Update on Pinkerton; E. cuniculi the possible cause of his symptoms...

[Jenk]

Today, my vet told me that Pinkerton's E. cuniculi (E.C.) titer count is on the high end of the moderate range. (Until today, I didn't realize that E.C. test results are separated into "low," "moderate," and "high" ranges.)

My vet wants to talk to another exotics-only vet before proceeding but said she'll likely go ahead with E.C. treatment without another titer test. (She knows my DH and I have already broken the bank in the New Year and said she doesn't see the need for us to do another titer test, since Pink's current E.C. count is reasonably high and he has certain symptoms.)

I just wish my vet would consider doing empirical treatment on Emma, too; it seems that she's not comfortable trying--even though she once told me she could do a de-worming treatment on Emma due to all her (Emma's) stasis issues. Now, she seems to lean toward the idea of requiring an E.C. for Emma, too. My thought? If E.C. is present--even if it's not "easy" to transmit--I'd feel better if Panacur treatment were given for both buns at the same time.

Please send prayers and positive vibes that Pinkerton is one of the lucky ones whose body fights and overcomes E.C.


Thank you,

Jenk

 

[LakeCondo]

:imsick: Poor little guy.

 

[Bunnylova4eva]

Praying for your little sweetie. Hope he's feeling better soon. ray::sickbunny:

 

[TonyTina]

ray:

Your thought about treating the both of them does sound logical . I think deworming is done routinely by a lot of people, although maybe there are side effects to the meds? Best of luck.

 

[Jenk]

Thank you for the positive thoughts and prayers, Everyone.

TonyTina wrote:

Your thought about treating the both of them does sound logical . I think deworming is done routinely by a lot of people, although maybe there are side effects to the meds? Best of luck.

I'm a bit confused because, about two years ago, my vet said she'd consider de-worming Emma due to multiple stasis issues with no apparent cause. I know that Panacur is used to treat E.C., as well as pinworms. And while it can potentially cause sudden death, that "side effect" is considered a rather rare one.

I'd rather chance it and treat both buns with a Panacur ("de-worming") regimen. In Pink's case, we'd be treating primarily for E.C. In Emma's case, it could help with an (unknown) E.C. titer or possibly other internal parasites. And if she has no internal parasite issue, we'd have performed a pointless treatment. (Emma, like Pink, has been losing some weight, in spite of eating her normal amount of food.)

I don't get why vets get squeamish/reluctant to do certain preemptive treatment. After all, many pets are treated for parasites--even if they're not observed--when they enter a shelter. And I certainly don't want to risk having E.C. cycle around and around between my rabbits. (For all I know, Emma could be a carrier who infected Pink.)

 

[Nancy McClelland]

ray:

 

[LakeCondo]

If your vet is worried about a potential lawsuit, you could offer to sign something saying this is the treatment you prefer.

 

[Jenk]

LakeCondo wrote:

If your vet is worried about a potential lawsuit, you could offer to sign something saying this is the treatment you prefer.

Someone told me that all of Pink's test results don't indicate that any form of treatment is necessary. I am so confused. I know that a bun with a high E.C. titer count isn't usually treated without verifiable (usually neurological) symptoms. But my vet is starting to feel frustrated about Pink's observable symptoms and unclear diagnostic results.

One vet says E.C. doesn't typically attack just the kidneys; yet a well-known exotics specialist told my regular vet that E.C. can attack/affect the kidneys and not produce the typical neurological symptoms.

I know Pink's blood work indicates nothing amiss with his kidneys, at least as of early December 2011. But his behavior and weight loss continue to spike my anxiety. (The only thing his blood work possibly indicates is chronic inflammation and either parasitic activity or allergies. But allergies wouldn't explain Pink's weight loss.)

Jenk

 

[tamsin]

My understanding is that EC is both easily transmitted (a study in the UK found that over 50% of rabbits had been exposed) and the lesions it causes are often found in the kidneys as well as the brain. Obviously you get different symptoms depending where the lesions develop.

I hadn't heard of issues with pancur, we use it routinely in the UK for treating internal parasites, with longer courses for EC (it's even sold packaged specifically for bunnies).

