If your pet rabbit has a head tilt, it is most likely caused by an issue in the ear or brain. Figuring out what exactly is the cause of the tilt can be a little bit challenging. There can be a few explanations for why your rabbit is suddenly cocking its head to one side or the other, but regardless of the why, your rabbit will need to see a veterinarian if you see a head tilt.
Here are possible reasons for a head tilt in your rabbit, including ear infections and calcium crystals.
Other Symptoms to Monitor
It can be easier to decipher what the cause of the head tilt is from with other accompanying symptoms. Here are some to look out for:
- Loss of balance/falling over
- Walking in circles or bumping into things
- Flickering eye movements, uneven pupils, sinking of the eye(s)
- Drooping on one side of their face
- Drooping ear
Rabbit Head Tilt from Ear Infections
Your rabbit can get an ear infection in one or both ears. The infection can be due to bacteria, yeast, or sometimes a mixture of both—and it can also cause a head tilt in rabbits.
Your vet will take a sample of the debris in your rabbit's ear (it may just look like wax), smear it on a glass slide, stain it, and look at it under a microscope to see if there is an infection. Topical medications (ear drops) are usually prescribed to treat ear infections in rabbits.
If the ear infection is really bad or has been left untreated for a long period of time, the head tilt may remain even after the ear infection has been treated. Some head tilts may remain long term but rabbits may benefit from physical therapy to help retrain and strengthen their neck muscles.
Rabbit Head Tilt from an Abscess
Rabbits are very prone to developing localized infections called abscesses. They can get them just about anywhere in or on their body, and if an abscess is in the area of the ear canal, they may cause a head tilt. Tooth abscesses, abscesses behind the eye, or abscesses under the skin by the ear may all put pressure on the ear canal, causing your rabbit's equilibrium to be off and give them a head tilt. Depending on where the abscess originates, it may require antibiotics or surgery to remove it.
If an abscess is due to a bad tooth in your rabbit's mouth, it will need to be extracted under anesthesia. The abscess may also be filled with antibiotics, surgically opened to allow it to drain, and cleaned out. Abscesses are not fun to deal with. They can be very difficult to get rid of and no one likes to give medications to their pets.
Rabbit Head Tilt from Ear Mites
Ear mites are tiny little pests that make their homes in the ear canals of many kinds of animals. Rabbits are prone to be infested by these arachnids, and when ear mites are feeding on the ear wax in your rabbit's ear, it can be very loud, painful, and annoying to your rabbit. These side effects of the ear mites may cause your rabbit to tilt their head, shake their head, scratch at their ear, and rub their head on the ground in an attempt to stop the pain and annoyance.
Ear mites are usually pretty easy to get rid, of but you need to make sure a medication that is safe for rabbits is used. If the wrong medication is used, you could cause such harm as deafness, pain, and even death to your rabbit. Ear mites can be easily seen under a microscope by your vet and typically once the infestation is cleared up the head tilt will go away.
Rabbit Head Tilt from Calcium Ear Crystals
These crystals or stones are called otoconia and are not able to be visualized with the naked eye but can develop in the ear canal of a rabbit and cause head tilt. The head tilt can be so severe that a rabbit is unable to stand up and may just lay on the ground or even roll. These calcium crystals can be dislodged with targeted manipulation of the head or may move on their own over time. When the crystals dislodge, the rabbit's head tilt may suddenly disappear.
Rabbit Head Tilt from E. Cuniculi
Historically thought of as the primary reason for a head tilt, Encephalitozoon cuniculi, more often referred to as E. cuniculi, is actually unlikely to infect and cause problems in your rabbit in the United States. According to Dr. Karen Rosenthal, a renowed exotics veterinarian, author, and educator, there is no test to determine an active infection and even if a rabbit was infected, the disease is understood to affect a part of the brain that would not result in a head tilt. Tests that are available are antibody, not antigen, tests and only indicate exposure to the protozoan. Head tilts are more likely caused by ear infections, mites or calcium crystals than E. cuniculi.
Courses of treatment for any of the above should always begin with a visit to the veterinarian. Head tilts can improve with proper treatments, time, and physical therapy but your veterinarian will be needed to properly diagnose your rabbit.
Verpy E, Leibovici M, Petit C. Characterization of otoconin-95, the major protein of murine otoconia, provides insights into the formation of these inner ear biominerals. Proc Natl Acad Sci U S A. 1999;96(2):529-534. doi:10.1073/pnas.96.2.529