wet butt and light spot inside eye, Possible EC

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I would assess him in the morning.
if he is retaining fluids that would be a signifcant problem

but the way that you last described him makes me feel that he can wait until the good vet can treat him..
you are doing most evrything a vet would do other than possibly add a newmedication.
 
I think your plan to keep him hydrated and have sub-q's if needed will work. It sounds like he drank plenty today, and I don't think going to the other vet would help much other than getting him some sub-q's--this is a pretty complex issue, the water retention/intake question, and I'd want a vet that's very up on their game and knows rabbits to handle it.

I think you're doing a great job encouraging him to drink, and checking for dehydration.
 
Great news! His tummy is back to normal. I wonder if the simethicone drops helped or if it' just a coincidence? He still isn't drinking much water even though I gave him a cup of water and Pedialyte.

He's acting completely normal. He was out playing for about 3 hours and was binkying, taunting Rory, investigating the kitchen, getting excited when he thought I was going to give him treats, following me around. He pooped everywhere like normal too and they are of normal size and texture.

I will cancel the vet appointment when they open because I agree he would be better off with me at home. He seems to be doing ok so far.
 
Thought I'd give this thread an update. I'm kind of in a holding pattern with Skyler. The vet doesn't return from her 2 week long trip until Monday. I still don't know what the results of his blood test were- I plan to call on Monday when the vet is there.

Skyler's eye looks the same as it did and he's showing no signs of paresis, thank goodness. He's drinking more water than he was but still not as much as he was a couple weeks ago. He's acting cheery and spry as ever. Oh and he jumped out of my arms when I was giving him Panacur last night :( He can be such a wiggly guy! This is the first time he's ever succeeded in getting away from me when I've held him, he fell about 3 1/2 feet and landed on his feet. He isn't acting injured, thank goodness!
 
It sounds like he's not letting this sickness get him down, which is a great attitude to have!
 
I talked to the vet for a good 45 minutes just now. She got the blood test results back when she was in California but had to wait to get home so she could consult all of her books and sources. She said his blood results look normal, EXCEPT for his liver values. His bilirubin levels are up to .9, while .75 is normal. His ALT levels are up to 120 when 79 is normal.

She said this could mean many things. She's thinking there's a good chance he has hepatic coccidiosis on top of EC. Tallulah died from coccidiosis a year and a half ago. She said the coccidia starts out in the blood stream then can move into the liver. So it could be hepatic coccidiosis and EC, or hepatic coccidiosis and some random eye problem, or EC and a bacterial infection of the liver, or some other liver disease like hepatic lipidosis. She said that hepatic coccidiosis usually hits bunnies hard and fast, and if he has it, it's mild so far but that it is a scary illness and often fatal.

The plan is to take in a fecal sample. She's going to look at it under the microscope and send some off to a lab. She said they may not be able to find any coccidia in the poop but it doesn't mean it's not there. We're going to do another blood test in 2 weeks too. Randy, she said she will most likely treat him with Ponazuril if she thinks it's the hepatic coccidiosis.

Poor Skyler! He gets a double whammy of terrible. I'm happy he's still a happy, bouncy bunny and not acting sad. He's drinking more now too, which is a relief.

What do you guys think? :(
 
Oh gee, I hope it's not hepatic coccidiosis. I thought EC could also cause liver damage, did she mention that EC could be the reason the liver values look off?
 
Claire, I looked up EC too and it says it can cause liver damage... I will ask her about it tomorrow when we bring Rory in as well as the stool sample. I would just as soon NOT go around doing random testing on Skyler if it's unlikely he has what he's being tested for. I'm pretty sure she based the hepatic coccidiosis thing solely on the fact that he has elevated liver enzymes, but if elevated liver enzymes is normal for bunnies with EC, why would she think he could have hepatic coccidiosis? Does anyone else know about this? :(
 
I am not sure why she would think he had the coccidiosis. Has he had intestinal coccidia before? Maybe that was part of it. Also, it's possible that she would use a different treatment (rather than the typical panacur antiparasitic) for hepatic coccidiosis, and she would have wanted to add another medication if it's that. I don't know if a fecal test for coccida would tell you whether or not there is hepatic coccida, because I was under the assumption that hepatic coccidiosis stays in the liver and doesn't move to other organs, and all you can do to see if it's there is to do a liver biopsy. Also, if it's EC damage to the liver, there's not a whole lot more you can do than treat the EC.

Big hugs sent your way, hope you get some more answers.
 
