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Forum BEHAVIOR HELP: Head Tilt Questions Needing Answers

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    • fatnhappy
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        Hi Everyone,

        I’m sorta new to the community but i’ve constantly searched and lurked on this forum for answers for a long time now. My poor bunny Romeo (is bonded to a girl named Juliet) just recently began having head tilt. We noticed it right away and maybe about 1-2 hours late if so because my gf and I were cooking dinner. Knowing head tilt is serious, we immediately rushed him to the emergency hospital but they didn’t have any bunny vets on site so they kept him overnight for monitoring and in the morning gave him antibiotics. We are prescribed Baytril and Metacam to feed him twice daily. At first we had him separated from Juliet because he would fall over a lot trying to go places, so we had to put pillows everywhere and surround him with cushions in case he fell. Our bunnies are strictly indoors and most stay in my room. We went to see our neighboring bunny store expert to help us feed our bunny antibiotics since he struggles all the time when being held and she suggested we let them both stay together. As soon as we brought him home and let him roam, the first thing he did was go straight to Juliet and groom her. It was the cutest thing. He doesn’t like being away from her. Anyways, back to the questions and main point. He’s eating hay if its in front of him and he was eating his vegetables gradually as well as drinking a little bit of water. He’s pooping and peeing as well. 

        But I noticed when he tries to sleep, he has an eye open or the other one is only half closed, is this normal? I read online that this can irritate his eyes and we should get some eye meds? Is this necessary? I don’t want to stress him out anymore than he already is because I can feel his pain when he’s walking and rolling and falling over cause of this head tilt. 

        Anyone ideas how long of treatments we need to give him before he gets better? Or advice? Would love everyone’s input as this is our first case of head tilt and it really breaks our hearts to see such a cute loving bunny be in such discomfort. He’s normally really active and jumps on my bed all the time but now he can barely walk without falling over. 

        My girlfriend and I are cancelling our trips because we think its best to watch over Romeo during this hardship. I’ve also stopped my travelling for work temporarily so I can stay at home to watch him. It brings us to tears just watching him fall over and struggle to get back up. We get very little sleep since we instantly wake up when we hear sounds of him falling over and we rush to him to help. 

        If anyone with similar experiences can give us advice on what we can do to continue to help him and make him better, it’d be greatly appreciated! 

        Also the eye question above, would love any answers or inputs! 

        Thanks and apologies for the long written post. 

        Kevin 


      • fatnhappy
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          bump really would like some help


        • Bam
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            Head tilt can be due to an ear infection, and Baytril is first choice antibiotics. Metacam helps with pain and swelling (it’s anti inflammatory).
            Another cause of head tilt is e cuniculi. That needs treatment with Panacur (fenbendazole) as well as Baytril, but Baytril has some effect.

            It’s good if he can be with Juliet, bonded rabbits need each other. I’ll write more soon, our car is just about to get towed. Slight generator problem
            TRabbits have 3 eyelids, one of which is translucent. That’s how they can sleep “with their eyes open” without hurting their eyes like humans would. Since both e cuniculi and a bad ear infection can affect the facial nerves, it could mean the eyelids aren’t closing like they should. You can test the blink reflex by nearing a q tip to the corner of his eyes, if he doesn’t blink, there’s sth wrong with the nerves to his eyelid. Then you should give him eye drops (tear replacement fdrops).Test both eyes. Many rabbits don’t close their outer eyelids when they sleep, it looks scary but it’s normal.

            The best thing would be to try and find a good rabbit savvy vet for continued treatment. Panacur (fenbendazole) is available OTC, and needs to be given for at least 28 days. It’s notoriously difficult to test for e cuniculi (high risk of false negatives), so many vets will choose to treat with Panacur on suspicion.

            It’s very important that he eats, and if he eats more if you hand-feed him, try to do that. Again it’s great he has his Juliet, it helps a lot to have a friend when you’re a bunny.

