{"id":6335,"date":"2021-09-22T14:15:14","date_gmt":"2021-09-22T14:15:14","guid":{"rendered":"https:\/\/aercmn.com\/?p=6335"},"modified":"2021-09-22T14:15:14","modified_gmt":"2021-09-22T14:15:14","slug":"head-tilts-in-rabbits-and-rodents","status":"publish","type":"post","link":"https:\/\/www.aercmn.com\/blog\/head-tilts-in-rabbits-and-rodents\/","title":{"rendered":"Head Tilts in Rabbits and Rodents"},"content":{"rendered":"

\"rabbit,<\/p>\n

It’s\u00a0a normal day at home and your rabbit is romping around in the other room.\u00a0Suddenly,\u00a0you hear a crash. You run in to find your bun rolling on her side, unable to stand up.\u00a0You’re\u00a0able to get her right-side-up, but\u00a0her\u00a0head\u00a0is\u00a0tilted to\u00a0one\u00a0side! Is she having a seizure?\u00a0Is there\u00a0something wrong with her brain?!?<\/span>\u00a0<\/span><\/p>\n

A head tilt can be\u00a0scary\u00a0to\u00a0see\u00a0in your pet.\u00a0At a glance, they suggest that something is wrong\u00a0inside\u00a0the animal’s head, and it could be serious.\u00a0This\u00a0assumption\u00a0is not\u00a0far off: head tilts usually\u00a0indicate\u00a0disease in the head,\u00a0specifically within the vestibular system. The vestibular system\u00a0orients\u00a0the\u00a0body\u00a0within\u00a0its\u00a0surroundings and\u00a0maintains\u00a0a\u00a0sense of balance. How serious\u00a0the problem\u00a0is\u00a0depends\u00a0upon what sort of disease is taking place.<\/span><\/p>\n

\"rat<\/span><\/h4>\n

What cause<\/span>s<\/span>\u00a0<\/span>a<\/span>\u00a0head tilt?<\/span><\/span>\u00a0<\/span><\/h4>\n

The\u00a0<\/span>source\u00a0<\/span>of<\/span>\u00a0a head tilt is usually either in the ear or the brain.\u00a0<\/span><\/span>\u00a0<\/span><\/p>\n

    \n
  • \n
    Ear:<\/span><\/span><\/h5>\n<\/li>\n<\/ul>\n

    Occasionally,<\/span>\u00a0discomfort in the external ear (the part of the ear\u00a0<\/span>outside<\/span>\u00a0the ear drum) will cause\u202fthe animal to hold its head at an angle<\/span>;\u00a0<\/span>causes include bacterial or yeast ear infections, ear mites, or growths in the external canal.<\/span><\/p>\n

    More commonly<\/span>,<\/span>\u00a0disease is found in the middle ear<\/span>\u00a0–\u00a0<\/span>the\u00a0<\/span>bony<\/span>\u00a0<\/span>portion<\/span>\u00a0of the ear found\u00a0<\/span>behind<\/span>\u00a0the\u00a0<\/span>ear drum<\/span>.\u00a0<\/span>The inner\u00a0<\/span>ear,\u00a0<\/span>a<\/span>\u00a0crucial piece of the vestibular system, lies within the middle ear<\/span>. The inner ear<\/span>\u00a0can be<\/span>come<\/span>\u00a0damaged\u00a0<\/span>due to<\/span>\u00a0<\/span>a middle\u00a0<\/span>ear\u00a0<\/span>infection.\u00a0<\/span>Treatment of middle ear infections often requires\u00a0<\/span>surgery<\/span>\u00a0or\u00a0<\/span>endoscopy<\/span>\u00a0<\/span>to remove the infected tissue and achieve a cure.<\/span><\/p>\n

    \"rabbit,<\/p>\n

      \n
    • \n
      \u00a0<\/span>Encephalitozoon<\/span>\u00a0<\/span>cuniculi<\/span>:<\/span><\/span><\/h5>\n<\/li>\n<\/ul>\n

      Head tilts in rabbits\u00a0can also be caused via\u00a0infection by a fungus called\u00a0<\/span>Encephalitozoon\u00a0cuniculi<\/span><\/i>\u00a0(also known as\u00a0<\/span>E.\u00a0cuniculi<\/span><\/i>\u00a0or\u00a0Ecun). The disease is common in rabbits, but not all exposed animals develop disease.\u00a0<\/span>E. cuniculi\u00a0<\/span><\/i>infections\u00a0often\u00a0affect the kidneys, eyes, and brain.\u00a0An infection in the brain is what results in vestibular symptoms\u00a0(head tilt, rolling), and this manifestation is\u00a0frequently\u00a0seen\u00a0in older rabbits.<\/span>\u00a0<\/span><\/p>\n

