Torticollis treatment advice

Question
Dear Dr. Krempel,

I hope you can help my bunny Booboo get well with some thoughts on which course best to pursue in his treatment from this point on.
This is the recent history:
Booboo is now three years old.
On the night between September 5th and 6th Booboo became depressed and very unwell. He could not eat or drink or poo. He was unable to lie down, sought the darkest and quietest corners, and occasionally chose to sit in corners facing the wall. At the time I thought it was from the pain but he wasn't grinding his teeth. I took him to the vet first thing on the 6th with a certainty of GI stasis.
On this visit he was given an injection of Metoclopramide 5mg (he is a 5LB gorgeous black otter lop), a dose of laxatone, and Probiocin. Within an hour after coming home from the vet Booboo was able to lie down on his stomach but as he was resting in this position with his right side against a wall I noticed an alarming new symptom. As he was dozing off his head kept falling to the right while his left eye (the one I could see) moved vertically in a manner of positional nystagmus. This motion was continual, the head would start falling to the right as the left eye acted in this slot-like manner. He would pick up his head back to the center and then it would start to fall again. He was getting worse and I took him back to the vet's office as soon as he was back from his lunch hour. At this time I requested re-examination, abdominal radiograph, and subcutaneous fluids. Radiograph revealed no gas but Booboo's stomach was filled with food and the portion of it could be seen descending in the small intestine but it wasn't moving any further from where it was. So, there was no bloat, no apparent intestinal obstruction, only a complete stasis. At his time the vet made one good guess which was that the stasis was a symptom secondary to the neurological problem eventhough the onset of symptoms was in a reverse order. Booboo's ears were completely clear on this as well as subsequent exams so there was nothing to culture. His molars are also not cause for any suspicion.
Booboo was given an injection of .5cc Baytril and prescribed this dose orally, twice a day.
This same day, after this second visit I kept researching more, got fresh pineapple and papaya to make juice for him, as well as pedialite. Every 4-5 hours I'd give him his fruit juice and followed with a dose of laxative 45min later. After reading even more, specifically about possible laxative contra-indications and its viscosity potentially cementing the matter in the stomach, I quit giving it to him so that his last dose was before midnight that same day (the 6th.) Simultaneously, I felt that this was the extent of this particular vet's ability to treat Booboo. The next day, we looked for another one. In the meantime I started Booboo on Critical Care that I have for him in his 1st aid kit. We saw the second vet on the afternoon of Sept. 7th where I recapped the events of the preceding 36 hours. Booboo was re-examined, given subcutaneous fluids, a 5mg injection of Reglan, and an injection of Baytril to help fight the suspect infection and bypass his stomach in this critical state. This vet's diagnostic assumption was Pasteurella infection. Again, nothing could be gotten out of his ears to culture. In the course of this first week Booboo's symptoms progressed so it was clear that he's suffering from Torticollis but the presence and the lack of certain symptoms make it difficult to know if the problem is peripheral/inner ear, or central. Booboo's balance was clearly affected, he rolled, his head was tilted, he had anorexia and general dullness/weakness/depression. However, he never circled (runs a super straight line), there are no gait abnormalities, never had rotary or vertical or horizontal/positional nystagmus except on that first day between the two visits to the vet(assuming that's what it was.) Now, here is the situation at this time:
We have the third vet on board but that hasn't shed light on what caused Booboo's Torticollis. Today is the 18th day on Baytril and Booboo's condition is remarkably improved. We gradually went from complete inability to eat, drink, and poo, subsequent days in our own make shift ICU, force feeding and hydration, intensive round-the-clock supportive care which included massage therapy, to fresh greens and drinking out of a shallow bowl, to fairly happy poops and cecotropes...In body and spirit Booboo is so much better now but I fear for him like I cannot tell you. We have nothing in diagnostic terms and if Pasturella is to blame, is it possible that it has responded so well to Baytril as I have read about a failure of Enroflaxacin to eradicate Pasteurella (a German lab study from '95.) In any case, it's fairly safe to say that causes other than pathogens can be eliminated as Booboo's indoor habitat is as ideal as they come for a single house bunny. Trauma, toxins, heat stroke are not plausible causes as Booboo lives in a very safe and controlled environment but not dull or depressing by any measure.
I will do everything to keep Booboo well and happy and so  I do not want to leave anything to chance or make an oversight. Is there a diagnostic test that would still make sense to do now, a nasal swab par example? Is it possible that Booboo's infection is anything but bacterial if his condition is so much improved in the second week on Baytril? Should I ask that Chloramphenicol be added to his Baytril? How long should he be on antibiotics to give him the best chance and avoid bacterial resistance? Is it still possible E. cuniculi might play a part in the clinical picture when his improvement has been so remarkable without use of bendazole meds?

You are a champion and a fairy god-mother of so many bunnies dear Dr. Krempel.
My Booboo Sweets sends a kiss. I shan't be jealous as so many of bunny parents I'm in your debt and feel only gratitude for your magnificent work.
Katarina

Answer
Dear Katarina,

The old saying goes:  If it ain't broke, don't fix it.  If the condition is improving with
Baytril, then stay the course.  It might not be Pasteurella.  A number of different bacteria
can cause intracranial abscesses that produce the signs you have seen in BooBoo, but as long
as they are sensitive to Baytril, I would not add anything else.

It is possible the condition could recur some day.  That will depend on whether any of the
causative bacteria survive this round of antibiotics (for this reason--especially in cases
of intracranial abscesses--it's wise to do as long a course as possible, and continue the
meds for at least 10 days after signs have subsided), and how good BooBoo's immune system
is.  But even if it recurs, and even if the new population of bacteria are resistant to
Batryil, there are other, related fluoroquinolones that could also be effective (e.g.,
ciprofloxcin, marbofloxacin, difloxacin).  You can try those, even if there's nothing to
culture.

It seems that the Baytril is helping, so it's likely this is an abscess. But in case it does
recur, you should read (and perhaps share with your vets) this exhaustive overview of the
various causes of torticollis in rabbits by Susan Brown, DVM.

www.rabbit.org/health/tilt.html

It is excellent, and should really help.

Don't worry too much.  Keep calm and keep up the meds.  Booboo can pick up on your emotions,
and if you're stressed, so will he be.  Do all you can (as you are), and watch him improve.
And then hope for the best.  This is not an uncommon condition, and it is treatable.

I hope this helps!

Dana