Meds for E.Cuniculi

Question

Jazzy   QUESTION: Hello Dr. Krempels,

Someone on bunspace.com referred me to you & I hope you can help.

My rabbit has been on Panacur for 3 months and 1 week to treat E.C. which has left her with severe head tilt. Within those 3 months, she's had 2 rounds of Ponazuril in conjunction with the Panacur. She was also on metacam/meloxicam for about 2 months. Her vet (a known rabbit saavy one) suggested keeping her on the metacam indefinitely, but to bring her in for kidney checks. I opted to discontinue the metacam after reading about other cases & decided the risks of keeping her on it outweighed the benefits.

Vet says to keep her on Panacur indefinitely, to keep the parasite at bay.

From what I've read from others, 3 months is quite long (2 1/2 is the most I've seen). I don't feel comfortable keeping her on a drug long-term & need another professional opinon.

My rabbit is able to move with borders on both sides (not completely independantly)- eating, drinking, poop, etc. is all normal. Rolling has stopped, unless she's picked up or falls into an awkward position. Head tilt is still severe, but I'm understanding that this doesn't necessarily have anything to do with the presence of the parasite in the system (?)

Any help would be greatly appreciated.

Jennifer

ANSWER: Dear Jennifer,

No one really knows how necessary it is to keep a bunny on Panacur once the full course has been completed.  Some bunnies have worsening symptoms if the drug is discontinued, and others do fine.  Perhaps discuss with your vet the option of taking her off and seeing how she does.  If she doesn't relapse, then I would agree it's better to keep her off the stuff for as long as possible.

The residual tilt might, as you say, have nothing to do with the parasite being present.  Muscles that have been cramped up this long can become fibrotic and fixed in their abnormal position.  For this reason, it's wise to do as much gentle manipulation and massage as bunny will tolerate, in an attempt to break up the scarring and fibrosis and help her achieve a more natural stance.  Exercise in a large, open area will help with this, as bunnies running in straight lines tend to straighten their heads. They do this *especially* in a new, unfamiliar area, so this might be something to try.

If you haven't already seen these, please have a look at:

www.rabbit.org/health/tilt.html

and

www.bio.miami.edu/hare/tilt.html

Hope this helps.

Dana

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

QUESTION: Thank you, Dr. Kremples. I appreciate your quick response!

One final question: with Panacur (or with this disease) do you know if I can stop & start again if symptoms worsen, or could stopping it cause irreversable damage? (I will def. check with her vet on this, but a 2nd opinion is crucial to me at this point)

This has been such a tricky, terrible nightmare- Thank you again for your help!!

Jen

Answer
Dear Jen,

To answer your question:  "with Panacur (or with this disease) do you know if I can stop & start again if symptoms worsen, or could stopping it cause irreversable damage? "

Unfortunately, no one really knows for sure.  If the parasites are killed by the Panacur and bun is not re-exposed, then the problem could be arrested.  If not, the signs could become worse.  Whether they will get *permanently* worse is not certain.  But I know many people who have stopped Panacur, seen signs get worse, and then seen them get better when the Panacur is started again.

Since Panacur isn't without risks, you might seriously want to talk to your vet about trying toltrazuril/ponazuril.

Good luck!

Dana