Otitis Media or Interna in Rabbits

Symptoms may vary if there are any at all in your rabbit.

• Head tilt – You may notice your rabbit begin to turn his head to one side without any cause and without stopping
• Scratching or rubbing – He may begin to rub and scratch at his ears that are bothering him
• Head shaking – You may notice your rabbit shaking his head often without any relief when he does it 

Types

There are both middle ear and inner ear infections. Both begin as an outer ear infection that moves further into your rabbit’s ear.

Media

• Starts in the outer ear, but left untreated moves to the middle ear
• Can have facial paralysis in this phase

Interna

• Moves to the inner ear if left untreated
• Can cause damage to the vestibular system (hearing loss, head tilt, circling, leaning or falling, incoordination)
• Can lead to the infection going to your rabbit’s brain

There are several causes of otitis media and interna. Some of the causes include allergy, autoimmune, endocrine, glandular disorders, immune-mediated, fungal, parasites and diseases of an abnormal ear.

• Allergy
• Autoimmune
• Endocrine
• Glandular disorders
• Immune-mediated – this can be caused by drug reactions 
• Fungal (yeast infections)
• Infection (Pasteurella multocida, Pseudomonas sp., Staphylococcus spp., Streptococcus spp.)
• Parasites
• Diseases of an abnormal ear
• Lop-eared rabbits are more prone to issues

If you suspect your rabbit is suffering from middle or inner ear infections, it will be necessary to bring him to the veterinarian. The veterinarian will want to know what symptoms you have noticed and if there have been any obvious changes that could explain his new symptoms. 

A physical examination will need to be done in order to identify any symptoms your rabbit is experiencing such as pain, discharge from his ears, crusting of his ears, or matted fur. Once this is complete, a more in-depth exam of his ears may be necessary. Due to the pain your rabbit may be in at this point, sedation will most likely be necessary to complete this part of the exam. 

MRIs, CT scans or other imaging tests may be necessary to determine any further damage to your rabbit’s ears, brain, nerves and more. Lastly, samples may be taken from your rabbit via blood or of the discharge from his ears to identify the underlying cause of his ear infections.

Treatment will be dependent on the underlying cause of your rabbit’s ear infection. To treat his immediate infection, antibiotics will most likely be prescribed. These antibiotics will be administered for at least 30 days and up to 6 months or longer. Treatment may be lifelong to keep his symptoms at bay.

If there are other issues such as a yeast infection or parasites, those will be treated as well. Surgery may be necessary to clean out any debris from his ears. This includes draining abscesses and surgery to relieve ongoing pain issues your rabbit may be experiencing, and total removal of his ear canal may be necessary. Treatment can also involve steroids to treat head tilts as well. 

There may be long term hearing loss and damage due to these infections. However, your rabbit can continue to live a quality life with proper care. Medication management may be life long and it is possible for the infections to come back if maintenance of his ears is not maintained.

Follow up appointments will be necessary to ensure your rabbit’s ears are remaining clear and clean and that all signs of infection are gone. Ongoing upkeep of his ears will also be very important. This will involve learning how to properly care for your rabbit’s ears and how to clean them without causing him pain or discomfort.

Proper ear cleaning is done 1 to 2 times a week and they should be kept dry and have ventilation. Prognosis is good if the symptoms are caught and treated early on, however, there can be lifelong issues including hearing loss and neurological discrepancies. 

Your rabbit can live a quality life despite hearing loss or neurological concerns. Provided with a comforting environment, he will do well. Learning how to properly care for his hygiene will also benefit him and you.