Encephalitozoon Cuniculi and GI Stasis

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Mushroom

Well-Known Member
Joined
Aug 6, 2013
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Location
Toronto, Ontario, Canada
Hi everyone,

This post is about my rabbit, Mushroom. He is a 5 year old Netherland Dwarf, purchased from a pet store, has been on timothy hay and Oxbow adult rabbit food for his whole adult life, supplemented by fresh greens - namely parsley, lettuce, carrot tops, and celery leaves. He is a picky eater and sometimes has had stomach upsets when trying new foods.



This past Sunday Mushroom was limping a bit on his left hind leg and sometimes falling over. My regular vet was closed because it was a Sunday, and yesterday was a holiday Monday, so I talked to an exotic animal vet about what was happening. They said that it was probably a sprain. They are located 50 minutes away from where we live and I didn't want to bring him in if he only needed some rest because carrides really stress him out. I also noticed he wasnt pooping at much, but I thought it was because of the stress of his foot (he has had inconsistency in the past and has always been helped through it with greens and tummy massages). At about 11:45 that night he started having seizures, so we rushed him to the emergency vet.

He was quickly diagnosed with EC and GI Stasis. He was put on
Panacur - 0.2ml once daily for one month
Metacam - 0.2ml every 12 hours for one month
Ranitidine -0.08ml every 12 hours for 5-7 days
Simethicone - 1ml every 8 hours for as long as needed

Emerg gave me the option to keep him overnight, or take him home to administer the drugs myself. I was nervous about leaving him there, scary noises seemed to be setting off his seizures and I wasn't sure if he was going to pass with me being 50 minutes away. I opted to take him home and care for him myself.

It was a rough few hours from 3 am until 1pm. He had a seizure at least every three hours, the longest lasting 7 seconds. I called emerg and they told me I could come in if I like, but he would have to be put on ??? (they said it was like a bunny valium), put on anaesthesia and be given fluid in order to help combat the seizures. I decided to take some time to see how he was doing since he had only had one dose of his meds at that point. I am very glad I kept him home his seizures have gradually been getting shorter, and farther apart. His last one was at 1pm yesterday and lasted only 1 second - it could have possibly even been a roll. Throughout everything he has had a healthy appetite and can eat on his own. He doesnt like critical care food, but will eat hay, parsley lettuce and pellets sometimes. He can stand upright if i use my hands like a bumper, and he has been conscious this whole time. He often thinks he can walk or jump farther than he can without rolling, and will regularly try to get out of the safe area I am keep him in if I show him the way out.



I am hoping for advice on any instances with bunny EC... what should I expect? What are more emergency signs I should look out for?

How long can Simethicone be safely used, when can I tell when it is no longer needed? (He is pooping about 10 soft pellets every 2 hours - yesterday there were far less pellets and about a tablespoon of globby poo throughout the day)

Should I be concerned about renal failure? he went a long time without peeing yesterday prior to 1pm and was ultra thirsty in the evening of the Sunday before the seizures. He has been peeing a lot today, but we have also been syringing him a fair bit of water bc he hasnt been drinking on his own. I noticed his pee smells a little different then usual... mildly asparagusy? but I was wondering if that is just from the meds.

Any advice or similar experiences would be great to hear! Thanks so much for reading!
 
Here are links on EC from our library. Take the time to go through them.


http://www.rabbitsonline.net/f22/e-cuniculi-encephalitozoon-12817/


it sounds like you have been handling things well with him up to this point. Without a titer the positive response to the fenbendazole (Panacur) would be an indication that he is suffering from EC. Right now you need to make sure that he is eating and very well hydrated. You may want a vet or vet tech teach you to do suqutaneous fluids at home. It is really not difficult and actually much easier to do than force oral fluids.
The simethicone actually breaks up gas bubbles. and is not absorbed into the body. . There is no need to give it every hour if his tummy is soft and he is eating and pooping. I would stop it and continue to assess his gut for gurgling , harness etc
If seizures would reccur I would get the valium type meds to prevent them from continuing.
At some point EC does cause renal impairment but since it is a chronic illness that may not be the case now. I don't know why your rabbit has a strange odor to his urine , however, you can get lab tests (bloodwork) done that can assess whether the kidneys are functioning normally.
There is also another drug available ( usually used for an encephalitis in horses) that has been used got for treatment of EC. It is called Marquis ( ponazuril. If the fenbendazole does not work sufficiently the Ponazuril may be a way to go. )
I (cross my fingers) have not had a rabbit with EC but many forum members have and there are numerous threads on it if you do a search.
 
