A rabbit that presents head tilt should be seen as soon as possible as this is always a concern. A good understanding of how to approach head tilt in rabbits is essential for a successful outcome; it is important not only to formulate a list of differential diagnosis in order to establish an adequate treatment plan but also to know how to better support the rabbit during the course of the disease. The two main causes of head tilt in rabbits are E. cuniculi and ear disease. However, other causes such as trauma, neoplasia and degenerative disease have been reported and should be taken in consideration during the investigation.
E. cuniculi (EC) is a well known disease of pet rabbits caused by Microsporidia. A recent study by Keeble and Shaw (2006) reported that 52% of the UK rabbit population is seropositive without showing clinical signs. The spores are transmitted via the urine-oral route and once ingested they target several organs especially kidneys and brain. Affected animals are generally immunosuppressed and show clinical signs such as head tilt and polyuria and polydipsia. At the present moment, both diagnosis and treatment are considered challenging.
Head tilt can also occur due to inner and middle ear infections. Otitis media and interna can be caused not only by untreated otitis externa but also by respiratory infections, common in pet rabbits. A thorough investigation can aid the diagnosis. Although radiographic examination is still considered essential as easily available, CT scanning should be offered when possible as it is considered the gold standard in order to achieve a definitive diagnosis.
This lecture will discuss the differential diagnosis of head tilt in pet rabbits and will give an update of the available diagnostic tests and treatments. Will also give some tips on how support the rabbit patient while hospitalised.