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A crooked head is difficult to cure and easy to die. Don't you like eating grass?

Causes, treatment and nursing care of patients with head tilt.

Causes and treatment of crooked head disease

It is always sad to see rabbits with crooked heads, and I can't help thinking: Is it right to decide to let them continue to live? Did you have fun? Is it possible for him to be cured? When this happens suddenly to rabbits, most people will have these questions in their minds.

Possible causes of crooked head (also known as torticollis or crooked neck) include:

Middle ear/inner ear infection (middle ear/inner ear inflammation)

Stroke (cerebrovascular injury)

wound

Cancer (malignant tumor)

Neck muscle contraction

Microsporidia encephalitis

Parasites will migrate to the brain.

be poisoned

If you want to diagnose the real culprit, you often need to start by excluding other possible factors. Let's check these reasons one by one, starting with the most likely reason:

Inner ear infection

The infection of the inner ear may be due to the infection of the outer ear (the initial infection was neglected or untreated, but it gradually spread to the inner ear), or the upper respiratory tract infection caused otitis media, which in turn caused the infection of the inner ear; It may also be caused by bacterial infection in the nasal cavity or blood. X-ray photography helps to determine whether the middle ear is infected. Bacteria cultured from infected ears include Staphylococcus, Pseudomonas, Streptococcus epidermidis, Bacteroides, Escherichia coli, etc., which must be treated actively and can be completely cured after long-term treatment.

If there is exudate (pus) in the deep ear canal, it is necessary to do bacterial culture and antibiotic sensitivity test to determine what kind of bacteria it is and which antibiotic is the most effective treatment. However, if bacterial culture cannot be carried out, many veterinarians will use the most effective general antibiotics for inner ear infection, such as Baylor, chloramphenicol or penicillin; If you don't get better after four weeks, you'd better switch to other antibiotics. If antibiotic treatment fails, the veterinarian may suggest that the secretions obtained by surgery should be cultured and tested for drug sensitivity, and these secretions should be cleaned and drained. Antibiotics must be stopped three days before bacterial culture. Another treatment method is to bury a drainage tube (to drain pus), but the secretions produced by rabbits are usually sticky and cannot be drained.

If the phenomenon of crooked head is serious, steroids can be given to reduce the inflammatory reaction. If the rabbit doesn't eat or drink, the veterinarian will inject some nutrient solution under the skin and feed it with a feeding tube. Although the report of middle ear infection points out that the success rate of treatment is not high, I have heard many successful cases of treatment. The secret is to take antibiotics for a long time, which usually takes at least 30 days, but some rabbits may continue to use antibiotics for half a year or for life. If it can't be completely cured, besides medication, care and a good environment should be given to provide a good quality of life.

stroke

Stroke is usually understood by observing clinical symptoms. Stroke in humans is easy to diagnose, but it is difficult for rabbits. Like the human body, it can kill rabbits instantly. If you survive, it may only affect half of the rabbit's face at first, and then the whole body may be affected: one face will droop, one eye may have functional problems, it can't move freely normally, and it will turn around, and so on. Usually it will gradually return to normal after a few months. One of my rabbits had a stroke for about three years, and the symptoms were only on one side of his head. You can't see it if you don't pay attention, but it looks a little funny. Take care of this stroke rabbit, you must pay attention to its diet and movements. Antibiotics are not helpful to improve stroke, but sometimes they can help prevent infection. Acupuncture can also be considered to be helpful to the rehabilitation of stroke.

wound

The swelling of the face, neck or head may be caused by brain injury, which will cause the rabbit's head to tilt. Trauma may also be caused by nerve reaction. Depending on the severity, anti-inflammatory drugs may help the recovery speed.

cancer

Tumors that grow in the brain, neck or ears can cause symptoms of head tilt.

Neck muscle contraction

Muscle spasms can cause the head to tilt temporarily, but once the muscles are relaxed, this situation will naturally be eliminated.

Microsporidia encephalitis

Microsporidia is a parasite of protozoa, which can cause brain diseases (meningitis and small cysts) and paralysis of any part of the body, because all parts of the body are controlled by the brain. (For a detailed introduction of parasites, see Volume III, Issue 2 of HRJ. After this protozoan infection, other symptoms, such as falling, dragging feet or turning over, often appear before the head appears. After these symptoms appear, they may return to normal for weeks or months, and then they will fail. If there are antibodies against microsporidia in the blood, we can know whether the rabbit is infected.

