# Feeding Head Tilt Bunny



## Sabine (Apr 4, 2013)

My almost 5 year old Netherland Dwarf girl Asha has suddenly come down with severe head tilt two days ago. She has been getting regular injections since but the tilt really hasn't improved.
I am really worried about her ability to eat and drink so I have started syringe feeding her food an liquids. I am finding this very difficult as I am virtually feeding her upside down. Whenever she spits some out it end up in her nose. The way she curls up I can't find a better way of feeding her.
She seems to be eating tiny amounts of food herself and I found a small bit of poop in the cage this morning. I wonder how much and how often I should feed her. She only weighs 900g. I somehow can't judge how much she should be getting.
Any advice would be of great help!


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## JBun (Apr 4, 2013)

Did the vet give you Oxbow critical care food mix to syringe feed her with? That's usually the easiest and best thing to be feeding a sick rabbit. If you don't have it, you can ask your vet about it. Are you syringing the food and water into the front or side of her mouth? When I syringe fed one of my rabbits that is 1.3 kg, I fed about 6-9cc of food mix, every 3-4 hours. If you water yours down much, then you would need to feed more. If you are just feeding mashed up pellets, then you would just take the amount that you normally feed in a day, and divide that up into 5 or 6 feedings. You could try giving your rabbit a neck massage before syringe feedings, as it may help loosen up the muscles a bit, so that the head tilt isn't as severe.

What medication is the vet injecting for the head tilt? Usually they will treat for an ear infection with antibiotics, but head tilt can often be caused by a protazoa called e. cuniculi, so it's a good idea to treat for the EC at the same tine. The treatment is with fenbendazole(Panacur) at 20mg/kg once a day for 4 weeks. This treatment needs to be started immediately, especially with how severe the head tilt sounds, and your buns lack of response to the injections it's getting. But talk to your vet right away, and get your bun started on this other med. Here's some info on e. cuniculi.

http://www.bio.miami.edu/hare/tilt.html


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## Sabine (Apr 4, 2013)

I am syringe feeding a critical care equivalent called "Recovery" which is easier to avail of in Europe. I syringe into the side of the mouth. She is being treated with baytril and another antibiotic. I forgot to ask about panacur. The last time I dosed all my rabbits with it is almost a year ago and i am kicking myself now that I let it slide. It is also not helping having wild buns visiting on a regular basis at the moment...


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## tonyshuman (Apr 4, 2013)

The head tilt is most likely to be caused by an ear infection, so I wouldn't worry about panacur at the moment. If you think it could be EC-related tilt, check for vertical vs. horizontal nystagmus as shown on this webpage: http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm 

You might want to get her on some sea-sickness meds--meclizine is used frequently. She may also need pain meds. Often the vets treat the infection but forget about trying to get the bunny feeling better in the meantime while the antibiotics start working--the seasickness meds and/or pain meds can help her to feel more willing to eat. Can you get her to eat the stuff out of a plate? How much of a tilt are we talking? More than 90 degrees? A bunny burrito may be your best option for her:
http://www.medirabbit.com/EN/Transport/Towel/Towel.htm

Are your buns up to date with vaccines? I would worry about that with wild buns in the area.


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## Sabine (Apr 4, 2013)

Thank you for the replies. Yes my rabbits are up to date with vaccines. I knew there were wild rabbits in the area bit it is only been in the last few months that we have been having regular visits to the garden.
That link was very interesting. Strange you say about the sea sickness as when I was watching her eyes I thought of sea sickness myself and even felt a bit nauseaous but thought it was my human interpretation of her condition. I can't really tell what way her eyes are moving as they are relatively still at the moment. I would think they tend to go more side to side (horizontal?). What would that indicate?
The tilt is very dramatic. At times she is totally on the side rolling over and over or it is almost 180 degrees.


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## tonyshuman (Apr 4, 2013)

Horizontal is more indicative of an ear infection. I would look into the meclizine for sure. They sell it sometimes over-the-counter for people and this mentions dosing
http://en.allexperts.com/q/Rabbits-703/Dosage-Meclizine-Wryneck.htm
Poor girl. I can imagine it being very difficult to get her to eat. I wonder if she would lick it off of something instead of having it put in her mouth? If she's feeling really unwell she probably won't want to do that. You might try canned pumpkin or one of the baby foods instead since they're more tasty than the Recovery stuff.


