EC rabbit mommy desperate for help :(

[raniabear]

Hi,

please stop and give me some advice if you can. over a month ago i got home to the scene of my rabbit covered in urine showing her first signs of EC. long story short she finished her 28 panacur and metacam cycle 2 weeks ago ( i think, my life is blending all together atp) and she still rolls when she loses balance...still unable to really support herself on her own much. her under eye is also...i don't know, but that's an issue for later. she has been improving overtime with balance, strength, appetite, etc. but she finished the cycle and was on nothing until i convinced her vet to let us try ponazuril/ toltrazuril as i read SOME hope in its usage without adverse effects (I'm desperate).

i also got her some more panacur and metacam and was instructed to start giving her all 3 together. we don't have a set plan yet as her vet appt is in 3 weeks, and honestly i just wanted to ask if anyone has any advice or experience or anything to help me know how to do this right.

i just feel like i messed up by finishing the 28 day cycle and now randomly starting again 2 weeks later like i don't know if that's the best way to target the parasite considering the cycle and stuff... should i give her some more rest until her vet appt (bloodwork) and THEN start the meds? like Aug 6? I'm just scared of starting it too early or wasting precious time and starting too late. please please give me some guidance i live for this rabbit i've had her for almost 8 years.

thank you to any and all help.

 

[joey&boo]

Welcome to RU. I'm sorry your beloved un is struggling with EC. Opinion is divided, I can only say what I'd do & share a little experience. Many years ago my bun came down with EC (brought on by the stress of bereavement). She had really severe head tilt. Already blind in one eye, her "good" eye was pointing at the floor. It took 5-6 heart wrenching weeks & then there was steady progress. She recovered to the extent she did have a tendency to run in circles & did have her head at a jaunty angle. But she had a really happy couple of years after that. Although panacur is recommended for 28 days for active infection it won't always be long enough. All the drug does is reduce the parasitic load. I'd restart now with your vets agreement. There are anti dizziness meds that can help.

I'm pleased to hear bun is getting a little stronger. Sending loads of well wishes

 

[Shimmer]

With my EC rabbits, I've just kept going with the Panacur and metacam 28 day cycle until the symptoms stabilised / minimised. Sometimes that was just one cycle (for repeat offenders who looked like they were showing symptoms again), to continuously for nearly a year for one particularly badly affected rabbit. Typically, I think it's taken about 3 cycles on average for mine - so continually treating for as long as necessary. It can be a rollercoaster - some weeks they seem better, then they relapse a few days later. Just keep supporting them - make sure that food and water are accessible (or syringe feed) and that they are toileting Ok and are kept clean. The symptoms don't always entirely disappear - you just get to a new normal and you recognise when they are relapsing.

Don't forget that the parasite is excreted in urine, so anything that comes in contact with urine (flooring, bedding, toys, trays, bowls, etc) should be adequately disinfected weekly, and hay & litter tray substrates disposed of. That means leaving in a bleach solution, steam cleaning, or using a disinfectant like Virkon S. You need to check that whatever you use will actually kill the EC spores (not all disinfectants will), and that it won't damage the items being cleaned. Virkon can be used to wash fabric, such as fleece blankets. If you don't disinfect properly, the spores in the urine reinfect any rabbit that comes in contact with them and the cycle goes on.

Treatment for the affected rabbit (and it's companions) doesn't totally eliminate the EC parasite - it just reduces the loading in the body. Symptoms can reccur, such as when the rabbit is under stress. Disinfection reduces the environmental load and the risk of reinfection. The 28 days is based on the lifecycle of the parasite - you won't know what stage it's at when you start treatment, so it covers all bases.

Companion rabbits need Panacur treatment at the same time as the affected one, but they don't need the metacam if they have no symptoms.

I've not used any other treatments for EC, so I can't help with those, I'm afraid.

