📚 What Is Head Tilt?

Torticollis, or head tilt, is when a rabbit holds its head at an abnormal angle—often with nystagmus (eye flicking), circling, or rolling behaviors :contentReference[oaicite:3]{index=3}.

⚠️ Why It Matters—and Common Causes

This sign often indicates a vestibular problem affecting the ear or brain. Common causes include:

• Encephalitozoon cuniculi: A parasite leading to inner ear/brain inflammation :contentReference[oaicite:4]{index=4}.
• Otitis media/interna: Bacterial ear infection, especially in lop‑eared breeds :contentReference[oaicite:5]{index=5}.
• Ear mites, abscesses, tumors, toxins or trauma: Less common, but important to investigate :contentReference[oaicite:6]{index=6}.
• Toxoplasma gondii: Rare protozoal cause, especially in outdoor rabbits :contentReference[oaicite:7]{index=7}.

👀 Recognizing Key Signs

• Head tilt, nystagmus, circling or rolling :contentReference[oaicite:8]{index=8}.
• Loss of balance, inability to stand, or erratic movements :contentReference[oaicite:9]{index=9}.
• Ear signs: discharge, scratching, swelling :contentReference[oaicite:10]{index=10}.
• Neurological signs: seizures, weakness, changes in mentation :contentReference[oaicite:11]{index=11}.

🔍 Diagnosis & Workup

• Detailed history—onset, diet, ear trauma, environment.
• Full physical and neurological exam looking at ear, eye, vestibular responses :contentReference[oaicite:12]{index=12}.
• Bloodwork & serology for E. cuniculi and, if needed, Toxoplasma :contentReference[oaicite:13]{index=13}.
• Ear swabs/cultures for infection; microscopy for mites :contentReference[oaicite:14]{index=14}.
• CT/MRI to check for ear inflammation, abscesses, bulla changes or central lesions :contentReference[oaicite:15]{index=15}.
• Otoscopic exam and radiographs to assess ear canals and tympanic bullae :contentReference[oaicite:16]{index=16}.

💉 Treatment Strategies

1. Antiparasitic for E. cuniculi

• Fenbendazole 28–60 days, sometimes combined with anti‑inflammatories; recovery may take weeks to months :contentReference[oaicite:17]{index=17}.

2. Treating Ear Infections

• Long-term antibiotics (culture-based), NSAIDs for pain :contentReference[oaicite:18]{index=18}.
• Surgery (ear canal ablation, bulla osteotomy) if infection is deep :contentReference[oaicite:19]{index=19}.

3. Supportive Care

• Fluid therapy (IV/SQ) & syringe feeding to prevent gut stasis :contentReference[oaicite:20]{index=20}.
• Pain control with NSAIDs/opioids; anti-nausea/motion meds like meclizine or prochlorperazine :contentReference[oaicite:21]{index=21}.
• Anxiolytics (e.g., midazolam) for stress relief :contentReference[oaicite:22]{index=22}.
• Analgesia and sedation may be needed for physical therapy :contentReference[oaicite:23]{index=23}.

4. Rehabilitation & Home Care

• Confine to padded area; low-entry bowls and carrier-lined towels for safety :contentReference[oaicite:24]{index=24}.
• Physical therapy—assisted walking, balance exercises, acupuncture :contentReference[oaicite:25]{index=25}.
• Keep ears and eyes clean, monitor for secondary infections.
• Regular follow-up and repeat imaging or serology to track progress :contentReference[oaicite:26]{index=26}.

📊 Prognosis

• Many rabbits adapt well—tilt may remain but they enjoy normal lives :contentReference[oaicite:27]{index=27}.
• Early treatment improves recovery; chronic or deep-seated issues may carry guarded prognosis :contentReference[oaicite:28]{index=28}.
• Permanent tilt without pain is not a euthanasia reason—it can be managed :contentReference[oaicite:29]{index=29}.

🛡️ Prevention & Monitoring

• Regular ear exams—especially in lop breeds.
• Test new rabbits for E. cuniculi or Toxoplasma before introduction :contentReference[oaicite:30]{index=30}.
• Maintain clean environment to reduce mite/infection risk.
• Immediate vet visits at first sign—balance loss or tilt.

🧠 Vet Tips for 2025

• Don’t assume E. cuniculi—ear disease is equally common :contentReference[oaicite:31]{index=31}.
• Use CT/MRI for detailed ear and brain evaluation :contentReference[oaicite:32]{index=32}.
• Combine antiparasitic, antimicrobials, analgesia & balance therapy.
• Coach owners on supportive home environment for safe recovery :contentReference[oaicite:33]{index=33}.
• Promote physical therapy and long-term monitoring for chronic cases.

🔚 Final Takeaway

Rabbit head tilt (torticollis) often stems from treatable issues—inner ear infections and E. cuniculi being most common. With thorough diagnosis, targeted treatment, and supportive nursing (padding, fluids, therapy), many rabbits recover function or adapt comfortably. Persistent tilt is not a sign of suffering—quality care can give bunnies happy lives in 2025 and beyond. 🐇❤️

🌟 Partner Services

• Ask A Vet: Expert support for diagnostics, CT imaging referrals, medication planning, and home care coaching.
• Woopf: Safe housing kits, padded fleece bedding, syringe feeding & balance tool bundles.
• Purrz: Vestibular health supplements, anti-nausea formulas, rehabilitation accessories (e.g., support harnesses).