The rabbit ear, like that of human beings, is divided into three main parts, the external, middle and inner part. Therefore, when looking at rabbit ear infections, we will consider those that affect the external, middle and inner parts.
Several conditions might affect each of these parts, whereas we will discuss most of these conditions in this post, some may be covered in the on their own separate posts, due to their unique causes, symptoms as well as treatment protocols.
Do not be baffled by the use of the term otitis, it only means the inflammation of the various parts we are going to look at and it is one of the symptoms of various disease and conditions.
External ear infections – otitis externa
Various diseases, conditions, and infestation can affect the external ear which is made of made of the pinna and the external auditory canal.
Lopped bunnies have been found more vulnerable to these conditions, infestations or disease as changes in humidity, will encourage microbial activity, especially yeast and bacteria.
Rabbit ear infection picture
Causes of external rabbit ear problems
Various things can cause otitis externa and they can be by pathogenic microorganisms or parasites. The most frequent noted causes include the following:
- Allergies and irritants
- Foreign bodies including grass seeds, hay debris, and so on
- Parasites, especially the ear mites.
- Breeds – the lopped ears are predisposed to infections since their ears they do not allow free air circulation
- The auditory canal becoming narrower
- Environments that have higher humidity
- Any underlying middle ear infections
Signs and symptoms
Depending on which specific cause we are talking about, the symptoms expected will vary. Some of the common ones that are often observed include the following:
- Pain characterized by ground digging and holding down of ears
- Swelling and redness
- Exudate, often thick, whitish in color flowing out from the ear canal
- Excessive accumulation of earwax
- Crusts on the auditory canal
- Head shaking
- Anorexia and lack of interest in eating
- Presence of scales and flakes on ears.
- Loss of hearing
Diagnosis and treatment
Diagnosis is by looking at clinical signs, performing a biopsy for microscopic examination, culture, and histopathology, otoscopic tests under sedation, radiographs to see if anything is lodged in the ear or check for tumors or abscesses.
Since their ceruminous glands (specialized sweat glands located on eternal ear canal) hardly suffer from hyperplasia (enlargement of these the ceruminous gland tissues often as an initial stage of cancer), most external ear treatment often very effective.
Depending on what diagnosis reveals as the cause of otitis externa, treatment may involve the use of antibiotic ear drops, pain relief or anti-inflammatory medications, oral or injectable antibiotics, among others for a certain duration.
Ear drops (and ear soaking with antibiotics) might not be effective if your bunny has too much wax buildup. Therefore, you should consider wax removal where possible.
Sometimes, your vet may need a specialized endoscope to remove any debris and wax under anesthesia as well as an ear wick if the canal is severely swollen to allow topical medicine delivery.
Also, antibiotic ear flushing may help reduce the chances of bacterial infection, especially where there are debris and earwax buildup.
Finally, it is possible for this pet to end up with an ear abscess if you do not treat otitis externa or if it has a severe otitis media. CT scans and radiography may help identify the presence of abscesses.
Middle and Inner ear infections – Otitis media and interna
Rabbits can suffer from middle and inner ear infections (otitis media and otitis interna respectively). The resultant otitis (inflammation or infection) could be acute or chronic.
The various causative agents can spread from the external ear into the middle part. If left untreated, the infection can further spread into the innermost part and consequently cause otitis interna, a condition that is at times referred to as labyrinthitis.
Usually, middle ear infections cause fluid and pus production in this area and in case of the tympanic membrane ruptures, this pus and fluids will start oozing from the auditory canal and cause infection on the outer ear.
Causes middle and inner rabbit ear infection
Otitis media and interna can be caused by bacteria, fungi, yeast or parasites with Pasteurella multocida that is naturally found in this pet’s nasal passages (without causing any notable clinical signs) being the most identified cause.
This bacterium may find a way to the middle ear via the “Eustachian tube or mandibular molar root abscess with exposure to the Eustachian tube.” 
Also, the opportunistic, pathogenic Staphylococcus aureus is another possible bacterium that can lead to severe otitis interna and media. This bacterium may be resistant to some antibiotics and it normally occurs in the rabbit’s nasopharyngeal cavity.
Other causes include Streptococcus spp., Enterococcus spp, Escherichia coli, Pseudomonas spp, and Proteus spp. There may be a few cases of Candida spp. and Pityrosporum spp. yeasts and rarely the Cryptococcus ssp. fungal infection.
