E.Cuniculi and hind leg paralysis

[Bugs&Beau]

Hi, was after a bit of advice.
Almost 2 weeks ago I noticed my 6 month old rabbit, Holly, walking around her run instead of hopping it gradually got worse and the back leg didn’t seem to be working at all, she was dragging it behind her when she moved and when I picked her up the leg appeared to tremble. She has not suffered any trauma that I have seen and all the other rabbits in her run are fine.
I took her to the vets, they didn’t think there was any breakages but possible soft tissue damage and prescribed metacam for 8 days.
Her other back leg seemed to start slowly going too, it still has a little movement but she is dragging them both behind her now when she moves. On Tuesday morning when I went in to see her she was dirty where she hadn’t been able to move into the right position to go to the toilet or clean herself. She is still as bright as a button and seems perfectly happy just not moving around as much. Her eating is perfectly fine and she still tries to bite me whenever I pick her up which is normal.
I took her back to the vet to speak with them, they offered an X-ray but at £500 I can’t afford it. They have said she is likely just disabled now and there is nothing that we can do about it.
I have read about hind leg paralysis and e.Cuniculi so have asked if we could try the 28 days of panacur. The vet said I could give it a go but doubts that it will help her. She has said to keep an eye that it doesn’t spread further up her body and has advised to pts if it does.
Going to see her this morning, she is cleaner than she has been the last 2 days and I have found her moving around slightly more and going into different hidey houses that she has.
Has anyone else had a similar thing happen to their rabbit and had them recover? Or should I prepare myself for the worst.
Sorry for the long post and thank you for reading

 

[Orenoko]

Buy a course of wormer ASAP but she also needs painkillers and antibiotics may be helpful for the duration not just 8 days. You don't need a prescription to get panacur and it is definitely worth a try. Most buns don't like the taste, you can mix with something tasty like banana to help her eat it. It may be worth trying another vet as well as I wouldn't be happy with that assessment if it was my bun. Rabbits can recover from E cuniculi, sometimes fully, sometimes partially, but it's often a long journey of weeks if not months, and they often get worse before they get better.

I had a rabbit who didn't have e cuniculi but he did have an untreated ear infection when I adopted him and it caused long term health issues, including hind leg weakness and weight loss. It was very costly when I add it all up so you would also potentially have to factor this in if you're struggling financially. I accepted that we were looking at palliative care and we treated him with steroid injections, however they have side effects so I would not use those unless as a last resort, they were the one thing he responded to and given I knew his life was limited I thought it would be best for him. I also ended up paying for someone to come and do physio for him.

I'm not sure if she's an indoor or outdoor bun but if she's outdoors I would bring her in as she'll be vulnerable and I'd want to keep a closer eye on her. Also if you have another bun it would be worth worming them also.

Edited to add - sorry I want to re-emphasise seeing another vet. The more I think about it the worse the vet's response seems, it comes across as very casual and not willing to help much.

 

[Shimmer]

Your vet should be aware of EC and the standard treatment protocol. Hind leg weakness is a common symptom, along with head tilt. If your vet is certain there is no physical damage eg to the spine, then you could ask about EC treatment. It is very treatable and shouldn't be a PTS issue. Caught early, the symptoms should resolve completely. Sometimes there is a residual weakness or head tilt, but rabbits cope with it. It can be quite a rollercoaster ride, but take it a week at a time and provide whatever support the rabbit needs (feeding, water easy to access, bum cleaning, etc). You may also need more than one round of treatment if 28 days doesn't resolve it. Usually there is a significant improvement in a couple of weeks. It's not expensive, just requires your time and dedication.


For info:
Standard treatment for EC is 28 days of Panacur with metacam - both daily, and by mouth. Panacur is to reduce the parasite loading. Metacam (or other anti-inflammatory) is to reduce the neurological damage done by the parasite (which is what causes the head tilt, hind leg weakness, etc). Sometimes, a vet may also prescribe antibiotics for the affected rabbit, just to cover other possibilities like an ear infection.

