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Forum HOUSE RABBIT Q & A Ear Infection and Possible Head Tilt

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    • alcyone
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        Marley (who is a little over 5 years old) went to the vet this morning after about a week and a half of acting funny and me struggling to find a vet that would see him soon. During that week and a half we went from “I think something’s off with him,” to “something’s definitely wrong,” to “I’m really worried,” and now “I hope this isn’t too bad.”

        It started with his behavior. He just didn’t seem like himself. He was napping a lot, he wasn’t very active, and I could just tell something was off. I watched him closely for a couple days and noticed his ear seemed to be bothering him. Then his eye on the same side became pink and irritated. This happens occasionally and I’ve been told he’s probably doing it himself somehow, so I wasn’t too concerned with the eye at first. Then I noticed his head tilting ever so slightly, and with that, the ear, and the eye, I became very concerned. During my hunt to get him into a vet his head ended up tilting enough that it’s now noticeable to others, but not near as bad as I see in pictures when I look up images of bunnies with head tilt.

        We went to the vet today, where she said the inside of the bothered ear looks red and irritated. She wasn’t too concerned about the eye but gave us medicine to clear it up anyway. She concluded he has a bacterial infection in his ear and informed me that if I had other bunnies (I don’t) it is contagious. She gave me medicine to treat both ears and said to call after the weekend to let her know how he’s doing. She said if he doesn’t seem any better then we’ll talk. The medicine for the eye is called Terramycin and the medicine for the ear is Dermalone. Is anyone familiar with either of these?

        It also seemed like after the vet put the medicine in his ear, his nose was extra snotty. Marley does a lot of “snorting” to clear his nose, he’s kind of a snotty little guy. I’ve taken him to the vet before because of it, I’m a very paranoid bunny mom so I wanted to be sure it wasn’t any kind of respiratory problem. They didn’t seem concerned at all, they said his breathing and everything seemed great. Could this extra snotty nose be related to the medicine in his ear? He seemed a little extra snotty before the medicine and I forgot to mention it to the vet, but I could actually see the snot on his nose when we got home.

        I guess I’m writing this because I’m concerned his head won’t return to normal or that this won’t pass. Should I really expect improvement in as little as two days? Do you guys have any advice or tips? His behavior has returned to normal for the most part and he’s continued eating like normal. He’s been very loveable and I know he’s still not back to himself completely of course, but his behavior is definitely better than it was a few days ago. I just want to get him better as quickly as possible, and I definitely don’t want him to get any worse, so I want to be sure neither myself or the vet are missing anything. Thank you all in advance!


      • Bam
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          There’s no connection between the outer ear and the nose, the tympanic membrane is in the way, so the ear meds cant have physically reached his nose. The terramycin (antibiotic against bacteria) for the eyes could though. I’ve read about increased snottiness after giving antibiotics before. It’s like antibiotics loosen things up. Antibiotics kill lots of bacteria and the dead bact together with the dead immuno cells (white blood cells) that have been fighting the infection do have to go somewhere. Expulsing it all as snot is an excellent way for the body to get rid of it.

          The med for his ears contains antibiotics that kill bacteria and fungus and a corticosteroid that reduces swelling. Corticosteroids should be used with great care in rabbits, because they are as a species sensitive to steroids. It’s a powerful drug.

          It does seem like the meds are working, but the head tilt could persist for a period even after the infection has been eradicated. Does his balance seem good?


        • alcyone
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            Thank you so much for that information, that’s very comforting about the nose and I will be sure not to use too much of the ear medication at a time. A “pea size amount” until the tube is gone is what the vet said, but knowing what a pea size is when it’s going into his ear is kind of tough, so less may be more if it can be dangerous.

            His balance does seem slightly off, but nothing that’s extremely concerning. I’ve noticed him stumble once or twice since this started, but he seems to be hopping around fine for the most part. The tilt is noticeable so I’m hoping the vet would’ve prescribed anything else necessary for that if it’s a separate issue. Will treating the ear infection resolve the tilt?


          • alcyone
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              Here are a couple pictures to show how much he is tilting his head.

              Edit: these might not be showing up, I will fix them when I get on my computer

              [FL edit: I got them to show but I cannot rotate them, sorry.   ~ jerseygirl]


            • jerseygirl
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                Will treating the ear infection resolve the tilt?

                Most likely. : ) If it is ear infection that is the cause. It does sound as though it is, in his case. Some rabbits might be left with a “residual” tilt but they adapt very well. I think because you’ve gotten right onto treating it, there’s a good chance of full recovery. Im not certain how long you can treat rabbit with the form of med you were given but ear sometimes infections need antibiotics for 4-6 weeks. It does depend on type of infection and where (inner ear, outer etc..)

                I wonder if the increased snottiness was due to your rabbit breathing faster due to stress of going to the vet?

                By the way, I treated my lop recently for an abscess in his ear and was given a similar medication. It was an Antibiotic/Antifungal/steroidal med called Otomax.

                It was drops that he managed to fling a good portion back out of his ears.
                Is the Dermalone a gel? Is the med staying in his ear okay? I did find my rabbits coat greasy on the side with the infected ear, as the meds eventually made it’s way out.

                It’s good to read he is acting better. Im guessing that’s the steroid providing some pain relief.


              • alcyone
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                  I literally just sighed with relief, thank you so much! I wonder if that’s why she said to call after the weekend? I asked how long I would need to continue using it because I’d read it could take a while to treat and she said until it’s gone. I will double check with her on Monday to be sure it’s safe to use as long as needed.

                  As for the nose, that’s actually really possible. His breathing does change with nerves and he’s always been a little sniffly as is. Come to think of it, it could even be something as simple as allergies from leaving the house, he’s strictly indoors and hasn’t been in the car since his last vet visit in March.

                  Oh geez, I could definitely see that getting old quick! Thankfully this is a gel and seems to be staying in his ear surprisingly well. The tube has a long end that you stick into the ear and you hardly see any on the outside.

                  I was also pleasantly surprised by how little Marley minds the medicines. We syringe fed him critical care in March to resolve GI stasis and he was not a fan of the syringe in the slightest. Thankfully this seems like it will be much less stressful for him as long as we can get him all healed up!


                • jerseygirl
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                    As for the nose, that’s actually really possible. His breathing does change with nerves and he’s always been a little sniffly as is. Come to think of it, it could even be something as simple as allergies from leaving the house, he’s strictly indoors and hasn’t been in the car since his last vet visit in March.

                    Quite possible! And temperature changes also. Snuffly buns seem to have flare ups when the weather warms up, so if the car or vet clinic was warmer then he is used to, that could come into play also. And stress (going to vet) or fact he has other health issues going on could exacerbate existing issues.


                  • alcyone
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                      His balance is definitely off. It’s been hard to tell because he’s not a very active bunny as is, but he tried to stand up on his back legs today and stumbled over. I also noticed his eye kind of twitching today. He was nervous when it happened and now that he’s calmed down it seems fine, but it really worried me. Do you guys still think treating the ear will eventually resolve these things, or could it be something separate? And when could I expect to see him getting better? Thank you guys so much again, I really appreciate the help!


                    • Bam
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                        Eyes twitching is called nystagmus. It has to do with the balance system. It can come from an ear infection, and in your case it likely does, but it can also be from e cuniculi. I think you should call your vet. He might need oral antibiotics for the ear infection or even injections. If its e cuniculi, he can be treated with Panacur (fenbendazole) at the same time. Panacur is an OTC antiparasitic and it can be given together with antibiotics. There’s no good test for e cuniculi so most vets treat on suspicion, because fenbendazole has comparatively very few side effects.

                        I think you should call and ask your vet about these things. His balance/head tilt issue is getting worse, so more powerful treatment could be warranted. Sometimes vets combine abx with metacam (antiinflammatory painkiller) and medicine against nausea (vertigo can cause nausea). Is he still eating well?


