Peeing outside litter box and now seizure presumed EC prognosis?

[Felicity0118]

Hi all!

thankyou for being Here in a time of need. So background is I got Dave from a rescue in September 2022 he was about two years old at the time.

At the time when I rescued him, he drank and ate so much when he came home and I just thought that was normal for him.

He bonded with my bunny perfectly and everything’s been great since. Roundabout Christmas time he started having sporadic wees outside his litter box which have just been getting worse and worse. I thought it was behavioural or a UTI and I was really reluctant for him to go to the vets and have antibiotics and to be honest I guess life just got in the way. I’ve just got back from being in a hospital with pneumonia (I know my life is just chaos right now!) and he started peeing in a different area which made me think it’s about time to really get this checked out. Thankfully my regular vet was too busy and I ended up taking him to the local vet surgery and he ended up having a seizure during a very calm routine exam 🙁

It now looks like he has EC and I’m absolutely tearing myself apart because I knew about EC but I always thought it was head tilts and I never considered that his peeing outside the litter box would’ve been there if I’d known I would’ve done something. Frustrated because at the time when I got him from the rescue, I should’ve considered getting him anti-parasitic treatment but I was going through bonding and I was concentrating on that and didn’t really understand the gravity and likelihood of EC.

Basically, I’m hoping for some comfort from you that I’m not a terrible bunny Mum! 🙁

and if anybody knows if his kidneys are going to improve? Currently at the vets, apparently his back legs aren’t working as well, but that’s a new symptom and I don’t know if that’s going to be Permanant so please any advice will be greatly appreciated because I feel awful right now!

 

[Em]

It does sound like EC to me but I wouldn’t beat yourself up; it’s often misdiagnosed by even vets, so while yes I would have said he should have been brought the second a problem was suspected if you did bring him to the vet earlier there’s no way of knowing as to whether he would have been treated in time anyway. Mistakes get made, it is unfortunate that you were not able to get ahead of this sooner, but the fact you’ve recognised your mistakes and will learn from them is what is important.

Ive had two buns with EC: my current 8 year old female has EC and her brother also had EC. Unfortunately he succumbed to secondary issues that arose from his, but we did manage for a while. For her her symptoms were seizures and thankfully since finishing her panacur treatment she hasn’t had a single episode since and shows no other symptoms. My male had it a lot worse and was at one point basically paralysed and had really bad urinary incontinence. For him, the urinary incontinence never improved even with treatment. It caused permanent damage and he was treated within 1-2 weeks of the onset of initial systems (delayed only due to a misdiagnosis of arthritis by a vet). He did regain strength in his hind limbs but was never 100%… I would say he regained about 70% of his strength back, but he was a large rabbit (French lop) who was already older (for a frenchie anyway, he was 6) so I think that combination also went against him.

start on panacur asap. Most vets are too slow with treating for EC. You need to start now even if it is only suspected as EC is fatal if untreated and can cause permanent and irreversible damage that greatly impacts their quality of life.

[DanaNM]

Don’t beat yourself up, I went through the same thing with my bun. We thought it was just age and arthritis until he started circling and had head tilt… that was months after he started peeing outside the box and having hind leg weakness.

Key is to just start treating with panacur ASAP, and I would do follow ups to check on his kidney function. A lot of the symptoms are due to inflammation and should get better with treatment.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Felicity0118]

Hi both, thank you so much this is exactly what I needed to hear!

since posting, I have spoken to the vet and she was actually saying that treatment can be so problematic so wouldn’t blanket treat with panacur unless 100% and she said exactly the same thing even if I brought them in earlier it would’ve been difficult to sort and ID cause.

He’s now at the vets he’s up and moving and eating and drinking just a bit wobbly on his back legs. They’re about to put him under to take some bloods because sadly he’s getting a bit too stressed being handled. I really hope that he hasn’t had long-term effects from this. I’m particularly worried about his kidneys because that’s minimum 5-6 months of not being treated but he wasn’t at the point of true incontenance so I’m hoping hoping hugely improve the inflammation coming down so very thankful to hear that it might do that (crossing all my fingers and toes!!)

thankfully the vets are incredible maybe a little bit too much in the fact that they were going to send him about five hour drive to have a CT scan to look at other potential causes of his seizure just had them and was costed at £3500! which is a bit beyond my insurance! But hoping with the bloods we’ll have a diagnosis and prognosis

[Em]

Yeah definitely don’t beat yourself up, it is very frequently misdiagnosed! The main thing is he’s getting the help he needs now,  and it’s good to hear that he’s at least up and moving even if a bit wobbly.

the risk of side effects from panacur are no where near as high as the risk of death from untreated E.cuniculi. Is this a rabbit savvy vet you are dealing with? There is a risk of a bone marrow disorder from fenbendazole but my vet told me that it is super rare and the risks of this being EC and going untreated far outweighed the risks of the fenben. Treatment ASAP is paramount to the success of your rabbits recovery if this is EC you’re dealing with. I personally would not wait for a confirmed diagnosis of EC with a blood test – I did a blood test for my male and results took 4 weeks to come back. We started treatment anyway on week 2 because his symptoms worsened so bad I feared I was losing him. And once started on treatment, we saw improvements almost immediately. Same with my girl who had 2 seizures due to EC; we started treatment anyway and she’s never had one since (touch wood!).

