Head tilt - maybe controversial, sorry.

I’m so sorry if anything I write here is upsetting, or comes across as insensitive or cruel, it’s really not my intention whatsoever. I’m also sorry if anyone has strong opposing views, I know everyone here knows and does what is best for their own pets.

My 8 year old boy William presented with a sudden onset head tilt this morning when I went to give him his breakfast. We were seen by the vet within the hour, and he was given an injection to help his gut motility, and prescribed panacur, loxicom, and baytril, along with critical care. The vet explained how head tilt can be brought on by a number of causes, and that buns can go downhill very quickly. She said his prognosis was tentative, and would depend on how he responds to treatment.

I’ve moved him to a quiet room indoors, where he’s in a small pen to be monitored more closely. His head is severely tilted to the right, he circles, and often rolls right over. He has allowed me to syringe maybe 40ml of critical care through the day, and has eaten 2 pieces of spinach, but nothing else all day. Only 1 small poop.

I’ve been reading an awful lot since getting back from the vets, and many papers, forums, social media pages, and anecdotes are quick to say how a head tilt bun can still live a long life, and that they adapt, despite often needing many adaptions and ongoing hands-on treatment.

I suppose where I’m struggling is knowing what is an acceptable life for a bun, or for any animal in fact. In a similar vein, I don’t believe it’s always ethical to put elderly pets in wheelchairs when they can’t walk anymore, or a pet which can’t express its own bowels, or move by itself. Obviously there are a vast array of palliative treatments which can often help a pet with its difficulties, but I think that sometimes goes too far and crosses into murky water when it comes to what’s best for the animal.

So while I read about and see people nursing their head tilt buns, creating small padded areas where they can’t move around and fall, bathing them because they can’t groom, syringing them long-term because they can’t eat or drink, and then say that the bun is adapting and surviving, despite often still having that head tilt remain...I just wonder if that’s really what’s best.

I worry that I could put him through the stress and uncertainty of a month of medication & syringe feeding, and it still might have an outcome which isn’t an acceptable life for him. Does ‘better a week too early, than a day too late’ apply here? No matter how this post may come across, I’m not a hard nosed person who wouldn’t give an animal a chance, I just have to know that that chance would lead to something that I could live with in my heart.

Previously, I’ve thrown countless treatments, overnight vet stays, and a huge amount of money, when my cat was in kidney failure, only to have him pts 2 weeks later - he never should’ve been put through that, and it shames me. I’ve also cared for, medicated, spent another fortune on my cat with a terminal cancer diagnosis, and nursed him for 5 months and then helped him on his way when it was time. I’m currently nursing and rehabbing my 10 year old dog, who’s cruciate operation was the most money I’ve spent on anything. He has a 12 week+ recovery ahead, and if there hadn’t been a certainty that he’ll fully recover and have a normal quality of life, I would’ve definitely thought about whether or not to put him through it.

I know nothing in life is certain, and a rabbit forum or rabbit social media is hardly the place to be completely objective, but I do wonder whether the path of treatment is the humane one, when there is a sizeable chance that the rabbit’s life will continue to be impacted by their condition. They might not die from a head tilt, but is it really ok to let them live with one?

Again, I’m sorry if I hit any raw nerves, particularly in others who have been in the same position. If anyone could offer maybe some anecdotes, or impartial advice, it would be appreciated. Admin, please also remove this post if it particularly upsets anyone, that’s not what I want to do, thank you.

I totally get where you're coming from.

My dog had cancer in her spine and they could've operated, but they were sure it'd come back, I didn't want to put her through that huge op just to be in the same situation months later. Animals live in the moment.

I don't have direct experience with head tilt buns, my bun Clementine lost the use of her back legs and at first it was thought to be EC, just no headtilt and she was falling over etc..so I did a lot of research about headtilt, EC, ear infections. From what I gathered, it was worth giving them a chance, some buns apparently do recover even from severe head tilts, just needs the treatment and care. But I think if the 28 day course of panacur doesn't work, along with painkillers, and an antibiotics for a potentially ear infection - also anti sickness meds I read about? Helps with rolling? Hopefully someone else will know. But yea personally I'd probably give it til then and then reassess. Obviously you'll know best and its such a tough one to call and it's really distressing watching them roll it made me so upset. But I think from everything I read, I'd give it a go. Just my thoughts on it! I totally understand where you're coming from though and I hope you can make the best decision for you and your bun x

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Thank you so much for your thoughtful reply Graciee.