Parasites will migrate to the brain.

Behcet's nematode is a kind of nematode, which was originally parasitic in the intestines of raccoons and skunks. Rabbits may be infected by eating grass and other foods or touching contaminated bedding. After hatching, larvae migrate to the brain, where they live, grow and destroy brain tissue. At present, the treatment is not known. Even if ivermectin is used, the dose that penetrates into the brain may not be enough to kill the larvae (although this drug can kill the larvae before they reach the brain).

be poisoned

Rabbits may be poisoned if they eat something containing lead; Lead can be found in paint, imported pottery or poisonous plants.

How to take care of rabbits with crooked heads, no matter what the reason is, the situation of most crooked heads is very similar: drooping eyes (face down) usually can't be closed and need to be lubricated; Because of the lack of balance, the rabbit "rolled" and couldn't stand up, so I tried not to hold it; If you really want to hug the rabbit, try to hold it as close to your body as possible, and hold it firmly at the same time. According to the size of the rabbit, you can generally find a smaller space to raise him (such as a wool box with a higher box edge); Put an artificial wool blanket under it (urine can penetrate but it can keep dry), and then put a towel roll or a small blanket to support his body so that he won't fall down when he loses his balance. You can also put a plush rabbit toy with him.

Most rabbits still eat, but they may need to be carefully fed by hand. He may not want to eat feed, but if you feed yourself with food, he will usually be willing to eat all kinds of fresh vegetables, carrots and fruits. You can use green bristlegrass and alfalfa instead of supply, so that he can get enough crude fiber. If your rabbit doesn't want to eat, it may be ready to use a feeding tube. There are many kinds of food formulas to feed, and you can invent new ones yourself. The key point is to feed food into his stomach, so that his intestines can continue to wriggle, which can help him recover physically. Here's a recipe: feed with two servings of water, baby food mixed with vegetable flavor, a little banana, some lactic acid bacteria powder, and a little applesauce (or whatever he likes on weekdays). Feed him more and give him as much as you can. If he clenches his teeth and doesn't want to swallow food, pause first and try again later.

Get well or die. Some rickets can be treated successfully, while others can't. Blackberry is a lovely three-year-old French lop, adopted by a family that loves rabbits, and lives happily in a fairy-tale home. Three years later, he was diagnosed with inner ear infection. He was treated with antibiotics for several months and used a feeding tube for some time. Just as she was getting better, she suddenly had a stroke; This time she worked hard for a month, but she died of another stroke. The autopsy found that the infection in her inner ear was almost cured. We don't know why she had a stroke, but she is a brave soldier because she never gives up her life easily. No matter what the real reason is, some rabbits who survive will have a sequelae of crooked head all their lives; I found that the rabbit would adapt well, but the owner couldn't let it go. Rabbit is a great soldier. You can help him win the war of life with incomparable love and carrots.

Treatment of crooked head (torticollis)

Dr Dana M. Krempels

What is a crooked head? In medicine, this condition is called torticollis (Latin means twisted neck). Sometimes the crooked neck will cause the rabbit to tilt its head to one side of its body, which is usually accompanied by imbalance and rapid lateral eye movement, that is, nystagmus. This phenomenon will happen suddenly and gradually, but the result is the same. The rabbit will go to the crooked side. In some serious cases, the rabbit's sense of direction will become so bad that it can't walk, so that it tries to regain its balance and turn around most of the time. This is the most painful thing for rabbit farmers. Too many people make an unwise decision to euthanize their rabbits because they don't want to see them "continue to suffer".

In fact, it is usually treatable, but the recovery speed may be very slow; When all methods have been exhausted and there is no cure, finally consider whether to give euthanasia. But remember, permanent flopping does not "mean" euthanasia. Many crooked rabbits still live a happy life, running around like other normal rabbits.