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## Sabine (Apr 5, 2013)

I checked her this morning and she had eaten all of her pellets and not a scrap of veg left either. I refilled her bowl and she started tucking in straight away. The head tilt is still quite bad but I think the medication must be kicking in. The eyes look much calmer to. We are off to the vets this morning for another shot. Hopefully there'll be improvement over the weekend.
Thank you for all the help and info!


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## Sabine (Apr 5, 2013)

We are going to be back for one more injection tomorrow. Thankfully her appetite has greatly improved but the tilt is still severe. I asked about travel sickness remedies but my vet was a bit vague about it and only familiar with those for cats and dogs. I might have a look at the pharmacy later.
Unfortunately my vet will have to order in Lapazole (licensed panacur for rabbits) so I won't get it before Monday. I hope the weekend brings some improvement. The poor thing she has never been sick nor on her own in a cage for the last 5 years.


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## JBun (Apr 5, 2013)

I don't know if you will have this available there, but here we have a goat dewormer called Safeguard, that is fenbendazole, the same antiparasitic as Panacur, and it can often be found at animal feed stores. So if you are concerned about your rabbit having it sooner than Mon., you could try calling a feed store to see if they have any.

You may also want to ask your vet about picking up some Metacam suspension, which is an anti inflammatory. Not only will it bring down inflammation(if there is any), but will also help control any pain, which can affect a rabbits eating.


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## pamnock (Apr 5, 2013)

Nutri Cal for cats/dogs is an excellent way to provide nutrition/energy without having to syringe large amounts of messy mix.


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## Sabine (Apr 7, 2013)

Thank you Pam, I will have a look if I can get hold of nutri cal and keep in in the medicine cabinet. Thankfully Asha is eating well by herself now so I have stopped syringing at the moment.
JBun: I used a sheep wormer called Parazole in the past. It was always a nightmare to administer as the buns didn't like the taste. If the Lapazole doesn't arrive soon I will have to go out though and use it again.
Thank you very much for everyone's replys. I found some of the links really useful and will be forwarding them to my vet.


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## Sabine (Apr 7, 2013)

Asha has deteriorated since I posted this morning and I am back to syringe feeding her. She has moments when she perks up and shuffles around in the cage seeking out the food and water but apart from nibbling on a few dried herbs and hay she hasn't touched much. her poops are also getting less and smaller. She seemed very apathetic when I fed her earlier. I rooted out the Metacam but realized it is several months out of date so maybe not the safest option.
I also noticed that she makes rattly sounds when breathing. She actually did that from the start but I mistook it for grumbling. I only now realize that it is her breath making that sound. I wonder is that part of the condition or could anything else be going on?


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## tonyshuman (Apr 8, 2013)

Oh no, I'm sorry she's not doing well. I am not sure about the breathing, but it could be something like a snore where the soft palate is moving against the throat, since her head is in an unusual position. It could also be something much worse, like chest congestion. I think she needs in-patient hospital care if you can do it. It would be good to get her in a nice, warm incubator with a higher oxygen content in the air if possible, and maybe she'd tolerate an intra-nasal feeding tube to get the food into her.


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## JBun (Apr 8, 2013)

I'm so sorry she's not doing better. Were you able to start the fenbendazole? It couldn't hurt to try it since she's not getting better, and it may actually help. The metacam would help as well. I'm sure a few months past expiration shouldn't matter too much if it's all you have right now. If you're into the vet soon, you may want to pick up a new bottle. I hope she shows some improvement soon.


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## Sabine (Apr 9, 2013)

We went to the vets yesterday and will be injecting the baytril ourselves for the next few days (till Thursday). She also got a shot of Metacam and long acting penicillin. I started her of Lapizole (fenbendazole) too but her condition has not improved one bit. The head is totally tilted and she topples over a lot and ends up lying down with her legs up in the air.
I am still syringe feeding and also got hold of some Critical Care. She is actually eating a small bit herself and there is a good bit of poop and pee in her cage. It worries me that she is not seeking out the litter tray anymore but pees on the blanket and stays lying in it. I change them regularly and have thick towels underneath too.
I am actually beginning to wonder for how long treatment is useful or am I just prolonging her torment. It has been 7 days now with full treatment and her condition is no better than at the start. She can't be on baytril for that much longer.


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## Sabine (Apr 9, 2013)

P.S. The rattly breathing noise has stopped. Maybe it was just her awkward position and she has adjusted somehow.