Seeing him roll is very upsetting, as is wondering how much stress he’s going through. I agree that animals live in the moment, and going through this with a bun some how feels different to treatments I’ve gone through with cats and dogs. Not because the rabbits mean any less to me whatsoever, but because they’re vulnerable prey animals who are reliant on their senses to keep themselves safe. The cats and dog seek out human attention when they’re sick, whereas my rabbits have never been ‘people buns’.

It must be horrifying for a head tilt bun to not be able to stand upright, see correctly, or navigate their environment. Add to that the stress of being handled, medicated, and syringe fed, to possibly end up still permanently tilted? I just wonder what sort of life that is, and whether that time period of treatment is worth it, for an animal which lives in the moment.

While it is very upsetting to see head tilt bunnies, I have had five bunnies over the years who made full and almost full recoveries where they had minimal permanent tilt. Only one head tilt bunny did not survive and his tilt followed a injury when he got scared and hit his head, so not typical case.
You really will not know if your bunny will recover quickly until several days after treatment begins, though I have seen it get worse before it gets better. Once I see consistent improvement-wanting to eat, less circling,trying to wash, I have faith bunny has right treatment and will likely regain good quality of life-by that I mean recovery with no or minimal residual effects.
Of course causes vary and some cannot recover without invasive procedures or lengthy treatment-if at all. It is hard to know which ones will recover and which ones will not without trying.
That being said , please know I will respect any decision you make because you know your bunny best.
Sending positive vibes.

This will be a brief reply

What is right for one head tilt Rabbit will be wrong for another

Each case is unique,a holistic approach is needed, taking into account the ability of the individual Rabbit to cope with the intensive nursing care needed for weeks on end with no guaranties of a good outcome

Treatment regime covering both EC and Otitis Media -
Panacur for a minimum of 28 day, possibly 56 days
Antibiotic for at least 4-6 weeks
Meloxicam - duration can vary, at least 6 weeks
Prochlorperazine if rolling is an issue,for as long as needed
Subcutaneous fluids when needed
Ocular care, down side eye prone to trauma, infection, corneal ulceration. Up eye prone to ‘dry eye’
Syringe feeding, in initial stages Rabbit may be anorexic
Prokinetics when Rabbit is anorexic, to address secondary gut stasis risk
Dental monitoring


I have had Rabbits who could cope and one who could not, I let him go.

I am sorry your Rabbit is poorly, only you can decide what is right/ethical for him

I don’t have any experience of this so I can’t advise, but I’m sending lots of vibes xx

This is a horribly difficult decision to make and, as you have said, there will be differing views from members here. Possibly those views will be informed by their own experiences with pets, but the basic question about the ethics of euthanasia/quality of life will usually form an important part of that view.

I really can't say what I would do in your position, but I completely understand your thoughts. I think I would take into account the rabbit's age and general health prior to the head tilt. I think it's also important to consider how well the rabbit would cope with the hands on care of the treatment. As an owner I would like, if possible, to live with 'no regrets' after a rabbit has died. These are all things I would take into consideration, but ultimately the decision sadly must be yours and I really feel for you. It might be seen as procrastination, but I think at the moment I would just take it one day at a time.

Sending lots of hugs and lots of vibes for William.

You know him better than anyone else - including the vets.

I don't have any experience of head tilt, but I think it totally depends on the rabbit. As soon as I realised that Sonic was headstrong and independent to a point where it was a three man job to administer metacam ( :roll: ), I promised him that I wouldn't put him through anything that required more hands on care. When he broke his leg, the vet said they might be able to fix it, but there was no doubt in my mind it would cause him to become depressed.

As totally useless as this advice is... only you can make the decision, and I'm sure you'll do what's best for William.

It depends on various factors - what you can cope with in terms of nursing and hands-on care, etc, and on the rabbit. If there are other health concerns, how they cope with the symptoms and the treatment...

If it is most likely EC (could be other things), bunny is OK with handling, is eating (on its own or with help), and there are no other pre-existing health concerns, I would give the standard treatment a chance. Improvements can be rapid (within a week), although there are often temporary setbacks.

Only you can tell if it is right for these circumstances, though. What bothers us may not bother the rabbit (eg rolling), but often you just 'know' when it's not right to keep going.

