Head tilt but it's not E Cuniculi - Help!

[dex179]

Hi All

My rabbit Dexter came from boarding with a head tilt - this has progressively gotten worse over the last 3 weeks.

I went to the vets who thought it was E Cuniculi. So Dexter was prescribed Metoclopramide+Cisapride for the gut statis, and Panacur for the suspected E Cuniculi (which he's taken daily for the last 3 weeks).

However the blood test results came back and showed that statistically speaking, Dexter didn't have E Cuniculi (I don't think they can confirm as there is always a bit of EC present in rabbits' blood). The vets think he may have a middle ear infection, or even worse something wrong with his brain. They said they would need to do an MRI or CT scan to see what's going on. However the risks of this are high and I'm not sure if they do identify something, the next steps would make sense.

Does anyone know what an middle ear infection means? How can you recover from this?

Dexter is nearly 10 years old and has had a history of health problems, hence I am apprehensive of doing anything too rash. He is based in North London.

At the moment Dexter has the following symptoms/problems:
1. Head tilt, which is pretty much 90 degrees to the left (picture attached).
2. He does not have a sense of direction so only runs in circles.
3. Because he runs in circles, he cannot navigate as before and this means not being able to find his food (he only eats wetted pellets)
4. Because of the problems with his vision, he also doesn't move around much. I am using a combination of fleece blankets and vet fleece matts to prevent any problems with wet bottom.
5. His appetite isn't as good as before. I need to either hand feed him or put the bowl of pellets in front of his face for him to eat.
6. He has not touched his water bowl for weeks - I am hoping the wetted pellets gives him sufficient water - I am not sure?
7. His left leg sometimes gets floppy, especially after sitting for too long - this is the same side of his body which his head tilts. See pic 2

I have the following questions, and would be grateful for any help from the forum:
1. Do you think he's in pain, especially from the head tilt? How can I help him?
2. Do you think I need to get his left leg checked (the one that can get floppy)?
3. What is your opinion on his condition, especially given the symptoms I mentioned and the fact the vets think it's not E Cuniculi?
4. Any tips on how I can encourage him to eat or how to make it easy for him to find his food? I used to give him the run of a single room, but have massively restricted the size of his space.
5. Do you think the wetted pellets is sufficient for water intake? How else do you think I can get him to have water?
6. What else can I be doing to help him get better?

Any other comments/tips/notes would be most welcome and greatly appreciated

Thank you all for your help

Dex 179

 

[SarahP]

Poor Dexter, and poor you having to watch and deal with this.

I am slightly confused as to why the vet has never prescribed antibiotics in case of middle ear infection in the first place. Am definitely no expert on this, but I'd assume a vet would want to try out the simple first - eg. antibiotics and anti-inflammatories, along with the E cuniculi meds to try to cover all options. Has the vet said why they haven't prescribed broad spectrum antibiotics?

 

[InspectorMorse]

I agree with SarahP. Antibiotics are an essential part of treatment for any bacterial ear infection.

Further information here

*WARNING* GRAPHIC IMAGES ON LINKS

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/diagnosis-of-otitis-externa-media-and-interna-in-rabbits.pdf

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/treatment-of-otitis-externa-media-and-interna-in-rabbits.pdf

 

[Bunny Lovely]

Hi dex 179,
I am quite new to keeping rabbits, so just send my supportive view if that's OK.

It sounds like there is a lot going on. I personally would contact my vet again to go over own concerns and collective symptoms, including the floppy leg and ear tilt being same side.

I would be concerned about his water intake and so I personally would seek advice on this from vet. I have syringe fed my bun water before with a tiny syringe, but letting my bun lead, so drop at a time and letting her naturally take over to swallow when ready. She took it willingly and this would be important, so I would check with vet, if could advise on this further, as an option, or if any other options are available more suitable to help with water/fluid intake for dexter.

I would definitely just make another appointment for him. He does need to be seen, especially as it is worsening. Let us know how things go with vet. You can always ask for a second opinion if you stil are not getting it diagnosed. I would also let the boarding place know,, in case it is something that has been contracted as an infectious problem.

