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Paralysis-not EC, no breaks - update

Belle

New Kit
Firstly, thank you to everyone who replied to my post earlier today, and apologies for the vagueness of my email, I was at work and was trying to get something typed as quickly as I could and left out lots of vital information - sorry! :roll:

As mentioned, Oscar had what appeared to be a sore hind leg of some sort about 6 weeks ago, when he had to move, he held his left back paw tightly into his body, but preferred to stay still and not use it at all. After a week on a mild dose of metacam he appeared to make a full recovery.

A couple of weeks later the problem returned, again, I say it might be coincidental, but it was after he got a bit of a fright and scrambled on the wooden floor. Initially it looked like the same problem as before and we put him back onto the metacam but there was no improvement like the last time. We then had extensive x-rays taken of his spine and hind legs, which didnt show anything wrong (although, the only thing that the vet commented on that was only slightly different was there seemed to be a bigger gap between a couple of his vertebrae but this was closer to his neck and she didnt seem concerned by it at all).

We did a search on the internet and everything seemed to point to EC, it was two weeks ago on Friday and we spoke with the vet and got the panacur and started it right away, we didnt get the blood tests done until almost a week later (keen to start the treatment).
He has been on metacam also.

The vet confirmed last Friday that the blood tests showed a negative titer and that he didnt have EC. Now we are at a loss.

My vet is on holiday for two weeks and so it is my intention to take Oscar to see her when she returns (he also needs to have second blood test) and just continue with the panacur and metacam in the meantime.

There have been some improvements, a couple of weeks ago, for around a week, he just wouldnt move and was wetting himself (never once has he been off his food) but now, although he looks uncomfortable and it looks as though it is a massive effort and it takes him a while, he will make his way to his litter tray and has only wet a couple of times.

Another positive. A couple of weeks ago his tail seemed "dead" and it just flopped, but now he has movement in it again and moves it out the way when you touch it or he goes to the toilet.

He does have feeling in his feet (we tried to pinch/tickle him and he pulled away) and he looks as though he wants to move, he pushes himself up onto his back feet and tries to move forward (he creates this odd shape with his back, like he has a skirt round his back end and like he cant sit "normally") but sometimes just gives up, but sometimes with a gentle tap to his backside he just goes for it and can move, albeit not far and very clumsily, but he can move.

Today he even stretched out one of his back paws to wash it, which we havent seen him do for some time. He still cant balance on his back end to use both his front paws for washing/grooming, and he just uses one at a time.

A couple of specific questions:-
  • I had considered arthritis but would like to know how this is diagnosed and are there any treatments?what treatments are available?
  • Are there any ways of telling whether he has had a bad knock other than what we have already done?
  • If there is any spinal damage, what can be done?
  • As he still has a healthy appetite, we are assuming he is not in any pain, is this assumption correct?

I know this looks like war and peace, but I thought it best to give as much info as I could. He is a handsome big boy and it breaks my heart to see him so immobile and I would hate to think he was suffering. Im hoping to gather as much information as possible and take it to my vet when she returns from holiday.

Thanking you in anticipation of your response, any suggestions or comments welcome.

:wave:
 
Is the second blood test he will be having another EC titre one ?

I am not sure how helpful that would be given that he's already on Fenbendazole :?

The fact that he is showing signs of improvement, albeit very slow, still makes me think EC may be the prime suspect rather than an injury or arthritis :? I may be completely wrong though!!

I would also be vigilant re cleaning his environment as *if* it were to be EC then he could potentially keep reinfecting himself as EC spores are shed in the effected Rabbit's urine. A 10% bleach solution will kill EC spores. EC spores remain viable outside of the host for up to 30 days.

These links may be of interest to you

http://www.bio.miami.edu/hare/paresis.html

http://www.veterinarypartner.com/Content.plx?P=A&A=490&S=5

Answers to your questions are in red !! I am not qualified and am just a Bunny Mum but the answers are what I *think* may be the case.

A couple of specific questions:-
  • I had considered arthritis but would like to know how this is diagnosed and are there any treatments?what treatments are available? Some arthritic changes can be detected on radiographs. Some may involve 'thickening' of the bone at the effected joint(s) so could be detected on examination. A 'pain response' may also be noted when examining an arthritic 'hot spot'. Blood tests may give evidence of an inflammatory condition. Treatment usually involves non steroidal anti-inflammatories, physio. My Vet also gives accupuncture.
  • Are there any ways of telling whether he has had a bad knock other than what we have already done?
    An MRI scan might provide a more detailed picture than an Xray but I would guess MRI scans are only available at Specialist Units.
  • If there is any spinal damage, what can be done?
    It would depend entirely on what the damage was.
  • As he still has a healthy appetite, we are assuming he is not in any pain, is this assumption correct?
The fact that he has a healthy appetite is a positive sign and probably indicates that he is not too uncomfortable. But personally I would want to continue to give Metacam for it's anti-inflammatory properties as much as for its analgesic ones. My Vet would probably also prescribe an anti GI ulcer med eg Ranitidine (AKA Zantac) for a Bun on longterm Metacam.
 
