Brain parasite in domestic rabbit

Question
Hi Dana
Briefly - have just taken rabbit to vet because very unsteady on feet.  She has diagnosed a brain parasite.  Could you tell me likelihood of survival?
History - I picked Stewart up on the nature reserve that I work on.  He had been dumped by previous owner.  He was in a very bad way - malnourished, dehydrated, mange, kidney problems, floppy ear and head tipped to side with floppy ear.  We managed to pull him through and until today was happy and healthy.  He occasionally went off his food and his faeces was very small, but after a couple of bowls of recuperation food would be back to his normal psychopathic self.  He has been off food for a couple of days, but still eating about half of his normal amount.  Vet says that she suspected that he had the parasite when I found him because of his ear and head tilt.  She has given him a wormer and anti-biotic but says that if he starts rolling around that he will need to be put down. Would you agree with that, and what do you think his chances are.
Thanks
panicking

Answer
Dear Sarah,

You need to find a vet who is more willing to take your bunny seriously as a patient.  This parasite, Encephalitozoon cuniculi, is treatable, and the sooner aggressive treatment is begun, the better.

The wormer the vet gave you was probably Panacur (fenbendazole), which is commonly used to treat E. cuniculi.  But if you are in the UK, then a more effective drug can be given along with the Panacur (we have given both together with excellent results):  ponazuril/toltrazuril.  

Our vets use both drugs at 20mg/kg once per day for a *full 30 days*.  

You can also read more about this problem and its various treatments in these articles:

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

www.rabbit.org/health/tilt.html

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

And you can also use the list linked here to find a rabbit savvy vet near you:

www.rabbit.org/vets

Don't give up hope.  This condition is often quite treatable, and even if bunny starts to roll, there is no reason to immediately consider euthanasia.  Patience and careful treatment and husbandry are the key to success.

Hope this helps.  Stewart is very lucky to have such a caring "mom."

Dana