                      • alcyone
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                          Okay, thank you very much, I’ll definitely give the vet a call in the morning. He is still eating well thankfully.

                          Last night after putting his medicine in his ears and eye he was acting very strange. I don’t know if he was just scared, maybe he could feel the medicine in his ear doing something, but he was stretching out like he was going to hop but staying stretched and bobbing his head all around. I brought him close to me and petted him for about half an hour to an hour to get him to calm down and he stopped. He’s not doing that today thank goodness but he is holding the problem ear up (he’s a lop.)


                        • Beeskerlady
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                            Praying for you and your sweet bunny, hope he gets well soon.


                          • alcyone
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                              Thank you so much, that truly means the world! It’s so sad seeing him like this but then he hops over and gives me kisses and I just feel sure he’ll be okay. He’s a strong boy, he bounced back so quickly from GI stasis that I know he can bounce back from this, too!


                            • Beeskerlady
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                                I feel the same way about my Sassy. Prayers continue


                              • alcyone
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                                  Thanks again, I really appreciate it!

                                  I just thought of something that could be important. Everything I read about head tilt says the bunny will tilt their head down, putting the ear that is infected down to the ground. Marley is doing the opposite. He’s tilting so the infected ear is up on top of his head. Could this possibly indicate it’s not head tilt but just the medication in his ear doing its thing and causing him to feel funny? His balance is still off today, but I’m really hoping it’s just an ear infection and not head tilt as well.


                                • LittlePuffyTail
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                                    That is strange but the tilt started before you began the meds, right?

                                    I had a bunny recover from a slight tilt (vet suspected and treated for e cuniculi) and her recovered.

                                    Sending along some ((((Healing Vibes))) to your adorable little guy.


                                  • alcyone
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                                      Thank you so much, we can definitely use all the healing vibes we can get!

                                      Yes, he did have a slight tilt before starting the meds but I think its worsened a bit since starting them.

                                      He’s still holding up the infected ear but he’s not acting like he was last night, so thank goodness for that! The last thing he needs right now is to turn into a bobble head, which is sort of what he resembled last night


                                    • alcyone
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                                        We’re heading back to the vet in the morning with a list of questions in hopes of figuring out what’s going on exactly. Marley’s balance is still very off and his tilt seems to have worsened. He’s still holding up the infected ear as well. He hasn’t resembled a bobble head again since the other night, so that’s a plus, and he’s still eating. I’ll update everyone tomorrow when we hear what the vet has to say.

                                        If anyone would like to add any suggestions as to what I should ask the vet, any other medications to look into, etc, that would be great. Thanks again!


                                      • Bam
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                                          I don’t have any suggestions except what I’ve mentioned before, I just want to send lots of good vet-vibes for (((((Marley)))))

                                          We’ll be looking forward to your update.


                                        • alcyone
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                                            Thank you so much, I really appreciate it as well as all of the help!


                                          • sarahthegemini
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                                              I’ve not experienced this so don’t have anything helpful to say but I am sending virtual huggies for him, he looks like an absolute sweetheart. Healing vibes Marley xxx


                                            • alcyone
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                                                That in itself is so very helpful, thank you so much, it truly means the world!


                                              • alcyone
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                                                  The vet gave Marley two shots, one of Vetalog and one of Baytril after I mentioned having read about it. She said they only have shots of Baytril there, no oral doses, but she gave him a shot anyway to try to get ahead of what’s going on.

                                                  She did say it’s head tilt, and that his ear looks better but we need to get the head taken care of.

                                                  In addition to the shots she gave him an oral dose of Albon and prescribed us with a dose per day, and said to call back around the end of the week.

                                                  I’m reading that Albon is more commonly prescribed for coccidia and it’s concerning me. I asked her if Albon is similar to Baytril and if it will serve the same purpose and she said yes. Will Albon do the same thing as Baytril? Have you guys heard of it being used to treat head tilt/ear infections?


                                                • jerseygirl
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                                                    That’s right, the sulfa drugs are commonly used for treating intestinal coccidia. But are a bacterial antibiotic also.

                                                    I think the injectable baytril can be given orally -but obviously not as palatable that way.

                                                    How is Marley doing now?


                                                  • Bam
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                                                      Yes, how is he doing? Sulfa drugs have antibacterial effects by inhibiting the bacterias’ synthesis of folate (one of the vitamins B). They can’t thrive without folate. Humans and buns get folate from food, but bacteria must make it themselves.


                                                    • alcyone
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                                                        The tilt is still there, and he’s still holding the infected ear up, but the first few days after the shots the tilt seemed so much better. Before the shots he barely straightened his head to eat, but after them he looked completely normal eating. I’m wondering if he needs a second dose of the shots and to continue this Albon. He does seem better I think, but he’s not quite straight yet.

                                                        All of this stress has him peeing outside of his litter box and on the floor when he’s out of his cage, which is very unlike him. His appetite is back to normal though, and his poop has gone back to normal as well. Thankfully he never stopped eating, but he was eating slightly less. His balance seems to have improved slightly also. He was having trouble getting around before, but he’s hopping like himself now. I’m going to give the vet a call in the morning and see what she thinks we should do next, but I do see improvement, so hopefully that continues! Thank you guys so much for asking and for all of your help!


                                                      • Bam
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                                                          I’m glad he seems to be doing better! Vetalog (a corticosteroid) is a powerful drug, and should be given with great caution to bunnies. Rabbits are extra sensitive to corticosteroids. A single dose can have a dramatically good effect on head tilt though, but I’ve mostly read about it in conjunction with head tilt due to e cuniculi. If an infection is causing this, more corticosteroids could have too much of a suppressing effect on the immune defense, so this is something your vet must carefully consider. The immune defense works together with Albon, the Albon weakens the bacteria so the immune defense can kill them.

                                                          A longer course of Albon could be needed, it often is with ear infections.


                                                        • alcyone
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                                                            Is this typically something that’s slow to heal? His balance is still off and I think that’s a big reason he’s not using his litter box, but I have seen improvements thankfully. I can’t help but feel like I should be doing more for him, but maybe I just need to be patient and let the Albon to do its thing.


                                                          • alcyone
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                                                              I spoke with the vet today and explained that the shot seemed to help at first, but he’s kind of back to where he started before the shot so I’m thinking it’s wearing off. She said we could come back in for another shot, but I know steroids are more of a last resort for rabbits and I wasn’t sure it was a good idea. We concluded giving the Albon until the 18th to do its thing, which would be 21 days of treatment. She said if he gets worse to call but otherwise we can give this a chance to work.

                                                              Do you guys think this is the right call? I feel like I mostly made it and I’m nervous about it. It’s so hard to look at him with his tilted head and know if I’m doing the right thing for him or not. I know this can take a long time to heal, but the shot wearing off and seeing him tilting more has me wondering if patience or another shot is the right call.


                                                            • Bam
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                                                                Instead of corticosteroids for head tilt, some sources (Medirabbit for one) suggests Metacam, an NSAID (non steroidal anti inflammatory drug). It’s the same type of drug as Voltaren for humans. It’s not as powerful as corticosteroids in reducing inflammation, but it doesn’t suppress the immune defense, which is the big risk with corticosteroids. Metacam and corticosteroids can NOT be used at the same time though, so the steroids must have worn off before you use Metacam. And vice versa, if you’re thinking about repeating the Vetalog. 

                                                                Some vets like to give ranitidine (Zantac) togeter with Metacam to minimize the risk of stomach complications (NSAIDs are somewhat hard on the tummy, although as a rule well tolerated by rabbits even for long term treatment).

                                                                And yes, this is something that often takes a long time to heal. It’s very frustrating, but you just have to hang in there and not give up hope. Many, if not most, buns need several weeks on antibiotics to fight off an ear infection. Some buns might need a series of courses of antibiotics. 


                                                              • alcyone
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                                                                  You’re always so helpful, thank you so much! If things get worse or stay the same I’ll definitely mention those to her. I’ll give him a few more days so I know the Vetalog has worn off completely and we’ll see where he’s at.


