Has Anyone Ever Seen This Problem Before?

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MyBabyBunnies

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So I was hoping that someone on here has seen a rabbit with this problem before. First off, I would like to say that I AM working with my bunny savvy vet and have been for 6 weeks but we have not been able to stop these episodes from having despite our best efforts.

First, a little background. Mocha is my 11 year old rabbit who has never had a medical problem in his life aside from arthritis. He has been on Metacam, Tramadol, and we recently added Cartophen which seem to be making him comfortable. Zoey is my 8.5 year old rabbit who has had significant eye ulcer problems for years. One eye has been removed and we controlled the problem in the other eye but she has now developed cataracts. She also had a very slight head tilt that the vet and I attributed to a slight pasturella infection (which we also assumed the cause of her eye problems was). These 2 have been together for 8 years and haven't been exposed to other animals except at the vet clinic for years.

For the last 2 years Mocha has exhibited issues with his right hind leg. The vet thought it was injury/arthritis related but he was still able to use it to get around. About 3 weeks ago he lost his ability to get up from his right side. The problem has slowly been progressing, he can still use his leg when I get him up but he tends to trip over it and sometimes his toes curl under causing him to fall. He is very unstable in his hind end and appears wobbly. I should mention that when he lost the ability to get up from one side, he was being treated with Panacur for EC and Baytril just in case there was an infection present.

Now onto his neurological symptoms (see video links for clips). About 7 weeks ago I heard a scuffle and ran to find Mocha unable to stand up. After a few minutes he was fine and back to normal. He had a few more episodes before I managed to catch it on video. Originally we assumed it was seizures but it does not appear to be that. His episodes almost always go like this: his head starts to tilt to the side until it is flat on the ground (it also tilts backwards sometimes), then his ears, face, mouth, and occasionally legs twitch (he goes completely limp when this happens), and then he seems to wake up off balance and rolls. Within minutes he is back to normal - eating and his head returns to normal.

Then Zoey started having some issues a week ago with her right hind leg not working as it should, very similar to how Mocha's started years ago.

When Mocha's episodes started I took him to the vet and we assumed it was either EC or a brain tumor. We started treating him with Panacur with no real progress (his rolling did seem to not be as severe but the frequency of episodes did not decrease). After 5 weeks of this, I opted to try to Ponazuril. He hasn't been on it long enough to say whether there has been any progress or if he's just had a good day.

I am really hoping someone may have seem something similar and give me and my vet some ideas. See the links below for the video clips.

https://www.dropcam.com/c/5986d432bf3f48bdb85f84c7094ba546.mp4
https://www.dropcam.com/c/1d531a06c0674099acfaf742f616ae35.mp4

 

MyBabyBunnies

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I should also say Mocha has uveitis.

I have ruled out toxins, vitamin deficiencies, and trauma as the cause for any of his symptoms.
 

JBun

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Have you had a blood titer done to check e. cuniculi antibodies, or any other testing for parasitic diseases that cause neurological problems? What about xrays to rule out an abscess, mass, or spinal problems?

I haven't personally experienced these type of symptoms with any of my rabbits, but I have come across a lot with the research I've done, so I'll just throw some ideas out there. Then if something sounds like a possibility, you could discuss it with your vet.

To me it almost looks like he is just dozing off, but I'm assuming that has been ruled out. Otherwise I would think either a seizure or possibly stroke. It almost looks like a petit mal or absence seizure that you would see in people. This could just be due to aging problems, or could have to do with some sort of bacterial or parasitic infection, though things like vit A deficiency and poisoning can also cause neurological problems. I don't know how possible this is as a cause, but has toxoplasmosis ever been considered?

One other idea would be for your vet to consult with a rabbit specialist. I don't know your location, but I know the UK has some of the best rabbit specialists out there, Frances Harcourt Brown being one of them.

Here are some links that may help you in researching the possible cause of your buns medical problems.
http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=385181&pageID=1&sk=&date=
http://www.bio.miami.edu/hare/paresis.html
http://www.medirabbit.com/EN/Neurology/Neurology_main.htm
http://wildpro.twycrosszoo.org/List_Vols/Lagomorphs/Contents_Lagomorphs.htm
 

missyscove

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Hi MBB! Glad to see you around but sorry it's with a problem!
This is so timely since we're just finishing up our midterms for my neuro block today.