            If this is an ear infection and not e cuniculi, rather a long course of Baytril could be needed, often several weeks.
            I’m writing this from my phone, I’m stranded away from home. I hope I’m making some sense at least. We have members whose buns have had head tilt, I hope they’ll see this thread. The site Disabled Rabbits has good tips and info.


          • Gregmo
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              I can offer no help in terms of the head tilting as I have not experienced this with my family of bunnies.

              But in terms of the eyes – one shut one open when sleeping – my guys do that all the time.  I don’t see any real concern there. 


            • fatnhappy
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                Thanks bam and Gregmo! I appreciate the answers! He hasn’t been eating as much, he likes nibbling on hay but def does not eat his pellets. He will come out at night when we are half asleep to eat vegetables though. I’m worried that he isn’t moving around much or pooping or peeing as much. I’d hate to think he’s mad or hate’s us for having to force hold him to feed him meds i know how much he hates being held and when he is, struggles for his life. He’s such an energetic bunny before and it brings me to tears to see him topple over or even struggle or fall off balance.


              • Tgbarber
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                  I can’t offer any expertise as i have no experience. But I’ll offer my moral support. You sound so worried and sound like such good bunny parents. Take care


                • fatnhappy
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                    Thank you Tgbarber! I My gf and I love our bunnies and miss their activeness. We used to find the digging into the feeder in the middle of night annoying but now we would give anything for Romeo to be healthy again and would love to hear that noise. Both Romeo and Juliet brings a lot of joy to us when we are stressed and we would do anything to get Romeo healthy again and keep both Romeo and Juliet healthy at all times.


                  • mobysmom01
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                      I’m so sorry to hear you’re going through this. We had a long and painful bout of head tilt with one of our bunnies a few years back.

                      First, it’s great that he is eating anything at all on his own. Keep putting stuff where he can easily get to it. However, if he is pooping significantly less or his poops look a lot smaller he could be entering stasis- sounds like you’re experienced bunny owners so you probably know about syringe feeding and critical care. We had to syringe feed our guy for quite a while. He didn’t mind it at first- once they are wrapped in a little bunny burrito with a towel it is easier to give it to them, and meds too.

                      My rabbit was also on antibiotics in case it was a nasty ear infection and I think we were also on an antibiotic for e cuniculi, and metacam for potential pain. We also got an e cuniculi test which was negative but we treated for it anyway.

                      The eye thing is what my vet called ‘stargazing’- where one eye is wide open and lifted toward the ceiling. It’s pretty common with head tilt I think. We did get lubricant drops to put in his eye.

                      The rolling is so distressing to watch, I totally feel your pain with that. Our vet told us it was much worse for us than for him, and if your guy is able to get around at all still that’s awesome.

                      Our guy did require pretty constant care but I think your bun is in better shape than mine was and you’re staying on top of it. Keep us posted and let me know if you have any more questions. Hang in there, I know how tough it is and how suddenly it seems to come on.


                    • mobysmom01
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                        Oh and also- yes, panacur and baytril are what my guy was on for antibiotics. We also gave him something for nausea each day.


                      • Bam
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                          If you think this is e cuniculi, it could be good to medicate Juliet as well. 9 days of Panacur is the recommended treatment for a bun that’s been exposed but has no symptoms. Both Romeo and Juliet should then get Panacur for 9 days every 6 months.

                          They forgive you for giving them meds, even if they hate it when you do it. It’s actually a very good sign that Romeo is fighting his meds -a really weak bunny won’t put up a fight. And you are doing it in his best interest.


                        • fatnhappy
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                            OMG Thank everyone for the support and answers! Thank you mobysmom01 and bam! Do you guys know that if he’s rolling and then freezes and then rolls hectically again if we should help him up or just leave him to get up on their own? I feel like every time I try to help him i’m making it worse and he’s fighting it but at the same time he’s rolling so hard and fast I feel like it’s bad for him, it’s almost like he’s having a seizure when he’s rolling around. Does the Nausea medication help him be more balanced and less tipping over? IF so, do you remember the medication name? If he’s rolling around a lot, does that mean he’s getting worse? but he is moving around a lot more. We are currently giving him his baytril, meta cam, some critical care and vitamin Bs.


