Head tilt

Question 1

What is the immediate treatment of the rolling rabbit

Answer 1

Place in O2 cage with towels
Let the rabbit roll
No Dx or treatment while still rolling (prevent fracture or other trauma)
Wait until rolling has stopped
History forms

Question 2

Important information about history for rolling rabbit/head tilt

Answer 2

When did it start
Trauma
Parasite prevention
First episode?
Diet
Where was it adopted and when

Question 3

Neurological exam in a rolling rabbit

Answer 3

side of the head tilt
Nystagmus?
CP?

Question 4

Differential for head tilt

Answer 4

Vestibular disease
- CNS: Toxin (lead), bacterial infections, baylisascaris (outdoor), encephalitoozon, degenerative disease, neoplasia
- PNS: Otitis media/interna, head trauma, iatrogenic ear cleaning, unlikely 9polys, neoplasia, aminoglycoside toxicosis), otoconia/otoliths 95-99% of head tilt PNS and it is due to calcium prticles floating in the endolymph

**Vestibular disease is not usually seen with external parasite or even bacterial otitis

Question 5

Differenciating CNS and PNS disease for a head tilt in rabbit

Answer 5

Will both have head tilt and dysequilibrum
CNS: Conscious proprioceptive deficit, hemiparesis, head/intention tremors/hypermetria

PNS: usually only signs are head tilt and dysequilibrum. Sometimes signs of facial nerve paralysis (paresis/paralysis of the eyelids, lip and ear) reduced or absent tear production

Question 6

Treatment of head tilt secondary to otoconia/otolith

Answer 6

• Supportive care and time: Will improve over days to weeks = Fluid and assis feed if not eating!!
• Purposeful head movement - Modifier Epley maneuver (will help move otolith out of the canal)
• +/- Antibiotic (possibly) , Meclizine, midazolam, Meloxicam

Question 7

E. cuniculi clinical signs

Answer 7

Chronic degenerative disease
Mentation change, lethargy (cerebrum)
CP deficits, hemiparesis, head tremors, hypermetria (cerebellum)