Torticollis

Question
Dear Randy,
Last night, when my daughter went to the basement to feed her rabbit, she discovered what we thought at the time was a broken neck.  Now, after reading your answer to another owner and from a quick immersion into the topic, I think her bunny has torticollis.  I am not sure at this point what out position will be, but what I need to know is 1)Can humans contract the bacteria from either touching the bunny or cleaning out the cage? and 2) Can the condition correct itself without antibiotics?  Thank you so much for your help, Patricia

Answer
Hi Patricia,

Torticollis...aka head tilt or wry neck...can be a very complex issue depending on the cause.  I think you already know that the vast majority of these cases are caused by a bacterial infection....either primary or secondary to another underlying cause.  

A disease that can pass from humans to animals or animals to humans is known as a zoonosis.  Most, but not all, bacterial infections in a rabbit are caused by a pathogen known as Pasteurella Multocida.  Nearly every mammal (including humans) and many birds carry this bacteria sub-clinically....meaning we already have it but our immune system is keeping it contained.  This bacteria, if this is the cause,  carries no greater risk to humans than any other bacteria out in the world. Obviously the very young, the elderly or those with suppressed immune systems do carry a higher risk of contracting a bacteria, but our immune systems can usually handle these things with no problems.  Honestly, you have a much higher chance of getting a bacteria from a public area than from an animal.  I deal with very sick animals all the time and don't really worry about it.  Just normal santiation....just wash your hands with warm water and soap after handling the rabbit.

I would consider this an emergency and seek the advice and assistance of a rabbit savvy vet.  These type of infections can escalate quickly.  The infection can easily enter the brain.  By treating the infection early and aggressively, there is a much better chance for recovery.  Honestly, most vets undertreat vestibular infections.  The general rule for years has been the use of certain antibiotics that are considered "safe".  But are they effective?  Increasingly, the answer is no.  I now use drugs against these infections, and use them in combinations with other drugs. to aggressively attack these infections...and most of these more aggressive treatments are not widely known. Some of the drugs I use now were considered "unsafe" or "fatal" if used in a rabbit..and that was just a couple of years ago.

The proper way to treat this is to culture any debris in the ear.  If the culture returns with "no growth" it could mean a couple of things.  It could mean the infection is not bacterial.  But, pasteurella is notoriously difficult to grow in a dish...so we go by symptoms and body temp.  If we have no growth and an elevated body temp, I suspect and treat for pasteurella.  Most vets will prescribe a Sulfa drug like Septra or an enro/ciprofloxacin like Baytril or Cipro.  We are seeing these drugs become ineffective.  I generally use a combination of Zithromax and Pen G (a derivative of penicillin).  You will often read articles that state never to use penicilliin in a rabbit...not accurate.  But as with any medical treatment, there can always be side effects.  Do not attempt to use these drugs except under the direct instructions of a rabbit savvy vet.  Administering these drugs in an improper dose or administration route will result in death of the rabbit.  The dosing and the manner the drugs are administered are crucial.  I am not suggesting using these drugs...I only mention them to offer "points of conversation" to discuss with your vet.

I have never seen a case of tilt resolve without intervention.  Not saying it's  impossible but it is highly unlikely.  The longer it takes to get medical attention to this rabbit, the less likely the tilt will correct.  Ear infections are also quite painful and uncomfortable so pain management should be in place. We have treated ear infections continuously on a rabbit for as long as 8 months.  I really would like to see this rabbit at a vet as soon as possible.  If your vet is unfamiliar with treating this, I would be glad to consult with him/her.  Since I am not a vet, some doctors won't do that..but many others realize what I do and are willing to learn.  And when they learn, it also gives them the opportunity to enhance and improve on my protocols...and that is a win for the rabbits.  Please get him to a vet...and don't hesitate to contact me if I can help you more.  I will be out of town from early afternoon on 1/12 until maybe early afternoon on the 13th but I will check back as often as I can until that point.

Randy