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Ataxic Rabbit

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Kaycejones

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Hi all! I'm new here and just adopted a rabbit that has severe ataxia. I'm a Veterinary Technician and he is under the care of a Veterinarian. He presented from Animal Services as a stray with severe ataxia. He's thin but eating, drinking and has normal stool and urine. We are running a Rabbit Neurological Panel now and ran a fecal which was negative. He has improved slightly but is definitely still wobbly. No headtilt nor nystagmus. I am here to see if anyone has any suggestions on his care especially if we find nothing treatable and he is likely to remain ataxic. Anyone with chronic wobbly rabbits? What things do you do to make their life easier? I'm going to start litter training so that I can use non slip material in his cage as well as his room and free roan areas. I also am not adding levels for fear of him falling. Any thoughts?
 
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JBun

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E. cuniculi and an inner/middle ear infection would be the most common causes. But because it can sometimes be difficult to determine which one, until scans or blood tests confirm one or the other, many rabbit vets will start off treating for both with panacur(fenbendazole) for the EC, an antibiotic like baytril for possible ear infection, and meloxicam to reduce inflammation(higher dosage range).


Medirabbit (inner ear infection in rabbits)

If an ear infection is looking to be the cause, I would consider azithromycin over baytril(most commonly prescribed to rabbits). Infections can be difficult to clear up in rabbits, and this antibiotic seems to be an effective one(depending on the bacteria involved), and seems to work quickly. I've used it for a stubborn infection with some of my rabbits, and it cleared it up, with a reduction of symptoms in just a few days. Just can have a risk of severe digestive upset for some rabbits(in which case it shouldn't be used), or may start off causing some abdominal cramping that will usually subside after a few days, so something to be aware of especially if there is a resulting lack of appetite.

When the neurological symptoms are really severe, sometimes corticosteroids will be used instead of the meloxicam initially, just to get the inflammation under control quickly. But because of it's affect on the immune system, this is usually used as a last resort.
Medirabbit (corticosteroid use in rabbits)

Some other, or less common causes for ataxia, would be head trauma, tumor, toxoplasmosis(particularly for rabbits around cats), toxins, heat stroke, floppy rabbit syndrome(usually resolves in a week with supportive care), nematodiasis(for rabbits exposed to wild animal excrement), and for very young baby rabbits born with the issue(usually don't survive a couple weeks) it can be from vit. A toxicity during the mom's pregnancy. Even though your rabbit isn't showing signs of head tilt, the causes of head tilt and ataxia are going to be essentially the same.



As for care, setting up towel rolls and supportive padded siding can sometimes be helpful, but that will depend on the extent of the illness and exactly how it's manifesting.
Info on caring for a disabled rabbit.
 

Kaycejones

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I'll run this by his doctor this week, and get him started on something. I have him set up with bumpers and low litter boxes. He seem.better if he can get a little room than in his crate pen so I have him on a big blanket so he has room to right himself. He can hop but topples over. I'm thinking a chair or somesort of walker may be in his future.
 

JBun

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There are specially made bunny carts or diy cart instructions on youtube or other places, that you can get. So definitely an option.

I would get with your vet asap though. If your bun isn't already started on these meds, the sooner they're started, the best chance there is of reversing the ataxia and reducing the chance of cell damage resulting in permanent disability.

Getting those anti inflammatories started at an effective dosage, is essential. Vets less experienced with rabbits often under dose meloxicam. Rabbits need a much higher dose than other animals, so here's a link with dosage info and the medical references to back it up. I wouldn't want to start off at a dose of anything lower than 0.6mg/kg twice a day, provided there are no prior kidney issues and blood tests confirm they're functioning normally.
 

Kaycejones

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I'll pick up some Fenbendezole and Meloxicam tomorrow and we'll have to order Baytril or Azithromycin but shouldn't take more than a couple days. We are hoping for some bloodwork results as we don't know his history at all.
 

Kaycejones

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Anyone used dosed out appropriately Safegaurd equine pellets? I'm wondering if this may be an easier route than liquid. The equine pellets are dosed out g/lb but I can calculate to fit his dose easily and being feed based I bet he'd eat them readily.
 

