Potential E.cuniculi + URI: Hind Limb Weakness

[Em]

Bit of a backstory: I have a 6 year old French Lop who has been a walking vet bill since May of 2022. He was diagnosed with a Staph A infection which has proven a nightmare to completely get rid of. Originally suspected as a heart problem, did all of the testing under the sun, only to have all results run clear and that he has a very very stubborn URI. It cleared up by the end of October with a combination of penicillin injections and oral baytril. However, it has now returned and seems to have brought a whole new set of problems with it.

April 30th I noticed he got up from a flop in a very weird motion. Like he struggled getting up and then walked over to me vs hopping. I proceeded to observe him, fearing he somehow broke his leg, and noticed he was shuffling when hopping, like almost holding his back legs together to the side while hopping if that makes sense. This was late at night, so I stayed up all night to ring the vet the next morning only for him to act like nothing happened and proceed to have everyone tell me I was overreacting and that he was fine. So I waited, and he was fine the rest of the day.

Next morning it happened again, so vet time it was. At this point I had excessively googled the possible causes for hind limb weakness and E.cuniculi was screaming at me. His vet appointment came, and of course he was acting fine so I did my best to explain it to the vet. He told me that he believed it was arthritis due to his age and breed, or inflammation I believe he said from his URI. When I brought up the concerns I had with it being E.cuniculi, he told me it was unlikely and that he didn’t believe it to be the case. He said if it didn’t improve within 10 days we would go from there. He was given antibiotics for his URI and metacam and we left very relived that it was “just” arthritis. this was on Wednesday (May 3rd).

He had no episodes of the hind limb weakness, that is until May 11th when he was totally fine that morning and afternoon but was totally paralysed by evening. He had NO control of his back legs or bladder. I panicked and immediately rang the vet and they informed me they would have no exotic vet on staff for a number of weeks. I can’t get him to another exotic vet for scans just yet (transport), so I expressed I simply was not satisfied to not treat for E.cuniculi as even an unlikely scenario given its fatality when left untreated and given his symptoms. We have since started panacur which we begun on May 12th for a 28 day course treatment. I am also giving him metacam twice daily.

I have already seen a huge improvement and he is no longer paralysed and can stand up, groom himself, and move around now. However, he is still weak in his hind legs and you can see it when he hops as he sometimes decides to walk. I believe this is simply due to the fact that he was paralysed and I’m sure his legs feel funny and his muscles are very weak. So I’ve been doing some physical therapy with him (working on his balance in short sessions, by holding treats above his head for him to reach), massages, letting him out for supervised time in the garden to encourage him to walk around and use his muscles, and I’m also looking into red light therapy. I do notice though that sometimes he will occasionally drag his legs, even if just for a minute, and then we stop and go back inside for cage rest. He is also usually 4.3kg, but has maintained 3.8kg since October of last year. Which is very scrawny, but he not concerningly thin but I would like more weight on him. But he has the appetite of a horse and is usually very active, so that’s what we attributed to despite nothing working to help him gain weight (it was also explained that it was probably due to his URI that he couldn’t gain weight) – now I’m wondering if this was a symptom of E cuniculi long ago?

does this sound like e.cuniculi to anyone who has dealt with it? Like I said, I am unable to bring him to another exotic vet until either the weekend or next week if we are able to for further scans, and I don’t want to stress him on a journey unnecessarily if he is clearly improving gradually on his course of treatment. My other question, if it is E.cuniculi, is it possible he can go on to live an otherwise normal life? Are their lifespans affected by this? Should I treat him regularly with panacur now going forward?

also I should add: he lives with a 7 year old Lionhead. Should i treat her as a precaution? Will it do anything?

I added the fact he has a URI in case anyone who has dealt with staph A has any treatment recs. penicillin and baytril combo just doesn’t seem as effective this time round. We have done baytril nebulised this round so maybe going back to oral will be better? I will discuss that also with my vet over the phone anyway. Just looking for some opinions.

thank you to anyone who has read all that! Just very stressed about my poor guy.

 

[DanaNM]

This does sound like EC, I’m sorry your vet didn’t take you seriously (I’ve dealt with this as well) ! With EC, some symptoms are due to inflammation, but others are due to the damage to the nervous system. The ones due to inflammation improve with treatment, but the damage to the nervous system is permanent. Your bun will likely always have some hind leg weakness, but it sounds like he is feeling much much better and it is encouraging that you are seeing improvements this early in the treatment course. I recommend checking out http://www.disabledrabbits.com/ to see some ideas on how to set up his environment to help him be more comfortable and safe.

