Head tilts in rabbits are a common concern among pet rabbit owners and often prompt urgent visits to veterinary clinics. This guide explores the causes, symptoms, and treatment options for head tilts in rabbits, emphasizing the specialized pet care available at our pet hospital in Hong Kong. Through this overview, we hope to support pet rabbit owners with valuable information while providing insights into how Zodiac Pet & Exotic Hospital’s expert vet team can assist in diagnosing and treating this condition.
Understanding Head Tilt in Rabbits – Pet Care Tip
Rabbits develop head tilts because there is a problem with the balance center in their ear(s) or their brain. This makes them think their head is in a normal position when it is tilted to the side.
Inside the ear, there are tubes filled with fluid (“semicircular canals”). This fluid moves when the rabbit moves their head. The signal then goes from the ear to the brain via a nerve called Cranial Nerve 8 (or the “vestibulocochlear nerve”). There are several parts of the brain that help to control movement and balance.
Recognizing Symptoms of Head Tilts in Rabbits
Rabbits with head tilts can also have rapid eye movement (“nystagmus”) and rolling/falling. If they have an ear infection, they may also have difficulty blinking their eye(s) and their lips can look drooped down or pulled up into a half smile.
Diagnosing Head Tilts: Peripheral vs. Central Causes
A physical examination and additional testing will help your veterinarian determine if your rabbit’s head tilt is “peripheral” or “central.”
“Peripheral” means the head tilt is caused by a problem outside of the brain. This means there is a problem with the inner ear or a problem with the nerve that connects the inner ear to the brain. This can be caused by infection, inflammation, or cancer in the ear or nerve.
“Central” means the head tilt is caused by a problem inside the brain. This can be caused by infection, inflammation, cancer, trauma, or a stroke.
Sometimes, rabbits can have both peripheral and central head tilts. For example, a rabbit may have an ear infection that spreads to their brain.
Once your veterinarian determines if the head tilt is peripheral or central, they will recommend diagnostic imaging such as a CT scan or an MRI. A CT scan is a 3-D x-ray and can help diagnose ear infections, but it is NOT very helpful for diagnosing a problem in the brain. Therefore, your veterinarian will recommend an MRI if they suspect your rabbit has a central head tilt. Your veterinarian will also recommend a blood and urine test to look for any signs of infection, dehydration, or kidney/liver problems.
Can E. cuniculi Cause Head Tilts in Rabbits?
E. cuniculi (Encephalitozoon cuniculi) is a fungus that is very common all over the world. This fungus forms spores that can stay in the environment for a long time. Rabbits can be infected by eating the infective spores shed by other rabbits OR from their mom when they are in her uterus. The fungus divides inside the rabbit’s kidneys and is then shed in their urine to infect other rabbits. This is primarily a disease that affects the kidneys, but it can affect other body parts such as the nervous system and the eye.
Since this disease is so common, many rabbits are exposed. Their body may fight off the infection and they never show any signs of illness but the immune system will let us know. We look for antibodies in the bloodstream (“IgG” and “IgM”). This lets us know that the rabbit was exposed to E. cuniculi at some point in their life, but it does not tell us when they were infected, if they are currently infected, or if they will become sick from the infection. Therefore, this test is really only helpful if it is negative.
Medications such as fenbendazole and albendazole may prevent E. cuniculi infection, but they do not eliminate the spores from the body. Even if the spores are gone, there can still be damage to the organs. Therefore, there is not a lot of benefit to using fenbendazole. In fact, there are many studies showing that fenbendazole can cause severe side effects such as damage to the bone marrow which can cause a decrease in red blood cells (anemia), platelets, and white blood cells. If fenbendazole is given to your rabbit, we recommend having blood tested at least once weekly during treatment.
So, does E. cuniculi cause head tilts in rabbits? The short answer is that it can cause head tilts if the spores are in the brain, but there will be lots of other signs of a brain infection such as seizures, blindness, headache, etc. There are MANY causes of head tilts in rabbits – a head tilt does NOT mean E. cuniculi and does NOT mean that your rabbit needs fenbendazole!
Treatment for Head Tilts in Rabbits: Options and Specialized Care
Treatment of head tilts depends on the cause of the head tilt. If the head tilt is caused by an ear infection, then antibiotics, painkillers, and even surgery may be recommended.
Many rabbits with head tilts feel very dizzy and don’t want to eat OR they may not be able to walk to their food/water. Therefore, we recommend syringe feeding them with critical care and giving them fluids to prevent dehydration. If rabbits are painful (with an ear infection or trauma) we will also use painkillers that help to decrease pain and inflammation. Acupuncture, physiotherapy, and massage therapy are also helpful to decrease pain, improve their walking/hopping, and improve their appetite.
Setting Up a Safe Space for Recovery at Home
Most rabbits can be treated at home, but in some cases rabbits with head tilts require hospitalization with intravenous fluids, antibiotics, and medications to improve their appetite. Because head tilts can be caused by problems in the brain, some rabbits with head tilts will also have seizures which can require hospitalization until the seizures are under control.
Rabbits with head tilts need a special cage that is well padded to prevent them from injuring themselves when walking/rolling. We recommend using towels, pillows, and/or blankets to provide a safe place for them.
About Zodiac Pet & Exotic Hospital
Zodiac Pet & Exotic Hospital is a veterinary specialty hospital in Hong Kong that provides exceptional pet care. As a leading exotic pet hospital, we specialize in treating various unique animals, ensuring that they receive the tailored attention they deserve. Our experienced exotic pet vets are passionate about their work, combining expertise with compassion for every visit. Whether you have a dog, cat, or an exotic pet, our animal hospital in Hong Kong is equipped to handle all your veterinary needs. Visit us for specialized treatment for your beloved pets today!
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