I’m not trying to scare you, and I’m sure other members will weigh their input, but side effects from fenbendazole are very rare and not at all common. While yes, a risk, EC can be deadly.

Also if you “shop around” for a CT you can often get them cheaper. My rabbits CT scans cost €400 (she has a heart and nose abnormality so gets CTs frequently unfortunately). We just have them read in house by a rabbit specialists who sees a lot of CTs instead of sending results abroad, so you are able to cut costs a little that way sometimes if you have a clinic willing to work with you. But of course if you’d rather have them sent away that’s totally understandable too! Just wanted to bring up that option to you

[Bam]

There is a risk of bone marrow suppression with Panacur (fenbendazole), but it is a rare side effect. I only know of one bun here that got bone marrow suppression, it was from oxybendazole (another bendazole). They had to stop the treatment for a while before they could continue it. Because as Em says, ec needs to be treated. Panacur is often combined with meloxicam to bring down the tissue inflammation that the ec causes.

[DanaNM]

Agree with all of the above, Panacur side effects are rare. If the vet is not sure about treating it, I would find another vet. Most rabbit savvy vets will treat on suspicion without even testing, because the tests are often unreliable. I had to switch vets because my vet was under-dosing both the Panacur and meloxicam. Thankfully you can get Panacur at feed-supply shops, so I was able to give the correct dosage while I waited for an appointment with a new vet.

In some countries it is more common to treat for EC prophylactically, some people will treat annually or any time a new rabbit is introduced to their household. In the US (and many other countries it seems), there is a more cautious approach and vets usually only treat when symptoms arise. Most rabbits (estimated between 60-80%) carry EC, but only a small number become symptomatic. I’ve heard the sentiment in veterinary medicine that you “treat the beast”, meaning you shouldn’t go digging for problems to treat when you don’t see symptoms, so I suspect this has something to do with the current approach. There is still a lot we don’t know about EC, and practices could change as we learn more.

My bun (who was nearly 14 at the time) handled the EC treatment like a champ, it’s usually very well-tolerated.  I volunteered at a rescue and know of many buns in various health states that were treated with Panacur, and they all did quite well on it.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Felicity0118]

Hi all, thank you again for all of your messages. I’m like drinking in all of this advice! And so thankful to have you all here, my mum just keeps saying I think it’s time to let him go (it’s been one day!)  I’ve just got back from the vets and he is not in brilliant shape.its  almost like he’s kind of paralysed from from the waist below which is a shock to say the least he’s immediately tried to run into the bedroom area behind the sofa so sort of helped him get there and I guess I’m just gonna leave him for a little bit and then… I might, I don’t know I don’t know what to do! I guess help peeing and eating and drinking when he seems to want to leave his hidey house?!

I spoke to the nurse when I got in to talk about everything and they don’t think that it is EC, she said something about lesions in vestibular something..? but they are treating EC as first suspicion to rule in/out. They don’t think that the history of peeing is linked which I think is a bit odd, overall I think the vets are quite savvy (Plymouth vet group/estover hospital). I think she’s due to get her Exotic certification next week in fact I think she’s taking some time off to study which is interesting!

but yeah, I felt the same because my other rabbit had panacur And she was totally fine, so it was a bit weird that this vet said that they don’t like giving it out adhoc so yeah, I’ve been sent home with panacur For both bunnies, antibiotics, paracetamol and gabapentin I think they want a follow up in a week once the blood results come back.

Now how an earth do I manage a half paralysed rabbit that’s hiding from me? Without freaking him out?! Eek!

[Felicity0118]

Ah whoops, I knew I forgot some bits! Thank you so much about the advice for the CT scan to shop around. It made me feel comfortable to say right now. Let’s not do it at that one because it was like five hours drive. The bunnies were really stressed just coming back from the vets and it was like the 20 minute drive. He’s not on anti-inflammatory just yet because I think they are concerned about his kidneys so I think they’re interested in doing that next week I guess?! I hate this. This is so hard to muddle my way through!

[LBJ10]

Vestibular disease (head tilt) is a classic symptom of EC. However, it is not the only symptom and many bunnies suffering from EC flares do not have head tilt. So I would be concerned if the vet was only looking at the classic symptoms and not the big picture. Hind end weakness is a common symptom and so is incontinence.

If your vet sent you home with medications to get started, then that’s good. Oftentimes bunnies get much worse while waiting on test results because it takes a long time. And, as Dana mentioned, the test for EC is unreliable.

I’m sorry that he has lost the function of his back legs. Perhaps that is partially from being sedated earlier. If you can, I would make him a bumpered area (like in a small room or inside an xpen) so he can’t hurt himself. You can roll up towels or fleece blankets to make bumpers. Pee pads are helpful if he can’t get to the litter box.

