# Chalk has head tilt :(



## mr_mouse_chalk (Aug 11, 2010)

Hi all,

long time since I've posted here - normally leave it to Jen, but she's in hospital tonight unfortunately (she had Gall Stones flare up over the weekend so had to have her Gall Bladder removed today)... she's on the mend fortunately and hopefully home tomorrow.

The worse news at the moment is that our little baby Chalk has developed head tilt. 
I came home yesterday and she was being very strange - hiding in the corner of her cage, trying not to move. Then when she did she went outside and just scrunched herself up in the corner of a pen, and didn't seem to notice when it started raining on her.

I brought her in and could tell she wasn't right straight away - she seemed to be dragging one of her back legs. Took her to the overnight vets and they gave her some metacam and thought it was just a bit of pain....

This morning she was worse. She tried to clean herself and fell over sideways as she stood on her back legs to do it. She could barely move without stumbling into things. Took her straight to the vets who could see 'flickering' reactions in her left eye and her head was slightly tilted. They admitted her straight away and took some blood tests - but have started treatment whilst waiting for the results.
She's on a long course of Panacur and also Antibiotics - I believe she's currently on Baytrill.

I've read lots of horror stories about Head Tilt - but don't really have any idea how bad this is going to be. The vet seemed to think it being caught early (two nights ago she was absolutely fine!) is a good thing.

Any thoughts?

Are there particular antibiotics that are effective here that I should be pushing the vets for?

Any help appreciated - out of my mind with worry between Jen and Chalk...

Steve


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## ra7751 (Aug 12, 2010)

I would say that I would attempt to get a more aggressive treatment from your vet. Baytril is rarely effective these days. And Panacur, while not harmful, is from the long held and very incorrect notion that E Cuniculi causes head tilt....it doesn't. And if it did, Panacur is not very effective since it can't penetrate the blood/brain barrier. Ponazuril can penetrate the blood/brain barrier and is the drug of choice if EC is involved. Most head tilt is caused by either obvious trauma or by an inner and/or middle ear infection. The correct method is to culture the "down" ear and see if a bacteria grows. Since we know what usuallyis usually found in vestibular infections, I use either a combination of Penicillin (safe only as an injectable) and Zithromax OR Convenia (again, safe only as an injectable). While EC can always be involved, tilt is not a primary presentation of this affliction. EC compromises the immune system and allows opportunistic bacteria to make an appearance. Since the ears are the easiest infection point, you get tilt. The worst infection is in the "down" ear. The infection may not be visible by eye.

Randy


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## DeniseJP (Aug 12, 2010)

Prayers for Jen and Chalk... had my gallbladder out in January 2009 so I feel her pain...

Denise


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## pla725 (Aug 12, 2010)

Had my gallbladder out many years ago. Just take it easy.

Ruby, my Dutch girl, has head tilt and she gets along fine. Hers was from an ear infection. It was treated but redeveloped. She seems to be less tilted in the past week.


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## AngelnSnuffy (Aug 13, 2010)

Well wishes to Jen, hope she heals soon.

Steve, I'm sorry to hear this news, but like Randy said, it is very treatable. I would encourage your vet to treat along Randy's recommendations. I hope Chalk improves soon. You're a great bun dad for posting for Jen! Give Chalk some head rubs from me.

Keep us posted.


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## Little Bay Poo (Aug 13, 2010)

I remember when Ronnie came down with head tilt and I thought it was a death sentence. I assure you though, it is very treatable. He is still going strong and has been clear from infection for almost two years. As Randy says, I would look into a stronger antibiotic such as Penicillin. Also, be prepared to mix something like Critical Care if Chalk stops eating. If I remember correctly, we were force feeding Ronnie for a good month because he was not eating on his own.

I hope Jen is feeling better from her surgery. What a horrible time to get news of heat tilt. My thoughts are with you, Jen and Chalk. Please keep us updated with any progress :hug:


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## tonyshuman (Aug 13, 2010)

I have to agree with Randy and Robin. Panacur isn't going to help if it's actually E cuniculi, and a good way to get an idea of if the tilt is from EC is to look at the eye movements--if they're side to side, the tilt is probably caused by an ear infection. If they're up and down, it could be from EC. Usually tilt is from ear infections and a strong antibiotic is needed--Baytril has its uses, like low-grade respiratory infections, some UTIs, etc, but it's really not going to work fast enough in an ear infection. With an ear infection you have to treat it quickly to prevent permanent damage to the vestibular system in the ear--if you don't treat fast enough, the tilt will become permanent.