                                                                • alcyone
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                                                                    Are the Vetalog and Metacam actually used to treat head tilt, or are they more like something to make him feel better while the antibiotics are given time to work? Also, should antibiotics like Albon take time before you see any improvement, much less a healed bun?


                                                                  • Bam
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                                                                      Vetalog and Metacam are both anti inflammatory meds, although they work by different mechanisms. They aid in healing because they reduce inflammation. Metacam also has a pain killing action + reduces fever. But the ant inflammatory action is actually quite important in head tilt and really all types of infections of the respiratory tract (the ears are connected to the respiratory tract directly through the ear trumpet). It reduces swelling and helps the body to heal. Inflammation is the body’s way of trying to take care of a problem, but very often the inflammatory reaction is over the top and actually hinders more than it helps.

                                                                      Albon can take time. My bun got two weeks of a different but from the same family of antibiotics for a mild respiratory infection.


                                                                    • alcyone
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                                                                        Thank you so much, that makes a lot of sense! I think I’m going to try to get some Metacam for Marley. I’m not comfortable with any further steroids unless it’s absolutely necessary, I think the Metacam sounds like a good solution. I really appreciate all of your help and answers to my million questions, it’s making this whole process easier. Thanks again!


                                                                      • alcyone
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                                                                          I got Metacam today..$72 later! She gave me a 32ml bottle of the 1.5mg version and said to give him 1ml/cc once daily. Marley weighs about 5lb. Is this a good dosage for him? She said she’s never used this for rabbits before, (I’m the one that asked for it), so I just want to double check that she got the dosage right. Thanks!


                                                                        • Bam
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                                                                            That’s what it would cost here as well =( but it is good stuff and it’s well tolerated by rabbits even for longer term use. The dosage is correct, there’s actually quite a span, ranging from 0,2 ml/kg to 1,5 ml/kg according to Medirabbit. 1 ml of the Metacam you got gives him a dose of 0,66 mg per kg body weight. Shake the bottle before you measure up the dose.

                                                                            Some vets want to give ranitidine as well, to protect the stomach. Ranitidine is prescription free so you could just ask your vet if that’s sth she thinks would be suitable. (I’m only mentioning this because my vet gave me Metacam + ranitidin for my bunny, not all vets will find it necessary. I was told to crush one 150 mg pill for humans, mix with 10 ml water and give 0,35 ml of this suspension twice a day, the metacam once a day. Shake the suspension well before you measure it up in the feeding-syringe.)


                                                                          • alcyone
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                                                                              While the $72 part stunk, I don’t mind. I’ll spend whatever is necessary to get him feeling better, and this Metacam really seems to be helping! He’s holding his head much straighter since he started taking it. Do you happen to know how long it’s safe to give him this? Thank you so much for all of the suggestions, I’m really glad I got the Metacam instead of taking the risk of another Vetalog shot!


                                                                            • Bam
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                                                                                Medirabbit says metacam is well tolerated by rabbits even for long term use. It’s a drug that’s commonly prescribed for elderly buns that have arthritis/arthrosis-like problems. Rabbits can be on Metacam for years, although on low doses. Hopefully your boy won’t need to be on it for more than a couple weeks or so. If a bun is to be put on Metacam long term you start out with a high-ish dose for a week – couple of weeks so the ongoing inflammation is given a chance to heal up, then you start lowering the dose until you find the lowest helpful “maintenance” dose and stick with that.

                                                                                The main negative side effect to look out for is stomach problems, this is why Zantac (ranitidine) is often co-prescribed. Just like diclofenak and ibuprofen can be hard on human tummies, Metacam can be hard on buns’ tummies (and dogs’, for that matter). Rabbits with poor kidney function shouldn’t use Metacam.


                                                                              • alcyone
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                                                                                  Thank you so much! He’s so much straighter since starting the Metacam, I can’t believe it. He’s even straighter than he was with the Vetalog shot! I’ll speak with the vet about the Zantac. Is there a way to know if that’s something he should be on as well, or is it something that just kind of goes hand in hand with the Metacam? Also, is the 1ml considered a high dose and something I should lower after a week or so? I’m so amazed by how much better he seems to be doing with the Metacam, he’s even more active. He’s not a very active bun in general but he’s been hopping all over the place now!

                                                                                  Marley has been taking I believe 1ml of Albon daily since August 29th. Originally the vet said to give it until the 18th, but when I got the Metacam I needed a refill of the Albon as well, so she said to go ahead and give it to him until it’s gone. Is this safe to do and does it seem like a good idea? I’m not really familiar with how the Albon (or antibiotics in general) can negatively effect him.


                                                                                • Bam
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                                                                                    The zantac reduces amount of stomach acid (prevents stomach ulcers) and it also acts like a gut motility drug.
                                                                                    With regards to the metacam dose it’s really best if you ask your vet. 1 mg is not a huge dose for his weight, Medirabbit lists it it from 0,1 to 1,5 mg/kg body weight (Metacam is meloxicam in the table): http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm It’s wonderful to hear he’s being more active now. His infection could be responding to the Albon as well now.

                                                                                    Albon is an antibiotic so it does kill some of the beneficial bacteria in the gut. But you’re probably keeping an eye on his poop, if you start to see sticky poop, you can try a probiotic like Benebac. Head tilt ear-infections often require several weeks on antibiotics, that’s probably why your vet told you to finish this bottle as well.


                                                                                  • alcyone
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                                                                                      I’m happy to say that Marley has improved tremendously! His ear is finally back down, his balance is now only barely off, and his head is completely straight! The Metacam did wonders for him and I think the antibiotics have finally started to kick in. His balance is even well enough now that he can stand up on his back legs and clean his face again, which is just amazing to me. He still loses balance when getting on his litter box, but I think at this rate that won’t be an issue for much longer. He’s doing so much better and I just want to thank you, bam, for all of your help and knowledge. I really appreciate it and I feel you were a huge part in getting him back to himself, so thank you so very much for that.


                                                                                    • jerseygirl
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                                                                                        That’s great news! Im happy you’ve seen such an improvement. Im surprised the vet hadn’t used metacam for rabbits before. Maybe they’ll be more inclined to after seeing how it’s helped Marley!


                                                                                      • alcyone
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                                                                                          Thank you so much, I’m so thankful he’s doing so much better! Yeah I was surprised by that too, but I live in a small town area so a lot of these vets aren’t up to date with the best treatments for rabbits. That’s why I’m so paranoid and do so much research, questioning everything they give me for him! But I always end up glad I was paranoid and glad I did so much research, and this is a perfect example! I think it would’ve taken a lot longer to see these results without the Metacam, so thank you guys so much for giving me the heads up about it!


                                                                                        • Bam
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                                                                                            Thank you, alcyone! It’s truly wonderful to hear he’s making improvement. Standing on two legs while doing a facial clean really does sound like progress for a head tilt bun! Many, many continued-recovery-vibes for (((((Marley)))))


                                                                                          • alcyone
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                                                                                              Oh yes, he is definitely on the right track! Thanks so much, I truly appreciate it!


                                                                                            • alcyone
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                                                                                                I just got on the floor to hang out with Marley and his head is turned to the right (not tilted, turned like he is looking to the right) and his right eye is twitching like crazy, so much so that he’s closing the eye and I can barely get a look at it. It’s twitching much faster than it has the whole time he’s had head tilt, and I only noticed the twitch a couple times even so. He’s also breathing very fast. What in the world is going on? He’s been doing so great for days, he was even binkying today! Any ideas what this could be?


                                                                                              • Bam
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                                                                                                  I think you should call your vet. He could be having a relapse or the infection is spreading. Keep him warm and make sure he can’t hurt himself if he starts rolling.


                                                                                                • jerseygirl
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                                                                                                    Aw no! That is disappointing. {{{Marley}}}. Hopefully it is just a temporary setback.
                                                                                                    I wonder if his increased range of movements has brought on a bit of positional nystagmus? Did he have any loss of balance too?