                          • mobysmom01
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                              If he is still moving around when he’s up and about that’s good. He will probably take some to adjust to the tilt and hopefully then the rolling will cease somewhat, he’s probably feeling disoriented now too. I believe that is partially what the nausea meds were for, and another main reason to use them was to hopefully alleviate any nausea he felt from being upside down and improve his appetite.

                              We gave our guy antivert/bonine; generic name meclizine. I’m not sure it helped too much and our vet wasn’t sure it would either but she thought it was worth a try. Definitely, definitely talk with your vet before giving him anything – (although I’m sure you would touch base with your vet first, just wanted to say it!)

                              I think you can try to gently right him but he might end up rolling again. Our vet said to make sure there wasn’t anything he could hurt himself on and to try to create a padded area overall.

                              At our bunny’s worst we had him propped up in a carrier with lots of rolled up towels because he could not he move at all without rolling. We had him at the emergency vet at 3am one night because we just could not get the rolling under control.

                              Let me also say our guy was not very healthy from the day we adopted him, not with the head tilt but he always drank a ton, kept losing weight, and just seemed sick a lot of the time. So, hopefully it won’t get so severe with your bunny since he seems like a healthy guy overall!

                              Also, lots of rabbits to adjust to the head tilt, and for many after a while it diminishes too. It is such a painful process to watch for sure though.


                            • fatnhappy
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                                UPDATE: We ended up giving him some Dramamine with the Meclizine ingredient in it (1/2 a 25mg pill crushed mixed with critical care) and it seems to be helping a bit. We’ve now blocked off a small area with pillows and foam rollers and separated him from Juliet for now to prevent him from getting hurt. He seems to be doing better. He still topples over a bit every now and then but is able to get back on his feet really quick and just goes back to cleaning. He’s eating vegetables and has somewhat normal poop and peeing. That’s the good news,. Now we are just sad that he can’t be with Juliet and we hope this doesn’t have to be the case for very long. We need to keep him clear of anything that can harm him.


                              • mobysmom01
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                                  Sounds like he is doing well all things considered! How is Juliet doing


                                • fatnhappy
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                                    He’s digressing..good one day and bad another. He’s unable to stay up for a while last night, every time he makes a move he will fall and roll and it was painful to watch. His tilt doesn’t look like it’s getting better either. I know it’s only been about 5 days but we just want him to be better as soon as possible. Juliet snuck in last night to Romeo’s secluded area and ate his vegetable and hay..and cuddled with him for a little bit before jumping back out. She’s eating and hanging around her area.


                                  • vanessa
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                                      Were you able to get him panacur? Whether it is EC or just an ear infection, it will take a good few weeks to see improvement. Sometimes these things get worse before they get better. It sounds like you are on the right track.


                                    • vanessa
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                                        P.S. I have a bunny with EC, and he also had ear involvement. Walking in circles – still does that. He appeared paralysed to me for a while, but it was probalby because he was too nauseous and dizzy to move or hold himself upright. Nausea/dizziness meds to help. Either way – the choice treatment is panacur, baytril, metacam, some nausea/dizziness meds. For support – just what you are doing – critical care, itamon B, I might also add benebac. Soft cussioned area like you are doing – and lots of love. Keep the rabbits together. Were you able to get to a bunny vet?


                                      • fatnhappy
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                                          We have an appointment with our bunny vet on Wed. She’s been out of country for vacation. We don’t have panacur yet unfortunately. We need to get some, but we couldn’t find any over the counter. So we have to wait till we see our vet to get it.


