Caring for the Small Pet With Head Tilt

  • by Phyllis O’Beollain



    Regardless of the cause, if your rabbit or other small pet has head tilt, he or she is going to need special care – maybe for weeks or months or longer.


    Lack of balance

    Problems with the pet’s sensory perception are the cause of their lack of balance, inability to stand, circling and possible “rolling” (trying to gain their footing). This incoordination may necessitate a smaller habitat to prevent self-injury; a smaller cage or perhaps a box with higher sides. Pad any protrusions in the habitat (which cannot be removed) with blankets or towels to prevent injury. Put fake sheepskin (available at fabric stores) on the floor of the habitat to wick urine away from the pet. Rolled towels can be placed on the floor of the habitat so that he will be less likely to roll when he loses his balance. If he has no bonded pet friend, sometimes a small stuffed animal can be comforting.

    Your pet is already experiencing confusion as to the stability of the surface they are standing on; picking them up is going to exacerbate this. If you must pick your pet up, hold him securely against your body to help him feel more stable and secure.



    If your pet has facial paralysis, the eyelids will likely droop or even be unable to close. The eyes will need to be protected with ointments that your veterinarian will prescribe. Remove litter that contains excessive dust; and switch to a pelleted paper litter, shredded newspaper, or whatever is appropriate for your pet. Trim your pet’s nails to prevent them from accidentally scratching themselves in the affected eye.


    Eating and drinking

    Many pets with head tilt will not be able to eat, or will need lots of encouragement to eat. Hand feed them fresh vegetables and greens and even a bit of fruit to tempt them to eat, even if they are rejecting their pellets at this point. Rabbits especially are going to need to get hay into their tummies; you may want to try them on alfalfa hay if they are rejecting timothy hay. My neurologically impaired bunny will often eat alfalfa hay while rejecting everything else, including treats; it then seems to jump start her appetite for other foods.

    Food dishes need to be shallow. Watch your pet to figure out the best height for optimum access to food. A very shallow bowl or small plate may work, but sometimes a pet will inadvertently push their food off the other side of the dish and then not be able to get to it easily. My Oreo now uses a food dish with one side cut down which the small teenager hand-threw for her; a spoon rest might work well for you if you have no small potters in the house.

    If your pet refuses food altogether, you may need to syringe feed him. This is especially critical with rabbits; should their gut stop moving (stasis) it could potentially be fatal. Your veterinarian or vet tech will show you the correct technique; improper syringe feeding can cause aspiration (food or fluids into the lungs) and resulting pneumonia. Your veterinarian may prescribe Critical Care, a nutrient-packed food supplement for herbivores which can be mixed with water for syringe feeding. Your veterinarian may also be able to prescribe medication to reduce dizziness and nausea in your pet. You will need to feed your pet as much as he will accept at frequent intervals during the day.

    You will need to monitor your pet’s water intake – he may not be able to use a water bottle, and his lack of coordination will make it more likely that his water bowl will get tipped over or soiled. Do NOT use a large or deep bowl, as the pet’s lack of head control makes it more likely that he will aspirate (choke) on his water; he will need a shallow, heavy bowl (or two – a bowl at each end of the habitat will encourage drinking).


    Rabbits and cecotrophs

    As you may know, rabbits have two types of droppings; the ones called cecotropes are re-ingested by the rabbit to derive the optimum nutrition from the food and improve the digestive process. These droppings generally look like a small mass of grapes. If your rabbit’s condition is such that they cannot reach the anal area and the cecotropes, you should collect them and place them in an area where the rabbit can reach them. It is important to offer them but please do not worry excessively if your rabbit rejects them.



    If your pet is unable to move about much, it will be more prone to develop pressure sores. To minimize the chances of this, make sure your pet is on a soft surface that is covered with a material that wicks the urine away from the pet (fake fleece from the fabric store). Your pet may need to be turned from side to side multiple times a day – every two hours if that is possible.

    Urine and feces on the skin cause irritation, inflammation, pain, and can cause a secondary bacterial infection, so keep your pet’s personal areas clean and dry. Unscented baby wipes can work well for this. Your veterinarian may prescribe a soothing ointment to protect this area. Larger pets, such as rabbits, may benefit from diapers.


    Exercise and flexibility maintenance

    Your pet should be encouraged to exercise if /she is able; this will increase the appetite, help with digestion, maintain muscle tone, prevent joint stiffness and improve circulation. Even if your pet is not able to exercise, if you very gently flex and extend the limbs several times a day, as well as gently massage them, this is also very beneficial. In addition, some pet owners have reported definite improvements with the use of acupuncture and chiropractic treatments.



    Recovery from head tilt may never be complete; some neurological damage may be permanent (although this might only be a slight head tilt). If you are willing to take on the responsibility of caring for your pet’s special needs, most of these pets can live a happy life. Pets do not mourn for lost abilities or the changes in their lives. Pets live for the moment and adjust better than most people; generally it is the caregiver that has more of a problem with the aesthetics of the situation.

    Be patient. Some pets recover completely, some don’t. Pets who are permanently disabled are not necessarily unhappy. If your pet is eating and drinking, trying to groom, and moving about as best he can, he is showing signs he is recovering and enjoying life. If he has no appetite, is lethargic and depressed, and unresponsive to you, you should consult with your veterinarian to determine if the pet is in pain, what the long-term prognosis is, and what will be best for him.


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