JBun

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It would be hard to get the right dose with the pellets because they are designed for much larger animals. It also may be hard to get a rabbit to eat them voluntarily.

The liquid is pretty easy. I use the safeguard goat dewormer liquid(125ml bottle). It's 100mg/ml and dose for fenbendazole is 20mg/kg, once a day for at least 28 days, so it's 0.2ml/kg or about 0.09ml/lb, but I just round it up to 0.1ml/lb. A little bit more isn't usually going to be an issue, and there are even some vets that have dosed as high as 40mg/kg. But the 20mg/kg dose is based on research that was done, so that's usually what is prescribed. And there are other meds that have been tried for EC, but fenbendazole seems to remain the primary treatment, as far as I'm aware.

(EC treatments for rabbits)
 

Kaycejones

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It was actually super easy to get the right dose but I have training in pharmacology math as an LVT. It's about 2 teaspoons at 20mg/kg. For a 2.2kg rabbit. They're made with all ingredients that are in normal food and treats. Alfalfa instead of Timothy but it's a small amount. He ate them right up without question. Easy peasy.
 

Kaycejones

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I actually can't believe no one has ever bothered. Panacur tastes like poo. I used the livestock rather than equine pellets as the equine has a flavor additive as well as molasses. I measured how many cups per the pre measured lb, then how many teaspoons per cup, mg per tsp etc. Which worked out suprisingly even and simple. If I'd had a food scale it'd have been easier.
 

Kaycejones

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I ordered Baytril for mister bun bun. I got unflavored tablets so my understanding (according to VIN and other veterinary sourcing) is that I can crush his dose and mix with a little fruit juice to make it more palatable? I'm still considering dosing, I will recheck our exotics formulary (2019 doses) tomorrow when I should get the baytril.

I also picked up Meloxicam and am planning on starting on a high end dose of 1mg/kg/day per our exotic formulary. He likes the metcam luckily because he's going to need 1.4ml.

His bloodwork so far is pretty good, he was hypoglycemic at the time but is eating me out of house and home and may be unrelated to anything clinical(age of sample for instance), and has high Neutrophil/heterophil:leukocyte ratio at 3:1 vs normal 1:1 so likely a decent infection. I'm still waiting on the neuro side of the panel (EC and Pasturella). He's doing well, not much change but treatment was started yesterday. How long is generally accepted for improvement? Thank you for all your info! Bunny no name yet thanks you too <3
 

JBun

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There's really no fixed time for improvement. Too many factors, like how severe it's become before treatment has started. If an infection, what bacteria are involved and are they sensitive to the antibiotic being used. If EC, what extent of neurological and organ damage has already occurred. And the general health and immunity of the bunny.

If I wasn't seeing at least a little improvement after a week, two weeks at the most, I would consider changing antibiotics. If there was a significant decline by a week or less, I would want to change antibiotics But if it turns out to be EC instead of an infection, then EC is more difficult to determine. Some rabbits will pull right out of it and show improvement right away, for some it can take weeks, and for others there will just be a stabilizing of symptoms where they aren't worsening but are left with permanent cell damage that leaves them with permanent disability. It doesn't mean they are still sick, but just that there is irreversible damage that the rabbit has to learn to cope with. And EC can be an ongoing thing. It often doesn't go away completely and at some point symptoms will flair back up and treatment needs to be started again.

The baytril tablets I mixed up, it can be kind of hard to mix. If juice isn't working very well for you, I found a little natural maple syrup worked well to mix the powder in with. I don't know if baytril can ever be made too palatable, as rabbits apparently seem to find it's pretty disgusting, but mine didn't seem to mind it so much with the syrup. I was doing a dose of 10mg/kg twice a day.
 

Kaycejones

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That's pretty much what I was thinking. Thinking we'll recheck bloodwork after a coulple weeks and see how that hetero:lymph ratio is doing. I'm wondering if Meloxicam and baytril can be mixed together. He loves the Meloxicam and it's so sweet it might make thay enro more palatable if they don't interact.
 

JBun

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It's always nice when you don't have to make them take their meds. My buns LOVE meloxicam. One of their favorite 'treats'. I'm sure they wished they got it all the time.
 

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