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## JBun (Apr 9, 2013)

If the head tilt is being caused by the e. cuniculi protozoa, it may take several days on the fenbendazole to see any signs of improvement, and even when the full 4 week treatment is given, there may still be some permenant damage done, but it should halt the progression, if it's not too severe yet, and improve her condition.


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## tonyshuman (Apr 9, 2013)

I think the head tilt in this case, like most cases, is due to a bacterial infection, especially since you observed horizontal nystagmus. EC-induced head tilt is a later stage of the disease and usually the bunny looks very sick before they start to get a tilt. They would have had hind leg problems and urinary problems for several weeks before a head tilt would set in. The nystagmus in EC is also vertical instead of horizontal.

I am wondering if the antibiotics used are not effective. It may be time to switch to chloramphenicol or azithromycin. Chloramphenicol would be my first choice. Also, how frequently is she getting penicillin? It may not be enough. Usually the long-acting/short-acting combination penicillin (procaine+benzathine) is given every other day. Is there also any chance of getting meclizine or another anti-emetic (seasickness med)? The metacam is good, and it's good that she is eating, drinking, and eliminating normally, so she doesn't need the seasickness med to make her feel well enough to eat, but it might help reduce the rolling episodes.

I would also try to set her up in a cage with permeable bedding (like microfleece) on the bottom, with puppy pads or towels underneath. This would wick away urine better. You can also put rolled up towels on the sides of the cage so that she doesn't roll into the walls, and they may give her something to lie on comfortably. I think JadeIcing did something like that with a few of her head-tilt bunnies.


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## Sabine (Apr 10, 2013)

Unfortunately I won't be able to give her meclizine as it isn't licensed in Ireland. I could possibly order it in but it would take a while. My vet has some similar drugs for dogs but feels uncomfortable to prescribe them for a rabbit as dosing them would be very difficult.
I am not sure if chloramphenicol or azithromycin are available for rabbits but I will mention this to my vet when I see her tomorrow.
I put a lot of absorbent towels in the cage and a polyester fleece blanket on top. At the moment she is lying in the (cleaned out) litter tray and hasn't really moved since last night. She is apathetic most of the time but does nibble small amount of fresh food occasionally. I am still syringing critical care and liquids which is a struggle. Her weight has also dropped further and I fear the outlook is not great. 
She is getting the fenbendazole and we are injecting baytril. Unfortunately I won't be able to go the vets today and I am not sure if she will make it till tomorrow. She just looks as if she just wants to quietly slip away. I feel gutted to be loosing her as she is my very first Netherland dwarf and she has been such a lovely pet.


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## tonyshuman (Apr 10, 2013)

OK, poor girl and poor you. It's a sad situation and it doesn't sound like things are getting much better. I hope she starts to improve soon. I have heard of giving other seasickness meds to rabbits but I also don't know the conversion. There are formulas that convert these things, but there could be serious issues because some meds do unexpected things in different animals.


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## Sabine (Apr 11, 2013)

To my surprise (and delight) Asha is still with us and there is even a slight improvement. She is still nibbling on greens and bits of hay and is moving around a small bit. I think I am getting a bit better with the syringe feeding and seem to be able to get more critical care into her. The vet noticed that she did not appear dehydrated anymore but the tilt is still really bad so that she lies on her side for most part of the day. We are continuing the baytril injections for another while and she also gets the penicillin shots and the fenbendazole of course. I am a bit more hopeful now as Asha seems to hang in there and I was wrong thinking she had given up already.
We are due back to the vets on Saturday. So fingers crossed that by then we'll see some improvement.
P.S. I put a tiny drop of pineapple juice in her drinking water bowl. I did find her with her head in it this morning and I think she must have drunk a bit by herself.


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## Sabine (Apr 11, 2013)

Asha at her worst:


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## Bunnylova4eva (Apr 11, 2013)

Hadn't seen the thread until now-praying for your sweet Asha. I've been through head tilt with one of my bunnies, so I know I how difficult it can be caring for them. One idea on syringing- what size syringe are you using? The vet gave me big ones (like 10 mL or something) and my bunny just wasn't taking it. I tried then filling a 1 mL syring and she took it SO much better-difference of night and day! But, the problem was that it was hard to get the Critical care into a 1 mL syringe. So, I'd fill the big one and use that to fill from the top of the 1 mL syringe (if that makes any sense..).