I know bicillin (combination of penicillin G procaine and benzathine) isn't available in the UK, but what about Convenia? It's an injectible but it only has to be given every 5 days in rabbits, and it is a more aggressive antibiotic. If I remember right, Flashy's Tilly had tilt and got Convenia and it helped...

Here's a really informative sheet on tilt:
http://www.medirabbit.com/EN/Neurology/otitis_interna_media.PDF

I hope Jen feels better soon, and Chalk too!


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## mr_mouse_chalk (Aug 13, 2010)

Hi Everyone,

Thanks so much for the responses - Jen is home from hospital, but very sore now so not up to much typing yet.

Chalk is a different story. Having spoken to the vets the last couple of days they've been advising that she's improving, she is eating by herself (although initially they were having to syringe feed critical care)... but she isn't yet pooping so they're keeping her in at least until she does.

Blood test results don't indicate any renal problems or any other issues - but the EC specific tests aren't back yet... The vets seemed to be of the opinion that Chalk was a lot 'brighter' than when I dropped her off there on Wednesday.... 

All this said I visited earlier and Chalk is a long way from better. Her head is a lot more noticeably tilted than it was on Wednesday and although I saw her eating she clearly was still struggling for balance and was not the lively bunny I'm used to. Realise she is early into her recovery, but I'm worried that perhaps she's not as on the mend as they think she is.
Whilst I was holding her she got very confused and somehow flipped herself onto her back in my arms...

She's currently getting Panacur Paste, Baytrill (injectable), Vetagesic and Zantac at the vets... and so far they haven't done a culture from her ears which I am obviously going to push them to do.

I need some ammunition for when the vet calls me tomorrow:

1) Should they run a culture on the ear even if no signs of discharge/infection? (if they do how long does it typically take to get results?)

2) I suspect from everything I've read on this thread and elsewhere that she needs to be on penicillin. Because this isn't licensed for Rabbits in the UK the vet is going to need quite a bit of convincing. Does anyone have any links to published articles about the use of penicillin in bunnies being safe & effective for this sort of case?

3) As she's already on Baytrill would it be bad for her to switch before completing a decent length course?

Sorry for all the questions - just really keen to have something really bulletproof to put to the vet tomorrow when he calls me.

Steve


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## Pipp (Aug 13, 2010)

I doubt you'll win the penicillin battle. I don't think they can legally give it to her. 

You may be able to convince them to combine the Baytril injectable with an oral antibiotic, though. Zithromax seems to work very well. My vet uses Chloramphenicol.

There should be some good Convenia anecdotal evidence on the board (if it's administered every 8 days and not 14 like in dogs and cats) but they're I think mostly be from lay people and not Vet info. Its still new and it's not at this point recommended for rabbits.

Has she been on Baytril before? It's not totally useless, resistance depends on the rabbit and the area. 

PS: The vet will probably want to do the full seven day course of the injectable Baytril, but hopefully will be willing to combine it with the oral before then.


sas :clover:


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## mr_mouse_chalk (Aug 13, 2010)

Hi Sas,

Thanks for replying 

I'm hoping they might let me sign a form to agree to use of non licensed drugs - they used to do this for Metacam before it went licensed here a few years ago... but I'm with you that the battle may not be one I can win.

Will have a scout through the forum posts this evening.

She's had a lot of Baytril in the past when she had peritonitis (along with Ceptrin) and also when her absesses came back a year or so later. So she's had it in reasonable quantity. Does repeat usage make it less effective?

Steve


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## Pipp (Aug 13, 2010)

Yes, if she's had a lot of it, she could have built up a resistance. 

I honestly think you're best bet is going to be Zithromax. If the vet needs convincing, there should be a lot of newer data confirming its effectiveness in head tilt/ear infections. 

It works on a lot of different bacteria, I don't know that I'd bother with a culture first, just start her on it along with the Baytril and see how she is in three days, which could be how long it would take to get the culture anyway.