Is your vet an exotics specialist or a general practitioner who is knowledgeable about rabbits? If the latter, I'd recommend a consultation with an exotics specialist or (and this would be better) a neurologist.

What sorts of diagnostics have been done? Bloodwork, radiographs/x-rays, CT, MRI? If it is something like a brain tumor it'll take some heavy duty (and expensive) imaging to figure that out.

Has a neurological exam been done? What sort of nerve deficits were identified?
 

MyBabyBunnies

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Vitamin deficiency and toxins have been ruled out already. That was the absolute first thing I ruled out. As for toxoplasmosis, I believe the Ponazuril treats that as well as EC.

As for the dozing off, indeed it looks like that but it is NOT at all normal for a rabbits head to tilt 90 degrees to their body or backwards simply due to sleep. Also, the short lived head tilt seems to be a precursor to the "episodes" he's having. Also, up until 2 months ago, this rabbit was seen maybe one or twice in his life laying completely on his side. He was always more of a rabbit to lay down with his chin on the ground and not the side of his face.

My vet is not specifically an exotics vet but she is the absolute best in the area (I have been to EVERY vet in the area that will see rabbits over the last 5 years, so I know this). She regularly consults with specialists and has specifically looked into Mocha's case with other experienced veterinarians in other countries. This vet is about as close to a rabbit specialist that one can find in this area and has helped me nurse many rabbits back to health over the years.

We have not done any diagnosis tests. Given that his first episode happened 2 days after a regular check up, we have opted to not put the stress on him and aggrevate the problem further given that we thought his symptoms were very obvious indicators of the problem. On top of that, a lot of the tests (tither, etc) are inconclusive and may indicate a problem that may or may not be causing the problem (ie, some studies suggest up to 80% of rabbits have antibodies to EC but just because they test postive does not mean it's causing a problem or may ever cause a problem). Given his age, we have decided that it is in his best interest to attempt treatment because the only other option is to put him down. Also, given the expense of medications like Ponazuril, I have opted to put the money in that instead of expensive diagnosis that may or may not provide definitive results. And given his age, any sedation for testing would be life threatening.

I will hesitantly say that I believe the Panacur did help the severity but not the frequency of his episodes. And the Ponazuril does seem to be gradually working. He seems slightly more steady on his feet and the severity and quantity of episodes over the last 2 days has been an improvement on before when he would come out of an episode rolling and now he comes out of an episode with his legs stretch out like he's off balance but doesn't roll (he's only been on Ponazuril since Tuesday). I'm hesitant to say this because for a few days after starting the Panacur, he regained full use of his back leg (prior to losing his ability to get up) and then he declined again.

I do firmly believe he has EC, but I thought I would put it out there to see if anyone had seen anything similar just incase my intuition was wrong.
 
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MyBabyBunnies

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In fact, the 2 videos show the difference in the episodes he's having before and after Ponazuril. The one where he is in the middle of the room and rolls around was during Panacur treatment. The one where he is on the blanket by the food was from today, 3 days after starting the Ponazuril.
 

BlueMoods

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Get tests, especially for EC, but for other parasites that can invade the brain as well. That looks like EC and, since your other rabbit is being affected, it is contagious. I know testing is costly but you need to get to the bottom of this and, testing is the only thing that can identify the cause. I would strongly suspect EC. It can be resistant to medication, but knowing that's what it is would help.
 

JBun

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Being the owner and knowing your bun, you are seeing all of the signs and changes that we can't necessarily pick up in a video, so based on what you are saying, it does sound like you are doing the best thing at this point then. If it is EC, then hopefully you will start seeing some improvement with the ponzuril, especially since it may be a better med for treating EC than fenbendazole. One thing to keep in mind is that inflammation from the spores can sometimes result in irreversible damage, so there may be improvement on some symptoms, but other things may not get better due to the damage, though they also shouldn't get any worse.

I'm guessing that you are also treating your other rabbit as well, since she has started to show some symptoms?