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## tonyshuman (Apr 11, 2013)

The poor bun. I'm glad she's eating on her own and improving. You may want to put artificial tears in her eyes, as buns with severe tilt can often get problems with their up eyes (they don't close the lid as much so the eye gets dry) and their down eyes (they are closer to the ground and can get stuff in them. It sounds like she is getting better--the tilt may not be going away, which would be really difficult and sad for her to have to deal with for the rest of her life, but it is something that can be adapted to.


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## Sabine (Apr 12, 2013)

Bunnylova4eva: Thanks for the advice with the syringe. I actually tried it last night but even the back end of my 1ml syringe is to small to syringe the food into. I am going to ask the vet for an inbetween size as I do find my syringe rather large for a 900g bunny.

tonyhuman: I actually bought those artificial tears yesterday and have used them a few times. I had the vet look at her eyes yesterday. Thankfully there are no injuries just the down eye looked a bit irritated.

Some good news: Asha is doing much better with the eating. She ate most of the fresh food I left in the gcage overnight and a good bit of hay. I even put a few pellets in front of her nose and she ate those too. I just went into the garden for some dandelions and she is munching them at the moment. I think I will still syringe her a small bit as her weight is still only 850g and I am not sure how much she is drinking.
I'll be giving her the fenbendazole and the baytril injection in a minute too.
Her actual condition hasn't improved much but she appears stronger and more alert. I do hope we'll see some improvement soon.


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## tonyshuman (Apr 12, 2013)

So good to hear! Cmon Asha, keep eating!


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## holtzchick (Apr 12, 2013)

Hoping for a speedy recovery!! Poor girl has been through a lot!


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## HEM (Apr 12, 2013)

That is good news!!!
We are hoping that Asha continues to improve every day.
We will be thinking of you and Asha


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## Sabine (Apr 13, 2013)

Thanks everyone. We are just back from the vet's. My vet thinks that she has improved slightly when she examined her but I can't really see it. The good thing is that she is eating herself for the most part and her poops look normal. She weed on me several times yesterday so I think there is enough water going through her system. I did syringe her once this morning as her weight was slightly down again but will watch her food intake over the day.
We will keep injecting the baytril and giving the fenbendazole. Our next appointment is scheduled for next Wednesday. I hope by then I can see some more improvement.


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## Bunnylova4eva (Apr 14, 2013)

So glad to hear she is doing somehwat better! I have a special place in my heart for head tilt bunnies; today marks 2 years since I lost mine. :'(


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## Sabine (Apr 14, 2013)

Asha spends a lot of time just lying on her side motionless but does move around occasionally to get some food:



I hate seeing her like this and hope she'll be able to regain some quality of life back.
Here are some pictures from last Autumn:



And Asha with her friends Lint and Snickers:


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## Sabine (Apr 16, 2013)

It has been over two weeks now of treatment and there is absolutely no sign of improvement. The tilt is as bad as ever and she is hardly able to move around. In fact, she tends to lie in the same spot for most of the day. She does eat small amounts and I am still syringing her food to keep her weight up but I am really beginning to loose hope. Should there not be some sign of improvement after two weeks on baytril, penicillin and fenbendazole? Or is it the amount of medication that makes her so lethargic and unresponsive?
I know it can take a long time for head tilt to be cured but should the rabbit not show some signs of alertness after over two weeks?


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## tonyshuman (Apr 16, 2013)

If the dosing is right, the meds shouldn't make her lethargic/out of it. You may want to ask the vet to be sure the doses are right, and that they're correctly determining her body composition. I read this recently about bunnies being assumed to be overweight due to their breed, and the vets subsequently overdosing them with fat-soluble medicine. Fatty tissue often serves as a storage site for medicines--most drugs go into fatty tissue and don't come out as rapidly as they would for tissue that is more heavily supplied with blood. Some vets will see a round little nethie and assume that the bun is obese, having a lot of fatty tissue, when in fact the bunny is normal for the breed and it is not fat that makes them that shape. They subsequently change the dose to be higher to account for partitioning of the drug into the fat. If you think the meds are making her lethargic, for instance if she seems better right before you give her a dose, it's worth asking the vet. Overdoses of Baytril and penicillin seem to be first GI-related, then increased CNS activity, i.e. seizures, tremor, etc, instead of lethargy, from what I have read. Fenbendazole could cause depression like you note, but it is very hard to overdose (high doses are tolerated).
http://www.medirabbit.com/Safe_medication/Body_shape/Type_rabbit_en.htm

I would think that you would see at least some improvement in 2 weeks if there was going to be improvement. Some bunnies that get a head tilt will become cured of the infection/parasite that caused the initial injury to the inner ear, but will not resume a head upright position because the damage to the inner ear could not be repaired. Depending on the severity of the infection and how long it takes to get it under control, the tilt can become permanent. I don't know if you remember JadeIcing and her bunnies Ringo and Gabriel. They both had ear infections that didn't get treated thoroughly enough in time, and subsequently had permanent head tilts. They weren't as bad off as Asha is, though.