Hopefully the vet will agree. 


sas :clover:


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## Pipp (Aug 13, 2010)

Here's a few references to it being safe... 


http://en.allexperts.com/q/Rabbits-703/2009/1/Rabbit-eating-8.htm

http://www.onthewonk.com/?p=4.What+...trk=menu:What Treatment Should My Rabbit Have


A rabbitrehome.org post:

------------
www.onthewonk.co.uk 

they are fantastic and will give you ll the help you need! Katy who runs it saved my bunny when i didn't kno were to turn. My bunny had severe headtilt and i had tried all kinds of meds.Katy put me on to zithropmax and withing 2 days my bunny showed drastic improvements. 
My vets don't know too much either but are always happy to listen and take on what info i tell them. My vet was amazed by zithromax and now stocks it! __________________

I'm really sorry that I've missed your recent threads about your poorly bunny






I thought I'd share our story of our headtilt bun Wilson. He became very poorly last April with headtilt - which we didn't find the exact cause of



However, very long story short - we had Wilson on all sorts of different meds.

To start off with he was just on baytril (antibiotics), panacur & metacam - this was when his head was only slightly tilted. He then got progressively worse & his tilt changed sides - it was so bad his down eye was almost horizontal to the floor. We then changed him to steroid injections, depocillin injections & panacur - again sadly these did nothing for him.

He was having severe rolling episodes & we had to confine him to a padded cage for around 6 weeks. Eventually after bunny mad lisa on RU suggested it - we talked to our vet about Zithromax - it's an antibiotic that is used for humans & not licensed for rabbits, but Lisa had, had great results with it her for her headtilt bunny - so we felt we had no options left but to try it.

We switched him onto Zithromax & also started him on stemetil (human anti sickness drug) - continued with his panacur & I *think* his steroid injections. After just over a week of this treatment he was well enough to come out of his cage & go back with his partner Alice. We'd kept them in the same room at all times, but had to confine Wilson to a cage so he didn't hurt himself or Alice.

I have been told & read that the best way to deal with headtilt is to treat with as much strength of medication as possible - I think basically to try to beat the infection before it gets worse.

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## mouse_chalk (Aug 14, 2010)

Hi guys,
I'm sorry I haven't posted on this sooner- it's been a case of not being able to use my laptop too much and the time have been online I've been searching for information. 

We printed out the links posted here and a few other pages- I even got the name of the vet and practice mentioned on onthewonk.com who had used penicillin injections and zithromax and we took them to the vet on duty today (not the vet who's been treating her all week). Long story short he seemed very disinterested in what we said, still seemed to thi k that chalk is doing well despite her tilt looking worse- I'd say it's at 2 o-clock today  

We went


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## mouse_chalk (Aug 14, 2010)

To see a friend of ours who works at the pet store and has a verygood vet. That practice is closed today, as is a local 'expert place' in bristol but she called him at home and he reccommended a place about an hour away that is a referral place which specialises in exotics. Called great western referrals. We called them and have an appointment at 3.30pm (2pm here currently) so steve is getting chalk discharged now. We really didn't want to upset our vets as we've used them for a long time but given a choice between that and getting chalk the treatment she needs it's a no brainer. We're worried about the journey down the motorway but it's not too bumpy and we just feel this is time-crucial and chalk needs us to fight for her in anyway we can. We could not live with ourselves if she didn't recover and we knew that there might have been a way to help her. I've read of this place on rabbits united in the past, struggling on my iPhone hence the stilted replies and typing!

We


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## mouse_chalk (Aug 14, 2010)

The reply box keeps filling up and I have to press send so sorry for all the half finished posts! I was trying to say that I'm googling them on my iPhone but it's tricky. Car rides are also very painful for me right now but I'm not so bothered about that, chalk is more important. 

I'll post an update as soon as I have one. Thank you so much for all the advice and well wishes. 

Jen and steve xx


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## Nancy McClelland (Aug 14, 2010)

ray:


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## Luvr of Wabbits and Polar Bears (Aug 14, 2010)

Jen how did the vet trip go?


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## mr_mouse_chalk (Aug 14, 2010)

Hi everyone,

Sorry to be replying on Jen's behalf - but she's had to go back into hospital this evening, she was in severe pain on the way back from dropping Chalk off at the (new) vets. She's doing ok - but because she needs some strong pain relief they're keeping her in overnight to keep an eye on her.

