Otitis Media or Interna Average Cost

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What is Otitis Media or Interna?

These infections of the ear typically start as outer ear infections, that are untreated and progress into something bigger. There are possible long term costs for not treating these infections promptly once they are found. Some of the symptoms that are caused by these ear infections can mimic other underlying conditions. You may notice your rabbit scratching or rubbing his ear, tilting his head on the side of the infected ear.

Otitis media and interna are infections of the middle and inner ear. These infections, if left untreated, can have long standing consequences for your rabbit.

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Symptoms of 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 


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


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


  • 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

Causes of Otitis Media or Interna in Rabbits

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

Diagnosis of Otitis Media or Interna in Rabbits

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 of Otitis Media or Interna in Rabbits

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.

Recovery of Otitis Media or Interna in Rabbits

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.

Otitis Media or Interna Questions and Advice from Veterinary Professionals

Tic Tac
2 Years
Moderate condition
1 found helpful
Moderate condition

Has Symptoms

Head Tilt

A friend borrowed my lop doe to get a litter. One week before she was due, she began to exhibit head tilt and rolling. Her eyes were doing the classic constant back and forth flicking I have seen in rabbits with E. Cuniculi several times, so I told her to treat the doe with Fenbendazole.
the doe began to improve right away. After the first week of treatment, the doe gave birth to 3 kits. The delivery made the doe start rolling again. She did stop rolling after delivery was done, but her head tilt has gotten worse and has not improved in the last 2 weeks. She's been on the fenbendazole for nearly 3 weeks. I don't understand why the doe is not recovering. Could there be something else going on as well? My friend started treatment within 24 hours of onset. I am amazed the doe isn't getting better. Any ideas? Thank you!

Dr. Michele King, DVM
Dr. Michele King, DVM
1610 Recommendations
Thank you for your email. Without examining TicTac, I can't comment on what might be going on with her, but the stress of being pregnant and having kits may have exacerbated an underlying infection or condition with a strain on her immune system. She may have an inner ear infection, or a resistant E. Cuniculi infection. She should be seen by your veterinarian to rule out any underlying problems and get treatment for her problem, as they can see her and examine her. I hope that she is okay.

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