Head Tilt / Vestibular Disease

What is it, what causes it, what to watch for and what to do!

Authored by:

Edited by:

Jacqueline Arndt

Sarah Erickson and Carrie Oswald

Before we do a deep dive into Head Tilt it is important to note that this is an illness that requires emergency care. Any suggestions made below or by volunteers is not a replacement for medical care and should never be treated as such.


So, what is it and what causes it?


Head Tilt can also be referred to as Vestibular disease or Wry Neck. This condition can be caused by a few different factors such as an infection of the middle or inner ear, head injury, parasite infestation, or a protozoal parasite known as Encephalitozoon cuniculi (often called E.C. or E. cuniculi for short). Head Tilt causes nerves within the ear to send incorrect signals to the brain, and this often results in a loss of balance, wobbling, or a posture in which the head is turned/tilted. Oftentimes this can cause permanent changes to a rabbit’s sense of balance. Head Tilt can come on gradually or suddenly. If a bunny parent is very lucky, they may notice the issue early on when the rabbit has a slight quizzical tilt to its head but oftentimes, we may come home from work to find a fully tilted rabbit struggling to maintain their balance.


What to watch for!


If you notice any of the following symptoms you should bring your rabbit to a rabbit-savvy veterinarian as soon as possible! Within 3-12 hours of the first symptom a rabbit will often succumb to total loss of balance. Prompt treatment is vital to recovery.


  • Holding the head to one side (a handy trick to test this is to offer a bunny their favorite treat and make them run to you to watch how they move)

  • Hopping or turning in one direction only

  • Tumbling or inability to stand unassisted (it is important to protect the rabbit if/when they reach this point to prevent any injury)

  • Nystagmus (rapid, involuntary, repetitive movement of the rabbit’s eyes)


What to do!


Take a deep breath and calm yourself. Head Tilt can be scary, since it is hard to see our bunnies lose their balance and tumble so violently, but we need to be their calm port in this storm.

  1. Place the rabbit in a carrier that has been padded with towels or blankets. It is important to ensure these towels or blankets do not have any holes or loose fibers/strings that the rabbit could wrap around themselves while tumbling as this could cause strangulation or loss of blood flow and we certainly don’t need any other problems! We also want to make sure this carrier does not have any openings that a foot or leg may become lodged in during tumbling episodes. As always, if your rabbit is bonded, they should remain with their partner. Their mate can act as a source of comfort and a sturdy object to lean against. However, keep an eye on the bonded partner’s behavior. Sometimes the healthy rabbit may be scared or disturbed by their partner’s rolling and may lash out.

  2. Contact your designated rabbit savvy daily/emergency facility. Any facility worth their salt should understand the severity of Head Tilt but in the off chance you get a newer/training team member do not take no as an answer, if they try to schedule you for tomorrow or the next day ask to speak to another team member. You are your rabbit’s greatest advocate, do not be afraid to be pushy! If for whatever reason you are unable to get into your designated facilities right away, you may contact the RMHRR 24-Hour Healthline (https://www.rmhrr.org/rabbit-emergency-information) and we will offer advice until you can get your bunny to an emergency vet appointment. *We are not licensed veterinarians, and cannot offer medical treatment*

  3. When transporting your bunnies from your home to your vehicle it is important to prewarm/precool your vehicle and ensure they are placed securely, with the carrier crossways, in the back seat. A slow, calm, and steady trip to the veterinarian is much less stressful than a speedy, chaotic trip. The last thing a bunny with Head Tilt needs is to sit in the car while you deal with a speeding ticket or fender bender.

  4. Once your rabbit has been examined by a veterinarian the treatments offered may vary due to the suspected cause. In some cases, additional testing may be utilized to identify the cause. Common treatments may include but are not limited to: Antibiotics to address infection Dewormers to address parasitic involvement Anti-nausea or motility drugs to stimulate the digestive system as Head Tilt can sometimes cause GI Stasis IV or subcutaneous (sub-q) fluids to address dehydration Anti-inflammatory agents in case of possible discomfort from infection

  5. It is important to note that even with prompt treatment that Head Tilt can take weeks or even months to resolve. During this time, it is important to move the rabbit to a safer environment. Depending on the severity of the illness you may need to pad the perimeter of the rabbit’s area with rolled towels or blankets, like baby crib bumpers, to reduce the possibility of injury. Like with the carrier, it is important to ensure there are not any holes, loose strings or openings that could cause further injury to the rabbit. Other possible changes include low/easy entry litter boxes or the use of puppy training pads, and low/easy access water and food sources. In many cases some rabbits may need daily supplemental sub-q fluids and syringe feedings.


Do not hesitate to reach out to Rocky Mountain House Rabbit Rescue for advice. We deal with this illness regularly and are more than happy to help in any capacity. We understand the immense physical and emotional toll this illness takes on both bunny and parent and we want to be there for you!


If there is one thing we here at RMHRR cannot stress enough about Head Tilt - it is that a tilted bunny can still live a completely normal, happy, and fulfilling life. Head Tilt is never a reason to euthanize. Yes, the road to recovery can be long and can require a lot of creativity and ingenuity, but we owe it to our bunnies to give them every chance to succeed and recover! It is also important to know that even if treatment is prompt and recovery went smoothly that a bunny’s head may or may not return to normal AND THAT IS TOTALLY OKAY! This doesn’t mean that you did anything wrong or that the bunny is suffering.


It just means that your bunny has a new outlook on life, they are tilted and not broken!