All rabbits sharing the space need to be treated at the same time with Panacur. It's cheaper to get the 10% liquid cat / dog version for multiple rabbits. You can buy it eg online without a prescription. Metacam is a POM, so you need a vet to prescribe that for the affected rabbit.

The EC parasite is excreted in urine, hence the reason all rabbits in contact will need treating with Panacur, or you just continually reinfect. You also need to do a full disinfect / clean out on days 21 and 28 of the treatment cycle so that you break the lifecycle of the parasite and prevent reinfection. Anything that may have had contact with urine needs cleaning or disposing of. Bleach solution, steam clean or machine wash is fine. You can use other disinfectants which work on the parasite, such as Virkon (available online, in sachets or a bigger tub). Virkon can also be used in washing machines. Hay etc should be disposed of on those days.

There are lots of useful sites on the treatment of EC, and support groups for head tilt bunnies.

 

[Bugs&Beau]

Thank you both for your advice.
I started the panacur treatment yesterday, as the vet agreed to give it a go in case. She said hind leg weakness isn’t usually a symptom (which is the opposite to what I’ve read online) but e.cuniculi can present itself in weird and unusual ways sometimes. This was a vet that was recommended on a rabbit website, saying they were a rabbit savvy vet.

I will go to my usual vet and ask for a second opinion from them.
Holly is from a litter of unexpected rabbits that we had, 3 of which died from what the vet thought of as neurological issues quite early on, e.cuniculi was brought up then but I was told not to treat them all at the time in case it was treating them unnecessarily.
I will keep you updated on her progress. Thank you again for your help.

 

[joey&boo]

I think a 2nd opinion is a good idea. I agree with the advice above. EC isn't particularly hard on the purse strings to treat but I found it really distressing with my bun that had severe headtilt. Its was mainly loads of TLC & patience, quite the roller coaster ride, I'm glad I stuck with it though. My bun relapsed once early on but was just left with a little head tilt for her last few years - she was a very cheerful bunny. Its great to hear you are already seeing some improvement with Holly.

You may know this from your research & apologies if so, but EC spores are shed in urine & if your bun is poorly through EC there will likely be a high load & therefore loads of spores. This is why its really important to treat all buns. I have a bunny who is blind through EC, another who is very wonky with arthritis but the EC & head tilt she had prior to my adopting her 2015 exacerbates it. I lost a bunny 2020 through Kidney failure related to EC. Protection is so important. As Shimmer says the liquid stuff is so much cheaper - it also has the advantage of being able to more accurately dose

Good luck with Holly & her friends

Please keep us posted

 

[Bugs&Beau]

Do you know how you work out the dose for the 10% dog/cat liquid. Is it as it says on the box and 1ml for every 1kg? Trying to work out whether to get the rabbit panacur or the dog/cat one that you suggested for the other 3 rabbits. Holly’s panacur was prescribed and her dose is 0.36ml once a day

 

[joey&boo]

Do you know how you work out the dose for the 10% dog/cat liquid. Is it as it says on the box and 1ml for every 1kg? Trying to work out whether to get the rabbit panacur or the dog/cat one that you suggested for the other 3 rabbits. Holly’s panacur was prescribed and her dose is 0.36ml once a day

this recent-ish thread should help

http://forums.rabbitrehome.org.uk/showthread.php?480679-Panacur-paste-v-panacur-liquid&highlight=liquid+panacur

 

[Bugs&Beau]

That’s great, thank you

 

[Shimmer]

It's 0.2 ml / kg / day of the 10% Panacur to treat EC in rabbits. The dose on the packet is for dog / cat worming. The paste sold for rabbits is difficult to dose accurately and costs a lot more, especially if you are doing multiple rabbits, although some people find it easier to use.

I tend to get a 1ml syringe per bunny and mark up the dose on each syringe, with colour coded mark on the end of the plunger so they are easy to identify. You can then get the daily doses ready at the same time. It can get a bit messy (chalky), so use a small dish or saucer to put them in.