 

[InspectorMorse]

As you haven’t mentioned any diagnostics then the Vet must be treating on assumption of EC. The problem being that Otitis Media (middle ear infection) can present in the same way as EC, some signs might vary like the direction of any nystagmus involved. So if treating on assumptions then a Vet would usually cover for Otis media and will prescribe an antibiotic as well as Meloxicam and Fenbendazole.I would discuss this issue with the Vet ASAP.

Diagnosis of Otitis media involves a skull X-ray/CT scan, it’s not always possible to rule it out just by otoscopic examination of the ear canals. But as sedation would be needed personally I would prefer my Vet to agree to treat for infection just to cover all bases, even without diagnostic proof.

I would want this treatment to start ASAP:

Fenbendazole
Meloxicam
Antibiotic- Due to the legalities of the prescribing cascade Vets often start with Baytril (enrofloxacin). There are other antibiotics which can be tried, it would be the prescribing Vets professional judgement as to which antibiotic to use and whether it might be more appropriate to go straight for something like Azithromycin or Depocillin BY INJECTION ONLY.

Treatment might be needed for several weeks. It can take months for the Rabbit to regain mobility and stop rolling. Some Rabbits can be left with a permanent and significant head tilt. So treatment should also involve some physio. Input from a Veterinary physiotherapist would be useful.

Ponazuril/Toltrazuril is usually used to treat Coccidiosis in Rabbits. But there has been some evidence that Ponazuril used together with Fenbendazole can be effective when treating EC. Ponazuril is used to treat an Equine protozoal parasite that effects the central nervous system of the infected Horse and it is thought that similar benefits are possible when treating a Rabbit with EC, EC being another protozoal parasite.The dose of Ponazuril needs to be higher than that used to treat coccidiosis.

As EC is spread via spores shed in urine it’s important to minimise reinfection from the Rabbit ingesting urine contaminated hay. A* husbandry is essential. A 10% bleach solution, Anigene professional disinfectant https://www.thevetstore.net/shop/anigene/ and steam cleaning will all kill EC spores.

Additional information which might be of interest

*WARNING* Graphic images on links

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/treatment-of-encephalitozoon-cuniculi-infection-in-rabbits.pdf

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/diagnosis-of-otitis-externa-media-and-interna-in-rabbits.pdf

 

[bunny momma]

I had bunnies with similar symptoms from otis media (which IM mentioned above) and treating the infection and inflammation helped. Some showed residual symptoms, yet bunnies can adjust.
Sending vibes your bunny will improve.

 

[raniabear]

Welcome to RU. I'm sorry your beloved un is struggling with EC. Opinion is divided, I can only say what I'd do & share a little experience. Many years ago my bun came down with EC (brought on by the stress of bereavement). She had really severe head tilt. Already blind in one eye, her "good" eye was pointing at the floor. It took 5-6 heart wrenching weeks & then there was steady progress. She recovered to the extent she did have a tendency to run in circles & did have her head at a jaunty angle. But she had a really happy couple of years after that. Although panacur is recommended for 28 days for active infection it won't always be long enough. All the drug does is reduce the parasitic load. I'd restart now with your vets agreement. There are anti dizziness meds that can help.

I'm pleased to hear bun is getting a little stronger. Sending loads of well wishes

Thank you so much for your time and kind words. I've been wracking my head not being able to make a decision which is making the weight even heavier. It just consumes SOOO much of your energy and time having a rabbit that depends on you even for water. I'm scared to start the meds because what if her body can't handle it right now? i think it should be fine she only was on it for 28 days at 0.3ml a day.. im just so scared of also not doing it right ): i hate how perfect the cycle has to be like i dont mind disinfecting the entire world with 70% alcohol but what about her fur..? it's impossible to keep urine from touching her fur then being licked i just feel so lost and overwhelmed :/ i have been begging for anti dizziness pills but canadian vets act like im asking for a PISTOL -.-

 

[raniabear]

With my EC rabbits, I've just kept going with the Panacur and metacam 28 day cycle until the symptoms stabilised / minimised. Sometimes that was just one cycle (for repeat offenders who looked like they were showing symptoms again), to continuously for nearly a year for one particularly badly affected rabbit. Typically, I think it's taken about 3 cycles on average for mine - so continually treating for as long as necessary. It can be a rollercoaster - some weeks they seem better, then they relapse a few days later. Just keep supporting them - make sure that food and water are accessible (or syringe feed) and that they are toileting Ok and are kept clean. The symptoms don't always entirely disappear - you just get to a new normal and you recognise when they are relapsing.

