(RIP) Head Tilt Tilly

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Flashy

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Hi guys, sorry to post about this again.

- Location UK

- Description (Breed, color., weight) Sable Marten, probably a lop/Rex cross.

- Age Unknown, she is a rescue

- spayed/neutered? Spayed

- Notes on Fecal and Urinary Output
- are the bunny's poops and pees normal? Absolutely normal, nice and big poos, normal wee, as useless in her litter tray as normal
- When did they last use their litterbox? This morning. All is normal.
- Any unusual behavior? Nope

- Medical History -- has s/he been to the vet or been sick before? She has a residual head tilt. She had a dental last Monday

- Diet - what does your bunny eat? Pellets and hay, at the moment she is being fed up so she is getting lots of fresh, lots of carrots and pear too.
- when and what did s/he eat last? This morning (about an hour ago).

- movement - any unusual movements? Is s/he hopping normally? All fine and normal for Tilly.

- are there any plants, chocolate or other substances within reach? No.

- has the rabbit been outdoors? she lives outdoors but has been inside since the day before her dental


Tilly has been struggling for a while. After looking at all the possibilities we decided it was the teeth causing her problems. She had a dental last week on Monday. Monday night she was awful and we struggled with her. Her tummy went swollen and hard. It was only Thursday that it started to go down and since then she has been fine (although she has been on Metacam since Saturday 28th Nov). Her head tilt got worse due to the GA, but that is understandable.

She is also currently having Convenia.

Problem is she is still fading. She has lost weight, which is not unexpected after a GA with head tilt, and, to me, she just doesn't seem right, although she is lively, eating, happy, perky, and shows no signs of a problem.

My vet (we have just got back), says that either her dental knocked her sideways and she is still recovering, or that all her head problems are catching up with her and she is potentially fading. We discussed blood tests but right now feel its not in her best interests.

I don't know what to do from here. We don't know her age, so potentially this could be old age related.

Anyone else had a residual tilt bunny have a GA? How did they do?

Any thoughts or suggestions? Anything at all? I think I'm going to lose my girl, and I don't want to.

Thanks in advance.


 
The swollen, hard belly sounds like bloat, which would be a pretty serious GI upset. It could have been from the dental for sure. It could have been a combination of the tilt and the dental, too. It's really hard to say--you know best how she's doing and if it's becoming too much for her. I haven't had a seriously ill bunny before, so I can't really offer any more advice than that, sorry.
 
I'm so sorry to hear about Tilly. It sounds like you are doing all the right things. Hopefully Randy will see this and offer his input, as he has a lot of experience with head tilt and other ailments.

Ronnie has residual tilt but his case sounds a bit different than Tilly's. We stopped giving him all medications in December 2008, and for the past year he hasn't had any health issues (knock on wood). So, unfortunately I cannot offer any advice in this area.

Keep us updated, you and Tilly will be in my thoughts. :hug:
 
Thanks guys. She's been fine off of the Convenia from mid January until just recently when she started to get out of shape. It's all very confusing. I can't help but think there is maybe something else going on that we are missing.
 
I am sorry I can not offer any advise as I am not a Bunny expert BUT I did want to let you know you and your baby are in my prayers. Sending healing vibes your way!
 
I am really sorry about Tilly ..Tracy :(

It is hard tosay exactly what could be going on ; it is possible that the dental was harder on her for whatever reason :?

You probably will just need to watch her carefully to see if any other symptoms develop
Good Luck with her
:hug:

Maureen
 
I'm going to bump this back up because its easier to do that than start again.

Tilly was doing better, back outside, gaining weight, but her breathing is not right. It looks like an effort to breathe, and its through her nose. She has no mouth breathing. It is an effort though.

She is still on Convenia, so if there was an infection it should be being tackled, but there is no sign of any infection (either in her lungs or with any discharge from anywhere). She is also on Metacam.

She has had this before, when Summer was at her illest, so we put it down to stress and how stress affects her (sort of like a panic attack).

She's had an awful few weeks, but was doing so well for a week or so until last night.

Last night it was really errie here. We had an orange sky (at night time), horrible whistly wind, and just over half a foot of snow. Roger was understandably freaked and I think it freaked her out. Her breathing was awful. Really like a proper nose in air effort. She was also keeping her eyes mostly closed (I shaded her from the snow as much as possible in case it was that), and generally just sitting. She was eating though, if the food was given to her.