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## Sabine (Apr 17, 2013)

I seem to remember that my vet calculated the dosage just by weighing her. She just had a conversion chart then to calculate the dosage. I don't think body fat came into it.
Asha is off the baytril now as 2 weeks seems to be the maximum recommended dosage. She is just getting the penicillin a injections and the fenbendazole. She is eating by herself, even pellets but I still syringe her a bit to get some extra probiotics into her. Her weight is still rather low and I am wondering should I change to a different pellet like the junior/dwarf variety of the pellets she is already eating?


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## tonyshuman (Apr 17, 2013)

That may help. Would you say she's in good spirits?


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## Sabine (Apr 18, 2013)

It is hard to say. I reckon it doesn't help that she hasn't got her friends with her anymore. She is just very very quiet and lies in her cage. She does eat a decent amount for her size and this morning I didn't even find any cecals in her cage. As there were alot of other poops around and a good amount of food missing I assume she has started eating them again which is great. I still syringed her a small bit to get a few more probiotics into her. I never see her drinking from her bowl but as there is pee about I assume she must be doing it at some stage.
I am just wondering if this is as good as it gets and she'll just be a severely disabled bunny for the rest of her life? She is still rolling and can't hop. She moves by just shuffling about.


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## Azerane (Apr 18, 2013)

Aww, at least she is eating of her own will, that's a really good sign. If you're concerned about her drinking, you could always syringe some water into her mouth as well. Or measure out the amount that you give her and then re-measure it a bit later in the day.


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## tonyshuman (Apr 18, 2013)

It is good that her appetite is there. You can probably put her back with her friends if you think they'll treat her ok. I don't think whatever is going on medically can make them sick--they've probably already been exposed to it, be it EC or an ear infection bacteria. Maybe that would help her cheer up? I hate to say that I do think at this point, it's unlikely that she'll get a lot better in terms of being tilted. It seems that once the tilt has persisted this long, it usually doesn't go away. I have heard of longer-term improvements with panacur, around the time frame of 4 weeks or so, but not much longer. Does your vet have access to ponazuril? You might consider trying one of the less commonly used treatments for EC, like pyrimethamine.
http://www.medirabbit.com/EN/Neurology/cuniculi/pyrimethamine.htm
http://www.medirabbit.com/EN/Neurology/Signs/Cuniculi_signs.html
http://www.medirabbit.com/EN/Neurology/cuniculi/Starsky.htm

I am still not sure EC is the culprit here, since she had the horizontal nystagmus, which usually indicates an inner ear infection instead of EC-related head tilt. However, if everything else (ie the long-term tilt that didn't respond to aggressive antibiotic treatment) points to EC instead of an ear infection, maybe the nystagmus was just a red herring. The only other antibiotic that might help would be chloramphenicol, which has good blood-brain bioavailability.
http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm


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## adamjai (Apr 18, 2013)

I have a head tilt bunny who gets around and seems very happy. She's had a couple of rough patches that Panacur has helped her through, and I nearly lost her a couple of years ago but with a lot of syringe feeding was able to get weight on her and she pulled through. I would definitely put her with her bond mates, som rabbits can get very depressed when split up. I've heard of bond mates cuddling and propping up head tilt bunnies before.


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## LoisBunnies (Apr 19, 2013)

Hey, just wanted to give you some hope! My Poppy had what looks to be a similar degree of head tilt (I haven't read the whole thread though) I will attach a picture of her so you can decide for yourself. She was like that for three weeks, and didn't actually stand upright for two weeks. Over the space of about 8 weeks in total, her neck did straighten. She passed away in November, but I really don't know if it was head tilt or something else - what I do know is that we had six months of happy, healthy bunny  We got there with painkillers, antibiotics, panacur, pellets dissolved in water with added baby food syringe fed, and lots of water by syringe.