 

[Bugs&Beau]

A quick Holly update…she has started moving around more, using her right leg to hop and holding the left one up instead of dragging them both behind. I’ve also seen her twice today standing on all fours and stretching up still laying and sitting with legs splayed out but there’s been a definite improvement.

 

[joey&boo]

A quick Holly update…she has started moving around more, using her right leg to hop and holding the left one up instead of dragging them both behind. I’ve also seen her twice today standing on all fours and stretching up �� still laying and sitting with legs splayed out but there’s been a definite improvement.

Great news, brave little Holly. Good early indications she's responding well I'd say. Thanks for updating

 

[Bugs&Beau]

Hi…it’s been over a week now and Holly was doing really well and seemed to be getting better. She had stopped having accidents and needing to be cleaned up and then Yesterday she seems to have gone downhill, she needed cleaning up again, she was in a terrible mess when I found her this morning with poo everywhere and more poo again when I came home from work.
Is it usual to go downhill again with e.cuniculi, I feel so down about it and think if she’s going to be like this forever it would be kinder for her to be pts, or can they sometimes relapse and recover again, should I keep going with the treatment?

 

[InspectorMorse]

Hi…it’s been over a week now and Holly was doing really well and seemed to be getting better. She had stopped having accidents and needing to be cleaned up and then Yesterday she seems to have gone downhill, she needed cleaning up again, she was in a terrible mess when I found her this morning with poo everywhere and more poo again when I came home from work.
Is it usual to go downhill again with e.cuniculi, I feel so down about it and think if she’s going to be like this forever it would be kinder for her to be pts, or can they sometimes relapse and recover again, should I keep going with the treatment?

Yes, relapses can occur. How far into treatment is she now ?

 

[Bugs&Beau]

We are on day 15 of the panacur now. It really seemed to be helping, on Friday I was so pleased with how she was doing and now she seems to have gone backwards

 

[InspectorMorse]

Keep going with it. What other meds is she on ?

Some gentle physio can help her retain muscle tone and mass. Has the Vet mentioned this ?

 

[Bugs&Beau]

She isn’t on any other meds at the moment, just the panacur. I have been trying to help rub her legs, and getting her out of her run every day to have more of an explore to try and get them working better. I’ll keep going with the panacur, thank you

 

[Shimmer]

Recovery from EC is a rollercoaster ride, with relapse and recovery being quite common. Keep going with the treatment. It should not be a PTS issue. Even with residual symptoms (such as head tilt) after several rounds of treatment, the rabbit usually copes well.

You should also have some ant-inflammatory (eg Metacam) as that reduces neurological damage by the parasite, which is what causes the common symptoms. Panacur just deals with the parasite, not the damage it causes.

As the parasite is passed in urine, it is important to thoroughly clean on days 21 and 28 of the treatment. That breaks the reinfection cycle at a key point in the EC lifecycle. Bleach, steam, etc, or dispose of eg hay bedding.

 

[InspectorMorse]

She isn’t on any other meds at the moment, just the panacur. I have been trying to help rub her legs, and getting her out of her run every day to have more of an explore to try and get them working better. I’ll keep going with the panacur, thank you ��

As Shimmer has mentioned, Bunny needs to be on a non steroidal anti inflammatory such as Metacam ( Meloxicam). Have a read of the info on here which does contain some GRAPHIC IMAGES

https://www.vettimes.co.uk/app/uplo...phalitozoon-cuniculi-infection-in-rabbits.pdf

 

[Bugs&Beau]

That’s really great, will take a read.
Have had a good feel of her legs and all the other buns legs this evening and hers feel so boney compared to the others, like there’s not a lot of muscle, will definitely make sure I get her moving around more instead of letting her rest in the hope she can get some muscle back.

 

[InspectorMorse]

That’s really great, will take a read.
Have had a good feel of her legs and all the other buns legs this evening and hers feel so boney compared to the others, like there’s not a lot of muscle, will definitely make sure I get her moving around more instead of letting her rest in the hope she can get some muscle back.

If you can afford it getting a professional Veterinary Physio involved would be a good idea.

https://www.fitzpatrickreferrals.co.uk/services/rehabilitation/physiotherapy/