Don't forget that the parasite is excreted in urine, so anything that comes in contact with urine (flooring, bedding, toys, trays, bowls, etc) should be adequately disinfected weekly, and hay & litter tray substrates disposed of. That means leaving in a bleach solution, steam cleaning, or using a disinfectant like Virkon S. You need to check that whatever you use will actually kill the EC spores (not all disinfectants will), and that it won't damage the items being cleaned. Virkon can be used to wash fabric, such as fleece blankets. If you don't disinfect properly, the spores in the urine reinfect any rabbit that comes in contact with them and the cycle goes on.

Treatment for the affected rabbit (and it's companions) doesn't totally eliminate the EC parasite - it just reduces the loading in the body. Symptoms can reccur, such as when the rabbit is under stress. Disinfection reduces the environmental load and the risk of reinfection. The 28 days is based on the lifecycle of the parasite - you won't know what stage it's at when you start treatment, so it covers all bases.

Companion rabbits need Panacur treatment at the same time as the affected one, but they don't need the metacam if they have no symptoms.

I've not used any other treatments for EC, so I can't help with those, I'm afraid.

First of all, thank you so much for your time and words.

nearly a year

Oh wow! My vet was so ready to give up on my baby before we even started panacur for the first time.. getting him to prescribe it again needed BEGGING lol... It's especially sad as i have seen paralyzed rabbits get more hope than mine was given but i refuse to give up on her for as long as she wants to keep fighting. i am just worried about the health effects that vets always talk about with panacur and kidney/ bone marrow issues? i have a very expensive check up for her on the 6th because im worried about the damage it mightve done to her/ will do to her when i keep going..

when you say "cycles of 28 day panacur", how much average time is between them? i know you said usually based on symptoms reoccurring but mine finished her cycle 3 weeks ago i think? (im losing track of everything sigh) and i just dont know if it was enough so does the time between another cycle matter? would it have been better if i just kept going rather than stop? i had no choice ..

If you don't disinfect properly, the spores in the urine reinfect any rabbit that comes in contact with them and the cycle goes on.

Yes! i have been disinfecting almost everything in sight with 70% alcohol almost daily and bleach for the floors weekly! i wash her towels and stuff with dawn in the hottest washer and dryer setting. i try to keep her food, hay and water clean and away from her urine but she does eat from the hay rack and i cant always control the hay that falls onto her pad which she pees on ): i got her waterproof fleece pads which are great but i do work full time and she does have to sit in them for a while sometimes.. it doesnt like smear on her or anything but her feet will have urine on them from standing on it ): i do switch it when i get home but i dont know what to do about the urine on her fur ):... its impossible to keep it off her and she WILL lick it while grooming.. i try to clean her with baby wipes and thought about washing her feet with dawn but it wont even kill the spores so whats the point... again so lost..cant even get virkon in canada..

The 28 days is based on the lifecycle of the parasite - you won't know what stage it's at when you start treatment, so it covers all bases.

so sorry can you explain this to me like i'm 5? i just want to make sure i understand LOL

Thank you so much again for your time and tips.

 

[Shimmer]

Treatment for EC starts when there is a (usually presumptive) diagnosis. The 28 day cycles of treatment are consecutive - no gaps between until they stabilise / symptoms disappear.

I've not had an issue with panacur. There's a huge safety margin in dosing it. Metacam probably has more issues for long term use, but an otherwise healthy rabbit will metabolise metacam quite quickly (hence the bigger relative doses than dogs or cats can have). If you are worried, get a blood test for organ function (liver, kidney, etc). If it's definitely (or highly likely to be) EC, then not treating it isn't really a good option, either. The parasite causes damage to the nervous system - this is what causes the symptoms we see. Sometimes this can't be reversed and you may end up with some level of permanent head tilt or hind leg weakness. It can also cause permanent damage to eyes (WARNING - there are pictures in one of the links).