                                        • Bam
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                                            I’m glad your regular vet will be back soon!
                                            The active ingredient in Panacur, fenbendazole, is also found in Safeguard.


                                          • fatnhappy
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                                              Romeo is current at our bunny vet. He’ll be getting x-rays. The vet doesn’t think it’s an ear infection, rather believes it’s the E-Cuniculi. We’ll start with adding panacur on top of the baytril and metacam and hopefully see some progress. It sadden’s me that I didn’t get my hands on some panacur earlier so i could’ve started the treatment sooner. Our emergency care vet (“exotic pet specialist” but specializes in reptiles and amphibians) told us he was sure it was an ear infection -_- . It was very unfortunate that I couldn’t reach any bunny specialist vet’s during that time and i hope Romeo doesn’t get worse because of it. He’s lost weight too according to our bunny vet. With work requiring me to travel again and my girlfriend not being to stay home to take care of him as much, this definitely worries me for Romeo’s sake since we will need to get sitter for him

                                              Praying for Romeo’s full recovery.


                                            • Aaron
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                                                Poor little guy, what a trooper! I initially thought it was an inner ear infection because of the tilt, but vets know best! He needs medication for this, I hope he gets better.

                                                (P.S. – I have a rabbit named Juliet too!)


                                              • vanessa
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                                                  Wow. I’m glad you got a diagnosis and medicine, but I’m sad to hear EC. It does get worse before it gets better, and you shoudl only expect to see improvement after 4 weeks. Stick with the meds and don’t give up even if the first 4 weeks get rough.


                                                • fatnhappy
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                                                    Hey guys,

                                                    It’s been about 3 months now and Romeos condition has improved but also peaked and not getting better. He’s gotten a little more balance but still falls over. We’ve been on Panacur and Metacam for 3 months, and baytril for a month as well. We’ve now added Panazuril for sarcocystis a new disease recently found. But the meds don’t seem to be effective. Anyone else have any other suggestions? Really want Romeo to fully recover. We discovered it as soon as it happened and hoped that because we found it so early he’d make a quick recovery


                                                  • vanessa
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                                                      Sounds like my little guy. He plateued. Still getd recurring ear infections, still falls over, i have himon long term metacam and baytril with 5 days of fenbendazole once a month. If it is ec, the danage can often not be reversed. Ear infections can be notoriousely difficult to cure. If it is also arthritis (how old is your bunny?) it can give symptoms similar to ec (falling over wobbly poor gait). At some point you will want a blood test, because long term panacur can cause bone marrow suppression. Sorry to hear 🙁


                                                    • fatnhappy
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                                                        Hi Vanessa,

                                                        Romeo is only about 4 years old so not too old (hopefully it isn’t arthritis). Not sure if he’s getting recurring ear infections though if this isn’t gone yet. He’s had 2 separate blood tests already, 1 for ec and the other for the new Sarcocystis that is completely new with limited to no research data available. He came up positive on both and we’ve been treating for both but to no avail. I’ll ask the docs about the long term panacur because he’s been on it for a couple months now. Definitely don’t want any negative effects to him in the future either. Appreciate the response.


                                                      • vanessa
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                                                          Some bunnies respond to the typical 28-day panacur, others end up on long term panacur. Is he still rolling/tilting? You said he was getting better but stalled. What are his current symptoms? 4 years is a bit young for arthritis, but it can sat at 5 or 6 years. I havent found a whole lot of info about sarcocystis. No matter what it is, the cure for any of these isn’t guaranteed. I’v read a lot about EC, and you can suppress the parasite, and limit the damage, but you can’t reverse the damage, or kill the parasite. Also – 80% of rabbits have been exposed to EC, so a positive test doesn’t necessarily mean that theEC is causing the symptoms. It could be EC, and it could be something else. But it is still a wise idea to treat for EC. The blood test after EC treatment is specifically to check the blood count for side effecs of panacur. If it is EC, the damage can’t be reversed because the parasite causes cells in the CNS to rupture, and the bodies inflammation response (hence the need for Metacam) causes the formation fo granulomae, which are also damaging. With Lancelot – I dont’ know if he has EC, arthritis, ear infections, or all three. So I treat for all three. (I struggle to get blod work and x-rays out of the vets in my area…)