Also, it is possible for the vestibular system (that helps maintain balance as well as give a sense of spatial orientation) to be affected giving rise to vestibular diseases.
Acute otitis media is often associated with upper respiratory tract infections while chronic suppurative otitis media could be due to infections by including “Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae, Escherichia coli, Aspergillus spp. and Candida spp.,”  among others.
Finally, allergies, tumors, trauma, and foreign bodies can cause the various symptoms we are going to discuss. However, bacterial infections are the most common cause.
Besides the above causes, other factors that may increase the chances of your furry friend getting otitis media and interna include the following:
- External ear infections including mites
- Ear wick and flushing of ears vigorously may make them susceptible to infections that spread to the inner parts especially if they rupture the tympanic membrane.
- Weakened immunity system from sickness, use of corticosteroid, stress, and so own makes these animals vulnerable to bacterial infections.
- The use of an ear cleaning solutions and medications if the eardrum is ruptured can cause irritation.
This condition can happen without symptoms or have some. Also, some of these symptoms resemble those of external ear infections. Common symptoms include:
- Anorexia, depression, reluctance to move or chew
- Ear rubbing, scratching with paws, drooping (holding it down) and shaking
- Head shaking
- Symptoms of pain including teeth grinding
- Fluid oozing from the auditory canal for a ruptured tympanic membrane
- Throat infection and drying of eyes
- Facial paralysis in case of a pinched or damaged facial nerve
- Partial hearing loss due to pus accumulation
- Leaning towards the affected side
- Head tilt
- Circling, rolling and loss of full-body control (dizziness) – ataxia
- Nystagmus – repetitive and uncontrolled eye movement, mainly horizontal and rotary nystagmus, never vertical that is common in E. Cuniculi infection.
Nystagmus can also be caused by other diseases and conditions including eye disorders (such as cataract, retina problem, glaucoma, albinism), metabolic disorders, nutritional deficiencies (like magnesium, thiamine), lesion, trauma, among others.
Your vet will observe the various clinical signs that your rabbit has. However, since other conditions can cause some of the above symptoms, such as head shaking and head titling including some vestibular diseases or disorders, a differential diagnosis will help to rule out other causes.
Other diagnostic procedures may include bloodwork (including a complete blood count), serology tests, urinalysis, histology, and biopsies to determine the underlying cause (pathogenic microorganisms or parasites).
Finally, a facial and ear radiographs, MRI or CT scan may help detect foreign bodies, tumors or abscesses that may be blocking your rabbit’s auditory canal.
How do you treat a rabbit ear infection? The answer depends on what causes the infection in the first place. Treatment will include giving of specific medications such as antibiotics (after culture and sensitivity tests in case of bacterial causes) or antifungals for fungal infections.
These medications may be both oral and put directly into ears if there are not tympanic membrane perforations or ruptures.
Also, to help reduce the resultant inflammation, your vet may recommend various non-steroidal anti-inflammatory medications such as Metacam.
In case of any neurological signs such as ataxia, head tilting, etc., your vet may consider hospitalization and stabilization of the affected rabbit with electrolyte and fluid therapy.
Also, syringe feeding may be recommended if this pet does not eat as this can GI stasis and other problems including liver lipidosis.
Severe damage of canal and eardrum may require surgical removal of the auditory canal  which will cause long term hearing loss. Also, some tumors, abscesses may require surgical removal. After they stabilize, those hospitalized will be released.
For those that may suffer from permanent hearing loss, proper care can still ensure that these pets live a normal and quality life.
Recovery and rabbit ear infection home remedies
Before trying any rabbit ear treatment at home, you need to discuss with your vet since these organs are delicate and you could easily damage them.
While at home, you should not put anything into these pet’s ears. Only disinfect and clean them using a warm saline solution. Avoid flushing since this requires a vet.
To avoid future wax buildup, include ear cleaning as part of your grooming routine. Remove ear wax at least once to twice a week to avoid buildup with the help of mild ear cleaning solutions such as Nolvasan Otic which have Chlorhexidine. Let your vet guide you on what to use.
Also, give them a healthy diet that is high in fiber such as timothy hay as well as leafy greens like kales, carrot tops, romaine lettuce and so on.
Finally, provide good bedding (soft and warm), a solid even floor (if your pet has neurological symptoms) to avoid injuries and always ensure followup checkups by your vet while still under treatments since antibiotic treatments can take as long as 6 weeks.