The most important thing is to get rid of the causes of the crooked head. Once this factor is removed, the posture of the rabbit will be improved. There are many reasons for head tilt, including brain tumors, pustules in the brain, possible infection with microsporidia in the brain (but many rabbit experts doubt the correlation between the two) or stroke. So far, the most common cause we have observed is infection of the inner ear or middle ear. Rabbits usually have one or two symptoms of nystagmus and tilt of the head. Lateral movement usually indicates that the problem is in the middle ear and/or the inner ear;

Rapid eye movements may indicate brain stem damage, but this is not necessarily the case.

The vestibule of the ear controls balance and is located in the cranial fossa cavity at the base of both ears. When the inner ear is seriously infected, the cranial fossa will be filled with a large number of solid, cheese-like pus, which will press into the vestibule of the ear, leading to disorientation and tilt. Slight infection can cause tissue inflammation, and also affect vestibular function and tilt the head. Symptoms of a crooked head often appear suddenly; The faster the treatment, the higher the chance of recovery. Ideally, pus can be seen from the outside of the ear, and veterinarians can take samples for bacterial culture and antibiotic sensitivity test (send samples to the laboratory, culture bacteria in Petri dishes, and then test with several different antibiotics), which can provide veterinarians with two important information: one is the kind of bacteria that cause infection, and the other is to know what the most effective antibiotics are.

Pseudomonas and Pasteurella infection are the most common bacteria causing tilt, but other kinds of bacteria are also possible. Because of this, if samples can be found, we strongly suggest that bacterial culture and antibiotic sensitivity test must be done. After obtaining these two data, veterinarians may use two different antibiotics for treatment. Nowadays, many experienced veterinarians have found that the combination of different antibiotics is more effective for some stubborn bacteria that cause ear infections. No matter what medicine you use, you must follow the instructions and give enough dose and time. Internal/middle ear infection sometimes takes weeks to months to be completely cured, and the healing process may be very slow; It sounds like a long time, but as long as proper care is given and the rabbit eats, drinks and plays, it means that it doesn't want to give up its life yet. This situation is just a sense of loss, and it seems that it will not be painful; Since it is only a temporary problem, we will suggest giving your rabbit a chance to recover.

When antibiotics play a role, veterinarians may also prescribe some drugs to help rabbits adjust their balance, which also helps to control the discomfort caused by dizziness. Meclizine (trade name anti-vertigo) is very effective in controlling dizziness, and veterinarians may also prescribe some short-acting steroids to reduce the inflammatory reaction affecting the vestibule of the ear. We found that sometimes these two drugs can restore the normal posture of rabbits before the infection is completely controlled. Although there is no guarantee that these drugs will be effective immediately, they can still be expected to be effective. I once took care of three crooked rabbits, and all three survived and lived well.

Szlaby's failure suddenly appeared, but after giving Bailly 14 days, he was completely cured. When the other two, hamish and Jamie Blue, came for treatment, the situation was very serious. Jamie Blue is not only suffering from severe nystagmus, but also out of balance and unable to stand well. Many times she rolls involuntarily, so she must put it on the mat so as not to hurt herself. Methionine and steroids are helpful for acute symptoms, but it takes eight months to completely eliminate the Pseudomonas infection in the ear (this bacteria is resistant to all antibiotics except ciprofloxacin and colemycin in the sensitivity test). The main culprit of hamish's failure is Pseudomonas, but this strain has a good response to Baylor and aminoglycosides.

I mention this just to show that the antibiotics we usually choose that are effective for many bacteria may not work, so bacterial culture and antibiotic sensitivity test are still necessary. For Jamie Blue and hamish, acupuncture, shiatsu and massage are all helpful, but it seems that the most effective physical therapy (stopping tumbling) is to do regular exercise on a big playground, which must be big enough for them to run in circles until they can move in a straight line. Now they are both very happy, but their heads are slightly tilted.

Even a slight head tilt can be improved by exercise and massage. The conclusion is that the treatment of head tilt is feasible and the success rate is usually not low. This requires a lot of patience and understanding. Rabbits may not be the same as in the past, or they may not recover as you expected. If your rabbit is willing to struggle, can eat and drink, and shows some interest in his life (even if he is dizzy), he will have a chance to recover. Even if it takes months to treat and take care of this rabbit, it is worthwhile to see it run and jump normally again.