I don't know if this helps, but I send my support and best wishes ❤

 

[bunny momma]

I have had rabbits successfully recover from head tilt in the past.
Having tests done seems like an unnecessary risk at this stage. Treat with antibiotics and anti inflammatory for possible ear infection. Fluids can be given sub q at home to keep him hydrated if needed. Syringe feeds may not be needed if he is eating on his own.
Sending lots of positive vibes for Dexter.

 

[joey&boo]

I agree with others. Treatment with abx (prob injectable penicillin) would seem appropriate move now - reckon he could do with metacam as pain relief too - has good anti inflammatory properties which are beneficial in this situation

The best way to assess a buns diet can be through their poop. Dehydration, not enough intake, not enough fibre will show in his poops.

Ear infections in elder lops are sadly quite common. Because bunnies with balance problems struggle with travel personally I'd call vets & see if you can get the drugs & arrange review a few days later. A home visit would be ideal but I know v rarely possible

Loads of well wishes

 

[dex179]

Hi All

So I decided to take Dexter to the vets today. With the advice you all provided, I pressured the vet to prescribe anti biotics (doesn't give the name on the label) and metacam. Otherwise the vet was trying to recommend a CT scan and then an ear flush under GA if it was a middle ear infection.

Unfortunately he's still not eating by himself so I'm still either hand feeding him wetted pellets or syringe feeding him. Hoping the metacam will make him feel better.

Thank you all for your advice

Many Thanks
Dex 179

 

[Orenoko]

I've dealt with a rabbit with head tilt, it was permanent for him for a variety of reasons but initially caused by an ear infection. What I would say is improvement can take a long time so keep at it, and don't be afraid to ask the vet for more antibiotics and painkillers etc (I know long-term use isn't ideal but head tilt requires treatment for a good few weeks). I'd also encourage your bun to eat his favourite things, and perhaps supplement with something like critical care which you can syringe feed which will also help with water intake. Feeding favourites may not be "healthy" long term but just to help him get through the worst of things it may help. I hope Dexter makes a good recovery, I know how stressful head tilt can be, and you may think things aren't getting better but give it time for the medication to do its thing. Even if he is left with a bit of a head tilt he should be able to live a full life.

 

[Bunny Lovely]

Hi All

So I decided to take Dexter to the vets today. With the advice you all provided, I pressured the vet to prescribe anti biotics (doesn't give the name on the label) and metacam. Otherwise the vet was trying to recommend a CT scan and then an ear flush under GA if it was a middle ear infection.

Unfortunately he's still not eating by himself so I'm still either hand feeding him wetted pellets or syringe feeding him. Hoping the metacam will make him feel better.

Thank you all for your advice

Many Thanks
Dex 179

I am pleased you have gained the medication. Now hoping it helps with the recovery of dexter. You did great doing so
For issues with feeding, I tend to put small piles of hay mixed with favourite food, such as dandelion or basil, where they sleep or sit, just to help with any eating issues, so it is accessible where they can graze. Fresh grass is good too. I grow containers of grass normally grown for cats, or pick some grass from garden. This has helped during any difficulties for me. Not sure if this would work for dexter, but just mention as an option to try.

Wishing all the best for dexter. Keep at it. You are doing the best for him. ❤❤

 

[dex179]

Thank you all for your well wishes

He seems to have made slight improvements in diet after taking the metacam...I wish I pressed for this sooner. Hoping the antibiotics for the ear infection work. He still can't find his food so have to either put the bowl in his face or hand feed him!

I am pleased you have gained the medication. Now hoping it helps with the recovery of dexter. You did great doing so
For issues with feeding, I tend to put small piles of hay mixed with favourite food, such as dandelion or basil, where they sleep or sit, just to help with any eating issues, so it is accessible where they can graze. Fresh grass is good too. I grow containers of grass normally grown for cats, or pick some grass from garden. This has helped during any difficulties for me. Not sure if this would work for dexter, but just mention as an option to try.

