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Head tilt and steroids

gem6517

gem6517

Young Bun
Hi all,

Our girl-bun Mini is suffering from head tilt at the moment and I'm looking for a bit of reassurance/advice!

Mini first presented symptoms of head tilt on Friday 19th December when her head was hanging slightly to the left, drifting and her eyes were twitching. We got her straight to the vets on the Saturday morning, and she was put on Panacur. Mini has a chronic health condition which means she already takes Metacam, Zantac and Emeprid (metaclopramide) daily.

On Dec 24th after some rolling episodes we started giving her Stemetil for the dizziness, and then most recently on Dec 29th we started Septrin to treat a possible infection (she hasn't been tested to find the root cause of the head tilt). We also increased her usual Metacam dosage. Though she continued to get worse after initially being diagnosed I do feel like she's been brighter the past few days. She still eats and drinks on her own and her appetite is great! After she started the antibiotics, she continued to get worse for a couple of days until we had to syringe feed her for a couple of days because she just couldn't get to her food, but then she perked up and is eating on her own again now. Usually with Mini she has a very sensitive stomach and will stop eating easily when she's unwell, so I'm taking that as a good sign. Her nystagmus is also a lot better.

She actually boarded with the vets this weekend while my partner & I were away at a wedding. When the OH went to pick her up today he says the vet felt that she'd declined over the weekend and hinted that if she isn't showing improvement next week we might need to consider pts. She has given us Prednisolone, which is a steroid, in the meantime instead of the Metacam.

My OH said she seems fine now she's home and is happily munching hay and pellets. I wonder if being in a strange place, and probably in a cage not set up to properly meet her needs at the moment, might have more to do with the supposed decline. My gut feeling is it's way too early to be considering pts. She's only been on antibiotics for 2 weeks, and she's otherwise fine in herself, seems quite happy (apart from having to be separated from her husbun Jay) and is eating and drinking well on her own.

Really I'm looking for reassurance that we should give her more time. I'm also a little concerned about giving her the steroids as the vet mentioned to me last week that they can cause problems in rabbits. Mini already has underlying health problems and tbh my feeling is that the tilt is being caused by an infection rather than EC which obviously makes steroid use a bit controversial. Any advice or experience you have with steroids and head tilt would be great. I want to go armed with as much info as possible to our appointment next week - I'm not ready to give up on her yet!

Thanks, and sorry for such a long post!
 
gem6517 said:
Hi all,

Our girl-bun Mini is suffering from head tilt at the moment and I'm looking for a bit of reassurance/advice!

Mini first presented symptoms of head tilt on Friday 19th December when her head was hanging slightly to the left, drifting and her eyes were twitching. We got her straight to the vets on the Saturday morning, and she was put on Panacur. Mini has a chronic health condition which means she already takes Metacam, Zantac and Emeprid (metaclopramide) daily.

On Dec 24th after some rolling episodes we started giving her Stemetil for the dizziness, and then most recently on Dec 29th we started Septrin to treat a possible infection (she hasn't been tested to find the root cause of the head tilt). We also increased her usual Metacam dosage. Though she continued to get worse after initially being diagnosed I do feel like she's been brighter the past few days. She still eats and drinks on her own and her appetite is great! After she started the antibiotics, she continued to get worse for a couple of days until we had to syringe feed her for a couple of days because she just couldn't get to her food, but then she perked up and is eating on her own again now. Usually with Mini she has a very sensitive stomach and will stop eating easily when she's unwell, so I'm taking that as a good sign. Her nystagmus is also a lot better.

She actually boarded with the vets this weekend while my partner & I were away at a wedding. When the OH went to pick her up today he says the vet felt that she'd declined over the weekend and hinted that if she isn't showing improvement next week we might need to consider pts. She has given us Prednisolone, which is a steroid, in the meantime instead of the Metacam.

My OH said she seems fine now she's home and is happily munching hay and pellets. I wonder if being in a strange place, and probably in a cage not set up to properly meet her needs at the moment, might have more to do with the supposed decline. My gut feeling is it's way too early to be considering pts. She's only been on antibiotics for 2 weeks, and she's otherwise fine in herself, seems quite happy (apart from having to be separated from her husbun Jay) and is eating and drinking well on her own.

