DISEASE SUMMARY PAGE

Head Tilt / Vestibular Disease in Rabbits

Summary Information
Diseases / List of Miscellaneous / Metabolic / Multifactorial Diseases / Disease summary
Alternative Names
  • Torticollis
  • Wryneck
  • Labyrinthitis

See also:

Disease Agents

(B600.12.w12, B601.11.w11, B602.20.w20, B606.13.w13, J15.28.w1, J60.6.w2)

Infectious Agent(s)
Non-infectious Agent(s) --
Physical Agent(s) --
General Description
Clinical signs
  • Head tilt/torticollis (sudden onset)
  • Loss of balance.
    • In severe cases the rabbit rolls and spins continuously.
    • Head tilt, loss of balance and falling are seen with both central and peripheral vestibular disease, while rolling indicates central disease. (B600.12.w12)
  • Nystagmus
    • Horizontal or rotatory but not vertical or positional with otitis interna. (B600.12.w12, J15.28.w1)
      • With peripheral disease, nystagmus is horizontal or rotary, does not change direction if the head position is changed, and has the fast phase in the direction of the lesion. (B601.11.w11, J15.28.w1)
    • Vertical or positional nystagmus suggests central vestibular disease (horizontal or rotatory nystagmus may also occur). (B600.12.w12, J15.28.w1)
  • Ventrolateral strabismus may occur with either central or peripheral vestibular disease. (B600.12.w12)
  • Depression is more likely with central vestibular disease. (B600.12.w12)
  • Cerebellar signs (intention tremor) may be present with central vestibular disease. (B600.12.w12)
  • Hemiparesis and ipsilateral postural reaction deficit may be present with central vestibular disease. (B600.12.w12)
  • Head tremors, proprioceptive defects, hypermetria may occur with central disease. (B601.11.w11)
  • Horner's syndrome or facial nerve paralysis may be present associated with peripheral disease. (B601.11.w11)
  • Downward-pointing eye may show corneal oedema/ulceration. (J60.6.w2)
Further Information
Diagnosis
  • The main causes of head tilt in rabbits are Encephalitozoonosis in Lagomorphs and Bacterial Otitis Media / Interna in Lagomorphs
  • Generally, Encephalitozoonosis in Lagomorphs results in central vestibular disease while Bacterial Otitis Media / Interna in Lagomorphs causes peripheral disease. (B600.12.w12)
  • Some differences in clinical signs may indicate central disease:
    • Head tilt, loss of balance and falling are seen with both central and peripheral vestibular disease, while rolling indicates central disease. (B600.12.w12)
    • Horizontal or rotatory nystagmus may be seen with peripheral or central disease but vertical or positional nystagmus indicates central vestibular disease. (B600.12.w12)
    • Depression is more likely with central vestibular disease. (B600.12.w12)
    • Cerebellar signs (intention tremor) may be present with central vestibular disease. (B600.12.w12)
    • Hemiparesis and ipsilateral postural reaction deficit may be present with central vestibular disease. (B600.12.w12)
    • Horner's syndrome or facial nerve paralysis may be present associated with peripheral disease. (B601.11.w11)
  • Serological testing can confirm whether or not the rabbit has been infected with Encephalitozoon cuniculi; note that a positive result is suggestive but does not confirm that this is the cause of the head tilt, since the rabbit may also have a bacterial otitis media/interna. (B600.12.w12)
  • Pus in the ear canal does not prove that the signs are due to otitis interna. (B600.12.w12)
  • Radiography of the tympanic bullae may show changes indicating infection. (B600.12.w12)
  • Note: 
Treatment
  • Prior to a definitive diagnosis, treat aggressively for both Pasteurella multocida otitis interna and Encephalitozoon cuniculi infection.
  • Initially confine the rabbit to a cage or other safe environment to reduce the chance of traumatic injury, but as soon as possible encourage normal activity: activity actually increases the rate of compensation, while recovery may be reduced with enforced immobilisatiion. (B600.12.w12, B601.11.w11)
  • Prognosis depends on the severity of clinical signs and whether or not the condition is progressive. (B600.12.w12)
    • Signs may improve over a few weeks. (B601.11.w11)
    • Many rabbits with mild head tilt may lead a relatively normal life. (B600.12.w12)
  • Euthanasia is an appropriate treatment for severely-affected rabbits (e.g. with rolling). (B601.11.w11, J60.6.w2)
  • See also treatment for individual causes, particularly:
Associated Techniques
Host taxa groups /species Oryctolagus cuniculus domesticus - Domestic European rabbit
Disease Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referees John Chitty BVetMed CertZooMed MRCVS (V.w65)

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