Angie, I have been reading all of those links, and the threads on this forum, for the last few hours (between bunny feedings and cuddles!). Thank you so much for all of that information. I am so glad you mentioned learning how to do subqs at home - I had no idea that was possible and was worried about admitting Mushroom for fluids because he gets so stressed out in the car, at the vets, away from home or from his people. I am excited that I can help him with fluids from home and keep him as comfortable as possible

So far, no seizures have reoccured for 32 hours and the stumbling he was showing in his left hind leg has not been noticeable today.

I read about Marquis in some of those links and wrote it in my list of What To Do Next's... Do you think I should try Marquis once the 30 days of panacur are over? Should I mention it to my vet now?

Thanks so much for all your help. All of this information is much appreciated
 
Is he drinking water normally? If he is then the fluids might not be needed? My bunny Rocky has also had episodes resembling seizures. These were definitely enhanced when I had to take him to my exotic vet. He was having episodes every hour on the dot where before it was maybe once a month or two. Keeping him at home is the best thing for Rocky and luckily I am a vet tech so I could administer anything he needed. I would recommend the same for yours and like I said I'm not sure if the fluids are absolutely necessary.

Sometimes to combat seizures in dogs we prescribe diazepam or phenobarb. My boss suggested this only if it got bad as she hasnt ever used them in rabbits. As I brought Rocky back home his seizures diminished and I opted not to try the meds.
 
I want to learn how to administer fluids at home, in case I really need to. I would be more comfortable having the kit at home and ready for use. So far I have been able to get about 30 mls of water in him a day, and yesterday he began drinking a little from a bowl on his own for the first time since the seizures began!

The exotic emerg vet was also wary about meds for seizures, and suggested he could only be put on a med like valium for bunnies, and it would put him under until the seizures stopped. That made me really nervous. I read that if the kidneys are compromised (possibility with EC), going under can cause lower blood flow and can cause further damage to kidneys or begin renal failure :(

I am planning on testing Mushroom's liver and kidneys with a blood test by the 14 day mark for sure, but I was wondering if anyone's bun has had this blood test done - how invasive/stressful is it? (Also, should I be testing him before 14 days if he is strong enough?) Mushroom's seizures were set off by stress as well, and I want to avoid as much stress as possible for the little guy.

By the way, Mushroom had an excellent night. Hour 45 and still no seizures! He is pooping more and more, and they are looking more regular. He is still having trouble with eating his Critical Care and pellets, but will eat hay and greens on his own at least. His stability has improved a lot and he can stand up and move around on his blankets on his own! I think he is getting stronger so I have a lot of hope for him.:love:
 
This is Mushroom yesterday during a stomach cramp in the morning. I was massaging his belly until he felt better and he fell asleep in my arms :love:
e7iamv.jpg
 
I would keep him on the Panacur for now as long as it is working well and he is improving. If you want to present the possibility of Marquis/Ponazuril to your vet it is best for you to have knowledge of it Your self

We have an inactive moderator (ra7751) who is a wild life rehabber and works esp. with rabbits . He has a rabbit Rescue and works in coordination with the exotic vet program University of North Carolina and has posted in many threads on EC in previous years. If you go to "SEARCH" at the top of the page and type in ra7751 all threads that he has posted in the past will come up. It is worth it to skim through the topics and select the ones re EC ( for ex . head tilt, seizures etc). He exclusively uses Ponazuril at this point for EC and has very in-depth knowledge of the dynamic of the EC parasite on a rabbit's body.
I will attempt to post a video on how to give a rabbit sub q fluids, however, the rabbit is very docile which isn't always the case LOL
 
Hi again Angie!