Chalk is now in the care of 'Great Western Exotics' in Swindon - around 50 minutes drive from us. The vet we saw there was incredibly knowledgeable and much less close minded than our usual vets have been. She talked of using injectible penicillin and other stronger (than Baytril) antibiotics.

For the time being she has catheterised Chalk to get a decent flow of fluids into her (she's not been drinking enough), and she's continuing the syringe feeding to try and get her guts moving. Despite her eating the last couple of days there were no gut sounds when the vet listened to her.

The plan is to do a full head x-ray on Monday under sedation to attempt to see any damage or fluids in the ear, she also mentioned potentially doing an MRI scan if needed.

For the time being she isn't changing Chalk's medication drastically - she's going to use the maximum safe dosage of Baytril, along with continuing the 28 day course of panacur. She's on Zantac for her guts.
BUT - the big improvement here is that this vet is happy to consider stronger antibiotics in the event that the x-ray confirms ear infections, or if Chalk is still not seeming to respond to Baytril.

In herself Chalk was more lively today digging at a towel in the vets and moving around a lot more in the carrier during her longest ever car journey. She also made it very difficult for the vet to check her teeth during her initial exam. She was still a billion miles from our usual cheeky Chalk, but she did seem to have more fight about her today than yesterday.

The vet we are seeing has quite a write up on the practices website:

"Elisabetta Mancinelli

We are very proud at GWR to have the first ever European College of Zoological Medicine. Resident in Small Mammal Medicine, and in particular we are delighted that this post is supported by the Rabbit Welfare Fund.

As part of her residency, Elisabetta Mancinelli has spent a several months in Italy with small mammal Specialist Dr Vittorio Capelli, followed by a period at Utrecht University under Dr Nico Schoemaker (better known as lead researcher on ferret adrenal disease), followed by 9 months with Dr Anna Meredith at, Edinburgh University. She will spend the remainder of her residency (3 years) here at GWR with Neil Forbes, who leads the European
College of Zoological Medicine.

For Elisabetta this is a "dream come true"; she is looking forward to working with Specialists in different countries and we are looking forward to her spending time in Swindon, helping us to further develop our rabbit and small mammal expertise!"

All in all both Jen and I are more confident she's in good hands. Just waiting for a call in the morning to see how she's doing,

Steve


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## Sabine (Aug 14, 2010)

I am so sorry about poor Chalk (and Jen) Hope you both feel better soon. xx


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## BethM (Aug 14, 2010)

ray:


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## Pet_Bunny (Aug 14, 2010)

We are praying Chalk can pull through with the extreme measures and efforts you are doing for her. Glad you are taking comfort that you have confidence in the new doctor who is handling Chalk. Hope Jen feels better.

ray:ray:ray:


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## mr_mouse_chalk (Aug 15, 2010)

Quick update:

Jen still in a bit of pain so staying in Hospital at least another night.

Chalk much the same as yesterday, she's in a bigger cage so they've put some padding in to make sure she doesn't hurt herself if she stumbles. Slight gut movements - she produced 3 soft faeces while the vet examined her this morning, and has peed for first time in days.
All being well X-Rays tomorrow to see whats going on in her head.

Thanks for the continued support,

Steve


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## JadeIcing (Aug 15, 2010)

Pillow cases with towels rolled up work great as bumpers.


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## LuvaBun (Aug 15, 2010)

Sending positive thoughts for both Chalk and Jen ray:

You're doing a great job, Steve. Hang in there!

Jan


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## SnowyShiloh (Aug 16, 2010)

Oh I really hope Chalkie will be okay!!


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## AngelnSnuffy (Aug 16, 2010)

Get well very soon both of you! Thinking of you guys.


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## mr_mouse_chalk (Aug 16, 2010)

Chalk update for Monday Morning:

She's managed to pull her catheter out overnight which is much more like the feisty chalk we know! She's passing some small/dry faeces which is an improvement and the vet says that she's starting to have some decent guy movement sounds. So hopefully the gut stasis is now under control.

The test our old vet sent for E-Cunniculi came back marked as 'insufficient sample' so is having to be re-run. Not sure if this is just bad luck or if it's further proof we were right to change her care.

