Poor bun has suspected head tilt/E.C *and* overdose

So, so anxious about my beloved Poppet (4yr old dwarf lop). We found her laying limp under a bed in the early hours of last Thursday morning. When we tried to rouse her, she had what I believed to be a head tilt (never having seen it before), and she had to lean against the wall to be able to walk.

We took her to the vet, thinking that we'd caused it as we were in the middle of a 5-day worming (using Lapizole). She was wobbly and limp, and her head was bobbing. The vet thought it could be very early stages of head tilt, or E.C, or possibly a mass on her brain. He ensured us Lapizole is safe, and wouldn't have caused her illness. He gave us more Lapizole, Baytril and Metacam. He showed us how much to fill the syringes.

She seemed to perk up in the next couple of days (syringe fed), but something made me call the vets again. During the conversation it became clear we were overdosing her Metacam. Both OH and I clearly remember the vet showing how much to give her, but it was waaaay too much and we were told to bring her in. They gave her fluids, and gave me Fiberplex and Emprid. Her ears were fine, tummy was fine (no impactation) but as she'd been given too high dose of Metacam, the vet said not to give her more.

I've just been to the vet again, and they have given her Zantac. Poor Poppet is terrified of syringes, so all the medication along with syringe feeding and watering is stressing her out jo end. My heart breaks when I see her - as soon as she smells the critical care, she runs and hides...

She's eating fresh, chilled herbs, dried plantain and the odd pellet, but it's not enough.

Her head is steady, she can jump in and out if the litter tray and she can balance to was her face with two paws. She has improved, but I'm so worried about her, especially her luver and kidneys. It's very difficult - I just want her happy and healthy and scoffing her food.

How much metacam were you giving her? Tbh, it's very hard to overdose on metacam, unless you were using the wrong syringe.

She really does need to have some kind of NSAID (i.e metacam, tramadol etc) because this reduces the swelling caused by either an ear infection or E.C. Tbh, I would probably want to seek out a more rabbit savvy vet.

Routine worming is generally not recommended since there is little evidence to show it does anything to reduce the risk of EC. 5 days is nowhere near long enough to treat E.C. She needs a 28 day course AT LEAST. I would post up in "Rabbit Chat" asking for a rabbit savvy vet in your area.

Sorry, I didn't explain properly: my plan was to worm for 5 days, but then she fell ill. The vet has prescribed 28 days.

Beau Belle said:

Sorry, I didn't explain properly: my plan was to worm for 5 days, but then she fell ill. The vet has prescribed 28 days.

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Ah, I see. Did the vet discuss the possibility of an inner ear infection? This cannot be seen with a scope.

Poor Poppet As Vegan Bunny said, she'll definitely need painkillers - preferably twice a day as bunnies metabolise everything so fast. Approx how much metacam were you giving her, and what is her weight? Rabbits can tolerate and metabolise large doses of metacam. For a bunny around 2.5kg you'd be within the safe range at 1.2ml or a bit higher, twice a day. I forget the exact figures but it was recently found that they can tolerate much higher doses than is often recommended, and that it can help more with the pain. Overdoses of metacam in bunnies are rarely severe unless given massive amounts... I'm thinking 3ml plus here for a 2.5kg bunny, and that would have to be for several days at twice a day. Metacam is very well tolerated in bunnies and metabolised very fast. There's unlikely to be any damage to Poppet.

My bunnies are very receptive to syringe medication, but they absolutely love eating recovery food/critical care out of a bowl so I tend to mix their medicine in with that. I mix it up with Ella's kitchen baby food (the carrot one is great) into a solid blob which is a bit more watery than toothpaste or porridge but also holds its shape when put into a blob. My bunnies will only refuse it if they're in stasis and won't eat anything else. It may be worth trying your bun with medicine this way, and it's also great to give without medication for maintaining weight/fibre levels. Quite a few people have found it really effective. Certainly worth a try if you already have critical care in, the baby food is less than £1

The vet did check her ears, and said he couldn't find anything. She hasn't been scratching.

Yarezti, many thanks for tip about baby food - I'll give that a go. I'll try to put critical care in a bowl too - anything to avoid having to stress her out with syringes...

It was a proper overdose, I'm sorry to say. He gave me the syringe and placed his nail where I should fill it to. I have since found out this amount is for large animsls, like dogs. She still has a fixed pupil, which I belive is to do with that. I'm seeing a different vet now, and I've been asked to takeva sample if poo in to surgery later today.