If I suspected EC, I would dose all bunnies as a precaution. Did you vet give a reason why they thought doing that would be a bad idea?

 

[Bunnylova4eva]

Jenk wrote:

I don't get why vets get squeamish/reluctant to do certain preemptive treatment. After all, many pets are treated for parasites--even if they're not observed--when they enter a shelter. And I certainly don't want to risk having E.C. cycle around and around between my rabbits. (For all I know, Emma could be a carrier who infected Pink.)

I've felt this way before with things with our bunnes~and really it doesn't make sense. I'd see about signing something as someone mentioned saying you won't start a lawsuit.

 

[TonyTina]

I don't know if this is a good idea or not (I am not a vet) but at least where I live you can get a product called Safe-Guard off the shelf at pet or equine stores. It is supposed to be identical to Panacur (it is the same ingredient - fenbendazole). Again, not being a vet, I don't know if this is risky... does anyone else have experience with this product?

 

[Jenk]

tamsin wrote:

My understanding is that EC is both easily transmitted (a study in the UK found that over 50% of rabbits had been exposed) and the lesions it causes are often found in the kidneys as well as the brain. Obviously you get different symptoms depending where the lesions develop.

Once source told me it's believed that 50-80% of all rabbits have been exposed to E.C. and, thus, most rabbits would have a positive titer count, if tested.

I hadn't heard of issues with pancur, we use it routinely in the UK for treating internal parasites, with longer courses for EC (it's even sold packaged specifically for bunnies).

My vet has never witnessed such a reaction to Panacur but has read/heard that it's possible. But, again, it's said to be a very rare reaction.

If I suspected EC, I would dose all bunnies as a precaution. Did you vet give a reason why they thought doing that would be a bad idea?

The person who told me of so many rabbits being exposed to EC also said vets don't typically treat for it unless/until clinical symptoms appear.

My vet didn't say why she's uncomfy with the idea of treating both rabbits for EC; I got the impression that she'd want to test our female's EC titer before treating her. But what would be the point, when her titer count is likely to be positive?

My request was that the vet treat both buns for internal (intestinal) parasites--meaning give two injections total. (Granted, it's good to know what parasite might be active, so as to determine which drug to use. Fecal tests have revealed nothing on Pink, thus far.) In the past, she said she'd seriously consider doing so; recently, she said she could empirically treat Pink for parasites; then, when we last spoke, she said she'd want to do a fecal test on him--even though I told her that Pink had a float and smear (negative) done by another vet in early January.

I'm just feeling very frustrated at this point; my husband isn't willing to run anymore tests on Pink at this point, due to the what we've already spent on his vet care in the New Year.

 

[tamsin]

I think you need multiple tests to see if the levels alter to determine if it's an active infection rather than they've just been exposed. As you say it would be good to know which parasite but on the other hand, just treating will kill them all, be quicker and much cheaper! If it works then great, if not then you can keep looking further.

In the UK we can get this over the counter: http://www.vetuk.co.uk/rabbit-supplies-rabbit-wormers-c-649_651/panacur-rabbit-oral-paste-5g-p-1105 for routine use. I'm not sure it needs to be done routinely for healthy buns, but you've one bun with symptoms so it makes sense to treat that rabbit, plus any others otherwise they'll just reinfect each other.

I'd go with your orginal instincts give both both buns treatment at the same time.

 

[Jenk]

tamsin wrote:

I'd go with your orginal instincts give both both buns treatment at the same time.

Please realize that I'm talking about two different things: treatment for E. cuniculi and treatment for possible parasitic worms.

Pink has had one titer test for E. cuniculi (E.C.), and my vet would prefer to do one more titer test to see if his titer count increases a lot (or not). If reaches the high end of the titer-count spectrum, she'd prefer to perform the full (28-day) Panacur treatment for E.C. (My plan is to have Pink retested next week, at about the 3-week mark.)

My vet has recently said she'd consider treating Emma for possible intestinal worms, but she won't treat her for E.C. without testing her titer count. So if Pink's second titer count is high, he'll be the only one treated (for E.C.).


