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How to deal with the dreadful rabbit head tilt?

Vet Talks 3 min read
Image of a gray bunny with very long ears to illustrate an article about rabbit head tilt and e. cuniculi in bunnies.

As a bunny parent, you have probably heard that the rabbit head tilt is one of the scariest symptoms of E. cuniculi. But what is this disease that infects more than 50% of rabbits worldwide after all? E. cuniculi is short for Encephalitozoon cuniculi, a primitive fungus. This fungal infection affects mainly rabbits but can occasionally happen in mice, guinea pigs, rats, and dogs.

Rabbits can get the infection from their mothers, in utero, or by ingesting the spores present in the urine of an infected bunny. So making sure your little one is examined by a veterinarian as soon as they are welcomed into your family, learning more about their health history and doing research on the most common diseases that affect rabbits are good ways to prevent problems like E. cuniculi

With an early diagnosis, vet-prescribed treatment, natural support and extra love, a bunny with E. cuniculi can still have a good quality of life. 

What are the signs of E. cuniculi in bunnies?

The rabbit head tilt is one of the clear signs that your little one might have E. cuniculi. Back leg weakness, loss of balance, tremors and paralysis can also happen from the swelling and destruction of the nervous tissue in that area. Other than affecting your rabbit’s central nervous system, E. cuniculi can also lead to kidney and eye problems.

Signs of kidney failure and bladder weakness in your little one may include increased thirst and urination, weight loss and decreased appetite. NHV Tripsy may help support and protect your bunny kidneys in these cases. 

The rabbit head tilt is one of the clear signs that your little one might have E. cuniculi.

The E. cuniculi fungus can also affect the eyes of unborn rabbits as a result of in-utero infection. This may cause destruction of the lens and eye issues later in life (usually at around six months to two years of age). In these cases, NHV OcuLove can help maintain healthy eye function. Sometimes surgery in the eyes may also be required as the rabbit may develop a cloudy lens and cataracts

Unfortunately, once the rabbit develops severe clinical signs, E. cuniculi can be fatal. So if you notice any of these signs on your bunny, you should visit a local veterinarian for a diagnosis right away.  

Photo of two vet professionals drawing blood from a gray bunny to diagnose the dreadful rabbit head tilt and E. cuniculi in bunnies.

Diagnosing and treating E. cuniculi in rabbits

Caring for a rabbit with E. cuniculi should always start with a frank conversation with the vet. The specialist will diagnose your furkiddo based on the clinical symptoms described above, with the rabbit head tilt being the most obvious sign. Laboratory tests such as serologic testing and histopathology can help confirm the diagnosis. 

Some evidence suggests that some anti-helminthic (antiparasitic) drugs may be effective, but there is still no effective treatment accepted by the veterinarian community. The use of steroids in rabbits is also controversial, but they have been used in select cases due to their inflammatory properties on the central nervous system.

That is why it is very important to talk to a specialized vet before medicating your furry friend. 

Caring for a rabbit with E. cuniculi naturally  

Natural herbal supplements can work alongside the vet-prescribed treatment to offer extra support to a rabbit with E. cuniculi. NHV Milk Thistle, for example, may help protect the kidneys and liver against the side effects of long-term use of medication. 

Yucca contains steroidal saponins that stimulate the body to produce its own natural corticosteroids.

As steroids may be used in the treatment of rabbits with E. cuniculi, NHV Yucca may also be given for extra support. Yucca contains steroidal saponins that stimulate the body to produce its own natural corticosteroids, which makes it safe for life-long use. 

Seeing as rabbits affected by E. cuniculi have their immunity compromised, NHV Natures Immuno can also be really helpful. This formula contains a blend of medicinal mushrooms that help balance the immune system and support their overall health as they fight this disease.

Lastly, NHV Inulin-PK works as a natural dewormer and has anti-helminthic properties that can work well with the vet-prescribed treatment. We only ask that you respect a break of at least 30 minutes (preferably 2 hours) between any medication and our natural supplements. 


Seeing your little one with the dreadful rabbit head tilt can be scary. But we are here to help your journey in caring for a bunny with E. Cuniculi. Come chat with us for more tips on how to continue to give your pet bunny the best proactive and supportive care. We are always a message away!

Dr. Amanda Nascimento DVM, MVSc, PhD

Dr. Amanda Nascimento DVM, MVSc, PhD

Dr. Amanda completed her undergraduate degree in veterinary medicine in 2010 and graduate studies in veterinary pathology (MVSc. 2012 and PhD 2016) at the School of Veterinary Medicine, University of São Paulo. She completed her post-doctoral training at the Western College of Veterinary Medicine – University of Saskatchewan in 2018. Dr. Nascimento will be hosting her own blog series and sharing her knowledge with our extended NHV family.

Published: September 12, 2022

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