bunny cant use her front legs

Question
I'm at a loss on what is wrong with my poor bunny. Please note that i have taken her to vet several times during these issues & also on Mon. am taking her to another vet for second opinion. She is only 4 y/o & i love her so much. Starting at beginning;she has been wonderfully litter box trained but few months ago started peeing out in her pen as well. Vet did xray & thought she "might" have small stone in kidney & urinary infection. Antibiotics given & helped some but peeing situation gradually got worse. Then about 3 weeks ago she stopped eating or pooping for over 24 hrs & seemed liked she was in pain so took her to pet ER. X-ray showed bladder completely filled with "sludge or stones"; gave iv fluids & steroid injection & told to follow up with my vet. He figured she should have surgery to clean out bladder but when he put her under anesthesia & was relaxed, decided to try to express her bladder first & proceeded to express about 12cc sludge out, xray then was clear so didn't have to do surgery.(Also, during all this she was getting urine scald from peeing on self so much even tho every day i wash her bottom off & keep as clean as i can, still loseing fur on hind-quarters). Thought she would be fine but about a week ago she suddenly was unable to use her front left arm. She kind of flops on her chest or side pushing herself along with back legs. Can't sit up or get front paw in correct position; just crosses over across her chest. Not sure if right arm is doing this or not, seems to be ok i think, but her dew lap keeps me from viewing well. At first she was sitting with face to a corner & not eating but i have sat with her hand feeding her over & over to keep her eating. Its so pitiful seeing her pushing herself around on her chest/belly. Meantime my vet is at loss; thinks it could be neuorological but didnt do xrays or anything. When i move her leg for her it seems to move ok; no suspicious break, grinding,ect. I wonder if her shoulder could be dislocated but how could stand the pain? Anyway, i'm desperate for answers. I dont want her to suffer but i can't give up on her if this is fixable. Anyone have any ideas? I know bunnies can lose use of back legs in certain illnesses but cant find anything on loss of front leg like this. I am taking her to vet on Monday but any input would be appreciated. PLEASE help me figure out whats wrong with my sweet bunny! Thank you.

Answer
Dear Vickie,

I'm sorry about this terrible problem.  I know how horrible it is to watch someone you love in this condition and feel helpless to do anything.

Encephalitozoon cuniculi is generally associated with loss of the use of hind limbs, but because it infects the central nervous system, it probably has other manifestations we don't yet understand.  It might be worthwhile to ask the vet about treating her with Panacur and/or Ponazuril, in case this problem has E. cuniculi at its base.  E. cuniculi also infects the renal system, and though we can't say whether it causes sludge, its odd effects could have surprising signs in the infected individual.  We still have a lot to learn about what this parasite can do.

If your bunny has ever been outdoors grazing where wild animals roam and leave feces, then there is the possibility that she has cysticercosis (i.e., the larval infective stage of a tapeworm, for which she would be the intermediate host).  We have two rabbits who lost the use of their front, and then later, their hind limbs, and although we suspect cysticercossi, this can't be confirmed without post mortem (which we hope won't happen for a long time...).  Treatment is pretty harsh, and with mixed results, even for humans.

Baylisascaris procyoni is a roundworm parasite that could cause neurological signs like this.  If your bunny has been grazing where there are raccoons, then this, too, is a possibility.  Unfortunately, there is no treatment for this.

None of these possibilities is very nice, though E. cuniculi might be more treatable than the others.  But in the meantime, she might need a soft, thick hospital bed to prevent bedsores, and the best ones are available from Palacepet.com

I would ask about doing radiographs on the pectoral girdle and surrounding areas, just to be sure there's nothing broken or dislocated.  Sometimes hairline fractures are hard to detect until they start healing, but any such fracture should be stabilized with the limbs in a normal position so the break heals normally.

I hope this helps with some ideas.

Dana