head tilt in rabbits
Health and Wellness

Will My Rabbit Die from Head Tilt?

If your rabbit’s head is tilted, you’ll need to act fast. As well as being painful, head tilt (torticollis) can be very limiting. Simple tasks like eating, drinking, and grooming can become impossible.

Head tilt can sometimes result in death. However, if it is treated early, and proper aftercare is given, many rabbits will return to good health. Parasites and ear infections are the most common causes of head tilt.

Aftercare is a crucial part of the recovery process. If you give your rabbit good home care, this will aid recovery and prevent the spread of disease.

Is Head Tilt Fatal in Rabbits?

Contrary to what you might have read online, head tilt is not always fatal. In fact, some vets believe that we are too quick to euthanize rabbits with a head tilt. Having said that, it is a very serious condition. Rabbits have the best chance of survival if:

  • It Is Detected Early – The window for receiving treatment is small, so the sooner head tilt is detected, the better.
  • The Rabbit Can Function Normally – If a rabbit can still eat, drink, and groom herself (or be supported to do these things), she has the best chance of recovery.
  • The Rabbit is Still Breathing through their Nose – Nose breathing is a good sign because this is how rabbits are meant to breathe. If your rabbit’s head is tilted and she is breathing through her mouth, this would be classified as a medical emergency.

If the head tilt is severe and the rabbit is in intense pain, it is sometimes kinder to let them go.

What Is Head Tilt in Rabbits?

The clinical term for head tilt is torticollis (also called wry neck). In some cases, the head tilts to the side, and in other cases, it tips upwards. Torticollis can be mild, moderate, or severe. Some rabbits have a very slight head tilt, whereas others have a contorted neck.

Sadly, rabbits with torticollis are often agitated and difficult to comfort. This is probably because they are in pain. If they cannot keep their head upright, they’ll struggle to eat and drink.

Having said that, some rabbits with torticollis can function normally. Even so, they must be seen by a vet because the tilt may get worse.

What Causes Head Tilt in Rabbits?

Head tilt is a symptom of disease, rather than a disease in itself. So, it can be caused by many different factors. The most common causes are:

  • Parasite Infections – Encephalitozoonosis is a life-threatening parasitic infection that can cause wry neck in rabbits. Other dangerous parasites include Cuterebra, Baylisascaris, Toxoplasma gondii, and ear mites.
  • Bacterial Infections – These infections usually start in the rabbit’s nose or windpipe. If the infection moves into the inner ear, this can cause the head to tilt.
  • Muscle Spasms – These are temporary and can be brought on by stress, excitement, or unknown causes.
  • Cardiovascular Disease – Rabbits with heart disease may fling their head backwards to take in more air. Stroke can also cause a head tilt.
  • Tumor – In a small number of cases, a tumor in the brain, neck, or ear can cause wry neck.
  • Trauma – Head injury is rarely the cause of head tilt, but it’s something to be aware of.

Some of these causes are much more common than others, so let’s explore the common causes of head tilt in more detail.

Encephalitozoonosis and Head Tilt

One of the most common causes of wry neck is Encephalitozoonosis. This condition is caused by the Encephalitozoon cuniculi (E. Cuniculi) parasite. This tiny parasite invades the rabbit’s cells. The cells in the central nervous system (brain and spinal cord), eyes, and kidneys are most affected.

If a rabbit is infected with E. Cuniculi, it usually takes several weeks or even months for the head to tilt. The first signs of infection are:

  • Tripping
  • Dragging feet
  • Swaying or circling

So, if your rabbit has become increasingly clumsy, this suggests a parasite may have taken hold.

Why Early Treatment Is Important

Early diagnosis is essential to prevent severe head tilt. But it’s not just the head tilt you should be worried about. According to BMJ, Encephalitozoonosis can lead to:

  • Eye Disease
  • Kidney Disease
  • Heart Disease
  • Lung Disease – this is rare, but it could potentially lead to pneumonia.

How Do Rabbits Catch E. Cuniculi?

This tiny parasite can be found in the pee and poop of other animals. So, if rabbits touch, or even breathe in these spores, they can become infected. The following are risk factors:

  • Living with another rabbit that is carrying the E. Cuniculi parasite. Sometimes, rabbits carry the parasite for years without showing any symptoms. Ideally, if you are adopting a rabbit, you should have them screened for E. Cuniculi.
  • Cramped living conditions
  • Dirty and unsanitary living conditions
  • Breeding houses with multiple other rabbits
  • Contact with wild rabbits or rodents
  • Stress, steroids, or anything that weakens immunity – If a rabbit is carrying E. Cuniculi, a weakened immunity could flare up this disease.

