Head Tilt (Vestibular Disease) in Rabbits

The vestibular system is a major component of the sensory system, a complex system that includes the labyrinth of the inner ear, the medulla of the brain, and the vestibular nerve. Together, the system contributes to the correct positioning of different parts of the body, the smooth movements of the limbs and trunk, and proper balance. Therefore, dysfunction in the system can result in a false sense of movement, vertigo, wobbling eyes, heat tilt, and hearing loss.

In rabbits, vestibular disease is commonly due to ear infection and brain abscesses. Lop-eared rabbits may be more likely to be affected by ear infection, while dwarf breeds and older rabbits with poor immunity may be more predisposed to signs due to bacterial infection.

Symptoms and Types

Initially, the symptoms of vestibular disease are severe and sudden, including rolling eyes, loss of balance, tremors, head tilting, or an inability to lift the head. Other typicaly signs include:

• Nausea and vomiting
• Nasal and eye discharge
• Signs of ear infection — pain, fever, and ear discharge

Causes

• Inflammatory — infections, bacterial, viral, parasitic or fungal
• Idiopathic — unknown origin
• Traumatic — fracture, aggressive ear flushing (cleaning related)
• Neoplastic — tumors of the bone
• Toxic — lead poisoning
• Degenerative diseases
• Suppressed immune system
• Nutritional — lack of vitamin A (rare)

Diagnosis

Your veterinarian will perform a thorough physical exam on your rabbit, taking into account the background history of symptoms and possible incidents that might have led to this condition. There are several possible causes for this condition such as tumors, infection, or injury, and a differential diagnosis can be the best method for diagnosis. This process is guided by deeper inspection of the apparent outward symptoms, ruling out each of the more common causes until the correct disorder is settled upon and can be treated appropriately.

Often, head tilt is a symptom of an ear infection or injury, so your veterinarian will conduct a detailed examination of the ear, with an ear swab analysis of the contents or discharge in the ear canal. A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and a urinalysis. These tests may indicate if your rabbit is suffering from an infection, and if so, what kind. Visual diagnostics are also a necessary part of making a diagnosis. X-rays of the ear and skull will be used to look for the presence of lesions, internal injury, or the presence of tumors, and computed tomography (CT) and magnetic resonance imaging (MRI) can be used to for a more detailed visualization of the internal ear so that the exact location of any lesions or growths can be found.