I don't know that testing would do much good at this point, since you are already treating for EC, plus the treatment may affect the results of the titer to some extent. It would show if your bun has ever had it, but not necessarily if it is an active infection. Doing two separate blood tests can sometimes show if it is active, but then there is again, the fact that the treatment may affect the results.
 

Azerane

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Poor Mocha :( I really do hope the Ponazuril continues to see an improvement in him. I agree that the behaviour is reminiscent of dozing off, but as you said, the severe tilt of the head is not particularly natural and the fact that when he snaps out of it, he struggles and kicks around is not normal either. Definitely something nuerological though. I hope you can figure it out and see more improvement in him.
 

lovelops

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Something happened when I first posted this and it dissapeared. So I'm writing this again for the second time.

First off I want to let you know I feel for what you are going through and I know it must be difficult as hell not to have only one rabbit with a problem such as this, but now you are dealing with two in the same house hold. I know what it's like to personally deal with the medical community and not get straight answers. I had it happen the entire time I was taking care of my mother after she was paralyzed so I can sympathize with you. You are in my thoughts and I hope that collectively together between everyone here and your doctor and who ever else, we can figure out something to get things pointed in the right direction to put a name on this situation that is occuring. The full write up I have listed below has some of the same conditions you are listing that your bunnies have and might have something you can use. Hell it might not but I didn't think there was any harm in posting it here. Maybe there is something in there to help.

Take care and hang in there,
Vanessa


Concering the seizures:
My cousin and some other friends have been on Phenobarbital. It can be used both in humans and rabbits. In Rabbits they use the elixar/liquid. You can also ask your vet about Potassium Bromide. It can be used in conjunction with Phenobarb for a better effect to control seizures. Phenobarbital has been used for over 20 years for seizures and epilipesy treatment and works pretty well. If you find the Tramadol isn't work as well as you think please speak to the vet about Phenobarb and the Potassium Bromide combo.

Here is a full write up on E cunili:

When we first began to encounter rabbits with diminished control of the hindquarters, the assumption was that back injury, most likely from improper handling, was the cause. Although a rabbit's skeletal structure makes it very possible to suffer a broken back, this has not been the leading cause of paralysis in our foster homes. Since our fosterers have collectively rescued and lived with well over two-thousand rabbits, and our members across the country report their rabbits' health problems to us, we can report back to our readers from this growing database.

How Does a Rabbit Become Disabled?

Neurological impairment--in the form of partial or complete paralysis, loss of coordination, seizures, and head tilt-- has diverse causes. Besides trauma to the head or back, causes may include strokes (see page 9); tumors; bacterial infections--of the inner ear, brain, spine, lungs, bones, or joints; protozoan infections; viruses; nematodes; toxins; degenerative disease; and even osteoporosis.

Probably the most common but least recognized cause of rabbit paralysis is protozoal infection. A disease that has taken its toll on many rabbits across the U.S. is Encephalitozoonosis. The organism that causes it is a protozoan parasite called Encephalitozoon cuniculi, or in short E. cuniculi.

The Long Search

In 1989 I knew of 25 paraplegic rabbits. One of them was my own beloved Phoebe. When autopsies on several rabbits failed to show identifiable causes we started calling it the "mystery disease" or "old-bunny paralysis."

Dr. Carolynn Harvey began to follow all possible leads. During the next two years, we recorded every case of paralysis reported by our members across the county and noted in particular the cases in which bacterial infection had been ruled out. We tested blood and urine from our own rabbits and ran diagnostic tests for toxoplasmosis, corona viruses, lead poisoning, and many others.

Rediscovering an Old Disease

We asked for help from neuro-pathologists. When paralyzed rabbits died, Dr. Harvey sent brain tissue to Dr. Richard Evans in Southern California. He donated time and materials and electron microscopy.

By January 1991 the only positive identification that had ever turned up was Encephalitozoon cuniculi. Dr. Evans identified the organism early, but we did not realize the full significance until much later.

Most veterinary manuals and research labs say that these parasites do not usually present a problem in live animals and are found only incidentally at necropsy in animals who have died from other causes. Upon perusal, however, we noted an important difference between our house rabbits and rabbits being used in laboratory research. Our rabbits are much older. Most HRS members, with the aid of improved veterinary medicine, have kept their rabbits alive into their senior years. Most rabbits in laboratory settings are under two years old. Perhaps E. cuniculi would indeed cause problems if all rabbits were routinely kept until an older age.