Jenk

 

[tamsin]

Sorry, I am a bit confused The reason being pancur will treat both intertinal worms and EC. I'm not sure how your vet is going to treat for one without effecting the other, or why you'd even want to deliberately avoid treating for EC at the same time.

Killing two birds with one stone is a good thing, isn't it? Yes, it will mean that you then can't test for it, but so what, if you've killed it then thats a bit acedemic anyway.

Plus, even proving he's got an active EC infection doesn't guarentee it's the cause of the symptoms. If you've treated both rabbits for it, plus cleaned the enclosure, so you can guarentee its gone then atleast you can cross it off the list if the symptoms persist. If they don't then you've cured it for the price of the wormer. I really don't see the downside.

 

[Jenk]

tamsin wrote:

Sorry, I am a bit confused The reason being pancur will treat both intertinal worms and EC. I'm not sure how your vet is going to treat for one without effecting the other, or why you'd even want to deliberately avoid treating for EC at the same time.

Killing two birds with one stone is a good thing, isn't it? Yes, it will mean that you then can't test for it, but so what, if you've killed it then thats a bit acedemic anyway.

Again, it gets a bit tricky.

My vet said that since one bun having an active EC infection doesn't mean the other bun has (or ever will have) one, she is leery to treat both rabbits with a month-long regimen of Panacur. And since she's heard that some--technically a rare amount--of rabbits have died from Panacur, she seems a bit fearful to treat them both without apparent cause to do so.

She's less worried about de-worming them, but, of course, that entails many fewer doses of Panacur. But, true, 2-3 doses of Panacur wouldn't help if both rabbits were to have an active EC infection.

Do vets in the U.K. regularly treat for EC without suspecting its presence or even testing for it? (In our case, it's been so expensive trying to determine the cause of Pink's symptoms that we can't stomach doing multiple EC tests on Emma, too. But I don't think my vet will treat her for EC without a titer count for her.)

At the end of the day, I think it makes sense to de-worm them both at the same time, if that seems to be the route to go--i.e., de-worming rather than treating for EC. If Pink's second titer count is very high, my vet said she'd prefer to treat him for EC. But Emma needn't be treated at the same time for it.

My hope is that Pink's titer count won't have raised much, and, then, we'll try de-worming everyone (likely even our cat).

Plus, even proving he's got an active EC infection doesn't guarentee it's the cause of the symptoms. If you've treated both rabbits for it, plus cleaned the enclosure, so you can guarentee its gone then atleast you can cross it off the list if the symptoms persist. If they don't then you've cured it for the price of the wormer. I really don't see the downside.

I think the downside, to my vet's mind, is the risk of causing sudden death in a bun who may not have EC. She thinks it's worth the risk to treat for it if infection is proven or strongly suspected.

Again, treating for EC simultaneously isn't an absolute need, since it doesn't cycle around and reinfest like intestinal worms. But I understand your point about treating both buns at the same time. Still, I don't know that my vet will go for it. De-worming them together, yes; treating both for EC without having two titer counts on both buns, probably not.


Jenk

 

[tamsin]

Obviously it does depend a bit on the vet, but they do often treat based on symptoms rather than tests. Sometimes for speed, for example, standard treatment for a rabbit with headtilt would be to begin treatment for both ear infection and EC... no waiting around for tests to prove it's EC. Sometimes because of cost - tests can be expensive where as the actual treatment is relatively inexpensive.

I haven't heard about issues with pancur, do you have any more specifics? If it was a quick reactions then the short course would show it up anyway, so you could decide part way through whether to continue. Some buns react to meds then same way you get people alergic to some drugs.

Rabbits shed the EC spores in their urine, so if Pink has it Emma will have been exposed. If she did pick it up and is symptomless she could then reinfect Pink from the spores in her urine. I think the rec is to bleach everything on day 21 and 28 of the course to kill spores on surfaces.

There is some info from the Rabbit Welfare Association (UK org abit like house rabbit soc) here: http://www.rabbitwelfare.co.uk/resources/content/info-sheets/ecuniculi.htm

 

[Jenk]

I wrote a very lengthy reply, and, for whatever reason, it didn't show. My reply box was completely blank. Now I'm too frustrated to go back and retype all that I'd said. Grrr...


Jenk