She's having a series of full x-rays of the skull around now. Just waiting for a call to hear what they find.
Bit worried as she is under an anaestetic for these - but hopefully she'll continue to be the strong bunny I know and not let it effect her for long.

Mouse is very sad without her. She is still eating, but I'm worrying she's missing her too much. I mentioned this to the vet who wants me to bring Mouse in to stay with Chalk for the duration she's in hospital. Initially was sad at this idea as would have to not have Mouse at home for days, but I think it probably is the best thing for both of them to be around eachother. She might help Chalk's recovery. So will be taking Mouse over later this afternoon and hopefully see Chalk first-hand.

The other bit of possibly good news is that the flickering in her eye seems to have stopped today. The vet said this isn't necessarily a good sign of anything, but that she thinks it may mean chalk is feeling a bit more balanced..


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## mr_mouse_chalk (Aug 16, 2010)

She's had the x-ray and they've found no sign of an inner/middle ear infection.

The anesthetic has caused her head tilt to worsen as she came around - but the vet believes from experience this will be temporary.

They are continuing her treatment with a view to her hopefully being comfortable enough to come home later this week. Hope that is how it goes.


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## JadeIcing (Aug 16, 2010)

Is there any possible way she injured herself?


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## mr_mouse_chalk (Aug 16, 2010)

It's possible - but didn't see any sign of it.
When she was first 'off' we thought it was her leg as she was stumbling, but the other neurological symptoms followed pretty quickly...


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## naturestee (Aug 16, 2010)

Did she have a CBC?

*hugs*


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## JimD (Aug 16, 2010)

ray:

We'll keep you all in our thoughts and prayers.


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## mr_mouse_chalk (Aug 16, 2010)

naturestee wrote:


> Did she have a CBC?
> 
> *hugs*



Yep she's had full blood tests - all came back normal, no sign of problems. Tests were done last Wednesday - are being re-run today, hopefully fresh results tomorrow.


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## pumpkinandwhiskersmom (Aug 17, 2010)

Send healing thoughts your way!


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## mr_mouse_chalk (Aug 17, 2010)

Tuesday update:

Jen is still in hospital - she's having a pretty horrible time waiting for them to do something... but hopefully she'll be home with me soon.

Mouse has been really sad last few days, so today I drove her the hour or so down the motorway to take her to be with Chalk. The vet thought this would be good for both of them. I was a little worried that Mouse thought Chalk had gone forever, she sat on the mat in our living room last night and just stared at me all night. Probably sounds mad but she looked so sad.

I was a little worried after so long apart the reunion might not go to plan - but the worry was unfounded. 

I had a quick 10 mins with Chalk - she seems to be doing well compared to last week. Obviously head still tilted but she's doing better at managing with it.

Mouse was really happy to see her - as soon I let her out of the carrier she got straight into the other carrier with Chalk, and lay down next to her sister. Made me feel a bit better about the world.







Thanks for all the continued well wishes and support.


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## hartleybun (Aug 17, 2010)

:bunnyhug:what good news! that is such a touching photo too.

love to you all and continued good wishes being sent up the M5


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## SnowyShiloh (Aug 17, 2010)

That's such a sweet but sad picture of them together! I'm glad Mouse was able to go visit her sister. Sorry to hear Jen is still in the hospital  What a rough week for your family!


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## LuvaBun (Aug 17, 2010)

Lovely photo. I think Mouse being with Chalk will help her a lot 

Hugs to all of you!

JAN


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## pumpkinandwhiskersmom (Aug 17, 2010)

Poor sweet Chalk! It's great that Mouse is there to comfort her. Hope Jen is on the road to recovery real soon!


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## mr_mouse_chalk (Aug 19, 2010)

Chalk has been doing a lot better last couple of days.
The gut stasis is now a thing of the past and she's eating almost normally and drinking a fair amount of water. Everything is passing through normally again.

She still has the headtilt and is struggling at times not to roll with it - but she is doing better in herself.

Blood test results (re-test) came back normal, so she can come home this evening.

Just need to do some brutal cage restructuring and padding. Will be so nice to have them both back where they belong. 

She needs meds 3 times a day which will be fun with Chalk, but I am lucky that I can work from home and be there to look after her for the next week or so.