Cuniculi can also be passed from mother to child during birth. And according to Sage, Encephalitozoonosis is more common in dwarf rabbits than non-dwarf rabbits.

Other Parasitic Infections in Rabbits

Cuniculi is the most common parasitic infection, but there are some others to be aware of. The following four parasites can be caught from pets, wild animals, or insects.


Cuterebriasis is a parasitic disease that affects rabbits and cats. It can cause severe head tilt and death. The Cuterebra is a species of fly.

This fly lands on the rabbit’s fur and lays eggs in their skin. The eggs enter the rabbit’s central nervous system and cause imbalance, torticollis, and collapse.

Toxoplasma Gondii Infection

Cats are most often affected by Toxoplasma gondii, but it can occasionally affect rabbits.

Rabbits can catch this parasite from the urine and feces of cats. Toxoplasma gondii infection causes head tilt and imbalance. In rare cases, it can even spread to humans.

is head tilt in rabbits contagious?

Ear Mites

Ear mites are another parasite that can cause head tilt. Some early symptoms of ear mites include head shaking, excessive scratching, and grunting.

Baylisascaris spp.

This is a type of roundworm which lives in the intestines of raccoons and skunks. Rabbits could come into contact with this parasite if they are allowed to graze outdoors. Also, certain types of bedding may be contaminated with Baylisascaris spp.

If the eggs enter the rabbit’s central nervous system, they will start to eat away at the brain tissue. In the short term, this may cause head tilt.  This parasite will almost certainly cause death once it reaches the brain tissue, so early detection is vital.

Bacterial Infections and Rabbit Head Tilt

Bacterial infections are another disease that can cause a wry neck. Most bacterial infections start in the rabbit’s nose or throat. Bacterial infections can make it difficult to breathe. So, rabbits will often cock their head sideways or upwards to try and breathe more clearly.

If bacterial infections are contained in the nose or throat (and they don’t travel to the middle ears), they may only cause a slight head tilt. Additional symptoms include:

  • Coughing, sneezing and wheezing
  • Slow or rapid breathing
  • A milky or cloudy discharge from the eyes and nose
  • A reduced appetite
  • Lethargy
  • Flaring of the nostrils

If treatment is not provided, the infection may move from the nasal passages into the inner ears.

Inner Ear Infections and Rabbit Head Tilt

Inner ear infections are one of the most common causes of head tilt. As mentioned, they often start in the nose and then spread to the inner ears.

By the time the infection reaches the inner ears, the head tilt will be very pronounced. In most cases, rabbits with ear infections refuse food and water. This can quickly lead to weight loss and gastrointestinal stasis, so it is a medical emergency.

Various types of bacteria can cause rabbit ear infections. The most common type is Pasturella multocida. But others include, Staphylococcus sp, Pseudomonas aeruginosa, and Bordetella bronchiseptica (Kennel cough).

Is Head Tilt in Rabbits Contagious?

If your rabbit has a parasitic or bacterial infection, then this a health risk to others. Most of the infections mentioned in this article are contagious to cats, dogs, and other animals.

For example, Toxoplasma gondii is contagious to cats. And Bordetella bronchiseptica is contagious to both dogs and cats. What’s more, some infections could even spread to humans.

Science Direct provides an example of one older woman who caught Pasturella multocida from her rabbit. In reality, it’s rare for humans to catch P. Multocida from rabbits. But, anyone with a weakened immune system should take extra precautions.

But head tilt is not always contagious. If the head tilt is caused by one of the conditions discussed below, then it will not spread to others.

Muscle Spasms and Head Tilt

Muscle spasms are tricky to explain, because, in some cases, they can be a symptom of infection (parasitic or bacterial). But, in other cases, they are not a sign of illness.

For example, rabbits occasionally spasm when they are overstimulated. Either they’ve been given a tasty treat, or they’ve been stroked for too long. These occasional muscle spasms can cause the neck to stiffen, which can cause a temporary head tilt.

If your rabbit’s head tilt just lasts a minute or two, it is probably not a cause for concern.  However, if it happens regularly, or for long periods, this should be investigated.

Heart Disease and Rabbit Head Tilting Back

Rabbits with heart disease often tip their head back. This could be because they are struggling to breathe, and this position provides relief.

Heart disease looks similar to parasitic infections, so it is hard to distinguish between the two. For example, both conditions can cause labored breathing, loss of appetite, and head tilt. Perhaps one notable difference is that rabbits with heart disease have bulging eyes.