      Infection may be treated with anti-inflammatory drugs,\u00a0as well as\u00a0anti-parasite drugs called\u00a0benzimidazoles\u00a0(usually\u00a0fenbendazole,\u00a0also known as\u00a0Panacur\u00ae).\u00a0Unfortunately, the treatment regimen\u00a0generally\u00a0does\u00a0not\u00a0result in cure, only suppression of symptoms. Rabbits with\u00a0<\/span>E. cuniculi\u00a0<\/span><\/i>infections may experience\u00a0lifelong\u00a0intermittent recurrence of vestibular symptoms. These flare-ups can be controlled with repeated courses of medication.<\/span><\/p>\n

      \"rats,<\/p>\n

      Other\u00a0<\/span>possible\u00a0<\/span>causes of head tilts include<\/span>:<\/span><\/span>\u00a0<\/span><\/h4>\n
        \n
      • Head trauma<\/span>\u00a0<\/span><\/li>\n
      • Polyps (non-cancerous masses that have an inflammatory origin)<\/span><\/li>\n
      • Tumors (more common in rats)<\/span><\/li>\n
      • Bacterial and fungal infections besides\u00a0<\/span>E.\u00a0cuniculi<\/span><\/i>\u00a0are possible, but rare<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

        \u00a0<\/span>Note that hypothyroidism (an under-active thyroid gland) can cause a head tilt in other species, but no cases have been reported in rabbits or rodents.<\/span><\/i>\u00a0<\/span><\/p>\n

        \"bloodwork,<\/p>\n

        How\u00a0can my veterinarian diagnose the cause of a head tilt?\u00a0<\/span><\/b>\u00a0<\/span><\/h4>\n

        Diagnosis requires a combination of bloodwork and imaging.<\/span>\u00a0<\/span><\/p>\n

          \n
        • Computed tomography (CT) is the test of choice for assessing the middle and inner ears.\u00a0<\/span>\n
            \n
          • CTs are routinely performed on our exotic patients because they can be performed rapidly and do not require anesthesia; some patients may be imaged using sedation only.\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n
          • Magnetic resonance imaging (MRI) is superior for assessing the brain.<\/span>\n
              \n
            • MRI is rarely used for exotic patients because it requires anesthesia and takes much longer, making it riskier.<\/span><\/li>\n<\/ul>\n<\/li>\n
            • Bloodwork is used to assess red and white blood cells, acute phase proteins, and metabolic values (liver and kidney values; electrolytes).<\/span><\/li>\n
            • Thyroid hormone levels may also be measured to rule-out hypothyroidism.<\/span><\/li>\n
            • In rabbits, antibodies to\u00a0<\/span>E.\u00a0cuniculi<\/span><\/i>\u00a0are commonly measured to rule\u00a0out\u00a0<\/span>E.\u00a0cuniculi<\/span><\/i>\u00a0infection.<\/span>\n
                \n
              • The presence of antibodies\u00a0only\u00a0indicates\u00a0exposure to\u00a0<\/span>E.\u00a0cuniculi<\/span><\/i>\u00a0sometime in the past. Determining whether the animal\u2019s current symptoms are being caused by an\u00a0<\/span>E.\u00a0cuniculi\u00a0<\/span><\/i>infection requires a nuanced approach, taking the whole patient into consideration.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                \"mouse,<\/p>\n

                Depending on the underlying cause, the prognosis for\u00a0pets displaying a head tilt is variable.\u00a0In general, the odds of\u00a0complete resolution of the head tilt\u00a0are higher if\u00a0an accurate\u00a0diagnosis is made,\u00a0and treatment\u00a0is\u00a0initiated\u00a0early\u00a0in the course of the disease. Patients that have had a head tilt for months are less likely to have the\u00a0tilt\u00a0clear up, even if proper diagnosis and treatment is provided.<\/span>\u00a0<\/span><\/p>\n

                Fortunately,\u00a0even\u00a0if an animal\u2019s head tilt never goes away,\u00a0many\u00a0patients\u00a0can\u00a0have\u00a0a\u00a0good quality\u00a0of\u00a0life.\u00a0In fact, it is\u00a0common to\u00a0encounter\u00a0a rabbit that views the world with its head cocked\u00a0askew, but otherwise acts completely normal!\u00a0That said,\u00a0it\u2019s\u00a0important to work with a veterinarian savvy in exotic companion mammal practice to ensure that your pet gets\u00a0the\u00a0care it needs.<\/span>\u00a0<\/span><\/p>\n

                If you have any concerns about your pet and head tilts, contact your family veterinarian or set up a consultation with\u00a0Animal Emergency & Referral Center of Minnesota\u2019s\u00a0<\/span>Avian and Exotic Medicine Service<\/span><\/a>.\u00a0<\/span>\u00a0<\/span><\/p>\n

                \"Andrew<\/p>\n

                \u00a0<\/span><\/p>\n

                \u00a0<\/span><\/p>\n