Am I expecting too much to hope to see some improvement in her head tilt so soon? I know it can take weeks, and sometimes doesn't get better... but what are people on here's experiences?


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## Little Bay Poo (Aug 19, 2010)

So glad to hear that she is feeling better and eating on her own.
*
mr_mouse_chalk wrote: *


> Am I expecting too much to hope to see some improvement in her head tilt so soon? I know it can take weeks, and sometimes doesn't get better... but what are people on here's experiences?


I'm sure experiences vary quite a bit, based on many factors. With Ronnie, it was incredibly difficult to tell if his head was getting less tilted because it happened so gradually. He's still a bit crooked today, but when I look back on pictures from his illness I can see an improvement. 

When we got into this, I imagined that Ronnie's head would straighten itself out and that's how we'd know he was better. Not the case. In fact, determining his condition was a matter of trial and error. We were instructed to take him off the meds and "see what happens." By this time, we were a few months into treatment and his rolling had stopped completely. The true sign that Ronnie was better came many weeks after we halted treatment: he started humping again 

Best of luck with Chalk, I hope her improvements come swiftly. Keep us posted.


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## tonyshuman (Aug 19, 2010)

She's still taking antibiotics, right? Is it Baytril? You should see some improvement within 3-4 days with any given antibiotic--otherwise it is best to try a different antibiotic, as the bacteria are probably resistant to the drug if no improvement is seen within 3-4 days. I'm a bit confused because you said the head x-ray showed no sign of ear infection. What is she taking now?


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## Little Bay Poo (Aug 19, 2010)

I wanted to add:

Look for rolling and mobility improvements. When Ronnie was on Pen G, his rolling episodes were practically non-existent and he ran around very well (albeit in a circular pattern). Every 7th day, Ronnie was taken off Pen G for 3 days, and we could tell a big difference. By the third day he'd be stumbling around and rolling a lot. We actually had to put him on a combo of Baytril and Pen G to bridge the gap on his off days.


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## Pet_Bunny (Aug 19, 2010)

*mr_mouse_chalk wrote: *


> Am I expecting too much to hope to see some improvement in her head tilt so soon? I know it can take weeks, and sometimes doesn't get better... but what are people on here's experiences?



Pebbles hadseveral head tilts during her life. It could easily be caused by stress in some cases. She had all sorts of medications (Baytril, choropalm, ..., and some made up after a culture test).

In all cases sheshowed improvement just over 24 hours of taking her medicine. But it would be at lease 14 dayswith medication before she had fully recovered.

Lucky for me I would catch the head tilt early and get her to the doctor as soon aspossible and that Pebbles loves to take her medicine.


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## mr_mouse_chalk (Aug 19, 2010)

Thanks for all the advice everyone  
Good to hear the different experience of recovery times.

She's home now, the car journey unsettled her a bit but she's doing well. She's eaten a reasonable amount, had a drink and done all her toilet business. Not in the litter tray - but I'll forgive her given the circumstances.

I took down the upper two stories of her and mouses cage earlier - they have a two grid high one pen with lid now. The floor is covered in soft pet beds made safe in case she stumbles.

So far so good - she's a lot brighter than she was on Tuesday and her head tilt seems noticeably better at least to me. She's not stumbled and she's doing pretty good at eating / getting around and cleaning herself.

Here's a pic 







She is on quite a lot of meds still - spread out over 4 times of day she's on:

Zantac 0.27ml twice a day
Domperidone 0.5ml three times a day
Baytril 0.34ml once daily
Stemetil 0.3ml three times per day
Panacur Liquid 1.3ml once daily
Metacam 0.45ml twice daily

All her blood tests came back clear for normal organ functions and no sign of infections.

The E-Cuniculi test will be back early next week as apparently takes a few more days.

So far so good, but I have to give her more meds in 2 hours - I feel bad doing it as it seems to unsettle her so much, but I know she needs them...


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## mr_mouse_chalk (Aug 19, 2010)

Meant to say - Jen also sends thanks for all the support on this thread.

She is still in hospital, but keeping an eye on the forum from her iphone. But she can't post from it for some reason.