                                                                                                    Yeah I was surprised by that too, but I live in a small town area so a lot of these vets aren’t up to date with the best treatments for rabbits. That’s why I’m so paranoid and do so much research, questioning everything they give me for him! But I always end up glad I was paranoid and glad I did so much research, and this is a perfect example! I think it would’ve taken a lot longer to see these results without the Metacam, so thank you guys so much for giving me the heads up about it!

                                                                                                    He is a lucky bun to have you in his corner! Im glad the vet has been open to trying things also. Despite your not having used metacam for rabbits before, she must have consulted an up-to-date formularly or a rabbit savvy vet to work out his dosage. You could have paid and walked away with a bottle of lesser strength and a dose so minimal, it would be like just giving a bit of syrup without the analgesic/anti-inflammatory benefits.


                                                                                                  • alcyone
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                                                                                                      Thanks so much jerseygirl, that really means a lot! And yeah, I can tell she really wants to help and cares, or else I would probably be driving even farther away to see a vet. She’s done a really great job of working with me and helping me do things for him that I’m comfortable with so far, so I’m really thankful for that.

                                                                                                      So the second I put him back in his cage he’s back to normal again. Last night I sat with him for an hour and a half trying to calm him down and eventually I decided to try putting him his cage, I thought maybe he would feel safe there and calm down on his own. He went right back to normal right after I put him in there. I woke up this morning and he was himself again, his eye is fine and he’s looking straight ahead and acting normal. I took him out of his cage and not even an hour later it started again. Honestly, it could’ve been sooner, but I noticed it within an hour. I put him back in his cage again and, once again, it stopped instantly.

                                                                                                      Marley spends most of his time out of his cage in the same spot in my house. Since he’s been peeing on the floor the last month or so, I’ve been spraying around the area he hangs out in with Urine Gone (ingredients are water, soya, morpholinium, ethosulfate, cocamidopropyl, betaine, sodium bicarbonate, proteolytic enzymes, EDTA, and fragrance.) I let it soak into the carpet and don’t let him out for a while after spraying. I also haven’t sprayed under the table he spends his time in, just around it where he pees. It seems like the eye twitching and whatnot is related to that area of my house all of a sudden. Could it be some sort of reaction to what’s left of this Urine Gone in my carpet?

                                                                                                      Also, he was hopping in circles last night but his balance seemed otherwise fine. Right now I have him back out in a separate room with the door closed, away from where I’ve sprayed, and he seems like himself. He’s stretched out relaxing. He even stood up and cleaned his face again, so I’m thinking it may be a separate issue rather than a relapse. His head is straight (no tilt or turning now) and I’m watching his eyes very closely. Right now they seem normal, and they have since I took him back out of his cage and kept him away from the area sprayed.

                                                                                                      UPDATE: he started doing the same thing again. I put him back in his cage and he stopped. Why would he only do this outside of his cage?

                                                                                                      This started at 9:30pm last night and today is Saturday, so the vet (and all others around here) are already closed and won’t be open again until Monday.


                                                                                                    • Bam
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                                                                                                        I’m glad it stops when you put him back in his cage. I don’t know why that works for him. Maybe it could’ve sth to do with his cage being the environment he’s most familiar with. Like an old person that can get very confused in a care facility but gets around just fine in their own home. Not that Marley is an old rabbit, but he dies have an infection that affects his balance organs. (((((Marley)))))


                                                                                                      • alcyone
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                                                                                                          That’s exactly what I’m thinking, it’s his safe place. Whatever the reason, at least he’s okay in there. I feel bad leaving him in there but for the time being it seems to be best. I called several 24 hour vets that are well out of my area, just to try to get some advice. Only one even treated rabbits and they honestly weren’t helpful at all. We did pick up some Zantac last night, so we’ll start giving him that twice a day like you suggested. Maybe he’s experiencing nausea or something that’s stressing him out and causing this. Hopefully it works itself out. I feel like it’s out of my hands until at least Monday. At least he’s okay in his cage I guess!


                                                                                                        • alcyone
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                                                                                                            Can this eye twitching and hopping in circles be related to head tilt without his head being tilted? His head is straight, and his balance seems fine, so I’m confused! Also, could it be a side effect of the medications he’s been on? He’s been on Albon for almost a month and Metacam since the 11th. It’s killing me waiting until tomorrow to call the vet, and honestly, I’m really worried that she won’t know what’s wrong. I feel so guilty just waiting until tomorrow but I don’t know what to do for him.


                                                                                                          • Bam
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                                                                                                              You are doing all you can, so just hang in there. He has a safe place where he seems to be doing good, and that’s great.

                                                                                                              The hopping in circles/nystagmus can absolutely be due to the ear infection. The labyrinth where the balance organs are located are in the same area of the brain as the inner ear.


                                                                                                            • alcyone
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                                                                                                                I called the vet and she said to take him off the Metacam and bring him in Thursday for or a steroid shot. I don’t know if I agree with this. Could it be the Metacam? I don’t think so, I’m afraid she may just be doing this because she’s not familiar with the Metacam, but it’s caused great improvement and I don’t see how it could all of a sudden cause these issues. I’m afraid taking him off the Metacam will bring the tilt back and other issues.


                                                                                                              • Bam
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                                                                                                                  It’s not likely this is caused by the Metacam. But your vet probably feels the Metacam isn’t doing enough, and in order to receive corticosteroid he must be off the Metacam.

                                                                                                                  He might need another antibiotic, if the microorganisms causing his infection are not sensitive to the Albon.

                                                                                                                  If you haven’t already, please read this excellent article from Medirabbit:
                                                                                                                  http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm


                                                                                                                • alcyone
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                                                                                                                    That makes a lot of sense, I just don’t understand why she would feel the Metacam isn’t doing enough. She also hasn’t seen him, so maybe she’ll feel differently when she does and I get a chance to really explain everything to her. The Metacam really helped him. We are going to keep him off of it until Thursday and continue the Albon, then I guess we’ll see what she says when she sees him. I just really hope he’s okay the few days without the Metacam. I didn’t give it to him yesterday either because I had a feeling she’d say to do this. I guess we’ll see for sure on Thursday. These darn sick buns really stress us bunny parents out! This little guy is like my baby, I just hate when anything is wrong with him! I will read through that link this evening, thank you so much! I’ve read so many things about head tilt lately I don’t even know what I have and haven’t read anymore lol


                                                                                                                  • Bam
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                                                                                                                      Maybe she’ll reconsider when she sees him. It’s so difficult with ear infections inside of the tympanic membrane because you can’t take a sample and determine what bacteria are present. Another shot of baytril might be good?


                                                                                                                    • alcyone
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                                                                                                                        That’s a really good idea! I’ll mention the Baytril on Thursday. I also think I’m going to convince her that putting him back on the Metacam is the way to go rather than the steroid shot. I’ve seen so much improvement with the Metacam, maybe the antibiotic is what isn’t doing enough. Maybe the infection is getting worse or something. Either way, after being off of the Metacam for two days, I think his tilt is trying to come back already. I definitely think he should stay on the Metacam and avoid the shot. I’m going to have her take a look in his ears and see what she thinks, but I think once I get a chance to tell her how much the Metacam has helped thus far, she’ll probably agree it’s doing what it needs to.


                                                                                                                      • jerseygirl
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                                                                                                                          Are you still seeing the nystagmus now he’s off the metacam? Ive never heard of that being a sife effect of metacam.
                                                                                                                          Was she aware of how much it had helped? Maybe she was thinking it hadn’t and wanted to use something stronger.

                                                                                                                          Just speculation but I was thinking about how you said his eye movements stop once in his cage. I wondered if field of vision is more limited there and that helps. Im curious though – is his cage at ground level or up higher?


