E. Cuniculi?

Question
QUESTION: Hello Dana,
I would appreciate your advice. My rabbit Matilda who will be 7yrs old in Oct, 3 days ago appeared to have some weakness in her left leg, I wasn't sure if I was imagining this at first. The following night it was obvious something was wrong, as her legs were not holding her up while she was hopping  and she would drop to her left side. I took her to the vet yesterday, who has taken some blood for basic testing (great results) and some to check for E. Cuniculi. The vet also started her on Meloxicam incase it is arthritis. I am not confident that it is arthritis because of the rapid onset of her symptoms. The vet also gave her an injection of Procaine penicillin due to a mild ear infection. Today she is worse and is now dragging both her back legs when trying to mobilise. She also has some twitching with her lower back but this is not continuous and I have only noticed it twice. She seems okay apart from her legs - still eating, voiding etc not sure on the intake of fluids as I haven't seen her drink today. The blood results will not be available until 7 days. I am worried that her condition is going to get worse and her symptoms are going to be permanent or worse case die. If it is EC is it better to start treatment straight away to prevent this and then if the tests results are negative, then stop the treatment? Depending on the blood results, Matilda is tentatively booked in for an X-ray at the end of next week. Is there anything else I can do to help her while we wait for the blood results?
Thank you, Jan.

ANSWER: Dear Jan,

If this were my rabbit, I would want to start her on Panacur (fenbendazole) *and* ponazuril immediately.  Better to arrest the onset, if it is E. cuniculi, than to wait and let symptoms progress.  These drugs are safe enough (especially ponazuril) that one could administer them as a precaution, and then stop if the bloodwork is negative.  (Whatever that means; paired titers for E. cuniculi are not all that helpful, IMO.)

I hope your bunny will be fine.

Dana

---------- FOLLOW-UP ----------


Matilda  

Matilda   QUESTION: Hello Dana,

Thank you very much for your advice. We started her on the medication you suggested but ceased them when her blood results came back indicating that she did not have EC. We had X-rays done and the vet said they showed Spondylosis & a mass in the thoracic area but was unsure of what it was. She said it was rare to find a problem in this area but felt that it could possibly be cancer, a bone infection or an old/current injury. Though she is unclear of what is going on, she is saying Matilda has a poor prognosis and her condition will deteriorate.

We are continuing with the Meloxicam and have started her on Chloramphenicol and she will have a follow up X-ray in two weeks. She is alert, continues to eat really well & I am ensuring she has fluids by using a syringe. No problems with urination or bowels except that she can't get to her toilet box. She is still unable to use her hind legs but does move them if you touch them. She continues to groom herself the best she can and still has an attitude and seems comfortable.

I have confined her to an extra large cat litter tray with a hood at night with bedding that will keep her dry and lets the urine pass through. I put some hay inside and she has access to a water bottle. During the day, I keep her in a large kitty litter tray filled with hay. I alternate her position every four hours & check that she is clean. I am not sure if I am handling her too much if it is an injury to her spine, so I hope this is the right care.

Would greatly appreciate your opinion with this treatment & with the X-rays. I have more images if you need them.

I do not want her to suffer but give her a chance if there is one. Thank you very much for helping me Dana.

Kindest regards, Jan.

Answer
Dear Jan,

The thoracic mass might be unrelated to her paresis.  Thymoma is the most common thoracic mass seen in rabbits, and it is treatable with radiation.  You don't want radiation if it's an abscess, however, so the chlor is a good idea, just in case.  (We find that dual-acting penicillin injections every 48 hours are often *excellent* for resolving deep abscesses like this one, in case the chlor doesn't work.)

A biopsy would identify the mass, but it would not be without risk.  Here are some articles on thymoma and its treatment in rabbits:

http://www.rabbit.org/health/thymoma.html

http://www.rabbit.org/health/thymomastory.html

http://www.rabbit.org/health/Rabbitthymomas.pdf

If you Google "rabbit thymoma" you will find many more.  

If the paresis isn't bothering her too much, it's not a big deal for her to live in pampered splendor on a hospital fleece bed.  There's actually a Facebook group, "Disabled Rabbits", where caregivers of special needs bunnies share ideas and experience.  Loss of use of hind legs is really not a reason for euthanasia any more.

I hope the mass in her chest turns out to be something that can be treated.  Sending healing thoughts.

Dana