Really I'm looking for reassurance that we should give her more time. I'm also a little concerned about giving her the steroids as the vet mentioned to me last week that they can cause problems in rabbits. Mini already has underlying health problems and tbh my feeling is that the tilt is being caused by an infection rather than EC which obviously makes steroid use a bit controversial. Any advice or experience you have with steroids and head tilt would be great. I want to go armed with as much info as possible to our appointment next week - I'm not ready to give up on her yet!

Thanks, and sorry for such a long post!
Click to expand...

I am sorry to hear that Mini is unwell. I think you may be correct in assuming that being in a strange environment (the Vets) could have made it seem as though she had deteriorated. Could you take a video of her to show the Vet how she copes in her home environment. From what you describe it sounds as though she is doing reasonably well again now and I agree that it does appear to be rather premature to be considering PTS. Some people on here have had Rabbits on treatment for head tilt for several weeks, even months. Whilst the Rabbit may not make a 100% recovery-ie they remain somewhat 'wonky' they are able to enjoy a good quality of life.

With regards to the steroids, their use in Rabbits is controversial for the reasons you have stated-ie suppression of the immune system aswell as the potential of causing GI tract ulceration and liver damage. Whilst there are occasions where a steroid may be appropriate I am not sure that I would be happy to give it in your situation. However, I am not a Vet, I am just basing my thoughts on my past experiences.

These links might be of interest to you:

http://onthewonk.com/

http://www.disabledrabbits.com/head-tilt.html
 
gem6517 said:
Hi all,

Our girl-bun Mini is suffering from head tilt at the moment and I'm looking for a bit of reassurance/advice!

Mini first presented symptoms of head tilt on Friday 19th December when her head was hanging slightly to the left, drifting and her eyes were twitching. We got her straight to the vets on the Saturday morning, and she was put on Panacur. Mini has a chronic health condition which means she already takes Metacam, Zantac and Emeprid (metaclopramide) daily.

On Dec 24th after some rolling episodes we started giving her Stemetil for the dizziness, and then most recently on Dec 29th we started Septrin to treat a possible infection (she hasn't been tested to find the root cause of the head tilt). We also increased her usual Metacam dosage. Though she continued to get worse after initially being diagnosed I do feel like she's been brighter the past few days. She still eats and drinks on her own and her appetite is great! After she started the antibiotics, she continued to get worse for a couple of days until we had to syringe feed her for a couple of days because she just couldn't get to her food, but then she perked up and is eating on her own again now. Usually with Mini she has a very sensitive stomach and will stop eating easily when she's unwell, so I'm taking that as a good sign. Her nystagmus is also a lot better.

She actually boarded with the vets this weekend while my partner & I were away at a wedding. When the OH went to pick her up today he says the vet felt that she'd declined over the weekend and hinted that if she isn't showing improvement next week we might need to consider pts. She has given us Prednisolone, which is a steroid, in the meantime instead of the Metacam.

My OH said she seems fine now she's home and is happily munching hay and pellets. I wonder if being in a strange place, and probably in a cage not set up to properly meet her needs at the moment, might have more to do with the supposed decline. My gut feeling is it's way too early to be considering pts. She's only been on antibiotics for 2 weeks, and she's otherwise fine in herself, seems quite happy (apart from having to be separated from her husbun Jay) and is eating and drinking well on her own.

Really I'm looking for reassurance that we should give her more time. I'm also a little concerned about giving her the steroids as the vet mentioned to me last week that they can cause problems in rabbits. Mini already has underlying health problems and tbh my feeling is that the tilt is being caused by an infection rather than EC which obviously makes steroid use a bit controversial. Any advice or experience you have with steroids and head tilt would be great. I want to go armed with as much info as possible to our appointment next week - I'm not ready to give up on her yet!

Thanks, and sorry for such a long post!
Click to expand...

I feel you are completely right not to make a judgement to put her to sleep because of what the vet said concerning her deterioration. You said it yourself in that the cage at the vets was not set up to properly meet her needs right now. What you see at home is far more representative of her true state of being. I would put that out of your mind for the moment unless she gives you very good cause to suspect it may be the right thing to do!

You seem to be covering all bases as far as head tilt goes. Metacam to reduce damage to the nervous system, Panacur in case it's E.C. and an antibiotic to cover the possibility of an inner ear infection which can also affect balance.