                                                        • fatnhappy
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                                                            Hi Vanessa,

                                                            I appreciate the detailed response you’ve been giving me. Romeo is still rolling and tilting. His tilt doesn’t look bad at all when he’s eating just when he’s sitting there it’s like perpendicular to his body (very extreme). He can move in circles a little before falling over. He’s otherwise eating, drinking, pooping, and peeing normally. Any ideas how long it’ll take on a range of dates for him to somewhat be able to function normally like a bunny again even if not 100% cured? I will definitely ask for another blood test for side effects of panacur in any case. We’ve been on Metacam and Panacur for about 3 months, had baytril for 1 month, and now panazuril for the sarcocystis for about 3 weeks now. Not sure what else we can do. Romeo is definitely very strong willed so i’m not worried about that. Do you suggest xrays ? what would we be able to find with xrays?


                                                          • vanessa
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                                                              I think u r doing everything u can. Deepite mixed reviews i think ponazuril is worth trying. Because it has a better chance of killing parasites rather than just supressing them like panacur (chance / not guaranteed), its a good idea to keep ip with the metacam. Dead parasites illicit inflammation. The bodies redponse to parasite damage from live parasites also illicits inflamation, do regardless, id keep up with the metacam.

                                                              Typically after a 28 daytreatment of panacur/baytril, u should see improvement, iv read that the type of improvement u c will predict the rest if the improvement. Iv read of bunnies making a full recovery after 6 months, and some not at all. Head tilt is difficult. Lancelot didnt have head tilt, but he had paresis to the point where he couldnt even sit and just lay there looking completely paralyzed. It took him a month to b sble to sit in a donut, and a fee more months to b able to hop. He has had a few relapses coz the paradite cant really b killed. Each time, i c some improvement after 28 days. But head tilt can take many more months. Some ranbits live the rest of there lives hapily tilted. Others heal comletely. It depends on the bunnys immune system, the speed and appropriateness of the treatment, palliative support and the severity of the parasite damage.

                                                              If there is an ear infection involved, they r also difficult to cure. I would not give up the baytril/metacam.

                                                              At the moment i think lancelot has a relapse and arthritis, due to the nystagmus. He is back in a diaper and i have separated him from his pal. He is old. Your bunny has that advantage.


                                                            • fatnhappy
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                                                                Update: Romeo’s condition hasn’t changed. Still got a pretty bad tilt and still rolling. However, we are now treating him with a muscle relaxin medication to see if that will help his tilt get better. It’s been about 4 months now. He showed early improvement the first month but has since peaked and not gotten better ever since. Will continue with Panacur, Ponazuril will be used till we run out, continuous use of metacam and will see if the muscle relaxin helps his condition. On the flip side, we are now taking him to or living room to give him more space to walk around because we heard the physical therapy and space will help him adopt and walk straight. He can walk a few steps and in circles under a table when he’s lower to the center of gravity but when he steps outside he’ll fall over after a few steps. Slow but he’s happy being outside once in a while instead of always stuck in his little corner.

                                                                If anyone else has any ideas please let me know! Really want Romeo to get better!


                                                              • fatnhappy
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                                                                  Update: Romeo’s condition hasn’t changed. Still got a pretty bad tilt and still rolling. However, we are now treating him with a muscle relaxin medication to see if that will help his tilt get better. It’s been about 4 months now. He showed early improvement the first month but has since peaked and not gotten better ever since. Will continue with Panacur, Ponazuril will be used till we run out, continuous use of metacam and will see if the muscle relaxin helps his condition. On the flip side, we are now taking him to or living room to give him more space to walk around because we heard the physical therapy and space will help him adopt and walk straight. He can walk a few steps and in circles under a table when he’s lower to the center of gravity but when he steps outside he’ll fall over after a few steps. Slow but he’s happy being outside once in a while instead of always stuck in his little corner.