It’s not generally recommended to treat with panacur unless there are symptoms, as the medication is not without risks (although it’s generally very well tolerated). For that reason it’s not recommended to treat companion rabbits prophylactically, because it’s thought that many rabbits carry EC and never develop symptoms. There is still a lot we don’t know about the parasite though. In your case, I think I would just watch very closely for signs and symptoms in both rabbits, and be prepared to treat if symptoms flair.

As to whether EC was involved in his other history, I can’t say. It’s very possible that the other illness actually caused the EC flair, as he may have been carrying it for years but it became symptomatic when his immune system was weakened by the other infections. I don’t have as much knowledge about URI treatments so hopefully someone else will chime in, but I know they can be very stubborn and often require very long courses of 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.  

[Em]

I figured it was likely EC. I was told it rarely presents without a head tilt, so was assured it was very unlikely –  I even bought up the fact that I thought it was more likely EC than anything else due to the fact he was immunosuppressed due to his URI…. But I was told he’s a 6 year old frenchie so treat for arthritis before we start looking at anything more serious (which honestly did not make much sense to me given the serious nature of EC left untreated, but anyway – should have pushed the vet more than i did, and that’s my fault).

I feel really guilty that we missed those 5-7 days of treatment from his first appointment to when the paralysis started. Now I’m gonna always wonder if those few days would have impacted his recovery as he had no bouts of paralysis during that time – so we could have stopped further damage before it got to the stage that it did. 🙁

He was very stiff this morning, but no paralysis and still moving his legs – I think he might be extra stiff as I started his physical therapy yesterday, by letting him out in the garden for a few mins to encourage him walk around, so I imagine (or hope) that it’s just due to him not being used to using his legs.

Thank you for your advice! It’s very hard to find info on EC, as there is a lot of conflicting information. So I wasn’t sure whether to treat his companion or not. It’s a scary condition and honestly one I thought I’d never have to deal with.

Thank you for your response, very helpful – much appreciated!

I’ve rang a few exotic vets around; all out except for one, who doesn’t have weekend availability so it won’t be for another week if I could get him in… I just wanted to do further scans to be sure, blood work, and maybe discuss acupuncture or something. He’s just a really good boy and I really hope he has a full recovery. I am changing their setup around to cater for the fact this may be a lifelong impairment he has. It’s very difficult giving his sister loves her shelves and sulks if she can’t sunbathe in the window. So I’ll have to look into making everything adapted for him so he can have as close to a normal as possible back.

have you dealt with E.cuniculi yourself? Have you come across anything regarding treatment length? I have read conflicting info regarding the 28 treatment course, with some arguing for 6 weeks (though I know the risk of side effects would go inevitably up the longer we treat).

[DanaNM]

You’re welcome! Definitely don’t beat yourself up. And yes I went almost the same sequence of events with my bridge bunny Bun Jovi. He was 13 at the time and my first vet all wrote it off as arthritis. His progression wasn’t as fast as your bun, so it took me longer to realize something else was going on. We can only go off the info we have, so please don’t feel guilty!  It’s also possible he has both things going on, my bun did. So some of that stiffness could also be due to arthritis. It can take some time to get the pain meds dialed in, so if you aren’t seeing benefits talk to your vet about increasing his dosing frequency or adding in another med.

Acupuncture, cold laser therapy, and adequan injections have all be said to help anecdotally, it’s a question of what you think your bun will tolerate and their health in general. I did try a home-version of light therapy for my bun and I think it helped him a little? But after a while he stopped tolerating it so I didn’t force it.

28 days is the standard for panacur treatment (if you post the dose he’s getting we can confirm that as well). Some buns do need a second round if symptoms return. My vet (who I stopped going to) initially gave me the wrong dose of panacur so he was only getting half of what he should have, so he ended up having a whole second round (very frustrating in general).

As for your bun’s weight, I had very good luck with supplemental feeding of a recovery food called Emeraid (the herbivore sustain formula). Bun Jovi hated critical care and the sherwood brand, but he loved Emeriad and would eat it willingly. It really helped him keep his weight on until the very end of his life.

. . . 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.  

[Bam]

I totally agree with Dana, do not beat yourself up. I had a GSD whose lower back arthritis first presented as hind end paralysis. So I understand why your vet first thought of age related spinal/joint/ nerve root problem in a 6 y old Frenchie.

EC is still not fully understood, but I think many vets now know it can present in many other ways than head tilt. It can affect kidneys, causing urinary incontinence and loss of litterbox habits. It can def affect the lower back/hind end. It can even affect the GI system.

EC suppresses the immune system, so it kind of opens the field up to opportunistic pathogens.

