What causes head tilt in rabbits?

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Head tilt may sound like a cute bunny quirk but, as Petplan vet Brian Faulkner explains, it can point to serious health issues. Here, he shares his advice on spotting the signs, and explains the steps you should take to help your rabbits.

Monitor your bunnies

‘It helps to take note of any changes in the way your rabbits hold their heads,’ Brian says. ‘Head tilt – sometimes called wry neck or torticollis – can develop quite subtly, so you hardly notice it. But there are some early giveaways that all is not well. For example, difficulty eating, problems with balance, confusion and distress, or a reluctance to be held or to enjoy their usual social time with you, can all be signs that your bunnies are unwell.’
Sadly, once head tilt has progressed, the symptoms are all too obvious. ‘A rabbit’s head can quite suddenly become rotated to one side, and may even touch the floor. The eye on the affected side of the head could also possibly droop and look painful. It’s always very obvious that this condition is disorientating for bunnies, and they find it stressful to move their heads or be touched.’

Find the cause

There are no simple tests to identify the cause of head tilt, which can make diagnosis difficult – so your vet will consider several possibilities.
‘In some cases, head tilt could be caused by a rabbit having badly hit its head,’ Brian says. ‘More rarely, conditions such as a stroke or a tumour could also have resulted in the condition. Your vet will first rule out any bumps or injuries, and once these have been eliminated as a cause, an MRI scan may be recommended to check the brain itself.
‘It could also be the result of an inner ear infection,’ he continues, ‘and this can be treated with a long course of antibiotics. However, one of the most common reasons for head tilt is an infection caused by E Cuniculi, a parasite that affects rabbits’ nervous systems.’
While bunnies can be tested for this parasite, the results will only confirm that they have been exposed to E Cuniculi, and won’t be able to prove that this is what’s causing the head tilt. Because of this, many vets will prescribe a parasiticide as a necessary precaution.
‘The treatment is given over 28 days and aims to reduce inflammation, as well as to try to kill the parasite,’ explains Brian.

Take speedy action

If you notice your rabbits holding their heads to one side for any length of time, you should see a vet as quickly as possible. ‘The sooner we can make a diagnosis and start treatment, the better your bunnies’ chances are,’ Brian stresses. ‘Around half the rabbits I see will make a full recovery. But that really depends on the severity of the symptoms and how far along the infection is before treatment begins.’
Some rabbits can live quite happily with a persisting head tilt – so long as they’re helped to eat and drink, and to keep their rear ends clean, which they would normally do themselves. ‘Unfortunately, if the residual symptoms are causing rabbits distress, or making it impossible for them to eat, we have to consider putting them to sleep as the kindest option,’ says Brian.

Prevention can help

There are two effective ways to reduce the risk of head tilt: first, always make sure your rabbits’ hutch and run is kept clean. And second, keep a watchful eye on your bunnies, so that you’re able to spot any changes in their health and wellbeing. ‘Also, avoid overcrowding the hutch,’ advises Brian. ‘The more rabbits that are kept together, the harder it is to keep their environment clean, and the greater the risk of infection spreading between them.’
If you are bringing another rabbit into your home, it’s worth asking your vet about treating your new bunny with a parasiticide before he meets his hutch-mates. ‘The medication will help to reduce the risks of the E Cuniculi parasite spreading,’ Brian says. ‘It’s a reasonable precaution to take to keep your rabbits healthy and happy.’

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