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## Sabine (Apr 19, 2013)

Thank you everyone for your replies and encouragement.
tonyshuman: I have another vet appointment tomorrow and will mention the meds you listed to her. I was thinking about the nystagmus. It did appear horizontal to me when I tried to remember it but as her head was totally tilted maybe it was vertical and I just remembered it wrongly.
I am preparing a cage that should suit Asha and her friend Lint. I am hoping to try moving her in during the weekend.
Loisbunnies: Aww poor Poppy. She does look as bad as Asha in the picture. That's encouraging to hear that there may still be hope.
Today Asha seemed quite lively at times and almost stood up a few times. unfortunately her bursts of energy resulted in a lot of rolling around as well and that was a bit scary to watch. having said that there are times when I really think the neurological damage may be irreversible. Whenever I syringe feed her (which I am keeping to a minimum now since she is eating) ahe lies on her side or back afterwards and often there are tremors going through her body. The shaking can last for several minutes. I tried to capture it on camera but my husband was moving the camera a lot while filming so I am not sure if i it is that visible.



She also seems to be unable to control her bladder. I have been peed on about 5 times during the last week and that never used to happen. I wonder is that also a sign for something else going wrong?


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## LoisBunnies (Apr 19, 2013)

Try cutting leg holes in an old towel, popping her legs though whilst she is on her side and holding her upright with her feet on the ground. I did this a few times with Poppy and (once she got used to it) she seemed to enjoy being able to walk with support. Poppy did pee on me A LOT despite being speyed (she had never peed on me before) - I think it is because it takes them so long to go anywhere, they can't get away from you to go pee. Might be worth mentioning to the vet though. 
I found massaging her shoulderblades gently helped - I was scared to touch her neck as I was convinced it would hurt, but right down between her shoulderblades was tense and I found applying gentle pressure with two fingers actually made her push back into my fingers, as though it was easing the pressure in her neck. 
Also another thing which I found difficult was her eyes. Is her "down" eye alright? Poppy got a horribly sticky eye as apparently it can stop them being able to blink properly, plus as it is constantly runnging on blankets ETC it can get a bit dry and yucky. 
The shaking is exactly what we had with Poppy. We were sure it was neurological, however my vet explained that it is like being really drunk and the room is spinning, so they are spinning to attempt to correct their tilted head but get really confused and can't work out what way is "up" the spinning is hugely exhausing for them, so it does take quite some time to get their energy levels up. I found that she could eat baby food by herself and this is quite high in calories, so it was good for building her back up. She lost a significant amount of weight (i'd say, honestly, about 50%) however put it all back on after her recovery.
I really was very close to getting her put to sleep about three weeks in. I couldn't see how she could ever recover from such a severe illness. Shorly after that, she just turned a corner and improved quite quickly. Gentle playtime with her bunny friend did help, but I had to put her in the "sling" as the first few times I tried, she spun really badly as she tried to get to her friend. A little gentle competition for food was also good at encouraging her to eat


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## Sabine (Apr 19, 2013)

I am watching the down eye and I am putting some lubrication on. So far it looks only a bit red but nothing oozing out. I have ointment for that though if it does. I will try the sling tomorrow. That sounds like a great idea. Thank you, LoisBunnies, this is really giving me new hope as I we have been discussing putting her to sleep but whenever I seem to make up my mind she does something that makes me think she is going to fight this.
I am going to get up early tomorrow morning to syringe feed her as her poops appear smaller today. It's like having a baby again!


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## Sabine (Apr 20, 2013)

Unfortunately rebonding Asha to her former friend did not work out. Lint attacked her within seconds and I couldn't leave Asha there to fight it out. I may look for a gentler companion for her when she is better. I think she had been bullied a bit by Lint and Snickers in the few weeks before she got sick. I wonder if the stress contributed to her getting ill. it is such a shame as she had been with Lint since she came to us at 10 weeks. When we added Snickers last Autumn things seemed to be going well but it did became obvious that Lint and Snickers became much closer and Asha was left out in the cold a bit.


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## LoisBunnies (Apr 21, 2013)

Oh dear  MY vet DID say to be very careful about putting my two back together - she basically said that my other rabbit would probably bully Poppy and they may never have been okay to live together again - knowing my two rabbits, I knew this would NOT be the case, and sure enough, Poppy went back to being the "dominant" rabbit despite her wonky head. There is a really good website - i'm sure its called "onthewonk" which gives LOADS of hope for head tilt bunnies - I would read it a lot when Poppy was ill!

