Rabbit Facial Nerve Paresis & Paralysis: Vet Guide for 2025 🐇🧠

By Dr Duncan Houston BVSc

📚 What Is Facial Nerve Paresis & Paralysis?

Facial nerve (VII) dysfunction in rabbits causes weakness or total paralysis of facial muscles—resulting in drooping eyelids (ptosis), ear sagging, drooling (ptyalism), asymmetrical whiskers, and sometimes difficulty eating or grooming.

⚠️ Why It Matters

• Reduces blink reflex—exposes cornea to drying and ulcers.
• Impaired grooming leads to coat matting and skin irritation.
• Owner may miss subtle signs—early diagnosis preserves vision, feeding ability, and quality of life.

👀 Signs & Symptoms

• Ptosis (drooping upper eyelid) or retracted lip/mucus drooling.
• Ear droop—especially lop but also upright ear asymmetry.
• Diminished tear production—dry, reddened eye.
• Difficulty chewing or loss of whisker movement on one side.
• Often head tilt or imbalance if vestibular involvement.

⚠️ Common Causes

• Ear infection: Otitis media/interna—pain, head tilt, discharge.
• Trauma: Jaw/chest injury, bite wound, fracture.
• Neoplasia: Ear canal or nerve sheath tumors.
• E. cuniculi: Neurological parasite causing nerve damage.
• Idiopathic: Sudden onset without clear cause; needs supportive therapy.
• Toxicosis: Rare exposure to toxins affecting nerves.

🔍 Diagnostic Steps

• Detailed history—onset, head trauma, ear symptoms.
• Full otoscopic & physical exam—look for ear discharge or injury.
• Neurological exam—blinking, whiskers, lip tone testing.
• Imaging: CT or MRI of skull/ears to detect infection, abscesses, masses.
• Culture & cytology from ear discharge if infection suspected.
• Serology/PCR for E. cuniculi infection.

🛠️ Treatment Strategies

1. Treating the Underlying Cause

• **Ear infection/abscess**: Systemic antibiotics (e.g., enrofloxacin + metronidazole) ± topical ear therapy; surgical flushing/debridement if needed.
• **Trauma**: Soft-tissue repair, fracture stabilization, analgesia.
• **Neoplasia**: Surgical excision or radiation; referral to specialist for facial nerve-sparing approach.
• **E. cuniculi**: Fenbendazole therapy (20 mg/kg daily for at least 28 days) + anti-inflammatory medications.
• **Idiopathic**: Supportive care—lubrication, hydration, nutrition, eye protection.

2. Protecting the Eye & Facial Structures

• Apply artificial tears or gel 2–4× daily to prevent corneal drying.
• Use temporary tarsorrhaphy (eyelid closure) in severe cases to protect the cornea.
• Apply wound ointment and clean drooling areas to prevent dermatitis.
• Maintain oral hygiene; trim incisors if facial deviation causes uneven wear.

3. Analgesia & Anti-Inflammatory Support

• NSAIDs (meloxicam) or mild opioids as needed for pain.
• Corticosteroids trial in idiopathic cases—but only after ruling out infection!

4. Rehabilitation & Home Care

• Pass gentle massage of facial muscles and encourage grooming.
• Hand-feed soft/dampened foods if chewing is difficult; monitor intake.
• Eye protection: cover sharp objects, provide soft bedding.
• Observe and record nerve function daily—blinking, drool, whisker motion.

📊 Prognosis & Recovery

• Ear infection with early therapy—good prognosis; nerve function may return in 2–6 weeks.
• Neoplasia or extensive trauma—guarded prognosis.
• E. cuniculi – variable; early treatment improves recovery of facial strength.
• Idiopathic—some resolve fully; others have residual deficits.

🛡️ Prevention & Monitoring

• Regular ear exams and hygiene, especially in breeds with ear conformation issues.
• Routine check-ups after trauma, especially head injury.
• Preventative parasite treatment and sanitation for E. cuniculi.
• Advise minimizing risk in high-tumor-risk individuals through indoor housing!

🧠 Vet Tips for 2025

• Include blink and facial symmetry exam in every wellness check.
• Use ocular staining and referral imaging early in suspected facial nerve cases.
• Offer home care kits: tear gel, ointment, hygiene wipes, and feeding support.
• Provide telehealth follow-ups to assess nerve function and therapy adherence.
• Develop referral pathways for advanced imaging or specialist surgery if needed.

🔚 Final Takeaway

Facial nerve paresis in rabbits signals serious underlying concerns from infection to tumor. In 2025, early recognition, targeted diagnostics, nerve protection, and tailored therapies boost chances for recovery. With attentive care, many rabbits regain facial function, comfort, and quality of life. 🐇❤️

🌟 Partner Services

• Ask A Vet: Remote evaluation of facial nerve function, guidance on tear protection, antibiotic protocols, and rehab planning.
• Woopf: Home care kits—eye gel, soft food, grooming gloves, and hygiene supplies.
• Purrz: Humidifiers, tear gel refills, and grooming aids tailored to facial nerve recovery.