[Felicity0118]

Yeah, I’m so glad that I’ve got the medication and thankfully he absolutely loves it so he’s inhaling it all which is wonderful. However other rabbit is HATING this, she’s anxious that their main hide is now overrun with me and him and the medicine ended up being a huge fight to get in her so feel pretty grim!

Today isn’t looking brilliant for him he seems completely off his legs. They didn’t actually end up sedating in the end, so I can’t work out if this is all from the seizure or a progression from EC. I’m not quite sure, thinking about it the day that I took him to the vets he jumped into the litter tray and he just missed the top and failed to jump in properly so I think I just accidentally took him to the vets at literally the best time because I think he was starting to get quite unwell and my timing was bang on!. He’s typically lying down with his bed with the foam rollers down each side and doesn’t really move much but every and he tries to go and get himself away to go for the litter box and that he struggles with his back legs  and rolls over and panics and then I push him back up,  he seems quite paralysed and I feel like he’s not peeing as much as he should, but I guess that’s because he’s holding it cause he doesn’t want to wee on himself so I’ve opened up some nappies put that underneath him put hay and food near him and syringe feeding and water which he is loving. I am so worried about his polyuria! He’s <2kg and I would say we’re on 70ml water so far? (6am-11) And he seems desperate when I offer it to him. I’m just trying to sort out of water bottle as I’m absolutely panicking about going to work potentially next week and how I’m gonna manage with all of this. I just don’t want to leave him. He’s got very wet bum at the moment so I’m hoping this evening I’m gonna try and get him into the front room and put some cornstarch on his bum to see if I can dry it up a little bit and seems relatively bright spirits. He’s napping at the moment and he seems quite content. Any advice is hugely appreciated. I’m trying to stick to every 2-3 hours stick my head in have a look check on him off water food et cetera but Long-term, I’m starting to get quite anxious now I’m guessing by Monday he might be a bit better? Or is it very unlikely?

[DanaNM]

I’m so sorry he’s doing poorly. I hope he can regain some leg function soon and that the pain meds help. I can take a week or two to start seeing any improvements from the Panacur. You do need to keep a really close eye out for urine scald, it can be extremely painful and hard to deal with.

I recommend checking out some housing recommendations on http://www.disabledrabbits.com/

I know of one person with a paralyzed bun that kept her essentially in a baby play pen that was full of soft bedding and hay, and the bun quite happily would burrow around in there. With my EC bun I lined his pen with washable pee pads with sheepette medical faux shearling on top, that did well to keep the urine away from him so thankfully we didn’t have to deal with scald.  You can line his area with rolled up towels to provide bumpers for him to lean on as well.

 

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Felicity0118]

Oh fab thankyou! I’ve been struggling with the details of caring for him whilst he’s like this!
just chatted with the vet and so far bloods are normal, can’t remember what bloods are back first it was a panel of some sort (still waiting on kidney and EC)

he seemed better this morning but this eve he’s quite quiet and seems like his front paws seem bad now. But thankfully Lemon is there in with him cuddling him now as since we’ve got home she’s completely ignored him! Pest! Haha

[LBJ10]

If he wants to stand to eat or whatever, you may be able to gently prop him up and keep him stable. You may have to tuck his legs under him in order to do this. Oftentimes, when they start improving, they will be able to stand with some assistance (but unable to hop yet).

[Felicity0118]

Yeah, I’ve been using one of those bolster beds which he it’s interesting. He he’s always keeps trying to get back to whenever he leaves it so yeah, I think he’s he’s comfortable there.
Bit of an update we have improvement and so he has started scratching his face with his rile and his left leg I think is so we’ve got a bit more movement and he tried yesterday to sort of pop out of his safety place towards the toilet Didn’t quite make it but significant improvement I think the hardest thing for me is just trying really hard to stay off him and let him just work it out himself until he falls over and panics but he’s definitely showing signs of improvement. I just hope that it keeps this momentum because I Long-term, he’s not gonna be happy staying like this he’s a big fan of chasing around his Treatable and upsetting his sister, so fingers crossed he’s getting there! Thank you all again for all your support and significant knowledge. I don’t think I would’ve been able to get through these few days without you all

[Felicity0118]

Next update jic any readers going through the same, I was pessimistic yesterday thinking yesterday is likely the best he’ll do…forward to today!!! He was quite lethargic and didn’t see much improvement, till 9pm, he suddly emerged out of his box and sat there comfortably whilst his bunny buddy sat with him and groomed him, I then got this carrot topped box he loved and put it just out of reach, he tucked his back feet under and pushed himself forward! So I was mean…moved it again and again and he almost did an almost hop!!! Huge improvement I am astounded! Still unsure if it EC or an ear infection that the vet thinks it might be but whatever it is I think we’re definitely treating it!

[LBJ10]

I’m so glad to hear he is regaining some of his mobility back! Don’t panic if he regresses a little bit in the coming days. It isn’t unusual to have setbacks when recovering from EC.

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