                                                                                                                        • alcyone
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                                                                                                                            The last time I gave him the Metacam was Saturday and I’m still seeing nystagmus, yes. I didn’t really get a chance to explain how much it’s helped, they didn’t let me talk to her. I told the person who answered that he’s been doing better lately but I was thinking I’d talk to the vet herself and get to explain in more detail, but she was too busy to come to the phone so she just told the person who answered to tell me. I think you’re right, the more I’ve thought about it I think that’s her plan exactly. I’m thinking once I explain how much it’s helped she’ll realize the steroid shot isn’t necessary. I don’t know that the steroid would help the nystagmus anyway, would it? Should the Metacam help the nystagmus?

                                                                                                                            That does make sense, I hadn’t thought of that. It’s usually up higher but since he’s had head tilt I’ve put it on the floor so I can get him in and out better. When he was tilted it was very tricky getting him in and out of his cage safely.


                                                                                                                          • jerseygirl
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                                                                                                                              If the nystagmus is due to inflammation, then yes, the metacam should help. Maybe ring again and discuss?? The steroid shot can be powerful and quick acting but they are not something that can be continually given. Not without risk, anyway.

                                                                                                                              Im certainly not trying to give advice against what your vet has recommended. She is the one who has seen him after all. But I do think it important she be aware of how you saw the metacam help if you suspect she doesn’t know. She may be recommending the steroid shot again because she believes the NSAID hasn’t had any effect.


                                                                                                                            • alcyone
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                                                                                                                                That’s exactly what I’m thinking, and I definitely want to make sure she understands how much it’s helped. I just don’t understand why the nystagmus all of a sudden. Maybe a higher dosage for a short period of time could be necessary of the Metacam. The steroid just makes me so nervous, I know it’s risky and he’s already had it once. It has been a while so maybe another one is necessary to sort out the nystagmus for the time being, but I just feel like it’s a short term fix. What happens after the shot wears off, ya know? I’m also not sure why the Metacam wouldn’t have been keeping the nystagmus from happening in the first place if it should help. The whole thing is just so confusing. He was doing so well for a while, then all of a sudden this nystagmus came along and now I’m just so confused and stressed. I really hope we can get it figured out.


                                                                                                                              • jerseygirl
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                                                                                                                                  This is just speculation on my part…
                                                                                                                                  Normal progression often seen with head tilt is nystagmus, followed by the head tilting. It can then progress to a rolling phase. So I do wonder as things improve whether one could see those things in reverse, if that makes sense? Assuming nystagmus one of the lesser symptoms? I want to find a bit more about this but Im time poor atm! Hopefully I will get a bit more time later to investigate!


                                                                                                                                • alcyone
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                                                                                                                                    Hmm, that’s interesting! I’ll try to look into that too, wouldn’t that be something! It actually makes sense too, because I barely saw any nystagmus even when he was at his worst with the head tilt. I mean full on tilt and loss of balance, I barely saw any nystagmus, and when I did, it wasn’t as bad as it has been the last few days. It was just slight twitching, not nearly as fast or for as long as lately. I also noticed him scratching his ears a bit the other day, and I thought maybe that could mean they were starting to heal. I haven’t noticed him scratching much since. I don’t know, but he was doing really well. I mean, he’s been completely straight, acting like himself, and he was having no problems at all for a good week and a half at least, maybe even two weeks! That Metacam straightened his little head right up, he put his ear bad down, and he was doing so wonderfully. It would be awfully crazy if the nystagmus could somehow be part of the healing process, especially since he didn’t experience much of it at his worst. Maybe it’s catching up with him during healing?


                                                                                                                                  • alcyone
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                                                                                                                                      We got Marley to the vet this morning. Since he’s off the Metacam he’s a mess today: he’s trying to roll when you pick him up, his balance is off again, and the tilt is back. He’s also hopping in circles and I’ve seen nystagmus every time I’ve looked at him today. I feel so terrible for him.

                                                                                                                                      The vet wanted to give him the steroid shot, but I explained to her that the Metacam has helped him so much so she scratched that idea. She looked at his eyes which were twitching when we brought him in, I explained the hopping in circles and even put him down to show her, and I explained that all symptoms were gone while on the Metacam, then nystagmus started. I told her the last dose of Metacam we gave him was on Saturday, and since then all of his symptoms have returned, now accompanied by the nystagmus, hopping in circles, etc. Originially she mentioned treatment with seizure medication, but I explained that I read these are all things related to the ear infection, so she said she was going to give another vet a call if we had time.

                                                                                                                                      She came back and said the other vet suggested e cuniculi, and gave us Baytril tablets (she doesn’t have oral and it was my understanding they only had shots available, but now they have tablets? Idk) and a 30 day treatment of Panacur. She said you can test for the parasite for over $200, but it’s safe to just treat for it. I explained that I’ve read with e cuniculi nystagmus is often vertical, while Marley’s is horizontal. She said most times nystagmus is horizontal. Anyway, now we have Baytril tablets that he will take one of every 12 hours for two weeks, and .5ml of Panacur once daily for 30 days. Can I crush the Baytril tablets in some apple juice and give it to him that way? If so, unsweetened would be best, right?

                                                                                                                                      I have so many questions and concerns. She said he could still have symptoms even after treatment, which I understand rabbits can be left with a tilt after all of this is said and done, but the Metacam can offset with longterm use if it continues, correct? Since we aren’t sure it’s the parasite, but we’re now focusing our efforts on treating the parasite, what if he gets worse if that’s not the issue? She said after the 30 day treatment you don’t continue the Panacur, so if the symptoms remain, basically too bad, which really upset me. I want him to live the best most high quality life I can possibly give him, and after all of these guessing games I feel like I’ve let him down in some way. After seeing him without the Metacam, I feel like the Albon was definitely not doing what it needed to be. I asked about Baytril to begin with and was told they only had shots. Now we’re on to two new medications that, once again, we aren’t sure will solve the problems he’s having. Will these medications resolve the ear infection? Or is that even the issue anymore? I asked her and she said yes, it’s all connected, but I just want to double check. Can e cuniculi cause the ear problems, and every other symptom he’s having? If it is e cuniculi, will the symptoms even get better or go away?

                                                                                                                                      I asked about continuing the Metacam and she said the other vet didn’t seem to think it was necessary, but that the medications can be combined. Is this true? And should I start Metacam again with these medications, or wait until I see what these medications do first? If he is going to show improvement with these medications, when can I expect to see that? Do you think this is the right next step in his treatment? I’m just questioning everything about everything right now, I feel so terrible for him and I don’t know what tje right thing is anymore. I just want to do what’s best for him. I don’t want him to be in pain or uncomfortable without the Metacam, but I don’t want to mask the symptoms and not be able to tell what these new medications are doing.


                                                                                                                                    • Bam
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                                                                                                                                        Poor Marley.
                                                                                                                                        You saw such good results with Metacam + Medirabbit does recommend it for head tilt, so it seems very reasonable to keep the Metacam going.

                                                                                                                                        If it’s an ear infection and not EC, or EX secondary to the ear infection, Baytril is, as a rule first choice for ear infections. It has some additional effect on EC, but the drug that eliminates the EC parasite is Panacur (fenbendazole). Our member Boston’s mum treated her Boston for 6 weeks with Panacur, on her vet’s order, but 28 days used to be standard treatment. It’s not dangerous to keep it up for 6 weeks though.

                                                                                                                                        You can also use an additional anti-nausea drug if Marley gets an appetite problem.

                                                                                                                                        Panacur is a very slow-acting drug. The Baytril should show effect after 48-72 hours but the Panacur needs more time.

                                                                                                                                        Tests for EC are notoriously unreliable. Most vets prefer to treat anyway. Panacur is mild.

                                                                                                                                        From Marley’s point of view I think masking the symptoms is rather good. The symptoms are stressful for him. Stress raises cortisol levels which in turn elevates blood sugar and if cortisol levels are high for any prolonged amount of time, it suppresses the immune defense quite markedly.