EC treatment is relatively cheap and easy - but it needs dedication to daily dosing of medication and good hygiene. Most cases will make a really good recovery. The odd case is more severe (rabbit can't stand and has to be syringe fed), but even then, they can make huge improvements with treatment and go on to have a good quality of life. It does depend on the resources of the carer and the individual rabbit's temperament - some rabbits just can't deal with a lot of hands-on care.

Panacur is available in the UK without prescription. I use the 10% liquid cat / dog version.

The other thing is to consider an antibiotic (such as Baytril) for suspected ear infection which can cause some similar symptoms (eg head tilt). Often a vet will cover all bases for the first cycle of treatment (ie Baytril, Panacur & Metacam).

Anigene HLD4V High Level Disinfectant Cleaner is also suitable as a disinfectant which destroys EC spores.


Info on EC in rabbits:

Encephalitozoon Cuniculi

Our advice to help you care for your pets at home and in between visits to your practice.

www.mulberryvets.co.uk

Encephalitozoon cuniculi in rabbits

Encephalitozoon cuniculi is a small pathogen that is spread in urine and mainly affects the nervous system (brain and spinal cord) and kidneys. The disease is very common in the pet rabbit population and can be carried by other animals including wild rabbits.

www.rvc.ac.uk

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/treatment-of-encephalitozoon-cuniculi-infection-in-rabbits.pdf

Disinfection protocols for EC:

Disinfectants

Click here to find out all about Disinfectants & Rabbit Care - Explore which ones to use, when to use them, and how to use them safely today.

rabbitwelfare.co.uk

 

[raniabear]

As you haven’t mentioned any diagnostics then the Vet must be treating on assumption of EC. The problem being that Otitis Media (middle ear infection) can present in the same way as EC, some signs might vary like the direction of any nystagmus involved. So if treating on assumptions then a Vet would usually cover for Otis media and will prescribe an antibiotic as well as Meloxicam and Fenbendazole.I would discuss this issue with the Vet ASAP.

Diagnosis of Otitis media involves a skull X-ray/CT scan, it’s not always possible to rule it out just by otoscopic examination of the ear canals. But as sedation would be needed personally I would prefer my Vet to agree to treat for infection just to cover all bases, even without diagnostic proof.

I would want this treatment to start ASAP:

Fenbendazole
Meloxicam
Antibiotic- Due to the legalities of the prescribing cascade Vets often start with Baytril (enrofloxacin). There are other antibiotics which can be tried, it would be the prescribing Vets professional judgement as to which antibiotic to use and whether it might be more appropriate to go straight for something like Azithromycin or Depocillin BY INJECTION ONLY.

Treatment might be needed for several weeks. It can take months for the Rabbit to regain mobility and stop rolling. Some Rabbits can be left with a permanent and significant head tilt. So treatment should also involve some physio. Input from a Veterinary physiotherapist would be useful.

Ponazuril/Toltrazuril is usually used to treat Coccidiosis in Rabbits. But there has been some evidence that Ponazuril used together with Fenbendazole can be effective when treating EC. Ponazuril is used to treat an Equine protozoal parasite that effects the central nervous system of the infected Horse and it is thought that similar benefits are possible when treating a Rabbit with EC, EC being another protozoal parasite.The dose of Ponazuril needs to be higher than that used to treat coccidiosis.

As EC is spread via spores shed in urine it’s important to minimise reinfection from the Rabbit ingesting urine contaminated hay. A* husbandry is essential. A 10% bleach solution, Anigene professional disinfectant https://www.thevetstore.net/shop/anigene/ and steam cleaning will all kill EC spores.

Additional information which might be of interest

*WARNING* Graphic images on links

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/treatment-of-encephalitozoon-cuniculi-infection-in-rabbits.pdf

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/diagnosis-of-otitis-externa-media-and-interna-in-rabbits.pdf

Hi thank you for stopping by for us!

