Rabbit Otitis (External, Middle & Inner Ear): Vet Guide for 2025 🐇🎧

By Dr Duncan Houston BVSc

📚 What Is Otitis in Rabbits?

“Otitis” refers to inflammation or infection of the ear canals:

• Otitis externa: outer canal, often due to mites (Psoroptes cuniculi) or wax buildup.
• Otitis media: middle ear infection, commonly via Pasteurella, especially after chronic externa.
• Otitis interna: inner ear involvement, leading to vestibular signs like head tilt and nystagmus :contentReference[oaicite:2]{index=2}.

⚠️ Why It Matters

• Impacts quality of life: pain, balance issues, anorexia.
• Potential for severe consequences: spread to facial nerve (paralysis), vestibular system, deafness, osteomyelitis :contentReference[oaicite:3]{index=3}.
• Lop-eared breeds are predisposed due to ear anatomy limiting drainage :contentReference[oaicite:4]{index=4}.

👀 Recognizing Clinical Signs

• Otitis externa: head shaking, ear scratching, malodorous discharge, inflamed canal, ear-base swelling :contentReference[oaicite:5]{index=5}.
• Otitis media: often silent—swelling at ear base, pain, decreased appetite, possible facial asymmetry :contentReference[oaicite:6]{index=6}.
• Otitis interna: head tilt, ataxia, nystagmus, circling, possible deafness :contentReference[oaicite:7]{index=7}.

🔍 Diagnostic Approach

• Complete history: respiratory disease, environmental factors, duration of signs.
• Physical and neurological exam: check facial-nerve & vestibular function :contentReference[oaicite:8]{index=8}.
• Otoscopic/endoscopic evaluation: collect samples for cytology and culture :contentReference[oaicite:9]{index=9}.
• Imaging:
• Radiographs—limited sensitivity (~56%) :contentReference[oaicite:10]{index=10}.
• Ultrasound—can detect bulla fluid :contentReference[oaicite:11]{index=11}.
• CT scan—gold standard to assess bulla involvement and structure :contentReference[oaicite:12]{index=12}.
• Myringotomy or bulla tap: allows sampling of middle ear contents :contentReference[oaicite:13]{index=13}.
• Bloodwork: CBC/chemistry for systemic infection.
• Mite identification via skin scraping or ear swab for Psoroptes :contentReference[oaicite:14]{index=14}.

🛠️ Treatment Strategies

1. Otitis Externa (Medical Management)

• Flush canal with saline or ceruminolytic solutions under sedation :contentReference[oaicite:15]{index=15}.
• Apply topical antimicrobial agents (non-steroidal), preferably guided by culture :contentReference[oaicite:16]{index=16}.
• Treat mites with ivermectin or selamectin when present :contentReference[oaicite:17]{index=17}.
• Provide analgesia and NSAIDs; avoid corticosteroids without microbial control :contentReference[oaicite:18]{index=18}.

2. Otitis Media

• Extended systemic antibiotics (fluoroquinolones, trimethoprim-sulfa) per culture :contentReference[oaicite:19]{index=19}.
• Myringotomy and flushing of bulla when not ruptured.
• Lateral bulla osteotomy (LBO), sometimes combined with total ear canal ablation (TECA) when external disease is present :contentReference[oaicite:20]{index=20}.
• Place antibiotic-impregnated beads in surgical cavity :contentReference[oaicite:21]{index=21}.
• Post-op care: reform cavity, monitor facial nerve and provide analgesia.

3. Otitis Interna

• Treat underlying media infection aggressively.
• Manage vestibular signs with supportive care: fluids, rest, assisted feeding, eye protection.

🏠 Home Care & Monitoring

• Teach gentle ear cleaning and admin of drops.
• Observe for return of head tilt, scratching, appetite, discharge.
• Schedule rechecks with CT or endoscopy within weeks post-treatment.
• Continue pain relief, regular hygiene, and avoid reinfestation.

📊 Prognosis & Outcomes

• External otitis: generally excellent with early intervention.
• Media with surgery: good outcomes; residual nerve function varies.
• Interna: potential improvement, though vestibular deficits may persist.
• Diagnosis via CT/ultrasound essential given prevalence of subclinical cases :contentReference[oaicite:22]{index=22}.

🛡️ Prevention & Risk Reduction

• Routine ear inspection at wellness visits, especially in lop-eared breeds :contentReference[oaicite:23]{index=23}.
• Prompt treatment for external disease to prevent spread.
• Control mites, keep ears clean and dry, and minimize excess ear wax accumulation.

🧠 Vet Tips for 2025

• Incorporate otoscopic ear checks and palpation in all exams.
• Use CT early for suspected media/interna cases.
• Show owners proper ear cleaning and admin techniques.
• Use telehealth follow-ups for post-op wound and vestibular function monitoring.
• Refer complex cases to rabbit-savvy surgeons promptly.

🔚 Final Takeaway

Otitis in rabbits spans from external irritation to serious neurological disease. In 2025, early detection, thorough diagnostics (CT, cytology), targeted medical or surgical care, and attentive follow-up dramatically improve outcomes and protect your rabbit’s quality of life. 🐇❤️

🌟 Partner Services

• Ask A Vet: Remote ear exam guidance, follow-up after surgery, medication coaching.
• Woopf: Ear-care kits—flush solutions, topical drops, ear drying aids, and pain relief packs.
• Purrz: CT referral support, antibiotic reminder tools, ear-cleaning tutorial apps.