Also, if left untreated, parasitic infections can develop into heart disease. For example, Encephalitozoonosis can develop into secondary heart disease.

rabbit tilting head back

Stroke and Head Tilt

Stroke is another cardiovascular disease that can cause head tilt in rabbits. It is rare, but it’s important to be aware of the symptoms. Stroke symptoms include:

  • Facial weakness (one side may droop)
  • Nystagmus – Side-to-side eye movements
  • Circling
  • Tremors
  • Paralysis – particularly in the hind legs

Stroke has identifiable symptoms, so it is not easily confused with other conditions.

Trauma and Wry Neck

A wry neck is occasionally caused by head trauma. Rabbits get bumps to the head for all sorts of reasons. For example, if your rabbit is suddenly stunned by another animal, they may run away and accidentally hit their head. Rabbits are flighty creatures, so these accidents are reasonably common.

Injured rabbits are typically prescribed pain relief. Otherwise, they’ll find it difficult to eat, drink, and wash.

Tumors and Neck Tilt

Your rabbit’s neck tilt could be caused by a tumor in the face, back or neck. A tumor is a collection of cells that grow and create an abnormal lump.

The lump may contain fat, water, blood, or cancer. Cancer is very rare in rabbits so, even if your rabbit did have a tumor, it’s unlikely to be cancerous.

Even so, benign tumors still need to be examined because they may cause a painful head tilt.

How is Head Tilt Treated in Rabbits?

When you take your rabbit to the vet, they’ll do some investigative work, and provide one or more of the following treatments:

  • Rabbit Head Tilt Medication – Most infections will be treated with antibiotics. For example, tetracyclines are often prescribed for Encephalitozoonosis. If your rabbit has a cardiovascular illness, a different type of medication will be prescribed.
  • Fluid Therapy – A fluid injection may be necessary if your rabbit is struggling to drink.
  • Nutritional Therapy – Your rabbit may need to be fed with a syringe until they get their strength back.
  • Physical Therapy – Gentle back and neck massage can sometimes be useful for rabbits with wry neck. Don’t attempt to do this at home as it must be performed by a professional.
  • Pain Medication – There are various types of pain medication and anti-inflammatories. Corticosteroids can be effective if they are used sparingly. But, if they are used for too long, they can make things worse.
  • Surgery – In rare cases, surgery may be required to fix a head tilt.

Aftercare for Rabbits with Head Tilt

Your vet will tell you how to care for your rabbit during the recovery period. It’s important to follow this advice as it will be personalized to your bunny. Below is some advice on rabbit aftercare:

  • Warmth – When rabbits are healing from an illness or injury, they need to stay warm (but not overheated). If your rabbit usually lives outdoors, it’s a good idea to bring them indoors until they are fully recovered. But, try to make sure the ambient temperature does not rise above 23°C or 73 Fahrenheit.
  • Cleanliness – Rabbits with a head tilt may find it hard to stay clean. If your rabbit needs a helping hand, give their coat a brush and wipe over with a damp cloth. Dry them gently with a microfiber towel so they don’t get cold. And wipe her eyes with cotton wool and warm water.
  • Food and Drink – To prevent gastrointestinal stasis, your rabbit needs to eat and drink. Offer something tasty to eat, such as herbs or fresh greens. If this doesn’t work, you may need to feed your rabbit through a syringe. Speak to your vet for advice.

Preventing Head Tilt in Rabbits

Head tilt is a life-threatening condition, so we do our best to prevent it. Here are some tips:

  • When adopting a new rabbit, have her screened for Encephalitozoonosis. Remember, this parasite can sit dormant in some rabbits for years. If the rabbit tests positive, your vet may recommend treatment.
  • Make sure your rabbit hutch is spacious enough for the number of rabbits you have.
  • Clean the cage regularly to prevent infections.
  • Check your rabbit’s fur regularly for signs of urine scalding (wet tail) and flystrike.
  • Do not let your rabbit come into contact with wild animals, especially wild rabbits and rodents.
  • Limit your rabbit’s contact with household pets, such as cats and dogs.
  • If you have cats or dogs, provide regular flea treatment. Also, clean up any cat poop immediately. Disinfect any areas that may have been contaminated with cat urine or feces.
  • Check for any signs of illness daily.

Many of these diseases don’t cause a head tilt overnight. To begin with, they cause milder symptoms such as swaying, tripping, and rapid breathing. If you can catch the disease early, your rabbit will have the best chance of survival.