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ec trreatment

22 9:58:29

Question
QUESTION: Hi Dana

I have talked to several vets in my area regarding what their treatment protocol might be regarding EC.  No one is using Ponnazuril or Totrazuril.  Only one vet was familiar with the research info.  She is associated with  a school of veterinarian medicine.  She chose a different route of treatment based on some papers she read out of Europe.   This research targets the use of a dog/cat flea treatment to control EC.  I think the brand name is Program.   I could not find much on line that was helpful regarding it's use.  Other than it is nice to know there is a option to Advantage in flea control.    The vet feels she has had success using Program as a treatment method.    Do you know anything about this?

The other vet at the  vet school working with rabbits is more traditional with the use of Panacur and possibly Albendazole.    I simply thought of your thoughts on Albendazole.

I did find one vet who though unfamiliar with Ponnazuril or totrazuril was familiar with the combo of panacur and metacam.    Real nice vet.  I would work with her.    She did not seem to have any problem with my desire to advocate for my bunny.  

One young vet told me there is suspicion on the horizon that EC is a fungus.  Heard anything about that?   

What if any is the difference between Ponnazuril and Totrazuril?   

On the use of Panacur what if any is the issue of repeating the treatment or extending it?

My current vet sees no reason to treat the companions.   

I plan is to get some panacur 10% and figure how to create 20mg/kg with the help of a pharmicist than dose all bunnies in the area plus give them the totrazuril for a 30 day period.    

I am also wondering if there is anything similar to metacam that is safe that is over the counter?

Look forward to hearing from you.

Terri

ANSWER: Dear Terri,

Encephalitozoon cuniculi is certainly not a fungus.  It is a microsporidian parasite allied with other Alveolate protists, and is not particularly closely related to true fungi.

The microsporidians do, however, contain chitin, a structural polysaccharide found in fungi and in some animals (e.g., arthropods and some other invertebrates).  Because the active ingredient in Program (lufenuron) inhibits the synthesis and deposition of chitin, some believe that it could be effective against certain microsporidian parasites.  What's not clear, however, is whether the mode of action of lufenuron will be the same in these protists as it is in fleas or other arthropods (or fungi).  Some studies have shown that lufenuron can be effective against microsporidians in humans:

http://tinyurl.com/2e3qd2g

which may be why your vet is trying Program.  Sounds like a reasonable course of action.

I would NOT use albendazole in a rabbit, as it has been associated with acute death in this species.  Panacur/fenbendazole is far safer for rabbits.

As far as treating all the rabbits is concerned:  you could do that.  But there's no guarantee that they all have the parasite.  And even if they do, there's no guarantee that the parasite will ever make them sick.  Clinical signs show up sporadically in rabbits that test positive for E. c., so it's very hard to predict.  Also no one knows whether the parasites are actually killed, or just inhibited by the drugs being used.  Since lufenuron is going to work mainly on reproducing parasites, and not those just sitting there, encysted, in tissues, it might mainly work on preventing reinfection of the current host or of the host's companions.

Just some thoughts. Hope they help.

Dana





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

QUESTION: My vet did talk to the manufacturer of Ponazuril.  She is not comfortable using it.   She feels that all the info on it's use in rabbits is antidotal as opposed to lab tested.    It is off label and she mentioned she found info that suggested it was unsafe for use in bunnies.    I think mainly the manufacturer  could not vouch for it's safety since it was not tested on rabbits.  I am not surprised at her response.  She is pretty conservative in her response.    She is not the individual exploring the use of lufenuron.   She is comfortable with Panacur and is going to to go ahead and let me have the metacam.    That is good news.

Are you aware of any safety concerns in the use of Ponnazuril or Totrazuril in rabbits?

Is Ponnazuril and Totrazuril the same thing?

If not, how are they different?

Also, very interesting info on Lufenuron.  Worth keeping an eye on.  I am hoping they do more studies.  Do you have any thoughts on how it would be used to prevent infection on bunnies exposed to EC.   Would you have any suggestions on dosage for flea treatments.  I had no idea there was anything out there other than advantage for fleas in rabbits.

Thanks
Terri

Answer
Dear Terri,

Almost all the drugs we use on rabbits are used "off label."  For a pharmaceutical company to have something officially approved for use in a particular species by the FDA takes literally *millions* of research dollars, and few companies are willing to shell that out for rabbits.  In most cases, veterinary drugs are tested and approved for one or two species, and vets use it on any other species "off label."  This is done all the time.  If your bunny has ever been given Baytril, for example...that's "off label" use, too.  So as far as I'm concerned, that argument doesn't wash.

I have used ponazuril for several years in three different species of lagomorphs (Lepus californicus, Oryctolagus cuniculi, Sylvilagus floridianus) and have never seen any sort of adverse reaction.  On the contrary, I have seen excellent results--especially when the drug is used in conjunction with fenbendazole--using it for suspected E. cuniculi-caused head tilt.

It is, of course, up to your vet whether or not to prescribe ponazuril.  But you can always try to find another vet for a second opinion:

www.rabbit.org/vets

Toltrazuril sulfate is the active ingredient in ponazuril, and I'm not sure why there are two different "generic" names for the drug (which also goes by several different brand names, including Marquis and Baycox, all produced by Bayer).

I have never used lufenuron against fleas for rabbits; we use Revolution.  You can find dosage information for it here:

http://tinyurl.com/2c24g8x

if your vet is willing to try it.  

Hope this helps.

Dana