Thank you everyone so much for your kind, measured, compassionate responses - I know this is a very emotive topic, and I really appreciate it.

I rehomed William along with his brother Jack nearly 5 years ago, from a tiny 4ft hutch, where they were bedded on a sprinkling of sawdust, and fed carrots and huge scoops of muesli. I was told they were about 3 years old at the time. I very sadly lost Jack, but while William has been the stronger of the two, he has still suffered from dental problems, bouts of stasis, sore hocks, and inability to groom. Some of these things we’ve successfully managed and adapted for, but others continue to reoccur.

I am content that I gave him and his brother many years of good quality life, that they otherwise wouldn’t have had, but I made the decision a while ago that William and Roo will be my last rabbits, due to various personal circumstances.

For now, William has taken his meds this morning, and is grooming his face as best he can with his front paws, but fights the syringe feeding. I’ll try again in an hour once he’s settled down. There won’t be any rash decisions made, but I don’t know if either of us can cope with long-term nursing, if I’m completely honest.

I have no advice for you but wanted to send my love.

I also agree that it does depend on the particular animal as to what might be appropriate and when. Some are much happier about taking meds, some seem to adapt to disabilities better, etc etc.

So I suppose my view would be to trust your instincts, rather than have a particular 'rule' in mind. Lots of love to you x

Sorry you are in this position. I have had 2 Rabbits which recovered from head tilt and 1 which didn't. I did persevere with them and it can take a while for them to recover. If you are on FB there is an excellent group called Rabbits with head tilt, or something similar.

First of all I don't think you need to be so concerned about your post causing offence. Yes its an emotive subject but where to draw the line in terms of ending suffering is something we all need to think about at some point sadly.

I've found head tilt the hardest of all my rabbits health complaints & we constantly questioned out decisions about not letting Noodle go. She was an extreme case & I think it took 5 or so weeks before she started to improve. When she improved though it was pretty good. She had a jaunty little head tilt but needed no ongoing treatment, ammendmends to her set up (free roam). She died 2 years later from other stuff. I was happy I stuck by her. She ate willingly which helped (all hand fed) . I think little things like wanting to eat some things or groom are important in helping you evaluate how bunny is going. One day at a time. Loads of vibes for William

I comple understand where you're coming from, head tilt is really distressing to deal with, especially when it first comes on. I adopted a bun who developed head tilt, we decided to give him a chance and he did cope relatively well but he wasn't a normal bun and even now I question if I always did the right thing for him. He was left with a permanent tilt and some facial paralysis which meant ongoing dentals were needed. He also needed steroid jabs from time to time as he would get flare ups and start rolling again, and this seemed to be the only thing that controlled it. I do sometimes wonder if he was misdiagnosed initially and that this led to his ongoing damage and problems. I was also inexperienced with it and didn't even know what it was when I first heard the term.

However having said all of that he was a happy little thing, he would hop about and try to periscope even with his tilt and he'd flop down on his side and fall into the deepest sleep I've ever seen. We got him some physio to help him regain strength he'd lost which was a huge benefit for him.

It's really only a decision you can make as head tilt buns sometimes get worse before they get better, which can make you think you're doing the wrong thing. I think the fact you've got treatment so quickly is a massive plus. I would try giving all of your bun's favourite foods over the next few days to try and encourage them to keep eating and see where you're at in a few day's time. For me the big thing with head tilt is to take it one day at a time. I knew when enough was enough when Teddy developed side effects from the steroid, which i knew would happen eventually. Perhaps I should've drawn the line before then but I felt it was worth a shot.

I hope your bun makes a quick recovery, and if you do make the decision to say goodbye it's clear from your post that you've done it with his best interests in mind.

I want to thank everyone again for the kindness and compassion which I’ve come to recognise as true ‘RU-ness’.

It’s with an incredibly heavy heart that I and his vet decided to help William to the bridge this evening. He had deteriorated rapidly throughout the day, and it wasn’t fair to him. I’m consoled by the knowledge that we had over 4 wonderful years together, though he’ll be very sorely missed.

Oh, I'm so very, very sorry you lost your dear William... How sad that he deteriorated so quickly. It sounds like you and his vet made the kindest decision for him that you could.

Sending so many hugs to you. I'm so very sorry

Oh no!

Sending hugs for you x

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I'm sorry for your loss.