Advanced EC suspected in elderly rabbit

[jackie1992]

Hi everyone - I've spent weeks scouring the internet for resources and advice on treating suspected EC in my 10 year old rabbit. So far I haven't found info on a situation like mine, so I'm hoping someone has experience with this and can give some advice. I apologize in advance for this being so long!

Over the last 2-3 years, my bun has had 2 recurring head tilts. His vet at the time suspected potential ear infections or EC, so he was put on a 28 day course of SMZ, meloxicam and Panacur. He developed cataracts but otherwise made a full recovery both times.

However, back in November, he became very wobbly and showed signs of hind leg weakness. He would hop crooked and then sit with one leg out at an angle and sometimes drag it behind him. I took him to a new vet this time, who I believed was more rabbit savvy. She took some x rays and told me that it was possible arthritis and that she did not suspect EC. I figured that sounded reasonable given his age, so we moved ahead with weekly to bi-weekly acupuncture and laser therapy.

He would have good days and bad days until mid-February, when he collapsed on his side and developed a head tilt.

I brought him to see a bunny chiropractor for a second opinion, who suggested treatment for EC, but told me outlook was bleak. The other vet told me that she still didn't suspect EC and was reluctant to prescribe panacur due to potential side effects and studies that showed it might not actually do anything to treat/cure EC after all. She gave him meloxicam and Baytril instead.

We tried 20 days of Baytril with no improvement.

During my last appointment (early April), I finally convinced her to prescribe the Panacur and SMZ, as that is what helped him the previous two times. We are now 10 days into that treatment and have seen no improvement. In fact, he seems a little bit worse.

His appetite is normal, he is pooping normally, and hasn't lost any weight. We manually feed him mashed up pellets several times per day and he will drink from the bottle if you hold it up for him. He can lift his head when he gets excited for treats, but otherwise lays on his side all day and doesn't move. He's very dizzy so we can't flip him to his other side. We've had to treat his down eye for infection and put drops in daily.

To recap:

• November 2023: Onset of wobbling and hind end weakness. Vet suspected arthritis, not EC
• Nov 2023 - Feb: I took him for weekly to bi-weekly acupuncture and laser treatments
• Mid Feb: Collapsed on his side with a head tilt and dizziness. Vet still did not suspect EC
• Late Feb - Late March: Treated for potential ear infection with Baytril and meloxicam
• April 1: Started Panacur, SMZ, and meloxicam for potential EC
• April 11: 10 days into Panacur and no improvement

At this point it's been almost 2 months since the onset of his head tilt and I'm so worried that it could be EC and we left it untreated for so long, especially if it first started in November with the hind end weakness. I'm having horrible guilt that I should have pushed harder for the Panacur. I feel so bad for him and have no idea how to help.

I also know that it could be more complicated (i.e. a stroke, tumor, etc) than just EC for an elderly bunny. I made an appointment with a university animal hospital a few hours from me. I'm hoping they can give more insight, but they couldn't get me in until end of April.

We're getting to the point where I feel like I have to consider his quality of life, but that's such a hard decision because I still feel like there might be hope?

Has anyone had a similar situation with their bun and can share advice or a success story? Anything is so appreciated.

Thank you!

 

[InspectorMorse]

Panacur doesn’t cure EC, it can only reduce the number of spores circulating within the bloodstream. The EC parasite is excreted long before any clinical symptoms present, if they ever do. It is the spores they leave behind that cause the clinical symptoms when they erupt into cells of the CNS, kidneys, lenses of the eyes. The Rabbit’s immune system can keep things under control and the spores remain dormant. But if the immune system is compromised in some way a flare up of ‘active EC’ can occur. Giving Panacur when this happens might minimise the number of spores but not bring about a cure for the disease

Sometimes the cellular damage erupting EC spores cause is irreversible and the Rabbit does not recover. So for example they can be left with a permanent head tilt, which many Rabbits manage to adapt to living with. Sadly any damage to the kidneys cannot resolve.

It is possible that this time your Rabbit’s symptoms will not resolve, even though they have done in the past.

I expect the Vet you plan to see will suggest blood tests and they might give more clues as to the primary cause of your Rabbit’s symptoms. It’s possible that there are multiple things going on, eg a flare up of EC, a middle ear infection and arthritis.

with regards to the dizziness, prochloperazine or cyclizine can help lessen this.

 

[dex179]

Hi Jackie1992

Sorry to hear what you're going through. I am currently going through the exact same thing, where Dex developed a headtilt in November also.

My story is:
*When first thought it was EC we put him on Panacur straight away, and continued for nearly 2 months without any improvement
*about a month into the Panacur treatment, we also started treatment for possible middle ear infection, but after about a month of this treatment still not much improvement.
*We had a blood test, which showed that it was unlikely that EC was causing the tilt. Because of this, we decided to stop the Panacur treatment
*In the mean time I am only giving him metacam and gabapentin which both relieve pain and inflammation, and it seems to help
*I was also having weekly physio sessions for him. At first the physio was extremely pessimistic but Dexter has significantly improved where he now can sometimes lie and stand quite straight with only a small tilt, and you can see him trying to correct his head movement. On top of that I was doing the recommended exercises on Dexter. The physio is now recommending to come once every few weeks given the improvement.
*Like your rabbit Dexter is still eating really strong and pooing ok-ish. The only thing he doesn't do is eat the wet poos, which I am assuming is probably due to the infection or all the meds hes on.
*Dexter's hind legs are weak, with the leg opposite to the head tilt tucked in at an angle to his body. Sounds like a similar story to yours. The physio has commented that there is little to do here apart from helping with some exercises which can reduce stiffness.

From your story, the only difference to mine is that your rabbit is not on any pain relief? Maybe that is something that you could try? Metacam and Gabapentin can be given long term on smaller doses, according to my rabbit savvy vet.

Let me know if you have any other questions. I am based in North London, and if you are in the area I can recommend to you the animal physio I use, she's great.