Treatment could go on for several weeks or even months. My vet has actually doubled up the dose of Panacur and also given it for 6 weeks. If there's no improvement within 2 -3 weeks I would consider changing to a different antibiotic.

Personally speaking I would steer clear of steroids until you've exhausted other possibilities - I would go with your own gut instinct on this one.

Good luck :) She is lucky to have a devoted and caring bunny Mom by her side! xx
 
Thanks Jacks Jane & Mighty Max.

She seems fine now she's home & in her cage. Hopping about a bit, eating well and enjoying some strokes from us. She even got a few licks from her husbun & only fell over a couple of times while he was visiting.

I don't like to ignore the advice of the vet (and she is very good usually) but I think she's made the steroids recommendation on the basis of a dip in Mini's condition that I just can't see. So think we'll continue with Metacam for now. We're going back for a check up in a week so will see how she goes in the meantime.

So glad i have everyone else's experience on this forum & others to learn from! I've been scouring posts about head tilt & it's so helpful :)
 
gem6517 said:
Thanks Jacks Jane & Mighty Max.

She seems fine now she's home & in her cage. Hopping about a bit, eating well and enjoying some strokes from us. She even got a few licks from her husbun & only fell over a couple of times while he was visiting.

I don't like to ignore the advice of the vet (and she is very good usually) but I think she's made the steroids recommendation on the basis of a dip in Mini's condition that I just can't see. So think we'll continue with Metacam for now. We're going back for a check up in a week so will see how she goes in the meantime.

So glad i have everyone else's experience on this forum & others to learn from! I've been scouring posts about head tilt & it's so helpful :)
Click to expand...

I hope she continues to cope well now she is back home. It sounds as though she is doing great at the moment :)
 
I had a head tilt bunny, Kermit, and he was pretty much like how you describe your baby. In fact, I would say that your wee one seems to be doing better than Kermit was at this stage.

When he 1st got his tilt I had him in the living room with me, he used to roll violently and he would seem like he was getting better then take a big step back and be ill again. In all honesty I can say that it was about 2 months before he was even resembling normal, and even at that he was left with a permanent head tilt, but he coped really well.

I once tried to move him into my spare room and he freaked right out, he just couldn't take it. I put him back where he was. To me it really does sound like she deserves more time, it sounds like the vets visit has spooked her.

I personally would continue with the Metacam. You know your bunny best, and its not like you are trying her with meds that she has not been on, you are just continuing to give her what she has been having.

Also, are you careful when you pick her up, as in always keep her with her feet facing the ground, as this will give her less chance of being dizzy and having an episode. I always used to pick kermit up supported in my fore arms at each side, so he was perfectly in the standing position.
 
We try not to pick her up more than necessary Kermit & I try to be careful when I do. We have tried her in a slightly larger space but she gets quite dizzy & disoriented. Although she still manages to stay standing up most of the time, she just can't move around. In her little cage she's ok though - falling down occasionally but not really rolling. Mini's a lop & the 'up' ear has been sticking up since she's been tilted, but that has even popped back down tonight! So we're keeping our fingers crossed.
 
gem6517 said:
We try not to pick her up more than necessary Kermit & I try to be careful when I do. We have tried her in a slightly larger space but she gets quite dizzy & disoriented. Although she still manages to stay standing up most of the time, she just can't move around. In her little cage she's ok though - falling down occasionally but not really rolling. Mini's a lop & the 'up' ear has been sticking up since she's been tilted, but that has even popped back down tonight! So we're keeping our fingers crossed.
Click to expand...

Fingers crossed here too that she makes an improvement :thumb:
 
Sounds promising :) She will be fine in her small space. My K was in a nero 4 cage most of the time when he was really ill, so that was pretty small.

She doesn't sound as bad as she could be with the fact that she is not rolling when she falls over, that really is a good thing. My boy used to violently roll and it was rather distressing.

Well done for taking the time to care for her, I know how hard it can be and I know what a toll it can take on you.

Vibes for continued improvement.

When my boy came for a cuddle he found it good in between my legs! He felt supported there.
 
Kermit said:
Sounds promising :) She will be fine in her small space. My K was in a nero 4 cage most of the time when he was really ill, so that was pretty small.

