Head tilt in a rabbit

isolated rabbits

Overview

  • A problem inside the ear or brain is the most common cause of a head tilt in a rabbit.
  • This is because head position is controlled by the balance (vestibular) centre, which sits inside the ear/brain. Anything that disturbs the balance centre is likely to cause a head tilt, and often, other symptoms such as a loss of balance or flickering eye movements.
  • Book an appointment with your vet if your rabbit has developed a head tilt.
  • Book an urgent appointment if your rabbit has lost their balance, is distressed, falling over, or has stopped eating.

Causes

Head position is controlled by the balance (vestibular) centre, which sits inside the ear/brain. Anything that disturbs the balance centre (i.e. a problem inside the ear/brain) is likely to cause a head tilt, and often other symptoms such as a loss of balance or flickering eye movements. The two most common causes are:

  • An inner ear infection – inner ear infections are much deeper than a ‘normal’ ear infection and tend to affect the balance centre.
  • E.cuniculi parasite (Encephalitozoon cuniculi) – a common rabbit parasite that causes inflammation of the brain

Less common causes include:

  • Ear mites
  • Head injury
  • Neck pain
  • A drug reaction
  • A brain problem such as inflammation, infection or an abscess
  • A brain or ear tumour
  • Poisoning.
Rabbit tilting their head to the side

This rabbit has a head tilt caused by a brain parasite called E.cuniculi - image courtesy of Elisabetta Mancinelli.

Treatment

Treatment will depend on the cause of your rabbit’s head tilt. Follow the links above for more information about treating the common causes of a head tilt.

Other symptoms to look out for

If your rabbit has developed a head tilt, they may also have other symptoms such as:

  • Loss of balance/falling over
  • Walking in circles
  • Flickering eye movements
  • Head shaking
  • Itchy ears
  • Tremors
  • Bumping into things
  • A one sided droopy face
  • One eye sunken
  • Uneven pupils
  • Third eyelid showing
  • Uncontrollable rolling over (severe symptom)
  • Unable to stand (severe symptom).

When to contact your vet

Contact your vet for an appointment if your rabbit has developed a head tilt. You know your rabbit - even if they don’t have the exact symptoms listed above its best to contact your vet if you’re concerned.

Outlook

Your rabbit’s recovery will depend on what has caused their head tilt, how they respond to treatment and how they cope with the tilt (it often remains). If ear mites are the cause, your rabbit is likely to recover after treatment and their head tilt should improve. Sadly, rabbits that develop a head tilt because of anything other than ear mites tend to have a less hopeful outlook and many develop worse symptoms over time. It’s important to consider your rabbit’s quality of life and speak to your vet about their outlook. If your rabbit has been given a poor outlook and has severe symptoms such as uncontrollable rolling or being unable to stand, it may be kinder to put them to sleep.

Home care for a rabbit with a head tilt

Initially your rabbit may struggle to cope with their head tilt, but most adapt with time. While your rabbit is recovering, you will need to take extra care to keep them comfortable and safe.

A safe environment. A head tilt makes your rabbit feel as though the world is spinning around them (vertigo) so they are likely to fall over and bump into things. Keep your rabbit in a flat area with lots of padding, no sharp corners or deep water.

Reduce stress. Stress could make your rabbit’s symptoms worse – keep them in a quiet, stress free, familiar environment.

Handle gently. Moving your rabbit will make their symptoms much worse; keep handling to a minimum and if you need to pick them up, do it slowly and hold them securely.

Published: August 2019

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Written by vets and vet nurses. This advice is for UK pets only.

Illustrations by Samantha Elmhurst