I read through all of the posts on this forum on EC that I could find yesterday, and noticed ra7751's many posts. I am so happy I found this forum and that you have such amazing people on it because it has helped me learn so much. I will keep Marquis in mind in case Mushroom takes a turn for the worse. Right now he is showing so much improvement and I am hoping he continues on this path.
I started a blog about his progress here: http://www.rabbitsonline.net/f18/mushroom-ec-76352/


I watched that video on subcutaneous fluid yesterday after you suggested learning how to administer it. I was also wondering why the rabbit was so docile! I would hope Mushroom would be, but I can't be so sure..
 
I personally would mention Marquis right away, and see if your vet is willing to get some. They may not have it on hand as it is usually for horses and ordering it in may take some time. It is good that he's starting to improve. That should be an indicator that you have the right treatment. I am a bit concerned about the timeline--EC usually progresses more slowly. Hind leg paralysis is followed after a few days to weeks by eye problems, tilt, opportunistic infections, etc. It usually doesn't proceed to seizures within a few days. Is it possible he got into something he shouldn't have? I had a bunny get ivermectin poisoning and it sounds a bit like what you describe: difficulty moving, staggering gait, followed within 24 hours of going into seizures. It took several days for his body to clear the ivermectin. If he was exposed to a pesticide, it could explain what happened with him.

If you have to give sub-q's and he fights you or gets stressed and has a seizure, valium might be a good choice (the generic name is diazepam and it is used widely in vet medicine as a calming and/or pre-anesthetic agent) to give beforehand. Maybe that's the trick in the video ;)
 
Mushroom has been acting really well today as well.

Mushroom is usually confined to a room, I did not notice he got into anything unusual and there were no new substances in his room that could of given him any trouble. The greens he was getting were all from my garden and I don't use any pesticides / wash them very well. He ate some of my baseboards about 2 years ago, but I can't really think of anything else? If he was exposed to a pesticide and is doing better, would that mean his body is clearing it out and he would be okay now?
 
just called the exotic emerg vets to mention the Marquis and got told they do not carry it and to be careful about what I read online :pssd: They said they would order it in but I would have to bring Mushroom in for another checkup because it requires a prescription in Canada :X. Since I don't want to stress the little guy out with a car ride yet, I am going to insist it is ordered when I bring him in for his checkup in a week. A bit frustrating.
 
I don't know if this is true in Canada but many horse owners here use Marquis/ Ponazuril and since it is very expensive it is often easier to get a small amount from a horse owner ( if you are lucky to know one. ). I know that Dana Krempels has explained ( On All Experts) how to dose it using the paste .
I just happened on this place ( on-line) in Texas that makes suspensions for small animals. This would be wonderful although very expensive. Marquis is still off label for everything but horses ( I think but not sure) but "cutting edge" vets are learning about it and using it.

http://www.wedgewoodpetrx.com/items/rabbit/ponazuril-oral-suspension.html

The bottom line is that your rabbit is improving now and that is wonderful. :)
 
It is good to take what you read online with a grain of salt, of course, but Randy's experience. I know the shelter I volunteered at used to use Marquis for more routine anti-parasitic treatment (in dogs, cats, whatever came in) because it came in such large quantities and is so effective. Here's some advice from a true expert and leading researcher in rabbit medicine:
http://en.allexperts.com/q/Rabbits-703/2008/10/E-cuniculi-Ponazuril.htm
http://www.bio.miami.edu/hare/paresis.html

In any case, I think you've effectively ruled out any toxin exposure. If that were the case, it should be being cleared from his system, either through urine or feces. The problem we had with the ivermectin poisoning is that his GI system shut down, and ivermectin is primarily eliminated through the feces, so nothing was moving out. Since you are seeing continued improvement, I would stay the course your vet has set forth and assume it is EC-related. Maybe showing them the info from Dana Krempels will help to get them to change to ponazuril, however, if fenbendazole is working quickly and effectively enough, it probably is not necessary. Hope he continues to improve.
 

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