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It might be worth seeing a McTimoney chiropractor with your bunny. The spine might have come out of alignment, which could cause the sort of problems you describe. McTimoney chiropractors are very gentle and my dogs and my bunny have no problem with it at all.

Vera
 
I'm wondering about a disc prolapse - to me the symptoms sound more indicative of this. EC complicates things as it can cause inflammation neurologically so I agree you need to fully rule this out if you can.
I'm not a vet and my knowledge is based on human medicine...i'm going here on neuroanatomy of all mammals being similar! The fact you had an almost definite day of onset - when your bunny jumped and landed awkwardly would point to me to a disc prolapse somewhere along the lumbar vertebrae perhaps? Although, anywhere along the veterbral column can give motor and sensory problems....in humans the motor and sensory bundles are separated into tracts in the spinal cord and therefore compression on different tracts can give different symptoms, the acute and intermittent nature of symptoms and response to NSAID again makes me wonder about this. With arthritis I would expect more chronic changes both in bony changes and in bunny's symptoms - more progressive than sudden - and something more tenable on the Xray.
I personally think an MRI would be very helpful in this case, if you can find one nearby??!
My feelings are either spinal cord compression or nerve root compression from a prolapsed disc, I would be VERY wary about any manipulations of the spine or musculoskeletal system until a prolapse is ruled out as complete compression is a risk and would render bunny paralysed. Prolapses can heal given time and rest, they fibrose over, but anti-inflammatories and preventing bunny jumping around too much would probably be the treatment - unless severe prolapse where they might remove the disc? I have no idea if they would do this in a rabbit? Anyway, I'm purely speculating here as to the cause....I hope you can find out what is wrong with your poor bunny...you must be very worried and confused. Good luck:)
 
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Thank you so much for your responses, I really appreciate you all coming back to me so quickly and for all your suggestions, they were very interesting and have given me a lot to think about.

Im going to look into everything further and take all the information to my vet and hopefully find a solution.

There are so many different possibilities, each of which requires a different approach to treatment, do we encourage him to move, do we leave him to sit still.....! Its horrible not knowing if our kindness is causing more damage, so I think for now we are going to leave him do what he feels best and only encourage him to move when he looks like he wants to go somewhere, finish the panacur, continue the metacam and get him back to the vets in about 10 days armed with as much information as possible and start ruling possibilities out one by one.

I will no doubt post back very soon, I will check regularly to see if there are any more suggstions, and give an update when there is news.

In the meantime, thank you for your comments so far, I (and Oscar) really appreciate it.

:wave:
 
I have had a similar problem with my bunny. He doesn't have EC (we treated for this, but now been shown that as my vet suspected, it is not that), any breaks, arthritis (as shown on the xray), disc problems, inflammation around joints etc. He is eating and drinking fine, now pooing and weeing fine and can get around surprisingly well. He is on Metacam (increased since seeing rabbit specialist) but the problems eems to be more leg weakness rather than pain.

Our bun has had a semi-diagnosis from the specialist, of some neurological trauma - either superficial damage, stroke, tumour or lesion etc. We were offered MRI and CAT scans, which can run to well over £1000, but the specialist seemed to talk us out of it in a round abotu way, as it can only prove what he believes is wrong and nothing much can be done except keeping him out of pain and monitoring his quality of life.


We were flummoxed and the vets at my normal surgery, who treat our horses and cats as well so we definitely trust (have used them for years and they have such a diverse team with a wealth of knowledge and experience) have been checking his xrays over and over again to see if they have missed anything. Bloods, examinations, different treatments, specialist referral. The only thing the specialist could therefore narrow it down to was a neurological problem - has your vet explored this?
 