As you haven’t mentioned any diagnostics then the Vet must be treating on assumption of EC.

sorry im very absent minded at the moment i shouldve mentioned she did test positive for EC, negative for ear infection which is what i was hoping for but 2 penicillin shots later, i got the news ):

i did try to get baytril for her from the vet and also anti dizziness meds but they reject everything :/ i was hoping to mention baytril during her appt on aug 6 but every time i mention anything they shut me down and say its "poor, poor prognosis". *sigh* they make it so hard to fight or our little ones.

It can take months for the Rabbit to regain mobility and stop rolling

months of panacur or months of care? im willing to keep going for her i just dont know what to do about the panacur situation :/ as i mentioned she finished her first 28 day cycle and her symptoms have improved but not to the point where she doesnt need support.. her balance is still off sigh i dont know whether to do another cycle or wait till the appt and then do it im just lost

But there has been some evidence that Ponazuril used together with Fenbendazole can be effective when treating EC

yes!!! that's what i have seen online that gave me the hope to purchase this!! i had to push my vet SO hard to get it.

The dose of Ponazuril needs to be higher than that used to treat coccidiosis

any idea of said dosage? :S

minimise reinfection from the Rabbit ingesting urine contaminated hay

my baby is currently in a laundry basket and i got her a hayrack to minimize her eating infected hay, but i cant stop the little pieces from getting through onto her pad and her eating them :/ the issue is im at work for 9 hours of the day so the pad will absorb greatly, but her paws and the fallen hay will be in contact with urine ): i havent yet figured out what to do to disinfect HER FUR.. i can wash with dawn but that wont kill it.. she grooms herself so i just dont know what to do ): do i get her a cone LOL

husbandry

am i silly for not knowing what that is? they dont even have Anigene in canada ):

Thank you again for your input and for the additional links!! I have read the EC one but i will give the oxitis one a read now! :3

 

[raniabear]

I had bunnies with similar symptoms from otis media (which IM mentioned above) and treating the infection and inflammation helped. Some showed residual symptoms, yet bunnies can adjust.
Sending vibes your bunny will improve.

Thank you so much for your time and well wishes!! i guess its time to start a second panacur round ):

 

[Shimmer]

No, you don't need a cone. Rabbits don't do well with cones anyway as they can't express normal behaviour such as grooming or ingesting caecotrophs with them on.

You can't remove every tiny bit or urine - you just need good general hygiene. Clean / spot clean litter trays etc daily (ie where there is obvious urine output) and a weekly disinfect of everything else as well. There is no need to wash the rabbit or its feet, unless there's an issue with urine scald (damaged skin from constant contact with urine) or faecal matter in the fur that can't be combed out - in which case they may need a gentle bum bath. Just make sure she's not sitting in pools of urine. Puppy pads are useful if she's not using litter trays as it absorbs the urine straight away, so there's no opportunity to sit in it.

 

[raniabear]

Treatment for EC starts when there is a (usually presumptive) diagnosis. The 28 day cycles of treatment are consecutive - no gaps between until they stabilise / symptoms disappear.

I've not had an issue with panacur. There's a huge safety margin in dosing it. Metacam probably has more issues for long term use, but an otherwise healthy rabbit will metabolise metacam quite quickly (hence the bigger relative doses than dogs or cats can have). If you are worried, get a blood test for organ function (liver, kidney, etc). If it's definitely (or highly likely to be) EC, then not treating it isn't really a good option, either. The parasite causes damage to the nervous system - this is what causes the symptoms we see. Sometimes this can't be reversed and you may end up with some level of permanent head tilt or hind leg weakness. It can also cause permanent damage to eyes (WARNING - there are pictures in one of the links).

EC treatment is relatively cheap and easy - but it needs dedication to daily dosing of medication and good hygiene. Most cases will make a really good recovery. The odd case is more severe (rabbit can't stand and has to be syringe fed), but even then, they can make huge improvements with treatment and go on to have a good quality of life. It does depend on the resources of the carer and the individual rabbit's temperament - some rabbits just can't deal with a lot of hands-on care.