So this morning I followed my gut instinct and brought the pair of them into the coolest room of the house 'just in case'. When I brought her in I checked her gums and they are nice and pink which is always a good sign.

I don't know what to do for her. It's all very reminiscent of the day we let Summer go to the Bridge. We lost Summer to cancer. Tilly was spayed as an adult, so potentially there is a cancer risk too.

I just don't know what to do. She is not distressed by her breathing, and she is alert, just not as lively as normal.

Part of me is even wondering if I should be thinking of letting her go, but I'm not sure that's best for her.

Also, if a rabbit is on antibiotics, and Metacam, and had laboured (for want of a better word) breathing, what could cause that?

I've got stress and some fumes of some sort (which there are not). Any other physical problems? They listened to her heart but would that pick it up?

Please help me.
 
There are other things that can cause infection of the respiratory tract. Viruses can do that, chronic inflammation of the sinuses and nasal passage, and fungal infections could all cause problems breathing. If she had a cancer or reduced lung function, that could cause it too. Finally, the bacteria could be resistant to Convenia, although that's less common since it's a newer antibiotic. Has she been on Convenia constantly for a long time? That can lead to resistant bacteria taking up home in her respiratory tract.

I would try to get her some humid air. Use a humidifier near her cage, with a towel or blanket over both to make a little steam tent. It also would not hurt to have a vet listen to her lungs to see if she can hear anything out of the normal. If they think it's not from a bacterial infection and there are bad sounds, an x-ray might be able to help you see what was going on with her lungs.
 
Look at her gums....are they bright pink? If they are white....that means she is anemic, if they are blue/purple, she is having something going on in the lungs. I would suggest getting a chest x-ray. This really sounds like either a lower respiratory issue or either congestive heart failure. If it is a lower infection, that usually responds to something like Chloramphenicol and sometimes a nebulizer. If it's CHF, then you need to start protocols to eliminate the excess fluids and relieve the pressure on the heart and lungs. But get a look at those gums.

I have never had this type of reaction from either Convenia or Metacam. But it sounds as if there is some issue in the oxygen exchange that is excited under stress.

Randy
 
Thanks for the reply :)

The vet listened on Monday, and also two weeks before that and can hear nothing out of the ordinary.

Is a nasal swab worth doing to see if there anything nasty up there? Can that be done without a GA?

She was on Convenia from October 08-mid Jan 09, and then she started it again Nearly 3 weeks ago. She has had three doses, and is due her fourth on Monday. Currently we are completely snowed in or else I would have taken her today.

A GA is not really a good option for her to be honest, given how long it too her to recover before. I understand that it may become a necessity, but it will have to happen as late as possible.

Humid Air I can do. We don't have a humidifyer, but I might take her in the bathroom with me and run a bath. That's a good and easy thing I can do, thanks. Posting was worth it just for that suggestion :D I'll do that later.
 
ra7751 wrote:
Look at her gums....are they bright pink? If they are white....that means she is anemic, if they are blue/purple, she is having something going on in the lungs. I would suggest getting a chest x-ray. This really sounds like either a lower respiratory issue or either congestive heart failure. If it is a lower infection, that usually responds to something like Chloramphenicol and sometimes a nebulizer. If it's CHF, then you need to start protocols to eliminate the excess fluids and relieve the pressure on the heart and lungs. But get a look at those gums.

I have never had this type of reaction from either Convenia or Metacam. But it sounds as if there is some issue in the oxygen exchange that is excited under stress.

Randy
Randy thank you for replying :)

I looked at her gums earlier, they are not blue purple, they look normal to me. I'll go and have a look in a bit and compare her with somebunny else.

Would they find heart problems by listening to her heart? How would you diagnose it? She had a GA two and a half weeks ago, would they have identified a heart problem there?

I'm not sure we have Chloramphenicol available for use over here to be honest, not sure at all.

Thank you. When my mum has finished hoovering I shall go and do some gum inspections and report back with the results.
 
You should have Chloramphenicol available. It's a very old drug. It does carry some issues....it's very safe in animals but in some humans, it can cause a condition known as Aplastic Anemia...even a few specks of dust from the pills can cause this. Fortunately it is very rare. This drug is still used in Third World countries because it's cheap and effective against a wide range of bacteria. This drug is very helpful in "walled off" infections such as lower respiratory issues.