Wishing all the best for dexter. Keep at it. You are doing the best for him. ❤❤

Unfortunately Dexter has never been into hay or grass! He's also had an insane amount of health problems over the years. That's why I'm so surprised he's nearly 10 years old. I'm jus hoping he can at least start eating by himself

Random question - but does anyone know where I can find a small plate which has short sides and has a bit of weight to it so it's stable? I think Dexter's bowl is too tall and not sure if it's putting him off finding his food.

 

[Bunny Lovely]

Would a saucer work?
10 years not eating hay must have been quite a challenge. It means that you have achieved to feed him with something that works for him, so kerp going with it.

Try a saucer, which will be close to the floor and small. Great to hear he's improved. Even slightly is great, hope it continues

 

[joey&boo]

Pleased you got him seen & hoping he makes progress with treatment

 

[bunny momma]

Sending more vibes for Dexter.

 

[dex179]

Thank you all

I think Dexter is slowly improving, he's managed to find his bowl on his own a few times today. I think it's the metacam...so gutted I didn't challenge the vets when they said it wasn't needed

 

[bunny momma]

Thank you all

I think Dexter is slowly improving, he's managed to find his bowl on his own a few times today. I think it's the metacam...so gutted I didn't challenge the vets when they said it wasn't needed

You trusted the vet as we usually do, the important thing is he is improving now. It is nice to hear he is improving!

 

[dex179]

I have a question - I noticed he does this more than when he was his normal self:
(1) lick his chin and groom his face more
(2) turn and sit in the corner

Does any of this mean anything?

Thank you

 

[InspectorMorse]

Have a feel along his lower jaw for any lumps/signs of tenderness. The chin licking could indicate Dental pain. This could be as a result of molar spurs, elongated tooth roots, tooth root abscesses etc.

Check his bum to make sure it’s clean. Having a soiled bum due to not being able to eat their cecotrophs and clean themselves can cause a Rabbit to lick their chin and chest and pull at the fur on their chest.

Turning away and facing a wall often happens when a Rabbit is in pain and/or feels unwell.

 

[dex179]

Have a feel along his lower jaw for any lumps/signs of tenderness. The chin licking could indicate Dental pain. This could be as a result of molar spurs, elongated tooth roots, tooth root abscesses etc.

Check his bum to make sure it’s clean. Having a soiled bum due to not being able to eat their cecotrophs and clean themselves can cause a Rabbit to lick their chin and chest and pull at the fur on their chest.

Turning away and facing a wall often happens when a Rabbit is in pain and/or feels unwell.

Felt his lower jaw and I can't feel any lumps. If there were signs of tenderness, if I touched him in that spot, would be pull away for example? How would I check for this? He last went for a teeth clip and removing molar spurs 3 months ago

I've checked and his bum is all good

Do you just think the pain/feeling unwell is just from the head tilt or the possible middle ear infection?

 

[InspectorMorse]

Felt his lower jaw and I can't feel any lumps. If there were signs of tenderness, if I touched him in that spot, would be pull away for example? How would I check for this? He last went for a teeth clip and removing molar spurs 3 months ago

I've checked and his bum is all good

Do you just think the pain/feeling unwell is just from the head tilt or the possible middle ear infection?t

Middle ear infections can be extremely painful

In the three months since his last dental treatment he could easily have developed more dental problems which could be causing the chin licking and not eating

If his lower jaw was painful to touch he would pull away/ tense up/refuse to allow you to go near the area

 

[dex179]

Middle ear infections can be extremely painful

In the three months since his last dental treatment he could easily have developed more dental problems which could be causing the chin licking and not eating

If his lower jaw was painful to touch he would pull away/ tense up/refuse to allow you to go near the area

Thank you for your reply

Just an update - His appetite is improving, but his problem is that he sits in one place and can't find his food bowl. Putting his bowl near where he is laying sometimes works but if he strays too far from it he can't find it! And for some reason I need to hand feed him first to encourage him to eat..

I'm hoping with some TLC he'll slowly improve