Head tilt is back - Treatment advice - E Cuniculi

Hi guys
About 2 months ago Hiro went off his food, his head was moving from side to side, his eyes were flickering and he kept falling over. It was fairly bad and very distressing so we got him straight to the vets and they told us it was E Cuniculi and gave him a steroid and a 28 day course of panacur. He immediately seemed better from the steroid and the panacur seemed to work wonders. We had a few follow-up appointments and all seemed fine - apart from a very small head tilt. He finished the course about 3-4 weeks ago and he has been full of beans!

I went out for a coffee on Monday and when I got home I opened the treat drawer and Hiro didn't come begging. I instantly knew that something was wrong (he's a greedy boy!) and when I looked in his tunnel it was obvious that the symptoms were back but maybe not as severe as last time. We took him straight back to the vets where they gave him another steroid and another 28 day course of panacur...

He seems OK in himself, he's very alert, playful and he is eating fine but I'm just wondering if I can do anything else? Any further tests or treatments? An even longer course of the panacur maybe? I suppose I'm just concerned that if the first course didn't work for long then this one won't either!

Any help or personal experiences wanted!
Thank you
X

I'm sorry to hear that Hiro is unwell again. Obviously he needs to be seen by the Vet again this morning. It may be a relapse of the EC symptoms .Neither Panacur or Corticosteroids can 'cure EC, the Panacur can reduce the number of EC spores circulating in an infected Rabbit's bloodstream, corticosteroids reduce inflammation and it is inflammation that causes clinical symptoms. Corticosteroids do need to be used with extreme caution due to their potential of causing adverse side effects including lowering the immune system, gastric ulceration and liver damage. A non steroidal anti-inflammatory, eg Metacam, may be preferable to use.

Head tilt can have other causes such as middle ear infection. Without a definitive diagnosis of EC (from blood tests) then I would want the Rabbit to have antibiotic treatment too to cover for a bacterial middle ear infection. Middle ear infections cannot always be detected just by looking into a Rabbit's ear with an otoscope. Xrays/CT scans are needed for that. But given the risks associated with giving a GA to an already unwell Rabbit the Vet may decide to treat symptomatically based on an assumed diagnosis-ie to prescribe Panacur, an antibiotic and a non-steroidal anti-inflammatory to cover for both EC and middle ear infection.

Cleaning an EC infected Rabbit's environment means making sure that all soiled bedding is removed daily, the risk of the Rabbit ingesting urine contaminated hay/food minimised by using hay racks/raised feed bowls. The environment needs to be bleach cleaned using a 10% bleach solution on days 21 and 28 of the course of Panacur. Surfaces that cannot be bleach cleaned can be steam cleaned, steam will kill EC spores. Grass based runs are best avoided as it's impossible to adequately disinfect grass/soil.

These links may be useful:

http://www.medirabbit.com/EN/Neurology/head_tilt.htm

http://www.gwexotics.com/wccms-resources/a/5/0/e/77554b90-a660-11e0-a685-0050568626ea.pdf

http://www.vettimes.co.uk/article/diagnosis-of-otitis-externa-media-and-interna-in-rabbits/

http://www.vettimes.co.uk/article/treatment-of-otitis-externa-media-and-interna-in-rabbits/


Good luck at the Vets x

My bunny Noodle who had EC ( & it sounds like exactly the same symptom as Hiro )had a relapse, perhaps 8 weeks after after her first attack. Frances Harcourt Brown was our vet at the time, & we were just started on panacur (she was already on metacam). The 2nd episode was much less severe & long lasting. We were advised to dose with panacur in anticipation of any stressful events like bonding, long journeys, house moves. She had another 2 years with us but no similar relapses after the second. Good that he is eating & playful. Many vibes for Hiro, I hope he bounces back quicker this time

roxyroller88 said:

Hi guys
About 2 months ago Hiro went off his food, his head was moving from side to side, his eyes were flickering and he kept falling over. It was fairly bad and very distressing so we got him straight to the vets and they told us it was E Cuniculi and gave him a steroid and a 28 day course of panacur. He immediately seemed better from the steroid and the panacur seemed to work wonders. We had a few follow-up appointments and all seemed fine - apart from a very small head tilt. He finished the course about 3-4 weeks ago and he has been full of beans!

I went out for a coffee on Monday and when I got home I opened the treat drawer and Hiro didn't come begging. I instantly knew that something was wrong (he's a greedy boy!) and when I looked in his tunnel it was obvious that the symptoms were back but maybe not as severe as last time. We took him straight back to the vets where they gave him another steroid and another 28 day course of panacur...

He seems OK in himself, he's very alert, playful and he is eating fine but I'm just wondering if I can do anything else? Any further tests or treatments? An even longer course of the panacur maybe? I suppose I'm just concerned that if the first course didn't work for long then this one won't either!

Any help or personal experiences wanted!
Thank you
X

Click to expand...

I'm sorry to hear this ..

The panacur can indeed work wonders, and my vet has agreed that it can turn around a situation rapidly, and even 'cure' head tilt. But this isn't always the case, and it varies from rabbit to rabbit. You've got on the case pretty quickly and I'm hoping you'll have success as well this time.

I'm sure you know all this, but if you have any other rabbits they should be treated with a 28 day course of panacur as well. You also need to disinfect the litter trays (especially on days 21 and 28 of treatment, to interrupt the life cycle of the parasite) and steam clean if possible any areas that can't be disinfected with bleach.

Your vet has probably not excluded the possibility of something else going on here? Perhaps inner ear disease or infection?

Good luck x

Thanks everyone.
The vet did look into his ears and said that they couldn't see anything going on but when we next go back I think I'll get them to check again. Or maybe get some bloods taken to confirm that it is in fact EC.
All other Rabbits are being treated too and I'm just about to clean everything now.
He does seem a lot better today though but he did before too!

roxyroller88 said:

Thanks everyone.
The vet did look into his ears and said that they couldn't see anything going on but when we next go back I think I'll get them to check again. Or maybe get some bloods taken to confirm that it is in fact EC.
All other Rabbits are being treated too and I'm just about to clean everything now.
He does seem a lot better today though but he did before too!

Click to expand...

Blood tests to confirm E.C. can be unreliable, and expensive because they involve two tests. By testing two separate samples (taken with an interval between then) a vet can see whether a rabbit is mounting an immune response to an active E. cuniculi infection.

Some info here:

http://www.houserabbit.co.uk/resources/content/info-sheets/ecuniculi.htm

https://www.vets-now.com/pet-owners/rabbit-care-advice/e-cuniculi-in-rabbits/

I'm glad he's better at the moment