E cuniculi questions (and thanks to the forum)

Hi, new poster here, registered to thank the posters on this board for the wealth of information on the threads about e cuniculi. I don’t think my rabbit would have survived the last few days without the knowledge I gained here, desperately searching for answers between syringe feeds. So thank you for the life saving advice you give on here!

My Netherland Dwarf, Vince had a slight head tilt and was subdued on Saturday, vet prescribed 28 days of panacur for Vince and his buddy Howard. Vince wasn’t eating after the trip to the vets, but was eating well by the morning, after syringe feeding. By Monday he was racing around getting up to no good as usual.

Wednesday evening he went horribly downhill. Tilt was much worse, with rolling and curling, and eye flickering. After each syringe feed he looked almost unconscious, and I thought that even if he made it till morning I’d be taking him to be euthanised. Between feeds I was searching for information, which was how I ended up here.

Yesterday morning he had improved, the eye flickering reduced, and while still very uncoordinated and dizzy, he looked more ‘present’ if that makes sense.

So I phoned the vet, told them I wasn’t going to move him unless completely necessary at this stage, and asked for a Metacam prescription. It was a different vet at the practice, and she spent most of the call trying to push for me to euthanise Vince. She refused to prescribe Metacam, saying that they wouldn’t in case of renal involvement.

I was exhausted from a very late night and very early morning, as well as the worry, and I may not have been very nice to her. By the end of the call I’d bullied, I mean persuaded her to prescribe Metacam. Quoted the Vet Times research summary at one point. There are some benefits to being battle axe aged!

As several posters on here had mentioned in earlier threads, around 12 hours after his first dose he was noticeably improved. Today he’s eating (not a lot, but it’s a start), moving around, clumsily but determined. I’ve padded his hutch with rolled up towels for support and ordered a supportive bed from Hare Apparent. He’s making attempts at grooming himself, and wobbling his little head at us for pets.

He’s fighting back, and after what he’s gone through in the last few days, I’m blown away by his resilience.

So, onto the questions, so I’m forearmed at our next vet visit (I’ll be asking for the first vet or the head of the practice. The vet who tried to refuse him treatment is not someone I’ll consult with again, and she’ll probably be relieved about that after our phone call yesterday).

Firstly, Metacam - how long should Vince take it? I’m very conscious that he might not have survived this far without it, so will dose him for as long as it takes.

Second, the 21 day and 28 day disinfection - will steam cleaning kill the spores? I’ll bleach if necessary, but would prefer to steam clean if it will be effective.

If you’ve read this far, thank you, and thanks again for the advice on this forum. I’d welcome any advice on how to get my little man through the next few weeks/months, and would love to read your stories too.

It’s been a horrible week, many tears shed and not a lot of sleep, but we are cautiously hopeful for Vince today.

Sorry to hear about poor Vince, but well done for being such a great advocate for him. With regards to the Metacam, how long to continue to use it depends on the individual case. Yes, it is important to consider the risks to the kidneys, EC can effect the Kidneys too. But with EC it is essential to reduce the inflammatory response as EC spores erupt into the CNS. I have had EC Rabbits on Metacam for the entire duration of the 28 day course of Panacur, usually at the lower end of the dose range. But this has not always been the case. If rolling becomes a big problem a drug called Prochlorperazine ( Stemetil) can help as it can reduce the dizziness.

Yes, steam cleaning will eradicate EC spores.

Whilst it might take several weeks I hope Vince will eventually make a good recovery, even if he is left with a head tilt. Bunnies can adapt very well to cope with living with a head tilt.

Thank you Inspector Morse, I’ll talk to the (competent) vet about treatment with Metacam for 28 days and see what he has to say about dosage.
The rolling is hugely improved, but I’ll keep Stemetil in mind if we have any setbacks. He could finally get some sleep yesterday evening, so I feel that the dizziness is easing for the moment.
We can see him making efforts to adjust to the tilt already, it gets me quite emotional to see his will to function.