Panacur is available in the UK without prescription. I use the 10% liquid cat / dog version.

The other thing is to consider an antibiotic (such as Baytril) for suspected ear infection which can cause some similar symptoms (eg head tilt). Often a vet will cover all bases for the first cycle of treatment (ie Baytril, Panacur & Metacam).

Anigene HLD4V High Level Disinfectant Cleaner is also suitable as a disinfectant which destroys EC spores.


Info on EC in rabbits:

Encephalitozoon Cuniculi

Our advice to help you care for your pets at home and in between visits to your practice.

www.mulberryvets.co.uk

Encephalitozoon cuniculi in rabbits

Encephalitozoon cuniculi is a small pathogen that is spread in urine and mainly affects the nervous system (brain and spinal cord) and kidneys. The disease is very common in the pet rabbit population and can be carried by other animals including wild rabbits.

www.rvc.ac.uk

https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/treatment-of-encephalitozoon-cuniculi-infection-in-rabbits.pdf

Disinfection protocols for EC:

Disinfectants

Click here to find out all about Disinfectants & Rabbit Care - Explore which ones to use, when to use them, and how to use them safely today.

rabbitwelfare.co.uk

Thank you for your reply!!

Metacam probably has more issues for long term use

This just relieved so much weight off my shoulders. the vet stressed SO much how detrimental panacur can be on their little bodies..

If you are worried, get a blood test for organ function (liver, kidney, etc). If it's definitely (or highly likely to be) EC, then not treating it isn't really a good option, either.

yes so her blood test for organs is on aug 6, my worry was whether to start ASAP (which im 4 days late on because i cant decide..) or to start her AFTER the blood tests because im worried the 28 days we already did might have harmed her organs ): im just so scared of doing the wrong and not optimal thing for her.. but yes i have definitely already treated her with a 28 day cycle as soon as we got the results for EC ): she just finished it about 3 weeks ago.

permanent damage to eyes

i cant even accept the fact that she might be going blind in her below eye.. i feel like im going crazy every second, theres too much to worry about and do aaaah

we cant get anything without a vet here so i get my panacur and metacam from them ): we dont even have that disinfector shipped to here.. my care for her is 99% controlled by her vet and my begging lol

do you have any tips on disinfecting her fur? i can clean everything around her but she will still groom her paws which always get urine on them and that's reinfection right there :/

Thank you for the insight and your time!! ill look at those resources right now

 

[raniabear]

No, you don't need a cone. Rabbits don't do well with cones anyway as they can't express normal behaviour such as grooming or ingesting caecotrophs with them on.

You can't remove every tiny bit or urine - you just need good general hygiene. Clean / spot clean litter trays etc daily (ie where there is obvious urine output) and a weekly disinfect of everything else as well. There is no need to wash the rabbit or its feet, unless there's an issue with urine scald (damaged skin from constant contact with urine) or faecal matter in the fur that can't be combed out - in which case they may need a gentle bum bath. Just make sure she's not sitting in pools of urine. Puppy pads are useful if she's not using litter trays as it absorbs the urine straight away, so there's no opportunity to sit in it.

LOL sorry bad cone joke

You can't remove every tiny bit or urine

okay thank you i needed to hear this because in my mind im going crazy trying to eliminate all possibility.. it also doesn't make sense to me that we eliminate all infection but they also need to eat their cecos sigh..... i HATE EC.

Just make sure she's not sitting in pools of urine

yes exactly!! thats what the fleece pads do i even put a puppy pad under for extra absorption and they swallow all the urine so shes not sitting in a pool but her paws still always have urine on them ): at least with this i feel peace of mind that im doing all that i can and not to go crazy about what i cant control.

Thank you again!!

 

[Shimmer]

You are doing a good job. Just keep going. You will get through it - it just needs time and TLC.

 

[raniabear]

Thank you <3