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## ra7751 (Aug 19, 2010)

Certainly a very interesting and very scary combination of drugs. I have never understood why vets use an antacid in rabbits that have guts that require an acidic environment. And I never use GI motility drugs. Sounds almost like a "treat for everything" type deal. And as far as the EC titer, it should come back positive since it only tests for antibodies in the blood. But as I have mentioned so many times....EC doesn't cause head tilt....it causes a compromised immune system that allows infections that do cause head tilt.

Randy


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## tonyshuman (Aug 19, 2010)

:yeahthat:


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## Little Bay Poo (Aug 20, 2010)

Chalk actually looks very good. Her tilt is hardly noticeable in the picture.


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## mr_mouse_chalk (Aug 20, 2010)

She's doing even better today 
She's been resting up all day, eating quite well and being much more cheeky like she normally is (ate a hole in a t-shirt of mine while I was giving her meds this morning).

She's been rattling the cage all evening since I got back from seeing Jen, so I opened the door, and have been supervising her ever since.

She's doing an equal amount of running around and lying down. But she seems to be good on her feet today.

Little video of her nibbling a takeaway menu she managed to knock out of the bin, and running in and out of our coffee table:

[ame]http://www.youtube.com/watch?v=ub8S0cVsaL4[/ame]


Little Bay Poo wrote:


> Chalk actually looks very good.Â  Her tilt is hardly noticeable in the picture.


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## mr_mouse_chalk (Aug 20, 2010)

Hi Randy,

It's difficult really as everyone in rabbit medicine (at least here in the UK) seems to have different opinions on which drugs to use. We are a bit limited with rabbit experts, but Elisabeth who has been treating Chalk has been very good so far.

I've read two different views on the antacids - some say that the normally acidic environment in a bunny can be dangerous to a bunny when food is not passing through, but I also see your point that trying to neutralise the natural acidity could be a bad move... I just wish I was enough of an expert to know which is for the best.

From our point of view Chalk has had a history of pretty severe gut stasis - she's been treated in different ways by different vets, but Zantac and the GI Mobility drugs do seem to have helped her out of it in the past...

Steve

ra7751 wrote:


> Certainly a very interesting and very scary combination of drugs.Â  I have never understood why vets use an antacid in rabbits that have guts that require an acidic environment.Â  And I never use GI motility drugs.Â  Sounds almost like a "treat for everything" type deal.Â  And as far as the EC titer, it should come back positive since it only tests for antibodies in the blood.Â  But as I have mentioned so many times....EC doesn't cause head tilt....it causes a compromised immune system that allows infections that do cause head tilt.
> 
> Randy


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## ra7751 (Aug 20, 2010)

Yea....rabbit medicine is starting to come into the modern world but we still have a lot of the older info still out there. Truth is the use of an antacid came from a time that it was known the gut of a rabbit was very acidic and the antacid was used in an effort to protect the oral drugs from the acidity. What wasn't known was why this caused GI issues like stasis....which is where the very dangerous practice of using motility drugs came from. What slows the gut is that the change in pH in the gut stresses the beneficial bacteria and that causes GI issues. Interesting that many vets will use an antacid and then use probiotics at the same time....and probiotics will acidify the GI....they basically wash each other out.

During GI events....and the changing pH.....gastric ulcers can form in the intestinal tract. These lesions will further thing an already very thin GI wall. The contractions induced by motility drugs can perforate these ulcers resulting in an almost immediate death.

As vets do more continuing education programs run by experienced exotic focus vets, they will learn these old ideas were based on incomplete clinical information. We now use many injectable drugs that just a few years ago were considered unsafe for rabbits. The injectables have minimal, if any, negative effects on the GI. We have much safer and effective methods to stimulate the GI...and not use motility drugs. We are using pain meds that were never considered for rabbits (and in my case with wildlife).....but they are safe and effective. And as far as vets, I have the utmost respect for vets....and most do a very good job treating rabbits and other exotics considering the lack of training they receive specifically on these animals while they are in school. But things are getting better.

Randy


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## mouse_chalk (Aug 23, 2010)

Hi all,

Now I'm finally home I can post an update on Chalky myself!

She's so different to when I last saw her. I guess I can see it more because I've been away from her. When we took her to Great Western Referrals last Saturday, she could barely stand, kept falling, rolling, couldn't clean herself even and her eyes were constantly flickering. Her head was also very noticeably tilted. 