                                                                                                                                        Metacam can be given with Baytril + Panacur.


                                                                                                                                      • alcyone
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                                                                                                                                          So basically by treating with the Baytril and the Panacur, we’re taking care of the possibility of both the ear infection and e cuniculi? It’s actually comforting to know the tests are inaccurate, I was second guessing myself wondering if we should get the test, so I’m kind of glad to know it probably would’ve resulted in treatment regardless. I would like to get him back on the Metacam, I can tell he’s miserable without it. You don’t think this is going to poorly effect his treatment in any way? How will we know if he’s any better after treating with the Panacur and Baytril? Maybe by taking him off of the Metacam again if necessary? Should I give the Baytril a few days or just go ahead and start the Metacam again? Thank you so much as always for all of your help and answers to my million questions!


                                                                                                                                        • Bam
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                                                                                                                                            Yes, Baytril kills the ear infection bacteria if they are of the most common causative species. It has some small beneficial effect against ec, I think the mechanism (“reason why”) is as yet unknown, but it’s the Panacur that kills the ec microsporidias.

                                                                                                                                            Depending on how he seems to be feeling you can wait a couple of days to see if the Baytril works, or re-start him on the Metacam right away. And then take him off the Metacam again. It’s a judgement call really, if he seems to be feeling lousy, I’d use the Metacam. GI side effects can arise after some time, so even if he’s tolerated it well in the past, it does take a toll on the stomach lining, so Ranitidine is still a good idea.


                                                                                                                                          • alcyone
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                                                                                                                                              I think I’m going to go ahead and give him a dose of Metacam and keep that up for maybe 3 or 4 days at least, that way he isn’t miserable while waiting for the other meds to kick in. Thanks so much for all of the info! Since I’ll be giving him the Baytril twice a day and Panacur once a day, does it matter if I give the Panacur at the same time as one of the doses of Baytril, or would it be better to give them three separate times? And same with the Metacam, does it matter if I give it to him at the same time as the others?


                                                                                                                                            • Bam
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                                                                                                                                                I don’t know about giving the meds separately or at the same time, but if they needed to be given at separate times I think the vet would’ve said so. I’d think it’s better to give the Panacur with one of the Baytril doses because getting meds twice a day is less stressful than 3 times.


                                                                                                                                              • alcyone
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                                                                                                                                                  That’s what I was thinking too. Thank you!


                                                                                                                                                • alcyone
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                                                                                                                                                    Well we had to go out of town for a couple days and I decided taking Marley made the most sense, since he’s needing medicine twice a day and I wanted to be able to keep an eye on him. He did great in the car on the way there, he just lounged in the back seat in his carrier and enjoyed the ride. We stopped and got him set up, then had to leave for the evening. Then we got him from where we had him set up, took him to our hotel, and everything was downhill from there. Friday night when we got to the hotel he couldn’t stand up. Since then we’ve been dealing with a lot of laying on our side and rolling. A lot of rolling. It’s been so hard and at this point I don’t know what to do for him. I’m wishing this Metacam would start to help, and I’m also hoping since we got home tonight being home will help, but with all of the rolling I think he’ll be spending another night in the carrier until i can figure out something better for him. It’s mesh on the sides so at least he can’t hurt himself in it. His head is so tilted and his balance is just a disaster. I really hope things start looking up for him soon.


                                                                                                                                                  • jerseygirl
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                                                                                                                                                      Aw, Im sorry to hear it. It’s one of those conditions that goes differently from one bun to the next. Some are fast onset, some slow. Some have fast turn around, others take much longer. I have high hopes for Marley, especially having such a dedicated human looking after him. {{{Marley}}}

                                                                                                                                                      I know youve read a lot about head tilt already so I hope you aren’t too overwhelmed by all the info. I came across this article last week and I was really impressed by it. I think you will find it interesting and hopeful helpful. http://www.mspca.org/angell_services/management-of-head-tilt-in-rabbits/

                                                                                                                                                      It mentions Meclizine too and that may be something you’d like to try for Marley. Its available OTC at most drug stores. It is supposed to help with dizziness and nausea. It’s hard to know if this is something a rabbit is actually experiencing but its another case of, lets assume it’s very likely and cover that base also. Much of treating head tilt is that approach, especially if caused by EC because it is difficult to establish for certain if EC infection is actively causing the symptoms.

                                                                                                                                                      Regarding Marley, his condition is due to inner ear infection, is that right?

                                                                                                                                                      About the meds being given together, I believe you can do so. When Maple was being treated for head tilt, I was giving them separate as well as trying syringe feed at times and I remember the vet saying she just would have given it all together. I hadn’t even considered it beforehand. I had a thread on here at the time so I’ll have to look it up and confirm about that! She went through rolling phase too and I know it can be distressing to see. They seem to cope okay but it is a bit tiring for them, I think. 

                                                                                                                                                      I had a short video of Maple while I was feeding her greens. She flipped into a roll then resumed munching on the greens as soon as she stopped.  I felt better after seeing her do that. 


                                                                                                                                                    • alcyone
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                                                                                                                                                        Thank you so much, and I will definitely give that a read and I will try that as well. Right now he’s on Baytril twice a day, Panacur once a day, and Metacam once a day. Would the Meclizene be safe with all of those? I’ve been giving the Metacam and one tablet or Baytril in the morning and Panacur and another Baytril tablet at night. He doesn’t seem any better and it’s very disheartening since we started these on Friday and the Metacam again on Thursday. I feel like we should be seeing at least SOME improvement by now. It seems like the nystagmus has gotten better, but now the poor guy is rolling all over the place.

                                                                                                                                                        We started treating it as an ear infection and I do believe that’s where it started, but now we’re treating for e cuniculi. It’s my understanding that the Baytril conquers the possibility of an ear infection and the Panacur takes on the e cuniculi.

                                                                                                                                                        It is comforting to see that he does want to eat as soon as he gets back on his feet. And he doesn’t stay on his side for long. He wants to get out of the carrier but loses his balance on the way out and ends up on his side again. I’m stumped because I can’t let him flip like that on the floor, he rolls all over the place and I don’t want him hurting himself. So he just keeps ending up back in the carrier since it seems like the safest place for him at the moment.

                                                                                                                                                        I feel terrible for him, he’s been breathing so fast from it and I just can’t imagine how stressful it just be. It breaks my heart to see him like this, and every day I just keep hoping he’s a little better tomorrow.


                                                                                                                                                      • Bam
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                                                                                                                                                          I’m sorry he’s taken this turn for the worse. Please read the article Jersey links to, it’s really good. It suggests oxibendazole instead of fenbendazole (Panacur), which is another bendazole that’s more effective against e cuniculi because it penetrates the blood-brain-barrier. The enrofloxacine the article mentions is the same as Baytril. The article doesn’t say that meclizine should be avoided together with the other meds. You could never treat head tilt with meclizine only, that wouldn’t do anything for the root cause of the condition, so I think it’s always given together with the other meds.

                                                                                                                                                          The article also speak of long treatment, 2-3 months both for ear infection and for ec. So it’s still kind of early days.


                                                                                                                                                        • alcyone
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                                                                                                                                                            Okay, thank you very much! Do you have any tips on how to keep him comfortable during all of this rolling? I’ve been keeping him in the carrier but I feel bad he doesn’t have much room in there, but at the same time I don’t think he needs much room in this condition. He has room to stretch out and get around comfortably. Should I try to make him an enclosed setup somewhere around the house? Or do you think the carrier is best for now?


                                                                                                                                                          • Bam
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                                                                                                                                                              Check out http://www.disabledrabbits.com/head-tilt.html, scroll down to supportive care. there are a few tips on how to make life more comfy for a head tilt bun. Rolled up towels and fleece blankets in a laudry basket, for example. For now it’s of course good you are keeping him in the carrier so he doesn’t hurt himself rolling around.