She doesn't sound as bad as she could be with the fact that she is not rolling when she falls over, that really is a good thing. My boy used to violently roll and it was rather distressing.

Well done for taking the time to care for her, I know how hard it can be and I know what a toll it can take on you.

Vibes for continued improvement.

When my boy came for a cuddle he found it good in between my legs! He felt supported there.
Click to expand...

Oh Kermit, what a beautiful photo :love:
 
https://vimeo.com/116788119

Sorry about the dodgy camera work, but this is Mini tonight having a hop around the coffee table. First time she's been able to do that really for a couple of weeks. Even a couple of days ago she was just sitting with her head down if she was put on the floor. IMPROVEMENT!! She got half-way around the room before tiring herself out :)


Sent from my iPhone using Tapatalk
 
So glad things are improving. My mini lop had the violent rolling so bad I had her in a Moses basket propped with towels. I took her up to bed with me at night so I could syringe her water and feed her herbs and veg as she could not manage it herself. It took a good 6 weeks before I could re unite her with her sister. But she was only left with a slight tilt and could run around the garden as normal. I got so much advice from this forum and it can be so upsetting when your rabbit goes through it. Good luck. X
 
gem6517 said:
https://vimeo.com/116788119

Sorry about the dodgy camera work, but this is Mini tonight having a hop around the coffee table. First time she's been able to do that really for a couple of weeks. Even a couple of days ago she was just sitting with her head down if she was put on the floor. IMPROVEMENT!! She got half-way around the room before tiring herself out :)


Sent from my iPhone using Tapatalk
Click to expand...

This is so encouraging !! It may take weeks and weeks, but eventually she could adjust to the severe tilt and be very capable of hopping about without falling over. From the video it does not seem as though Mini intends giving up any time soon !!

Do let us know how she progresses. Acupuncture and/or massage can help with any muscle spasms she may get in her neck due to the tilt. My Vet does Acupuncture and I have seen some amazing results from its use.
 
gem6517 said:
https://vimeo.com/116788119

Sorry about the dodgy camera work, but this is Mini tonight having a hop around the coffee table. First time she's been able to do that really for a couple of weeks. Even a couple of days ago she was just sitting with her head down if she was put on the floor. IMPROVEMENT!! She got half-way around the room before tiring herself out :)


Sent from my iPhone using Tapatalk
Click to expand...

Wow what an amazing video! I am so pleased at her determination!

When my bunnies have had head tilt I apply warmth and gentle massage so the muscles don't seize up too much in one direction. You have to be very careful and go very slowly, but it can improve things (bunny physiotherapy - my vet wholeheartedly supports this :thumb:)

Way to go Mini!!!!
 
Thanks guys. She did a couple of laps of the living room tonight, going around the edge for support :) She's so determined to move around, even though she's still very tilted.

I think one of the vets at our practice does acupuncture, so I'll ask about it on Monday.


Sent from my iPhone using Tapatalk
 
gem6517 said:
Thanks guys. She did a couple of laps of the living room tonight, going around the edge for support :) She's so determined to move around, even though she's still very tilted.

I think one of the vets at our practice does acupuncture, so I'll ask about it on Monday.


Sent from my iPhone using Tapatalk
Click to expand...

The more she practices the better her balance and co-ordination will get. Her confidence will grow too as she adjusts to her tilted view of her world. She clearly has a strong character and that will really work in her favour. I hope her next check up with the Vet goes well.
 
gem6517 said:
Thanks guys. She did a couple of laps of the living room tonight, going around the edge for support :) She's so determined to move around, even though she's still very tilted.

I think one of the vets at our practice does acupuncture, so I'll ask about it on Monday.


Sent from my iPhone using Tapatalk
Click to expand...

What a super update and a determined bunny :D Long may she continue to exercise and keep her balance! x
 
Love the update :)
She seems to be doing really well imo. She really manages to just get back up from her falls over. My boy rolled violently loads, twisted about 3 times then got up, so she is much better at this stage than he was, so there is much hope.

She might always have her tilt, but from the looks of things she is just learning to deal with it.

If her tilt remains you will probably get people coming to your house and seeing her and telling you that it is cruel, I had that loads, I just told them if they never liked Kermit and how he looked then they could just leave!
 
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