Randy
 
Chloramphenicol can have some bad human side effects, so it's possible that it's not available there, but it would be good if you can get it, especially if it can be nebulized into her lungs like Randy said.

If she were in CHF, I would think that her heart beat would be irregular--it would be something you could diagnose from a stethoscope. CHF can come on suddenly so it may not have been a factor when she was under GA a few weeks ago. Murmurs, arrhythmia, valve problems, etc--that's what they check for before putting the bunny under GA, and CHF would be a more acute heart problem, as opposed to those problems I listed which are chronic.

To me, it sounds like it's possible that her bacteria are resistant to Convenia, based on how long you've been treating her with it. It's a great drug but sometimes even the best drugs fail when bugs become resistant.

I myself have something called reactive airway disease, brought on by a bad cold that turned into a sinus infection that never fully resolved. I've been sick with this since Oct. It's not terrible, but sometimes I wheeze and cough. The doctor says that my airways may be inflamed and irritated because of the virus and following infection, and things like humid air can help with that.

Good luck~~
 
Right, her gums look the same as Sandy's, which I take to be a good sign, they don't look pale, and they are certainly not bluey or anything.

RE the aplastic anaemia, I don't know much about that, but currently I am severely anaemic (My level is 5.8 and should be between 11.5 and 16.5), if I go with Chloramphenicol, are they anaemias together likely to be a problem, or the current one potentially trigger the other one? Something I should mention to my vet?

Her head tilt is improving once more on the Convenia. I don't have any other options available to me with this vet other than Convenia. And I have no other decent vet available.

Would a scan or anything of her heart potentially show up a problem? Could they do that awake? what could trigger CHF?

Ack, I'm failing her and I can't stop it.


I'm sorry you've been ill Clare, I sure hope you start to get better soon.


 
Don't worry--you're doing what you can. Re: the safety issues with chloramphenicol--it would be best if it could be delivered via air in a nebulizing chamber, which would ideally be done at the vet's office.

If the head tilt is improving on the Convenia it's good; it's just also possible that some other bacterium that's resistant to the Convenia is colonizing her lungs and causing the breathing problem.

I would assume that a sonogram of the heart would also show any problems that might be occuring, if that's possible to do. There are other methods of diagnosing it in humans, but they may not be as applicable to Tilly. For instance, she'd probably have to be sedated for a chest x-ray. I'm not sure about veterinary EKGs, but they must be a possibility, but maybe not very common to have the equipment. The echocardiogram they also talk about is probably not available for animals except in the most specialized clinics.
http://www.mayoclinic.com/health/heart-failure/DS00061/DSECTION=tests-and-diagnosis

I did have a point when talking about my breathing thing: I just forgot to make it! I was saying that perhaps if Tilly has been having upper respiratory problems for a long time, her airways may be inflamed, causing a condition like asthma. The inflamed/irritated airways constrict so that air can't flow through as well. Now that's a bit of a slippery slope to go down, because the treatment for inflamed airways/asthma is inhaled steroids. However, in rabbits, the use of steroids is pretty much not recommended, especially if an infection could also be present. So, if she has inflamed airways because of long-term sickness, warm, wet air can help, and the vet may think about some inhaled steroids--but use caution when it comes to that! I think if it were an emergency situation, like the rabbit equivalent of an asthma attack, based on how her breathing sounds, then they might be a good idea. Anything less than that, I would not want to use steroids.
 
Umm...well I am not a doctor but my understanding is that Aplastic Anemia would effect 1 in 25,000-40,000 individuals. The condition suppresses the bone marrow's ability to produce red blood cells. So if you are one of the people that would be affected, this drug might not be something you would want to handle. It is always suggested to wear gloves and wash immediately after handling this drug.

Ask your vet if Zeniquin is available. That drug is related to Baytril but doens't have the resistance issues as of yet. And an x-ray should show fluid in the chest...but if the gums are a good color, that is a good sign there.

Randy


 
Thanks guys.

On reading up, I'm leaning more to a heart problem. In fact, I found a parallel situation with another rabbit.

What I have decided is that I won't put her under a GA. That would not be in her best interests at all. If that is the only option, then what is best for her is to let her go.

This is a nightmare!

I will take her in the bathroom later and see if that helps. If it does, that would be awesome.

Thanks for explaining a bit more about it Claire. I did wonder about asthma last night but didn't even know where to begin with that. I absolutely hear everything you say about steroids though.
 

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