Are you still giving her Panacur? If so, Pets at Home/Amazon sell it, and it is a lot cheaper than through your vet (well, it was cheaper than my vet anyway. My vet is very reasonable as well!)

Out of interest, what has been your total outlay for treating head tilt? I don't know if I got a good deal or not!


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## Sabine (Apr 21, 2013)

I think it didn't help that Asha was the one at the bottom of the pecking order in the trio. Lint and Snickers are back together again after also being separated for two weeks due to Snicker's nose injury.
I must have a look at the website you mentioned as I can do with encouragement.
Asha is still on fenbendazole. I saw little tubes of panacur paste advertised on some websites but found them incredibly expensive. I must have a look on Amazon. It never occured to me to look there. The one I am using now is called Lapizole. There are 100ml in the bottle and the dosage is 1ml per 1kg. So I get 100 doses out of it for a Netherland dwarf. The bottle is about &#8364;20 a bit dearer than the sheep wormer I used in the past but as this one is especially formulated for rabbits I thought it may be worth the extra.
I haven't got the bill for the last few injections of baytril and penicillin yet and have somewhat lost count as I paid for a neuter, a stitched up nose, teeth clipping, a rabbit being treated for pasteurella and a few of Asha's initial shots about 2 weeks ago. It came to &#8364;145 which I thought was reasonable all included.
We have done most of the recent baytril injections ourselves and my vet is even reusing the syringes (not the needles) to keep costs down. I think I owe for two bottles of Lapizole (as I am going to treat everybun), two packs of critical care and two weeks of penicillin and baytril injections. I did have a rabbits teeth clipped in between but that wasn't even put on the bill the last time. Basically I have no idea how much else there is to pay but hope it is going to be under &#8364;100.
I have stopped syringe feeding Asha now as she is eating quite a bit by herself I weight seems to be stable at the moment but I do weigh her every day just in case. The tilt hasn't greatly improved but she appears a bit more alert. We are due back to at the vet's on Wednesday. She will have received about 3 weeks of treatment by then


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## LoisBunnies (Apr 21, 2013)

Yeah, I would imagine that made a difference. Jerry is the most laid back bunny in the whole world, so he just chin-rubbed Poppy once and then flopped down beside her and that was it! He would befriend a shoe if he could, haha.

Here is a link to Amazon UK, where I am ordering my next load from (just for a routine dose) http://www.amazon.co.uk/dp/B004IA4CWU/?tag=skimlinks_replacement-20 - £4.30 is pretty good IMO, I pay about £8 from the vets and you only pay 1x postage and packaging no matter how much you buy  I have never used anything other than Panacur as they don't take strange food too well ...
Yeah, cost wise that is about what I was too. Initial appointment including two days board was £75, when she was given lots of IV stuff and syringe fed for the entire time. After that I was maybe £10-£15 per week for about 6 weeks, which was really only covering meds. It was really stressful as we had JUST moved house and hadn't even thought about vets yet (stupid, I know) so had to find one quickly! We struck gold with them though, they have been brilliant with all three rabbits, plus our other pets. 

It's really good you have her off the syringe! Poppy really improved once she started eating and got her strength back up. It is such a horrid illness


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## tonyshuman (Apr 22, 2013)

It's too bad Asha's buddies didn't take her back. It would have been a good comfort for her. It is encouraging to see that Poppy made a recovery from a similarly bad case. Asha's increased alertness is a good sign and may indicate that she is improving, just the tilt isn't going away. Urinary tract issues are usually one of the first signs of EC, as it attacks the kidneys and its spores are shed through the urine, so issues of that sort are not unexpected. She may also have gotten a UTI, however, or damage to her kidneys, but as long as the dosing of her meds is correct her kidneys should be ok. She isn't on metacam, right? It can be bad for the kidneys and shouldn't be given long-term.