I hate seeing her like this, she's such a lovely, cuddly bun always wanting food and treats. Right now she's hiding undrr the sofa to get away from me and my wide selection of syringes...

Hope the drugs help and she feels better soon. Sending lots of vibes for Poppet xx

Beau Belle said:

The vet did check her ears, and said he couldn't find anything. She hasn't been scratching.

Yarezti, many thanks for tip about baby food - I'll give that a go. I'll try to put critical care in a bowl too - anything to avoid having to stress her out with syringes...

It was a proper overdose, I'm sorry to say. He gave me the syringe and placed his nail where I should fill it to. I have since found out this amount is for large animsls, like dogs. She still has a fixed pupil, which I belive is to do with that. I'm seeing a different vet now, and I've been asked to takeva sample if poo in to surgery later today.

I hate seeing her like this, she's such a lovely, cuddly bun always wanting food and treats. Right now she's hiding undrr the sofa to get away from me and my wide selection of syringes...

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Inner ear infections cannot be seen with a scope as the infection will be BEHIND her ear drum. Not all buns will show symptoms of this, quite often the only symptom is a head tilt. This link can explain it more. http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm

Bear in mind that rabbits can handle quite a large dose of metacam without a problem. I am no expert, but I can't see how an overdose of metacam would affect her eyes? It would damage her kidneys/liver if anything, but I have no experience in overdosing a rabbit on metacam. A fixed pupil would suggest brain damage..I have no idea if metacam can cause that. http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Meloxicam.htm This link shows all the side effects of metacam, nothing about brain damage is mentioned. I would think that the fixed pupil is to do with whatever is causing the head tilt.

I am sorry that she has become wary of you. I've had this exact same problem with one of my buns who has had to be on a cocktail of drugs for various problems. Unfortunately there's nothing much you can do apart from attempt to build her trust back up once she has recovered. Sending her lots of vibes. x

If the EC parasite has attacked the brain that might cause a fixed pupil but equally a tumor on the brain could cause that and the head tilt.

Thank you for useful comments and well-wishes for Poppet.

Vegan Bunny - many thanks for links. I've had a read, but I think I'm so stressed I don't know what to make of it. She had Nystagmus (not sure which type), but it seems to have calmed down. The fixed pupil/overdose was my own conclusion, but may well be way off base (humans on drugs can often have large pupils). The vet did say that if it wasn't head tilt or E.C, it could be that she has a mass on her brain. He wanted to see how she responded to medication before booking her in for a scan.

Out of curiosity, how much critical care would you feed a bun of 2.5kg and how often?

I fed smaller portions at longer intervals before seeing vet yesterday. In between, Poppet ate handfuls of fresh herbs, and small amounts of dried herbs (no interest in hay). She had gotten to the point of picking up a few pellets (not many, but I deemed it an improvement). The vet asked me to feed twice the amount of food at shorter intervals, and cut down on the amount of water I was giving. I did that over night and today, but now she has no interest in fresh or dry herbs, and no pellets (and no apple - her favourite treat). It seems to me that isn't an improvement? At the moment, she's has about 12mg of critical care + 5 syringes of water every two hours. Her poo's are fewer, darker and smaller.

Beau Belle said:

Thank you for useful comments and well-wishes for Poppet.

Vegan Bunny - many thanks for links. I've had a read, but I think I'm so stressed I don't know what to make of it. She had Nystagmus (not sure which type), but it seems to have calmed down. The fixed pupil/overdose was my own conclusion, but may well be way off base (humans on drugs can often have large pupils). The vet did say that if it wasn't head tilt or E.C, it could be that she has a mass on her brain. He wanted to see how she responded to medication before booking her in for a scan.

Out of curiosity, how much critical care would you feed a bun of 2.5kg and how often?

I fed smaller portions at longer intervals before seeing vet yesterday. In between, Poppet ate handfuls of fresh herbs, and small amounts of dried herbs (no interest in hay). She had gotten to the point of picking up a few pellets (not many, but I deemed it an improvement). The vet asked me to feed twice the amount of food at shorter intervals, and cut down on the amount of water I was giving. I did that over night and today, but now she has no interest in fresh or dry herbs, and no pellets (and no apple - her favourite treat). It seems to me that isn't an improvement? At the moment, she's has about 12mg of critical care + 5 syringes of water every two hours. Her poo's are fewer, darker and smaller.

