Severe Head Tilt (Not our bunny)

[Kipcha]

We just got a pretty desperate call from a woman in Ontario who is needing vet advice. She has her rabbit on a number of medications (Which she gave me the info for so I'll list them below) and she just seems to be getting worse. They don't have actual rabbit vets there so she's running short on her options but her vet is open to suggestions so she is just looking for any possible help.


The rabbit is an 8 month old Mini Lop, spayed female. This is something that has been happening for 8 days. She said that they did have an incident at the clinic where they burritoed her and the owner thought she had a seizure since the rabbit all of a sudden fell on her side and just laid still for a few minutes, but the clinic said she had just overheated and she did get up a few minutes later.


Right now, she's on,


Hydroxyzine HCL - Getting a dose every 12 hours
She didn't give me the dosage for this but her vet recommended it. I'm not even sure what this is?


Dyplocillin Injections once a week. 0.23 mls an injection.


Baytril with 0.6 mls every 12 hours.


0.3 mls of panacur every 24 hours.


They are also having to feed and water her by hand every 2 hours since she can't eat and drink on her own.

She's just wanting advice for things for her own vet to try. Any suggestions?

 

[Imbrium]

since she doesn't have one in her area, I would try to track down a rabbit-savvy vet (in any location) with experience treating head tilt who would be willing to do a phone consult with her local vet - that would be the best source of good advice and treatment plans.

 

[JBun]

I've read of some other cases of ivermectin being used for e. cuniculi. Here are some links I found on it. I also found info on another treatment that has been tried with pyrimethamine. Also the rabbit should probably be on metacam, or corticosteroids if nothing else seems to be working *as a last resort*, to bring down any inflammation.

http://www.barbibrownsbunnies.com/ecuniculi.htm
http://chiefio.wordpress.com/2011/06/16/encephalitozoon-cuniculi-rabbits-cure/
http://www.rabbitnetwork.org/articles/treatment.shtml
http://www.medirabbit.com/EN/Neurology/cuniculi/pyrimethamine.htm
http://www.medirabbit.com/EN/Neurology/cuniculi/Starsky.htm

 

[Bunnylova4eva]

Yeah I would agree about ivermectin. I know I've heard of Ivermectin being used with great success when there's head tilt.

Also, I know of penicillin with Benzathine working sometimes. And, yes, I think the bunny should defnitly be on something like Metacam to control the pain. If you've ever had an ear infection, you know how much it hurts and is inflmaed. Or, if it's EC, this is needed to bring down the inflamation as well.

 

[tonyshuman]

The hydroxizine is to help with nausea/disorientation, I think. The duplocillin (must have been a typo?) is bicillin. They should try giving it every other day instead of just weekly.
http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm

I would think an anti-inflammatory/pain med may be helpful (metacam--meloxicam). I can't tell if their dosing is ok because I don't know the rabbit's weight and the concentration of the solutions. I would hope they are giving a probiotic (or critical care, which contains them) because of the heavy antibiotic treatment.

It seems like the vet isn't sure if it is parasitic or bacterial, so they're covering all the bases by treating both. It's probably not bad to to do that, but head tilt's most likely to be an ear infection, especially in a young rabbit, and with sudden onset (I am assuming that due to the rabbit's age--correct me if wrong). There are several causes:
http://www.medirabbit.com/EN/Neurology/head_tilt.htm

Maybe the vet can get in touch with an exotics specialist over the phone or skype and do a consult? That way the bunny wouldn't have to travel in such a poor state. I would first make sure the dosages of antibiotics are correct, switch from hydroxazine to meclizine (more commonly used in rabbits), add probiotic and metacam, and wait another week for improvement. Then look into a different antibiotic and/or antiparasitic, such as chloramphenicol or marquis (ponazuril) respectively. However this is no substitute for a consult or second opinion from an exotics specialist.

 

[Kipcha]

I sent her everything posted here, thank you so much everyone for taking the time to reply.

Yes, they did say that it came on very fast. Happened basically overnight by the sounds of it.

She did call again today to let us know how she is doing and said that she seems to be improving just a little bit because she was able to drink on her own, but her head is still severely tilted and she is still rolling. She is still syringe feeding her, but apparently the bunny is starting to get more eager for food rather then before where it was a struggle.

I'll keep everyone posted as she lets us know how the bunny is.

She did post a video, my Mom put it on her Facebook so hopefully people can see it...

https://www.facebook.com/video/embed?video_id=10200859415028122