                                                                  If anyone else has any ideas please let me know! Really want Romeo to get better!


                                                                • vanessa
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                                                                    I’m in a similar situation with Lancelot. He can’t either walk more than a few steps without falling over. But this week he has been trying to move around the room. So I keep my hand close by to steady him. He doesn’t roll/tilt, he just can’t balance and his right side is worse than his left. I don’t necesarily believe all bunnies can be healed either. I’v read stories of bunnies living out their lives with head tilt. Lancelot has been like this – off and on – for a year now.
                                                                    I’v heard of accupuncture and cold laser therapy. I’d have to drive 2 hours one way to try it so I haven’t.


                                                                  • fatnhappy
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                                                                      Hi Vanessa,

                                                                      Sorry to hear about Lancelot! We are now doing the same thing as we heard physical therapy is good for the bunny. So we began taking him to our living room so he can roam around while under our supervision. However, update from our vet, she doesn’t seem to think there’s anything else we can do for him as she told us to stop the panacur and metacam medication since it’s been about 4 months and no progress. Where did you hear about the accupuncture and cold laser therapy? I’m willing to try that for Romeo if it’s shown to be effective.


                                                                    • vanessa
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                                                                        I heard it from peole on the forum, and from reading ip about treating disabled bunnies. I have a wobble disc that i sit lancelot on to practice balance and muscle control. Just having the bunny do normal bunny things is good too, like walking, helping him climb over your legs, lean against your chest and stand up, etc. i have a book called “when your rabbit needs special care”. That and the disabled rabbit website r both helpful.


                                                                      • fatnhappy
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                                                                          Hi All,

                                                                          Update on Romeo: His head tilt never got better or improved unfortunately but we’ve since given him lots more space and started letting him roam around the apartment more and he’s adopted to it really well. He’s able to run around, eat, drink, and play with Juliet with no problems now. He seems happier now that he has space and get’s to be with Juliet again. We just unfortunately cannot find a way to make his tilt better. It’s stuck at that 90 degree angle it looks better when he’s cleaning or eating hay but it always falls back to that 90 degree angle. We are looking into some acupuncture treatment for him and see if that’ll help. If anyone else has any suggestions, i’m more than open to it!

                                                                          Thanks

                                                                          Kevin


                                                                        • vanessa
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                                                                            Oh boy… Well I’m glad he is feeling better – albeit tilted. I’v read of tilted bunnies living a happy tilted life… Its really hard to tell if he will improve. I’v heard goof things about accupuncture. Keep us updated.


                                                                          • Rosie
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                                                                              My sisters bunny got a parasite in his ear which caused him to fall over and have a head tilt. Once it was cleared up he still had a tilt for quite a while but coped with it very well. The tilt got better and he made a full recovery. Sorry I don’t know any details about the parasite or treatment.


                                                                            • fatnhappy
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                                                                                Hi All,

                                                                                It’s been a while, but happy to give an update: Romeo is running around although with a head tilt. Sometimes he still trips when in the litter box but is happy none the less. He recently had a relapse in which he would lose balance and just roll over every 10 seconds and that was scary for us. But we put him back on his meds and he got better. Then he somehow got sick and didn’t eat or poop and we had to take him in. Treated him for GI stasis and he’s now eating, drinking, pooping, and peeing normally again. Glad he’s back to healthy as he can be with his tilt.

                                                                                Don’t lose faith in your bunnies, they are strong creatures!


                                                                              • LittlePuffyTail
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                                                                                  I’m very happy for your update. Bunnies are amazing with how well they can adapt. And I’ve seen firsthand how strong they can be too.

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                                                                              Forum BEHAVIOR HELP: Head Tilt Questions Needing Answers