Since we suspected a particular agent to be responsible for the rabbit disease, we decided to monitor the health of a large number of rabbits over a long period of time and see if there was a correlation. We needed a way to identify the rabbits who had the parasites, so that we could keep records and watch them.

The Right Test

Dr. Drury Reavill of the Sacramento area spent a day making phone calls and tracking down the right test for us. Knowing our philosophy as an animal-welfare organization, she found a reliable non-destructive test conducted by the University of Missouri. For our study, veterinarians came to our fosters homes and drew a small amount of blood from each rabbit. They also collected blood from rabbits belonging to people who wished to participate in the study. Each time a batch of 50-70 samples accumulated, the serum was shipped air-freight to the lab. The lab then checked the serum for antibodies to E. cuniculi. If antibodies are present, it indicates that the animal has been exposed to the parasite and an immune response has been initiated. The greater the infection, and the more recent, the greater the antibody quantity, or titer, will be detected. This procedure is analogous to what is done in an AIDS test.

Because E. cuniculi are protozoa, they do not respond to antibiotics in the same way as bacteria. At the present time there is no drug therapy in the United States that can destroy E. cuniculi. That is the job of the immune system. However, some animals appear to be improved or stabilized when treated with Tetracycline or Chloramphenicol.

Inside the body, immune defenses are required to rid the animal of the parasites. If the animal is compromised by other kinds of infections or by stress, then the defense system won't be adequate to fight the E. cuniculi. (e.g. "My rabbit came down with enteritis and became paralyzed." or "My rabbit got snuffles and lost the use of his hind legs.")

The Route Traveled

The parasites are ingested. From the gastrointestinal tract they move in the bloodstream to the kidneys and other organs. The parasites can replicate in the kidneys and be shed in the urine. It's only while the E. cuniculi are in the kidneys (often causing pitting and scarring) that the infected animal is contagious. Encephalitozoons can be seen in brain cells long after kidney infection has resolved (possibly because it may take longer to break through the protective barrier provided by brain blood vessels). The parasites may simply remain there without causing any more damage. However, if they try to replicate, the damage can be severe.

Neurological damage does occur at some frequency, and we're not sure whether the damage is incurred by E. cuniculi directly, through natural growth and replication, or by the immune response itself. There are many well documented diseases in animals and humans, where the immune system reacts to a reasonably non-threatening pathogen, and the immune response itself is responsible for the disease state. If this is the case with E. cuniculi, it would mean the immune destruction of neural tissue could be a chronic problem and persist long after the parasite itself has been eliminated. So, in some paralysis cases, we may be seeing only the end result a of a process which was catalyzed months or years before.

Something to note here, if you have an infected rabbit who lives with other rabbits, is that most certainly by the time you see the outward signs of clinical disease, it is well past any contagious stage. The parasites are no longer in the kidneys. However, the spores that have been shed in the urine can remain in the environment for another month. Other rabbits can pick up spores from the environment for several weeks after the infected rabbit has stopped shedding. And since many other animal species can carry and shed these parasites, a rabbit who runs on the ground outdoors is more likely to pick them up.

Encephalitozoon Cuniculi Facts Review

E. cuniculi are shed only in the urine.
Infectious period lasts only a few days to a few weeks.
The infected animal is not contagious after the E. cuniculi leave the kidneys.
E. cuniculi are carried in the blood to other parts of the body, particularly neural tissue.
Spores from infected urine can remain in the environment for a month.
The parasites can infect and be shed by many other animals but seldom cause clinical disease in other animals.
A high number of rabbits throughout the United States have been infected at some time during their life, but few come down with the clinical disease.
Animals who are compromised are more likely to manifest clinical disease.
Neurological damage can be evident long after the parasites leave the kidneys.
Necropsies seldom show active parasites in the kidneys but may show scarring where the parasites have been.
Testing positive to the parasite only means that the animal has been exposed and is putting forth an immune response. It does not mean that an otherwise healthy animal will show symptoms of the disease.
Serology tests recognize immune response but do not distinguish early infections from long term or chronic infections.
Our Own Conclusions
Even with a high titer to E. cuniculi, a rabbit will probably not become disabled. Our study shows about a 12% chance of rabbits with high titers developing neurological disorders. We have known of only a few deaths that may be directly attributable to E. cuniculi infection. Although it may be a contributing factor, it is seldom the primary cause of death.

