Occasionally a rat will start to tilt its head to one side and it may also have poor balance, falling over when trying to groom or even when just walking along. Sometimes, the eye in the direction of the tilt will be affected as well, with a blink or even sinking of the eye being noticeable. There are several reasons for head tilt, all quite different and with different outcomes and a visit to the vet is essential to get a proper diagnosis.
Signs and symptoms
The head will be tilted, or it may be rotated to one side. The ‘direction’ of the tilt shows which ear is affected, if it turns out to be an ear infection. The rat will probably rub its head against the floor of the cage or scratch at the ear. Ear infections are just as painful for a rat as for a human and it will be in some distress. In some cases, there will be external signs, with a painful external ear (called the pinna) with possible cracking of the ear and visible swelling at the entrance. It may also be that the head tilt is connected with a respiratory tract infection and in this case it is almost certain that it is caused by a bacterial infection inside the ear which is causing pain and loss of balance. In some cases the rat will circle or lose its balance completely. Without the rat being seen by a vet it is nevertheless not possible to completely rule out the other common causes of head tilt and problems with balance. These are (in order of likelihood) a stroke or a pituitary tumour. Infections can happen in a rat of either sex at any age; strokes and pituitary tumours tend to affect older rats, with the tumours affecting mostly females.
Diagnosis of Head Tilt
Diagnosis by a vet is very important in cases of head tilt and/or loss of balance in a rat. It is most likely that the condition is caused by a bacterial infection of the middle and inner ear, but as strokes and pituitary tumours have such serious implications, they must be ruled out also. Infections can also become serious; if not resolved by the administration of the right antibiotic, the vestibular nerve can be irreparably damaged and the eardrum could rupture with the pressure of exudates from the tissues in the ear. If this happens, the rat could become deaf. It is this developing inflammation which causes the rat’s head to tilt. Although many animals recover completely from the infection, some never lose the head tilt; most regain their balance but remain susceptible to ear infections for life. One interesting diagnostic point is that a rat with a pituitary tumour can no longer hold its food in its forepaws; it will learn quickly to wedge the food somewhere to allow it to eat.
If the head tilt and balance issues are caused by an infection, the prognosis is good. It is difficult sometimes in rodents to choose an appropriate antibiotic as they do not tolerate them all, but the infection can usually be controlled relatively easily and with care the animal will make a full recovery, albeit with a slight tilt to the head sometimes. In cases of stroke, there is often a recovery in the first instance, with possibly a weakness in one side, as is often seen in human stroke victims. A rat will live with a reasonable quality of life following a stroke, but they rarely survive a second. If a pituitary tumour is diagnosed, steroid injections will help the rat for a while, but quite quickly the rat will lose its appetite completely and its quality of life will become very poor. At, or before this point, most owners decide that euthanasia is a kind option.
Treatment of Balance Problems
Treatment of head tilt caused by a bacterial infection is relatively simple but the nursing needs are quite intense as the ear will exude some quite unpleasant stuff and this will need to be mopped up regularly using a cotton bud or swab made of absorbent paper. This will need to be carefully applied so as to prevent scratching of the very sensitive and swollen inner surface of the ear, thus making the infection worse, but it will help the rat feel more comfortable as it will speed up the reduction in pressure in the middle and inner ear. Steroid cream or antibiotic ointments can be used and the rat will appreciate a flush with warmed normal saline or a proprietary ear wash available from most pet shops.
Care must be taken to dry the ear thoroughly before applying any medication. Looking after a rat with head tilt is quite a time consuming business. It often needs to be taken into a safer environment as its lack of balance could cause injuries in a multi-level cage and if it is eating with cage mates it may well be overwhelmed by them at feeding and could become malnourished. When feeding, high calorie foods should be offered, such as avocado, and also there are supplements for feeding to sick rats which will be taken with minimal chewing, as the painful ear will hurt even more when the jaws move.
Preventing head tilt and balance problems
Apart from keeping a close eye on the rats in their care, there is little an owner can do to prevent head tilt. Cleanliness is essential and care should be taken to make sure that the environment is kept as free as possible from potential breeding opportunities for the naturally-present bacteria such as pseudomonas and streptobacillus which invade the ear canal and cause the swelling and inflammation that cause head tilt.