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## Sabine (Apr 25, 2013)

She got some metacam injections initially and I gave her drops once or twice so I don't think that would have casued much harm. She hasn't weed on me lately but I guess i also haven't been taking her out as much to syringe feed her. maybe it is just lack of opportunity.
I still haven't reintroduced a litter tray as she still rolls quite badly and the litter gets kicked all over the place. i would also be worried about the down eye getting irritated. Right now she is on thick towels with a fleece blanket as the top layer.
She certainly eats with great appetite. The weight has balanced out at 850 g which is probably a good weight for her as I thought she had become a bit overweight at 900g+. She is really tiny and I remember around 800g was her young adult weight.
She is now getting penicillin every 5 days and she has another 10 or so of fenbendazole. The vet suggested to evaluate the situation at around 6 weeks into treatment. I do hope that by then there'll be some marked improvement.


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## tmaddox9 (Apr 28, 2013)

I work with head tilt bunnies in rescue. I attended a vet seminar on e. cuniculi today as a matter of fact. Most bunnies with head tilt that I have dealt with were the result of e. cuniculi. I would definitely look into the Panacur. If it is e.c. and you wait too long, it damages the vestibular nuclei in the brain and the tilt will be permanent. The anti-vertigo or sea sick medicine is called meclizine (generic name) and its very cheap. It can help if your bunny is rolling or spinning. We don't know if rabbits feel nauseated becase they are unable to vomit but Im guessing they do and the Meclizine will control that. Metacam will help with both pain and reduce inflammation. As for nystagmus, it is true horizontal often indicates ear infection and vertical will indicate neurological but that isn't always true. The e.c. Bunny I'm working with now has horizontal nystagmus. Neck massage and balance therapy are helpful too. You can add 100% canned pumpkin to the critical care food to entice bunny to eat. It is also very high in fibre so it will help keep things moving through the digestive systems. Buns love the stuff. Just make sure you get 100% pumpkin and not pie filling! If the bunny can not reach its cecatropes you may need to hand feed those as well, otherwise the bunny will not be absorbing nutrients from its food. Hydration is very important so if the bunny isn't drinking due to the tilt and you can't syringe enough then you may need administer sub cutaneous fluids. Also give Metacam with food as it will upset an empty stomach and can cause ulcers. Take care of the downward eye. It can become damaged or lacerated and will result in infection. I would put an opthamalic ointment in it keep it moist and protected. Encourage your bunny to eat with its favorite greens and give them to the bunny very wet. That's another way to increase hydration.


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## Sabine (Apr 29, 2013)

I am hoping Asha is on the road to recovery at this stage. The eating is not an issue anymore as i find her munching most of the time. The downward eye does look a bit read and I am treating it with ointment just in case.
Asha does spent some time now holding her body up although the head is still about 90 degrees tilted. I have started hanging some of the food a bit higher so that she is forced to reach up as the interest in food is there now.
I am also considering to reintroduce a toilet tray again soon so that she doesn't end up lying on wet patches too much. She still has another week of fenbendazole to go and she is getting her penicillin injections at 5 day intervals now. This is 4 weeks into the treatment now and there are definitely improvements although it's a slow process.


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## Sabine (Apr 29, 2013)

I meant to add: Last night I saw Asha for the first time playing again by chucking a plastic flower pot about. i am also able now to gently easy Asha's head straight when I have her relaxed on her back.


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## JBun (Apr 29, 2013)

Sweet little Asha  That's probably nice for her to be able to rest those neck muscles, being on her back. Does she seem calm when you do it? That's good that she is feeling well enough to want to play a little bit, and really good that she is eating on her own. Both very encouraging signs of improvement.


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## Sabine (May 11, 2013)

Asha's tilt is very strong still but her condition is stable. I am using Toltrazuril (also sold as Cevazuril or Baycox in Europe) for a few days.
Does anyone have experience with this drug? It is usually used for the treatment of coccidiosis.


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## Bigwig67 (May 22, 2013)

Hope Asha is getting better.


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## Bunnylova4eva (May 25, 2013)

How's Asha doing? Any better?


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## Sabine (Jun 12, 2013)

I am sorry I never saw the last post. i somehow don't get notifications on this thread.
Asha had improved to a point and we have had a few set backs since. The tilt is very bad still but she is able to hop about and her appetite is great.
Unfortunately she is not using the litter tray anymore which is a bit of a set back. We'll just have to wait and see and see at this stage.


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## bluecherry28 (Jun 14, 2013)

Hey Sabine, never knew such a wee bunny to battle the way Asha has and i know she will appreciate all the wonderful care you have been providing for her! Really hope she is still improving, i know it changes day to day but just give her a huge nose rub from me :happyrabbit:xx


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## Sabine (Jun 17, 2013)

Will do! Thanks Liz:sunshine:


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