I'm wondering about a disc prolapse - to me the symptoms sound more indicative of this. EC complicates things as it can cause inflammation neurologically so I agree you need to fully rule this out if you can.
I'm not a vet and my knowledge is based on human medicine...i'm going here on neuroanatomy of all mammals being similar! The fact you had an almost definite day of onset - when your bunny jumped and landed awkwardly would point to me to a disc prolapse somewhere along the lumbar vertebrae perhaps? Although, anywhere along the veterbral column can give motor and sensory problems....in humans the motor and sensory bundles are separated into tracts in the spinal cord and therefore compression on different tracts can give different symptoms, the acute and intermittent nature of symptoms and response to NSAID again makes me wonder about this. With arthritis I would expect more chronic changes both in bony changes and in bunny's symptoms - more progressive than sudden - and something more tenable on the Xray.
I personally think an MRI would be very helpful in this case, if you can find one nearby??!
My feelings are either spinal cord compression or nerve root compression from a prolapsed disc, I would be VERY wary about any manipulations of the spine or musculoskeletal system until a prolapse is ruled out as complete compression is a risk and would render bunny paralysed. Prolapses can heal given time and rest, they fibrose over, but anti-inflammatories and preventing bunny jumping around too much would probably be the treatment - unless severe prolapse where they might remove the disc? I have no idea if they would do this in a rabbit? Anyway, I'm purely speculating here as to the cause....I hope you can find out what is wrong with your poor bunny...you must be very worried and confused. Good luck:)


What a thorough post. I know you say your knowledge is based on human medicine, but I found this very interesting. Thank you!
 
The first part of your post seems very similar to what happened to my bun, except it was her front paw, and this fits with what prettylupin says too.

She held it up to her body one day for no apparent reason, so i initially though she hurt it, the vet did xrays and deep nerve test and found it was paralyised. She ruled out pretty much everything physically including cancer and bone deteriation, but even before the x-ray the first thing she said was a slipped disc. As the xray showed all her discs aligned correctly, she said it could have easily corrected itself, but nerves take a long time to recover and sometimes never do.

She like your bun recovered on metacam, although the dose was for longer, it was after a week to a week and a half when she started to walk on it normally, but she was on it 4 weeks plus taken slowly off it. She walks and runs fine on it and the vet did the deep nerve test and all is fine now, although the very bottom isnt workign properly but this doesnt affect her.

As prettylupin posted about the disc prolapse (i presume this is a slipped disc kinda thing), this fits excatly with my bun, and i would say so with your bun too if its the same thing as the first instance.

It may take longer to recover from the second spell, my vet said sometimes it can never recover, other times it takes much longer. If its the back leg it might affect the bun more too, mine still hopped around pretty normal considering, although not for as long, but the buns get most of their power from the back leg.

Regards to exercise, my vet said confine her, but this was when she wasnt 100% sure of the cause, but she just sat and looked unhappy, so after 3 days i got her out in the house, and let her take it at her pace, and she chose to hop around in small spells. I didnt alow her to go up any steps or anything though, just flat carpet.

My bun had a dose of 2* her weight in kgs in drops (shes 3kg so had 6 drops), on the dog metacam, if that helps.
 
Wow! It is very comforting to know that I am not alone, I really appreciate everyone who has taken time written a comment, its been very reassuring.

As you may know, my vet called the day she was finishing for her holidays to tell us that Oscar's blood test results were negative for EC, and at this time she did suggest that it may be a neurological problem, which I see being mentioned a lot in the posts on this site, and we will be looking into this on my vets return.

I was particularly comforted when I read Carrie1983's posts, what an encouraging story, the similaraties between Zebedee's and Oscar's symptoms and tests are uncanny!

Oscar has came on a lot from when I first posted, he was completely paralysed and incontinent for about a week but now can get about just enough to get into his litter tray and cope with small bouts of movement.

It is really strange to watch him, as you can see that he really wants to move but just cant move his back end and he holds himself in a strange position, the rear of his back sitting more straight that rounded.
He also cant put his feet down fully while sitting up, they sort of point up the way and I dont think he can grip with them quite the same.
When he wants to sit up he shuffles his front feet up to meet his back feet, meaning he doesnt have to move his back end, and when he lies down, again, he shuffles forward on his front feet until in a lying position.
He no longer lies to the side or lies with his legs kicked out at the back.

The strangest thing though is that when we see that he wants to move, we just tap him on his backside and give a wee lift and somehow he starts to get up some momentum and can hop, not drag or shuffle, hop to whereever he wants to go. He is still quite clumsy and slow, but it shows he has the movement in his legs, its like he doesnt have the connection from his brain to makes his legs actually move, but with a gentle nudge, its like a switch has been flicked!

We are continuing on the metacam, splitting the dose to twice a day until we can speak to our vet, we really want to know whether we can rule out trauma/spinal damage (thanks for your email prettylupin, very informative)so that we can start to give him massage, maybe stimulate the blood flow etc? May seem daft to some, but it could work!

A couple of specific questions:-

  • He cant clean his ears properly as he doesnt appear to be able to clean his feet correctly and get them to his ears. Does anyone know if I should be cleaning his ears for him, if so, what with?
  • When he was "paralysed", his tail went "dead" and floppy and he couldnt lift it when peeing, but now he can move it! Any suggestions?

Once again, thanks for posting, it has helped me tremendously!
 