As for your other bun, some vets recommend routine treatment with Panacur for 9 days for buns that have been full-on exposed to a confirmed EC bun. Other vets do not recommend this, as far as I know there’s still no consensus. As Dana says, many buns carry EC, but their immune defense is able to deal with it, so the bun never becomes symptomatic. That’s why routine treatment often is regarded as not worth the (slight, but still) risk of side effects.

 

[Em]

He doesn’t appreciate syringe feeding; often getting him to take his meds is a struggle, but he’s a lot better with it now! I’ve just increased his pellets, more veggies, and making hay more interesting to eat – but I might try offering critical care cookies and see how he likes those!

As for dosage, he’s on 0.76ml panacur (10% dog/cat suspension) and 19kg dog dose of metacam. He is 3.8kg (reminder: very scrawny for him, I’d like him at a minimum 4kg tbh). He gets the panacur once a day, metacam twice a day. I’m not sure when I should stop metacam? At what point it becomes a risk to carry on long term? His usual vet is out for an indefinite amount of time, and my backup is out until July. I have a last resort exotic vet but does not have appointments until next week. It’s like of course everyone is out the minute I really need the reassurance of one I trust.

I do definitely understand why my vet thought arthritis, don’t get me wrong. I just don’t really understand why we didn’t treat for E.cuniculi even just as a precaution, to cover our bases, from the get-go? Unless the side effects of panacur are really that bad. I was just told possible, but rare risk, of bone marrow suppression or something. But I will take that over risk my rabbit would otherwise definitely die from an untreated relentless parasite or be left with irreversible damage. You know? I’m just struggling with it, to be honest. Again, love my vet, not blaming them – they’ve done a lot for us and I really appreciate them – just questioning myself why I didn’t push for it. Can’t help it, I just feel so bad for him as he doesn’t understand why his legs aren’t working the way they should be.

I do want to get a concrete diagnosis even though I’m pretty certain it’s EC. More so just so I definitely know what we are dealing with, to better be prepared going forward. It’s just getting him into an exotic vet has proven a nightmare as they both went out sick not even halfway through his treatment.

I know you guys don’t have a crystal ball and no two cases are the same, but from your time here on the forum I’m sure you’ve seen plenty of EC cases. Do these guys go into live a relatively normal life? Do they follow a normal lifespan?  I know he’s a 6 year old frenchie. But I always expected him to make it to 9-12 years old. He’s always been as fit as a fiddle, and very small example of his breed so I thought we had everything going for us… and now all I think about is potential impending doom. I don’t want him to suffer either, or have his quality of life jeopardised even thought he’s trooping along.

 

 

[Bam]

0.76 ml panacur 10% is 20 mg per kilo body weight for a 3.8 kilo bun. (100 mg fenbendazole per 1 ml). That is the correct dosage for treatment of EC.

28 days is standard treatment for EC, but some vets extend it to 5 weeks if they see fit.

Rabbits as a rule tolerate metacam long term very well (Medirabbit). I had an elderbun who was on a high dose of metacam (1.2 mg/kilo body weight twice per day, as prescribed by his rabbit savvy vet) for 1 year and 8 months. For extended use it can be wise to combine the metacam with a stomach protecting drug like famotidine (zantac) or Sucralfate. I have used famotidine.

http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

[DanaNM]

Dang I had a whole reply typed out that must not have posted!

So, testing for EC is often unreliable, and may not be able to distinguish between an active infection that’s causing symptoms and a past infection. Often vets will treat on suspicion, but it is common for there to be some prompting from the owner for this to happen, unless there are very obvious neurological symptoms, like head tilt or seizures. Hindsight is 20/20 though, and the important thing is that the treatment appears to be working!  I think at this point it’s most important to get the other infections under control. As far as prognosis, the fact that he’s improving is a very good sign.

My guess is that vets may not jump to trying panacur because it is a very long course of medication, and sometimes the benefits don’t show up for weeks. The initial symptoms were EC symptoms, but they were also arthritis symptoms, so it usually makes sense in medicine to try to treat the simplest possibility first. Once you had other symptoms pop up, then of course it makes sense to treat for EC.

I mentioned Emeraid specifically because my bun also hated syringe feeding and critical care but would gobble up Emeriad from a plate (but hated other brands). Each brand has a bit dif flavor so buns have their preferences. 🙂

Metacam is usually very well tolerated long term. If your bun does have arthritis, it should be continued daily. If you don’t notice a benefit and his pain seems severe, another pain med can be added in as well.  Adding soft flooring that provides traction and a low-sided litter box will help him a lot as well. I used “sheepette”, a medical grade faux sheepskin, for my bun’s pen.

. . . 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.  

[Em]

Good to know! I’ll continue on with metacam so. I have him on a pre & probiotic, but I’ll definitely look into the suggestion for a stomach guard if we continue with metacam long term. I’ve found another exotic vet I’ll give a call in the morning and see if they’d be able to fit him in at some point.