I think Jane's covered everything.

Well done for advocating for your rabbit. EC can be a rollercoaster ride - so compare week by week, rather than day by day. Symptoms often get worse, then better, then worse again. Rabbits seem to cope well in general, as long as they are able to access food (may need syringe feeds) and water, and are kept clean and safe (eg confined if unable to stand - rolled up towels as boundary and puppy pads on the floor). The outcome is nearly always good, with maybe a slight residual effect eg head tilt. Catching it and treating it early is better for the outcome.

You may need more than one round of treatment, and it may reccur in future, but just continue with the standard treatment. Metacam is part of the standard treatment to reduce the effects of the damage to the CNS, which is what gives the visible symptoms. This needs a vet to prescribe it, obviously if there is no contra-indication. Panacur can be bought online - no prescription needed. I use the dog/cat 10% liquid as it's cheaper for multiple rabbits, and more accurate dosing than the paste syringe specifically for rabbits.

I had one rabbit with a very severe case of EC. She came inside one day. Was fine at the front door, but had collapsed by the time she got to the kitchen. She had many months on treatment, severe head tilt (head was 'fixed' right round to her shoulder), eyes flickering, unable to stand, etc. She recovered and was left with a slight head tilt. Once recovered, she continued to live outside, running around, jumping, etc. People who hadn't seen her at her worst would not have spotted anything wrong afterwards.

Hang on in there.

Hi and welcome to the forum :wave: I don't have any experience of EC, but will add my well done for advocating so well for Vince. I really hope he makes a speedy and full recovery, please let us know how he is doing.

Sending lots of vibes. Our bunny Blossom is just started her 2nd 28 days of EC treatment as one month wasn't quite enough.

We had good days and bad days. By about 3 weeks the good days were far more frequent.

Initially she needed help cleaning herself and and syringe feeding as she wasn't eating hay. She started cleaning herself after the first few days but needed help with food for a long time.

She had stemil and metacam for the full 28 days, and we did physio exercises as advised by http://www.disabledrabbits.com/

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Shimmer, thank you. It’s very useful to know we might not have a continuous improvement, and that perseverance isn’t an unkindness to him. One of the very frustrating parts of that conversation with the vet who didn’t want to help, was that there aren’t any contraindications in Vince’s case. 2 years old with no health issues before now, and no suspicion of renal problems. But she was telling me she wouldn’t give NSAIDS ‘in case’. While also telling me he had no chance of survival, I’m not sure what use she thought his kidney function would be to him if he was dead.

Great to hear about your bun’s recovery. His tilt is better today than yesterday, and he’s already learning to lean on things to do things like clean his face. He’s kind of furious at me for cleaning his face after feeds too, which feels like a step in the right direction.

Pets mum, thank you, I’m a lot more hopeful than I was 2 days ago. I’ll try to post a picture of him I took today - if I can work out how! :lol:

CarelessSquid, again, good to know. We can do the long haul, my husband and I both work from home, so we’re around for frequent syringe feeds, which are easier with 2 sets of hands! Great that Blossom is getting there, it gives me hope. Thank you for the physio link, I’d been wondering if anything like that was available- between the tilt itself and lack of activity of the last few days I’ll want to help him with physio.

Many vets don't have much training or experience of dealing with rabbits, unfortunately. I'm so glad you didn't take your vet's response at face value. EC isn't a terminal condition, although the symptoms can appear quite severe at times and it can have a sudden onset. It's pretty easy and cheap to treat, with a good outcome. It just needs patience and persistence.

Update, after a month with no energy to spare for online activity (I’ve got MS, can push on through when I need to, but it leaves me with nothing to spare).