E. cuniculi infection by itself does not usually even threaten an animal's health. When combined with other problems that strain the immune system, however, its destructive capabilities are greatly enhanced. Testing for E. cuniculi can be helpful in diagnosing rabbits with neurological disorders. When encephalitozoonosis is ruled out, concentration can be placed on other possibilities. When it is present, consideration can be placed on the synergistic effects. Precautions can be taken to protect the rabbit from undue exposure to other diseases and stress. Animals seem to have much less difficulty adjusting to loss of mobility than their humans do. Rabbits who manifest the clinical disease of encephalitozoonosis may stabilize and live comfortably for a prolonged period of time. Barlow (page 6) has lived four happy years, with animal companions and human attention, since his first symptom appeared. As with any chronic illness, our goal is to preserve life with quality.

Conclusion: Even with a high titer to E. cuniculi, a rabbit will probably not become disabled. Our study shows about a 12% chance of rabbits with high titers developing neurological disorders. We have known of only a few deaths that may be directly attributable to E. cuniculi infection. Although it may be a contributing factor, it is seldom the primary cause of death.

Rabbits who do manifest the clinical disease of Encephalitozoonosis can be stabilized and live comfortably for a prolonged period of time. Routine testing can be helpful in diagnosis. When E. cuniculi is ruled out, concentration can be placed on other possibilities. When it is present, consideration can be placed on the synergistic effects. Encephalitozoonosis by itself does not usually threaten an animal's health. When combined with other problems that strain the immune system, its destruction capabilities are greatly enhanced. On the other hand, a positive titer alone does not mean that the rabbit is terminally ill.

Our study has monitored the health of 136 rabbits from the original testing. Their present condition is illustrated in the original printed version of this article.


Barlow (left) is well known and loved in Los Angeles. He is propped upright with a rug-covered block. His symptoms began with a head tilt, followed by rear limb paralysis and incontinence. His tests were seropositive to E. cuniculi in 1991 and 1993

http://www.rabbit.org/journal/3-2/e-cuniculi.html
 

lovelops

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Quick question I forgot to put in the above post. After seeing the video it reminded me of my cousin having an Epileptic Seizure. Has that been ruled out? I put some links below but dont' know if they will show up as links.
Vanessa


Seizures (Epilepsy) in Rabbits | petMD
www.petmd.com › Rabbit Conditions‎
Rabbits, much like humans, can suffer from epileptic seizures. Occurring when specific neurons in the brain reach a point of “hyper excitability.” This, in turn, can ...
Seizure and their various causes - Medirabbit
www.medirabbit.com/EN/Neurology/seizure.htm‎
Idiopathic epilepsy has been observed in white furred, blue-eyed rabbits. ... The treatment of seizures in rabbits is commonly attempted with diazepam or ...
Seizures | Rabbits | Vetstream
www.vetstream.com/lapis/Content/Freeform/fre00313‎
Seizures may occur due to a primary intracranial lesion or secondary to ... Idiopathic epilepsy has only been reported in Beveren White and Vienna White rabbits. ... A number of zoonotic diseases are associated with seizures in rabbits.
Bunny Seizures?? - BinkyBunny.com - House Rabbit Information ...
www.binkybunny.com › ... › HOUSE RABBIT Q & A‎
Mar 3, 2013 - 12 posts - ‎5 authors
I am going to call my vet first thing in the morning but I thought I might be able to get a quick answer here to ease my mind. A few months ago ...
 

sisi.dee

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Help my rabbit has an ear infection help me i went to vet i am using baytril and oral drops for his ears and a pain medication his head rotates 180 degrees anyone heard of this
 

Mariam+Theo

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Post this on a new thread under "Heath and Wellness". You should get more responses there. I have never had issues with ear infections, but I know some people on here have. @JBun should be able to help you.
 
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