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I'm afraid I can't offer advice on the amount of critical care to give her since I don't really have much experience in this. I just syringed as much as my buns would take at 2 hourly intervals when they needed it.
She may be off her food due to pain. I would certainly talk to the vet about pain relief because a bun in pain won't eat.

What vets are you using and where do you live?

Sorry this is just a quick reply, i just wanted to tell you that rabbits actually need MORE metacam than dogs, even though dogs are much bigger. Rabbits have a much faster metabolism so need more metacam in order for it to have an effect. For example, my rabbit Digby weighs 4.5kg, but he has a 10kg dog dose Twice a day, and that is not the maximum dose. Just so you know :wave:

Oh! Ripminnie - you have no idea how relieved I feel at reading this! Oh gosh. I know it's too early to tell if she has suffered liver and/or kidney issues, but this fills me with hope. I've been so stressed about it, I threw up in the kitchen sink at work..! Thankfully my bosses are pet owners too, so I've had time off to care for her (and when I'm at work, OH has been here as we take it in turns).

VeganBunny - I live in East London, and use CompanionCare in Chingford. After my last post, I went to speak to them again and have agreed to carry on feeding as per their instruction a little longer and then update them. When I got back home, Poppet had done a *big* poo and whilst I don't like the idea of her having tummy ache, that could possibly be the issue. I bought a pouch of Ella's Kitchen food as per Yaretzi's suggestion, mixed it with critical care and I think she likes the taste better as there was less struggling. It went down easier. :thumb:

I'm keeping a close eye on her, and have been massaging her tummy which seems to relax her.

Glad you feel a bit better :wave: what does your bunny weigh and how much metacam were you giving her? Your vet should really already know about the different dosing for rabbits; if they don't, you definitely should find another :wave:

Beau Belle said:

Oh! Ripminnie - you have no idea how relieved I feel at reading this! Oh gosh. I know it's too early to tell if she has suffered liver and/or kidney issues, but this fills me with hope. I've been so stressed about it, I threw up in the kitchen sink at work..! Thankfully my bosses are pet owners too, so I've had time off to care for her (and when I'm at work, OH has been here as we take it in turns).

VeganBunny - I live in East London, and use CompanionCare in Chingford. After my last post, I went to speak to them again and have agreed to carry on feeding as per their instruction a little longer and then update them. When I got back home, Poppet had done a *big* poo and whilst I don't like the idea of her having tummy ache, that could possibly be the issue. I bought a pouch of Ella's Kitchen food as per Yaretzi's suggestion, mixed it with critical care and I think she likes the taste better as there was less struggling. It went down easier. :thumb:

I'm keeping a close eye on her, and have been massaging her tummy which seems to relax her.

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Beau Belle said:

Oh! Ripminnie - you have no idea how relieved I feel at reading this! Oh gosh. I know it's too early to tell if she has suffered liver and/or kidney issues, but this fills me with hope. I've been so stressed about it, I threw up in the kitchen sink at work..! Thankfully my bosses are pet owners too, so I've had time off to care for her (and when I'm at work, OH has been here as we take it in turns).

VeganBunny - I live in East London, and use CompanionCare in Chingford. After my last post, I went to speak to them again and have agreed to carry on feeding as per their instruction a little longer and then update them. When I got back home, Poppet had done a *big* poo and whilst I don't like the idea of her having tummy ache, that could possibly be the issue. I bought a pouch of Ella's Kitchen food as per Yaretzi's suggestion, mixed it with critical care and I think she likes the taste better as there was less struggling. It went down easier. :thumb:

I'm keeping a close eye on her, and have been massaging her tummy which seems to relax her.

Click to expand...

I agree with Ripminnie about finding a different vet. I really doubt that your vets really understand rabbits, since you obviously did not "overdose" her on metacam. My rabbit weighs 2kgs and was getting about 8kg (in loxicom doses) twice a day when he was suffering with his arthritis. As I mentioned before a rabbit can handle much more metacam than most people think.

The sooner you find a decent vet, the sooner will get the proper treatment and the more likely she is to recover.

I hope she begins to improve soon, but I must stress that she does need some form of NSAID.