Now, her head is still slightly tilted- if it was a clock face, I'd say 11.30? I think I said 1, 2 o'clock last time but I must have been working on some kind of backwards clock, because the tilt has always been to her right. At times it actually seems completely upright. It does get worse at times, like when she has to have her meds, she gets stressed being wrapped up in the towel, and it seems to tilt 'back an hour' or so, but recovers quite quickly after any stress. Forgive me using the clock references but it's the easiest way to describe the severity of the tilt? She hops, runs really well, not particularly fast, but she is definitely enjoying being able to move around, though she doesn't seem to overdo it- just a little run, a little explore, then a rest, and so on. I haven't seen her fall or stumble once since I came home yesterday evening and she is even getting in and out of the litter tray with no trouble at all. Steve turned their 3-level cage into a pen so she doesn't have to negotiate any jumps, but there is a cardboard box about 7inches tall in the living room for them to play with and hide under, and she has jumped on top of this several times with ease, that I've seen.

She's still ont he same medication, due for review with the vet tomorrow I believe (it feels so weird having all of this taken care of by Steve as I'm usually the one to administer meds, etc). The meds issue is... a headache. It is so frustrating to have a vet tell you one thing and yet everything else you read tell you another. One thing I am glad of though, is that we took Chalk out of the other vets, and transferred her there. A lot of the vets that we regularly see, are very good, caring and had it been any of them on duty that weekend, we perhaps might not have wanted to do it. But the vet that was on duty, I couldn't put my finger on it until after we left, but he just didn't seem to care. Not only about what we were saying, and showing him, but about Chalk. Her condition had clearly deteriorated from even the night before when we'd seen her, but he just shrugged and said that she looked ok. I honestly believe that if we hadn't taken her out of there, she would have deteriorated further, if not, worse *shudders*. 


As for me, well they discovered through MRI that I didn't have any more gallstones hiding, nor a bile leak which was feared, but *just* pancreatitis. I couldn't eat for about a week, aside from trying cereal with milk which made me incredibly ill. I've been discharged with not much info other than avoid all fats completely, but nobody's told me how long for. Currently I can only eat plain steamed or boiled veg, plain salad, or plain rice/pasta. Not even fat-free milk- a glass of that the other day started me off. I've lost over 6kg since I went in! I wanted to lose weight but not like this. I ate a piece of steamed fish for dinner last night but it had a tiny fat content and I was incredibly ill for hours and nearly ended up back in the emergency dept. Hopefully it will all clear up soon...


Thanks for all the support for Chalk and myself


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## SnowyShiloh (Aug 23, 2010)

Ugh  Poor both of you  I'm glad that you're both kind of doing better!


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## mr_mouse_chalk (Sep 4, 2010)

Bit slack on the updates - sadly Jen is still not well and back in Hospital, so it's been a bit hectic.

In good news though... Chalk is doing so well. 
The head tilt is almost gone / barely noticeable now. She's running around, binkying and being a right wriggler when I have to give her any medicines.

Thanks to everyone who posted on this thread - don't know what I would have done without the support.

Here's a little pic from tonight:


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## LuvaBun (Sep 5, 2010)

Thanks for the update, Steve. Great news that Chalk is doing so well - she looks wonderful.

Not such good news about Jen . Sorry she is still unwell. Sending her get well vibes!

Jan


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## Anaira (Sep 5, 2010)

Just read through this thread; so glad she's better now!:biggrin:Having owned rats for longer than rabbits, my first thought when reading this was, 'Oh no, tumor!' I've lost too many rats to head tumors, so I'm glad it isn't, and that she's better. Do you know what exactly caused the tilt?



Just on a side note, out of curiosity, in my experince, Baytril should not be injected as it can(and often does) cause nasty burns. I presume that would be the same for rabbits? I'm just curious here; I like to learn as much as I can about medicines.


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## AngelnSnuffy (Sep 9, 2010)

Thanks for the update Steve! That pic is cute!

Hubby said he wouldn't post for me if I'm sick...wha, what? He has to!


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## Briggers (Sep 12, 2010)

So glad bunny is getting better!!!

Sorry about the struggle with your wife, i hope things get sorted for her soon xxxx


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