                                                                                                                                                            • alcyone
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                                                                                                                                                                I got a laundry basket and hung towels over the side to avoid any little bunny paws getting stuck in the holes during rolling episodes. I also got some Meclizene (25 mg Dramamine tablets) I’m trying to find a dosage on this, does anyone happen to know one off hand? And would this be something I just crush and put in apple juice like we’ve been doing with the Baytril tablets?


                                                                                                                                                              • Bam
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                                                                                                                                                                  Rabbitwiki says
                                                                                                                                                                  Torticollis: 2-12 mg/kg PO sid-tid (Varga, 2013)
                                                                                                                                                                  Vestibular disorders: 2-12 mg/kg q8-12h; PO (Blackwells, 2011)
                                                                                                                                                                  http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits

                                                                                                                                                                  This means 2-12 mg/kg by mouth, once or twice per day for torticollis (torticollis is wry neck)
                                                                                                                                                                  or 2-12 mg/kg by mouth every 8 to 12 hour for vestibular disease (vestibular disease is when the balance organs in the inner ear are affected)

                                                                                                                                                                  It’s often easiest to get a correct dose by crushing a pill and dissolving it in water. So you need to decide how much you want to give him (there’s quite a span between 2 mg and 12 mg) and know his weight. Do you know his weight?


                                                                                                                                                                • alcyone
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                                                                                                                                                                    Yes, he weighs about 5 pounds.


                                                                                                                                                                  • Bam
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                                                                                                                                                                      You could give him a whole 25 mg pill, crushed and mixed with something. You’d be at the upper end of the scale though, almost 11 mg per kg. If the pill can be divided in halves it’d give him a dose of 5.4 mg per kg. Otherwise it’s easiest to dissolve it in for example 10 ml of water and measure up a suitable dose (each ml would contain 2.5 mg medicine).


                                                                                                                                                                    • alcyone
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                                                                                                                                                                        So I could try maybe half a pill crushed in apple juice twice a day? The poor guy has been on his side basically ever since I put him in the hamper, so I just put a pet bed in a garbage bag, wrapped it in a towel, and put it in the bottom of the hamper, and he got up when I put him in it. He’s back down now but we’ll see what this does for him. I’m just glad he’s continued eating through this. He’s been eating plenty of veggies and some hay, but basically no pellets because I can’t put a bowl in with him. I just can’t believe we haven’t seen any improvement yet, it’s breaking my heart.


                                                                                                                                                                      • Bam
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                                                                                                                                                                          Half a pill would give him a dose of 5.4 mg per kg bodyweight (he’s 2.3 kg). He might get drowsy, because that’s the most common side effect. I hope you’ll see some improvement. Otherwise you can increase the dose. It seems like meclizine has been prescribed to head tilt buns for a long time, which means it’s safe to use or vets would’ve stopped prescribing it.


                                                                                                                                                                        • alcyone
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                                                                                                                                                                            Thank you so much, I’ll get a pill ready for him right now. I feel bad loading him up with so many medicines but as long as they’re all safe and might help, it’s worth a shot!


                                                                                                                                                                          • Bam
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                                                                                                                                                                              Many people say meclizine made a real difference for their buns, so I think it’s worth a try. But I agree it’s scary to give them many meds. My Bam was on 5 meds for his lower respiratory infection. It felt like such a lot of meds for such a little guy (he weighs 2.3 kg just like Marley).


                                                                                                                                                                            • alcyone
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                                                                                                                                                                                Oh wow, that’s a lot! The Meclizene makes four for Marley. He used to weigh closer to 8 pounds, but after stasis he lost a bit of weight. Now he stays between 5 and 6. It is scary to give such a little guy all of these medicines and just hope something works, and this whole situation is scary because some days he’s seemed great and then just like that, he’s worse than ever.  

                                                                                                                                                                                I’m so thankful he still has an appetite. He’s been eating laying on his side today for the most part, a couple times he tried to get up to eat, but when he tried to clean his paws he fell down. I did get him to eat some pellets and hay, as well as a good amount of veggies today, and I even got him to drink some water from his bottle while laying down! He’s spent almost all day on his side, but he hasn’t been rolling much, so I guess that’s a good thing. Improvement, perhaps? 

                                                                                                                                                                                Also, this may be a dumb question, but with Marley peeing on towels lately, I’ve noticed the color of his pee, and it’s kind of an orangey almost red color. Is this normal? I only noticed because he peed on a white towel  but I figured it wouldn’t hurt to make sure it’s nothing to be concerned about. Also, I had to clean his butt last night, and I was just wondering, if I have to do this again do you have any tips for making it easier/less stressful for him? I felt so bad doing it, I’ve never had to clean his butt before and it really stressed him out. 

                                                                                                                                                                                He’s spent so much time breathing heavily since Friday night when the rolling first started, and now while on his side he goes through a lot of spurts of heavy breathing when I move him to change his towel or anything like that. I’m assuming this is to be expected with everything he’s going through, but it’s nothing extra to be concerned with, right? Just part of what he’s going through?


                                                                                                                                                                              • alcyone
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                                                                                                                                                                                  Marley spent all day on his side today. I don’t think he tried to stand up once. Is this a cause for concern? He rolled around a few times, but he’s just been laying on his side all day. I’m not seeing any signs of improvement. He’s been eating laying down, and I had to give him his first ever butt bath today. I’m starting to feel a little hopeless, please tell me what he’s doing is normal and he still has a chance to get better. I haven’t called the vet since he started rolling, since I’ve read it’s rather common with head tilt. I figure she’d just tell me to continue the medicine and hope for the best, which is what I’ve been doing. I feel like I should be doing more. Does he still have a chance to get better, even in this condition?


                                                                                                                                                                                • Bam
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                                                                                                                                                                                    Do you think your vet would be willing to read the head tilt article that Jerseygirl links to? https://www.mspca.org/angell_services/management-of-head-tilt-in-rabbits/

                                                                                                                                                                                    It suggests treating with oxibendazole rather than fenbendazole (Panacur). It’s a dewormer for cats and dogs and cattle, but I think it’s prescription only.

                                                                                                                                                                                    I’m very sorry he’s not doing any better. Is he still on Metacam? Another shot of Vetalog would be a possible last resort.

                                                                                                                                                                                    You asked in another thread if Critical care could be a good idea, and I think it could since nutrition and fiber is important.


                                                                                                                                                                                  • alcyone
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                                                                                                                                                                                      It couldn’t hurt to ask, but he’s only been on the Panacur for 6 days, does it make sense to switch him already? Should we give the Panacur a chance first?
                                                                                                                                                                                      Yes, he is still on Metacam, but I’m almost out, so I’m wondering if I should get more or just take him in for the shot after he’s been off of it for a few days. I’m torn because I think the Metacam helped him more when we started it the first time, but now it doesn’t seem like anything is helping him.
                                                                                                                                                                                      I’ve tried half a Dramamine tablet twice a day for the last two days and it didn’t seem to help, so I just gave him a whole 25mg tablet. Should I still give him that twice a day? Sorry, I’m terrible with math and doses and whatnot.
                                                                                                                                                                                      He wasn’t rolling really at all yesterday, but today he’s rolled and he woke me up throughout the night rolling. I’m not sure what to make of this.
                                                                                                                                                                                      Thankfully he’s eating hay and pellets now, so his appetite is the only issue we’re not having right now!


                                                                                                                                                                                    • Bam
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                                                                                                                                                                                        As for the Dramamine, the dose stated could be given every 8-12 hour according to Blackwell, once or twice per day according to Molly Varga, so it seems like it’d be safe to give 25 mg/twice a day.

                                                                                                                                                                                        Panacur is very slow acting, so 6 days is a very short time. You could give your vet the link to the article to read, maybe she’d like to investigate oxybendazole further after that or change Marley’s meds.