I thought I should update this since I talked to the vet today. She is interested in doing a liver biopsy on him. She said it's done very frequently on cats and dogs, all they have to do is anesthetize the bunny, make a little slit, and cut off a little piece of his liver and test it. Does this sound like a reasonable thing to do? It sounds scary to me, but I would consent to it being done if it would be helpful.

Skyler's doing great. The thing in his eye hasn't grown as far as I can tell. He's only peed on himself the once in the past month and a half. He's his regular happy, bouncy, hungry self and hasn't shown any health issues or signs of paresis or anything. I'm so glad that he's doing well so far!
 
I'd look into whether it would just be a whole lot safer and less stressful to simply try the Ponazuril first.

Find some other professional opinions and research and if warranted, present it to this vet with a firm request.

I think this vet is reacting to recommendations about clear diagnostics when treating horses. I don't see that being a concern with rabbits, considering how tough EC diagnostics are.

There are a LOT of rabbit experts pushing it these days and its had a few years of usage to verify basic safety. If it is hepatic coccida, the drug will definitely take care of it, and if its an effect of EC, the drug may possibly take care of it.

Where's the downside here?


sas :dunno:
 
I agree, Ponazuril would be the best course.

Perhaps the vet thinks if you treat with it and it's successful, you'll never know if there was hepatic coccidiosis there, and perhaps in the future you might treat the rabbit differently knowing it had the hepatic coccidiosis?
 
Pipp wrote:
I'd look into whether it would just be a whole lot safer and less stressful to simply try the Ponazuril first.

Find some other professional opinions and research and if warranted, present it to this vet with a firm request.

I think this vet is reacting to recommendations about clear diagnostics when treating horses. I don't see that being a concern with rabbits, considering how tough EC diagnostics are.

There are a LOT of rabbit experts pushing it these days and its had a few years of usage to verify basic safety. If it is hepatic coccida, the drug will definitely take care of it, and if its an effect of EC, the drug may possibly take care of it.

Where's the downside here?


sas :dunno:
Click to expand...


:yeahthat:I agree withsas and Claire re.the Ponazuril andI would not do the liver biopsy

 
The problem with the Ponazuril is that she HAS done a good deal of research on it, and has not found any evidence that convinces her it's a good thing to try on him. We've talked about Ponazuril several times and she's pretty adamant about not using it. She's talked to other rabbit experts as well and they agree with her. I simply cannot make the vet prescribe something that she doesn't want to prescribe- there's no way around it. If I could somehow get my hands on Ponazuril, I would give it to him and just not tell her, but that's pretty unlikely. Even if we went to the other clinic in town that sees rabbits and got them to prescribe it to him, our vet works closely with that clinic- she's there several times a week and actually used to work for them. I really doubt I'd be able to keep it "secret" and also don't want to damage the relationship with the only decent rabbit vet in a several hundred mile radius.

Good news is that his stool sample came back as negative for coccidia. When I went to pick up Rory and Phoebe Mae this afternoon, she said she wanted to see Skyler again in the middle of February to do another blood test, but didn't mention the liver biopsy (which she had talked about this morning before testing his poop). I'll call and ask if the results of the fecal test satisfied her.
 
This has probably been covered, but it's probable your vet is taking into consideration the high price of the drug and whether she can use the rest in her practice or maybe share with other vets, this seems to be a common occurrence. Supply companies seem to sell it in packages of four tubes at $200 each. Because its a horse prescription, she has to purchase a lot but will only use a minuscule amount needed for a rabbit.

I ran across a note from a Beagle breeder posted on a website asking people to not call her with inquiries about Ponazuril. She posted a link to a Beagle study for people to show their vets and said she couldn't share her prescriptions. The breeder also posted the URL for a drug company that will supply single tubes to Vets, here:

http://www.heartlandvetsupply.com/cart/product_info.php?products_id=750

This indicates resistance (or lack of knowledge on their part)may cost your Vet close to $1000 to get it. Ponazuril is great for hepatic coccidia, but the jury is still out on its effectiveness for EC. However, its safety has been tested and doesn't appear to be an issue. So it may be safe to try, but ultimately not worth the expense unless it is confirmed as coccidia.

When your Vet checked with other rabbit vets, did she discuss sharing the drug and the costs with her? Safety? Did they say it wasn't safe? Wasn't effective? Or wasn't worth the financial gamble?

Dana Krempel also lists the Heartland site as a source of Ponazuril here:

http://en.allexperts.com/q/Rabbits-703/2009/7/coccidia-rabbits-treating-ponazuril.htm

Here's some older dosing info:

http://en.allexperts.com/q/Rabbits-703/2009/1/Marquis-Ponazuril-dosage-2.htm

Hope this helps!


sas :clover:
 
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