticing these symptoms. Only rabbit vets will be well-versed in this disease. Testing for E.C. in asymptomatic rabbits is contested amongst vets. It is believed that as much as 80% (or higher) of rabbits have been exposed, so testing would only tell you that they have been exposed. However, the University or Florida, Miami is running very accurate blood tests on rabbits that can now tell you whether your rabbit is in an active E.C. infection.

​

Treatment: Check with your vet on dosing of Fenbendazole, it is usually given for 2-4 weeks, bloodwork may be needed to make sure there are no ill-effects from the drug. Make sure to watch your rabbit's food intake and check for new symptoms. Check for pain. As listed above, make their cage as comfortable as possible. If they do become paralyzed, consider getting your rabbit a cart--many bunnies do quite well with them.

​

Costs:  Vet visit $50. It depends on the vet as to whether you are charged for every visit requiring an injection. A peniciliin injection usually runs between $25 and $40. Many vets only charge for the shot or a tech visit fee. X-rays can cost upwards of $90. Meds are inexpensive. Fenbendazole is OTC and only cost about $15 a tube. It is a horse med. You may need two tubes depending on rabbit size.

​

Resources: Check out rabbit.org for more info. https://rabbit.org/encephalitozoon-cuniculi/ and https://rabbit.org/head-tilt-causes-and-treatment/