Bunny slight head tilt, lethargic and sneezing

[u/Decaf-Diva]

Rabbit with a slight head tilt, sneezing/nasal discharge, and suddenly eating less and losing weight – what should I discuss with the vet?

I’m worried about my rabbit Nowie and would really appreciate hearing your experiences and advice so I can prepare for my next conversation with the vet.

How it started:
Monday evening: Nowie suddenly developed a very slight head tilt (around 10 degrees) and was a little quieter than usual. He was still eating normally at that point.

That evening, I started Meranox (25 mg/ml) as a precaution against E. cuniculi (EC). He weighs around 2 kg, and I’m currently giving him 1.5 ml per dose. Initially, I wasn’t sure what dose he needed.
Tuesday: I took him to the vet. They couldn’t find anything unusual at the time. His teeth looked fine, and the vet also examined his abdomen by feeling it. He was still eating normally then and was even hopping around the floor at the clinic.

However, Nowie has been sneezing regularly through one nostril for weeks. On Tuesday, this suddenly became much worse, and he had noticeably more nasal discharge. The vet said they would prefer not to prescribe antibiotics without a clear reason, as the symptoms often return afterwards.

How he is doing now:
Since today, I feel that he has genuinely taken a turn for the worse. He’s much quieter and spends long periods sitting in his tunnel or hiding in his little house. Because he’s been so inactive, I also started keeping a closer eye on how often he uses his litter tray today.

Nowie really hasn’t been himself since Tuesday. Normally, he enthusiastically comes over to me in the morning for his food and even jumps onto the sofa. Now, he no longer comes over for food or treats on his own. I have to hold the food right under his nose, and even then, he only eats small amounts.

For example, he normally eats an entire three-cornered flaxseed treat in one go, but now he only eats a small part of it. He usually gets the whole treat into his mouth at once. He will still eat a few dried pea flakes, though.

Other symptoms I’ve noticed:
He’s lost around 100 g in two days.
I haven’t seen him drink. Normally, his water bowl is empty by the end of the day, but today he hadn’t finished all of it.
He has only used his litter tray twice today, as far as I’ve been able to keep track.
Thankfully, I’ve still seen him produce droppings, but he’s clearly eating much less than usual.
His temperature is 38.2°C (100.8°F).
I only started properly monitoring his litter tray visits today, so I’m not sure whether he’s also been urinating and passing droppings less frequently over the past few days.

What I’m worried about and what I’d like to ask:
Could the chronic sneezing and discharge from one nostril indicate an infection or another problem that could also be causing his current symptoms?

Would it be worth investigating this further or discussing antibiotics with the vet?

Could he still have molar or tooth-root problems despite the normal dental check? Could this explain why he’s eating so little?

Could the slight head tilt and change in behaviour indicate an ear infection, E. cuniculi, or another neurological problem? Today, his head actually seemed less tilted than before.

What tests or investigations would you recommend discussing with the vet in this situation?

Has anyone experienced a rabbit that initially seemed to be eating relatively normally but then deteriorated quickly, despite nothing being found during the first veterinary examination?

I’m going to contact the vet again, but I’m worried because Nowie has genuinely seemed to deteriorate since today, and I don’t want to overlook anything important.

I’ve attached a couple of photos from today. He does still go over to his food, but he stops eating very quickly (for example, he only ate four pellets from his evening meal). He’s spent almost the entire day sitting in his tunnel or little house.

Any experiences or advice would be greatly appreciated! ❤️

[u/Secret_Bunch_114]

Vet asap.

You know your bun. If something feels off, go to the vet

[u/Decaf-Diva → u/Secret_Bunch_114]

Yes I will!

[u/IisBubbles]

The lack of appetite is really concerning, when you went to the vet did they do any testing? Blood or anything? It may be worth getting him in again asap, or going to an er vet. You could try giving him critical care and see if his appetite gets better. There's absolutely people who will know more/have better advice and i have no idea about the nasal discharge but if his appetite doesnt get better, especially if he stops eating entirely, its an emergency.

[u/Decaf-Diva → u/IisBubbles]

Blood work isn’t really a thing here in my country unfortunately. I’m going to contact the vet as soon as they open. His appetite is so wonky. It’s not that he stopped eating, he’s just eating little bits. It’s so odd..

[u/petietherabbit924]

Based on what you've described, I'd want to rule out dental issues. Issues below the gumline can't be detected by physical examination. X-ray is necessary and sometimes a CT scan may be recommended. I'd also ask for blood tests because he's not improving. I'd ask for a Complete Blood Count and Comprehensive Metabolic Panel. Comprehensive Metabolic Panel tests for the following: Glucose, Potassium, Chloride, Carbon Dioxide (bicarbonate), kidney function (via BUN and creatinine), liver function and enzymes (via ALT, AST, ALP, and total bilirubin), and Protein & Minerals (via total protein, albumin, and calcium).

I hope vet checked bun's ears. Head tilt may be due to ear infection and/or EC.

Regarding your bun's symptoms of nasal discharge and sneezing, see the following for potential causes, diagnostic steps, etc. https://wabbitwiki.com/wiki/Snuffles

As for respiratory infection, it's important to do culture and sensitivity testing to try to use the most effective antibiotic. The comments in the following thread are in response to an owner that has a rabbit experiencing respiratory issues. They highlight the potential importance of obtaining comprehensive culture testing https://www.reddit.com/r/Rabbits/comments/1s402rw/severe_snuffles/ I see that the post was deleted from the foregoing thread, but the comments are still helpful.

An underlying illness that isn't being treated and is causing discomfort may prompt bun to eat less and act unwell. It sounds like bun is in the beginning stages of GI stasis and needs supportive care via force feeding a calorie dense food such as Critical Care and subcutaneous fluids https://wabbitwiki.com/wiki/Gastrointestinal_stasis Ask vet to rule out a blockage and liver lobe torsion, as force feeding isn't recommended in those types of situations.

I hope vet is an exotic pet vet that has extensive experience in treating rabbits, which is different from a vet that primarily sees cats and dogs and only sees rabbits occasionally.

[u/Faithfuldoglover]

Get thee to a vet; bunnies decline quickly.

[u/damiana8]

E. Cuniculi gets worse before it gets better, btw. I have a bun with it