                                                                                                                                                                                      • alcyone
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                                                                                                                                                                                          Okay, thank you! Have you read about other bunnies spending most of their time on their side with head tilt? I’ve read a lot about rolling but I haven’t seen many mention spending so much time on their side. I think he wants to lay on his other side to switch it up but can’t because of the tilt he wasn’t on his feet once today, but he did roll a bit. I think he wants to get up, but just can’t. Is it normal for a head tilt bun to be on their side this much, and to not even be able to stand?


                                                                                                                                                                                        • Bam
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                                                                                                                                                                                            I honestly don’t think it’s normal for a bun to be on it’s side this much. But I don’t know. If you have Facebook, there might be head tilt/E cuniculi groups you could reach out to. I did a FB search and came up with Help For Head Tilt Hoppers. There might be more, I think FB sorts the search results at least in part according to geographic location, because I first got a German group (couldn’t read it though, don’t know German well enough).

                                                                                                                                                                                            I think it’d be really good if you could connect with people who are going through/ have been through e c with their buns. We have members that have, but on a forum people come and go and aren’t always active.


                                                                                                                                                                                          • alcyone
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                                                                                                                                                                                              That’s a great idea, I will give that a shot. Thank you!
                                                                                                                                                                                              He’s been keeping his down eye closed and laying on that side, so how that eye is irritated. It looks like his eyelid is partially flipped up, and he won’t open it. I put some of the teramycin ointment on it (and the other eye just in case it’s irritated) and it melted into his eye, so I hope that helps. Have you ever heard of this? Most things I’ve read say they keep the down eye open, but he’s keeping his closed.


                                                                                                                                                                                            • jerseygirl
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                                                                                                                                                                                                Hi again
                                                                                                                                                                                                Maple spent at least a week on her side, from memory. She would go into rolls then settle on her side again.

                                                                                                                                                                                                He’s been keeping his down eye closed and laying on that side, so how that eye is irritated. It looks like his eyelid is partially flipped up, and he won’t open it.

                                                                                                                                                                                                This happen with Maple also. So I know what you mean by the eyelid partially flipped up. I think I kept putting lubricating eye drops in it.
                                                                                                                                                                                                At one of her checkups I voiced my concern about it but she looked at it and wasn’t concerned. She did not an ulcer starting on the other eye though. This was because she wasn’t able to close that eye.
                                                                                                                                                                                                Maple’s eye that was like how you describe Marleys did return to normal once she was back on her feet.
                                                                                                                                                                                                For her, I wanted to do treatment for at least a month, then reassess everything if little or no progress. I had read other accounts of it taking a month before seeing positive progress.

                                                                                                                                                                                                Yes, he is still on Metacam, but I’m almost out, so I’m wondering if I should get more or just take him in for the shot after he’s been off of it for a few days. I’m torn because I think the Metacam helped him more when we started it the first time, but now it doesn’t seem like anything is helping him.

                                                                                                                                                                                                He’s had 2 shots of the vetalog previously? 

                                                                                                                                                                                                  You know, it was much later at night after Maple had a shot that she managed to stand on her feet for a short time. It was after she rolled and she landed on her feet. I didn’t know if it were coincidence or due to the shot tbh. Looking back though, she was getting such a small dose of metacam beforehand, I have to wonder if it did anything for inflammation at all. I wonder how she would have been had she been getting dog strength metacam…


                                                                                                                                                                                              • jerseygirl
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                                                                                                                                                                                                  This is a video of her going into a roll. I had her quite contained by that point in a padded out cage base.
                                                                                                                                                                                                  http://www.youtube.com/watch?v=XkdRdWZ8hYg
                                                                                                                                                                                                  She became incontinent throughout this time and I was swapping out towels then used puppy pads under her when she was rolling less. The just ended up bunching up if I used them when she was rolling.


                                                                                                                                                                                                • alcyone
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                                                                                                                                                                                                    Marley is still on his side, and is still rolling at times, but not as bad as he was when this all started. I’m not seeing as much nystagmus, either, and if I do it’s only when he’s stressed. I have been putting Terramycin ointment in the irritated eye twice daily. I was putting it in both but it seemed to just irritate his good eye, rather than help anything. He does blink the good eye, and it looks pretty normal to me, except how wide he opens it when he’s stressed, but the down eye looks pretty rough with that eyelid flipped up. It seems like the Terramycin helps, but then he spends the night rolling around and laying on it and in the morning it’s back to where it was. I currently have him laying on towels, but I saw some suggest using fleece blankets to reduce irritation, so I think I’m going to try that. It’s really comforting to know that it’ll return to normal when he’s back on his feet, thank you for that!

                                                                                                                                                                                                    He has only had one shot of Vetalog, but I did end up just getting more Metacam instead of trying another Vetalog shot. I too can’t help but wonder if more Metacam would help him, but I don’t know how much is too much. He’s currently on 1ml daily and he weighs about 5lbs. 

                                                                                                                                                                                                    I followed bam’s advice and joined the Facebook group he mentioned. A lot of people are suggesting bicillin antibiotics. A few specific ones they’ve mentioned include Zithromax, Septrin, and Penicillin injections. Do you guys have any experience with any of these? We’re over a week into a two week treatment of Baytril with no signs of improvement, so I am wondering if a stronger antibiotic will be necessary. Regardless, I know we’ll need more than two weeks of Baytril if we stick with that. 

                                                                                                                                                                                                    What did you use to pad the cage base? I currently have Marley in a rectangular laundry basket. I have towels draped on the sides and I put a pet bed in a garbage bag, wrapped it in a towel, and put it in the bottom of the basket. It seems to be working okay, but I have to fix the towels on the side a lot. I think I need a big blanket or something else to cover the sides that he won’t be able to pull down when he rolls. Also, in the video I noticed Maple stretching her legs out a few times after rolling. Marley does this exact same thing after he rolls as well, I wonder why? I noticed she had a nice padding to lay her paws on when she did that, too. Maybe I need to rethink Marley’s hamper situation, maybe a different bed or something that gives him less space and more padding?


                                                                                                                                                                                                  • jerseygirl
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                                                                                                                                                                                                      From memory, zithromax is supposed to be very good for respiratory type infections and good penetrating tissue. Injectable penicillin is well tolerated by rabbits. Ive given it to 2 bunnies before, for abscesses.

                                                                                                                                                                                                      I think I used a peice of foam (like puzzle mat foam) on the cage base, then some rolled towels each side. Then a big towel over all of that. I did pick up one of those baby change mats that have bolsters on each side, and used that for another rabbit I was looking after one time.

                                                                                                                                                                                                      It’s a bit of trial and error on figuring out what works best for your rabbit. Maple had lost weight in that first week and was already small to begin with, so she seem so fragile to me. It seemed to help her having her surrounds padded out like that. She’d push her feet out to find what I think was the ground for her – even though it was the side. 

                                                                                                                                                                                                      My friend who had 2 rabbits go through head-tilt didn’t do this so much. She found if she propped them up against the baseboard, they could find their feet more. It depends on how your rabbit is, really. Our “upright:” is not their upright when they’re like this.

                                                                                                                                                                                                      I happened to read this article a few weeks ago, about an astronaut who had spent a year in space adjusting to life back on Earth. They stumble a fair bit when they first come back. He also wrote this for when he was in the space station:


                                                                                                                                                                                                      I had been on the station for a week, and was getting better at knowing where I was when I first woke up. If I had a headache, I knew it was because I had drifted too far from the vent blowing clean air at my face. I was often still disoriented about how my body was positioned: I would wake up convinced that I was upside down, because in the dark and without gravity, my inner ear took a random guess as to how my body was positioned in the small space. When I turned on a light, I had a sort of visual illusion that the room was rotating rapidly as it reoriented itself around me, though I knew it was actually my brain readjusting in response to new sensory input.

                                                                                                                                                                                                      Reading about rabbits with tilt around the same time, it had me speculating what it might be like for them orientating. It is thought their brains do adjust and you’ll often see them coping better after some time, even though still very tilted.

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                                                                                                                                                                                                  Forum HOUSE RABBIT Q & A Ear Infection and Possible Head Tilt