Vince is eating independently, including hay. I still give him a syringe of Critical Care before I go to bed, for my peace of mind more than anything. He’s not able to get on his litter tray yet though, even after we cut out one side. He had those days when he seemed to get worse with rolling, but with hindsight it seems like the “bad” spells were when he was pushing himself to do something. So he’d be rolling and falling, but after a couple of days he’d be doing something new, like grooming himself, or eating his cecotropes. He greets the dogs when they come by his pen, and gets excited for his feeds.
He seems to have plateaued though, so after some searching (here and on google in general), I’ve started gently straightening his head while gently massaging his neck (he wasn’t happy at first, but then got very relaxed and ended up licking the hand his head was resting on), and trying out a gentle balance exercise using a washing basket with some old yoga mat cut out in the bottom. Sort of a modified wobble board for a bunny.

I wish I’d started the physio side earlier, I know better than most people how essential it is.

It’s been a month, and he rolls over a lot, although he is eating and grooming himself well, and interested in the goings on around him - I think I’m looking for reassurance here, I am very much missing my old vets, in whom I had complete trust, and feeling quite alone in this. Obviously honesty is more important, but if there’s any reassurance to be given I’d appreciate it!

Running Hare said:

Update, after a month with no energy to spare for online activity (I’ve got MS, can push on through when I need to, but it leaves me with nothing to spare).

Vince is eating independently, including hay. I still give him a syringe of Critical Care before I go to bed, for my peace of mind more than anything. He’s not able to get on his litter tray yet though, even after we cut out one side. He had those days when he seemed to get worse with rolling, but with hindsight it seems like the “bad” spells were when he was pushing himself to do something. So he’d be rolling and falling, but after a couple of days he’d be doing something new, like grooming himself, or eating his cecotropes. He greets the dogs when they come by his pen, and gets excited for his feeds.
He seems to have plateaued though, so after some searching (here and on google in general), I’ve started gently straightening his head while gently massaging his neck (he wasn’t happy at first, but then got very relaxed and ended up licking the hand his head was resting on), and trying out a gentle balance exercise using a washing basket with some old yoga mat cut out in the bottom. Sort of a modified wobble board for a bunny.

I wish I’d started the physio side earlier, I know better than most people how essential it is.

It’s been a month, and he rolls over a lot, although he is eating and grooming himself well, and interested in the goings on around him - I think I’m looking for reassurance here, I am very much missing my old vets, in whom I had complete trust, and feeling quite alone in this. Obviously honesty is more important, but if there’s any reassurance to be given I’d appreciate it!

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This will be quicker than I'd like as I'm pooped but didn't want to read & run. It sounds like there is ongoing progress to me, as you'll have read its a rocky journey & disheartening at times. A month is only a ball park figure, its a sensible review date that fits with the 28 days pancur. about 10 years ago i had a head tilt (through EC) bun & she didn't make any progress at all for 5 weeks but then it was pretty quick with one minor relapse. You're doing a grand job - my bun had massages, wish I'd thought of physio

I would keep going with the panacur and metacam for another month. Metacam is essential to reduce the neurological damage - which causes the physical symptoms that you are doing the physio for. He's making progress, it's just slow and steady. Most will recover in the first couple of months, although there may be a slight residual head tilt, etc, which doesn't usually bother them. I had one that took the best part of a year with such slow progress, but she was fine in the end. The fact that he is feeding and cleaning himself makes things so much easier.

I would definitely keep going for another 28 days. Blossom is just finishing her 2nd month and is soo much more mobile for it.

She does still have a tilt even with the physio which I think we'll continue for a long time especially as she enjoys it.

Sending lots of vibes and hugs your way x

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Sorry to take so long to reply, I really am having to save my energy for essentials. Thanks for the encouragement, it is getting easier, for me and Vince.
I’ve realised something in the last few days, that he is in need of more cuddles. He’s always been a very affectionate bun, on his terms though, hated being picked up. So I was trying to minimise handling so as to not stress him out. But since starting massage, he’s really snuggling into it, and even fell asleep yesterday. It must have been a lonely 5 weeks for him, separated from Howard by his pen, too.
So we’ll be having more cuddles from now on