Hi,
Thanks for the update.

Yours does sound very similar to mine. My vet told me early on that it wasn't EC (which has now been confirmed) but people here said my vet was probably wrong and it did sound like EC. I trusted my vet and, having already treated for EC just in case, I went to see a specialist who then ruled it out completely and said that too many vets are too quick to diagnose EC with no blood test evidence and because they don't see the bigger picture. Quite worrying really as there are other more serious and not quite so serious problems that can cause this paralysis.

Zebedee also does this sitting like a dog business - he uses his front paws to steady himself. He is on a huge dose of metacam, but neither the specialist, nor my normal vet, believe he is in a great deal of pain as he is eating and drinking and seems quite chipper when he is allowed to roam (he went downhill a bit when he was holed up in a small space to help his leg). The lameness is neurological rather than pain-related.

My bun looks a bit lie a catterpillar when he moves, especially when he's on one and moving quickly! It doesn't seem to have affected his quality of life so far, which is great. There's no way I'll be investing in wheels for him. If he can't perform his bodily functions unaided, and that means getting around all be it compromised, then he will be PTS. I'm not selfish enough to keep the poor soul alive when his quality of life is so poor. Fingers crossed it won't come to that. :)

Good luck with your bun.
 
PS - Zebedee still seems to be able to clean his paws, and adjusts how he's sat to do it. He also manages to keep his ears clean, but back when we thought he may have some wax build-up causing balance issues, the vet gave us some ear cleaner that is meant for cats but can be used in rabbits. We apply it twice a week and use cotton wool to remove the wax.
 
We are continuing on the metacam, splitting the dose to twice a day until we can speak to our vet, we really want to know whether we can rule out trauma/spinal damage (thanks for your email prettylupin, very informative)so that we can start to give him massage, maybe stimulate the blood flow etc? May seem daft to some, but it could work!

Bunny neuroanatomy could be very different for all I know! I don't know how advanced developmentally speaking their spinal cords are re. tracts etc so please don't take my word for it!:) But I guess any prolapse could give rise to similar neurological symptoms from the areas affected by any compression even if just basic sensory and motor feedback systems. I do hope they can find what is wrong with poor Oscar, I expect there are many possibilites here at this stage.
If it's spinal then you probably wouldn't want to massage as you know for risk of further injury, but weakness from damage/trauma higher up in the brain might be helped by some gentle physio to help regain power and tone in the weak muscles. This is why a diagnosis is so important...as you are trying to get:), or as you say, atleast rule certain things out.
I think bunnies control ear wax and populations of skin/ear mites by grooming and so you may need to keep an eye on his ears for excess wax and watch his fur for any dry patches, i'm sure your vet can help you with this or other people on here with disabled bunnies. Hope Oscar feels better soon:)
 
PS - Zebedee still seems to be able to clean his paws, and adjusts how he's sat to do it. He also manages to keep his ears clean, but back when we thought he may have some wax build-up causing balance issues, the vet gave us some ear cleaner that is meant for cats but can be used in rabbits. We apply it twice a week and use cotton wool to remove the wax.

There you go! :D
 
Hi! I thought id post a wee update on Oscar as we have now been back to the vets since my last post.

The problem is definately neurological resulting in some form of nerve/spinal damage, although the cause itself remains unknown.

She ruled out a stroke because he would be worse on one side, whereas it is his complete back end that is affected.
Arthritis was ruled out because his injury was sudden and there were no signs that would indicate this on any of the x-rays and it isn't EC because his blood tests showed negative titer.

She pulled Oscar's hind legs out behind him and he pulled back, which she seemed pleased about, in fact, she seemed really pleased with his progress in general as the last time she seen him he was completely paralysed and incontinent but is now mobile enough to get in and out his litter tray and a wee shuffle about the back garden (although, yesterday he actually went for a wander around the garden! A first since he became poorly!).

He is to continue on the metacam, currently he is getting (and I hope I get this right) a mg in the morning and a mg in the evening. We are to watch for any upset to his stomach because of the metacam, but so far he seems ok.
We are also to give him some vitamins E and B to help with nerve regeneration and his immune system etc.

So, all in all, its all looking quite positive at the moment. The vet did explain that he may even improve some more, he may just stay the same, and there is every chance he could go back to where he was (she did make a point of saying that this type of illness by its very nature will get progressively worse over time, but for now, he seems to be coping fine).

We have to take him back in one month for a further check up.

Thank you to everyone who offered suggestions and words of comfort, I am truly grateful.

Oh, and something that interested me, I asked her why his tail was limp but he now has feeling etc and she explained that when recovering from paralysis, the body heals from the very tip up the way, so the tail would be the first to show signs of improvement!

Thanks again everyone :wave:

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