I did read about the blood test being a toss up with accuracy, DanaNM. I was told they compare the results of blood test with rabbits clinical signs and diagnose base on that. I was also thinking if not blood test, we could x-ray or CT him and rule out arthritis or other issues and so that would leave EC as the culprit. So there would be our diagnosis. But I’m sure it’s probably not gonna be as straightforward as that!

thank you both for your endless suggestions and super helpful info! Really appreciate it. My brains been a bit of a blur ever since this went down, so the reassurance is greatly appreciated.

if I may pick your brains for one more question:  am I right in encouraging him to walk around this early into recovery from paralysis? He is usually a free roam bun, but I’ve had him on cage rest as I didn’t want him overdoing himself. But now I’m worried keeping him on cage rest will cause his muscles and legs to further deteriorate with muscle wastage, and on the other hand I’m worried that if I don’t keep him on cage rest he will overdo it and go backwards with his progress.

and yes, definitely working on getting his URI under control. He’s made a lot of improvement but now he’s out of his baytril for his nebuliser. And I’m not sure how his clinic are gonna go about dispensing it to me given their exotic vet is out. So we will probably be forced to travel with him, which I would like to avoid if possible as I’m afraid of worsening his condition with stress of a journey like that.

[DanaNM]

So, with arthritis, gentle movement is encouraged, but high impact movements can cause more damage. I think allowing him to roam but removing chances to jump on things and making sure he has good traction everywhere would be OK.

. . . 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.  

[LBJ10]

So… staphycoccus is an opportunistic pathogen. It’s one of many bacteria that can just be present, but not causing any problems. Then a dip in the immune system from, say, an EC flare can give the bacteria the opportunity it needs to take over and cause an infection. I’m going to guess the URI is simply secondary to the EC. It’s possible his immune system was weakened long before he started presenting with EC symptoms.

Baytril is a broad-spectrum antibiotic, so it is often a go-to for vets. However, if you don’t think it is working, then you either need a longer course or a different antibiotic. How did they determine it was staph? Is it possible the staph just grew in a culture, but it isn’t the cause of the symptoms? Could another bacteria be the culprit? Just some thoughts. Cultures aren’t always reliable, after all. I don’t think it hurts to try another antibiotic if the Baytril doesn’t seem effective.

RE: Lifespan – It really depends on the individual. Bunnies with chronic EC infections tend to have a shortened life expectancy just because the EC keeps having flare-ups. Bunnies that have EC and it is “permanently” sent into remission with treatment tend to have a better outlook.

[Em]

Would you say the URI is secondary to the EC despite him being diagnosed with a staph infection in May of 2022?

he was diagnosed with staph from a nasal swab. So I actually don’t know as to whether it was misdiagnosed due to possible contamination. My vet did say he had a hard time believing it was “just” a staph an infection given then stubborn nature of it.

Id like to continue baytril for another 10 days given I have heard him improve, so I’ll contact the vet and see if we can arrange that. If not I’ll get an appointment with another exotic and see if they would try something else.

I do hope he can go on to live a normal life. He’s responding well so far, so I hope we have that in our favour.

[Bam]

The URI could be the “first symptom” of an ec flare-up, since e c suppresses the immune defense. When the immune defense of an animal (or human) is suppressed, bacteria and other microbes that are normally present in the environment without causing harm, can seize the opportunity to start to multiply and cause illness. Then in turn the bacterial infection occupies the immune defense so it has less weaponry to use against the ec.

It’s not currently possible to say if a bun will get well after treatment for ec or if there will be sequelae i e permanent injury to the organs which were attacked by the ec. Some buns can also continue to improve well after the course of panacur is finished, because  some of the damage done might just need time to heal.

 

 

[Em]

When you say flare up, is that when the EC gets bad to the point it shows obvious symptoms? Is it not worth treating preventatively, say every 4/6 months, to stop further potential damage if it can lurk silently in the shadows like that?

I didn’t even think it was possible for EC to present as an URI. There really is so much about this disease that I don’t know. I thought it was obvious, head tilt, hind limb weakness, incontinence- things like that. It simply weakening the immune system and then presenting as a URI didnt even cross my mind as a possibility.

Sorry for all the questions, I just want to be best prepared in helping him through this. I have contacted his vet to see if I can get a longer course of antibiotics (baytril) given we have seen some improvement. Poor guy is on a concoction of meds it feels.

[DanaNM]

I think what Bam meant was that the lowered immune system that lead to the URI could have been the first symptom, not that the URI symptoms themselves were EC symptoms (correct me if I’m wrong though Bam!).

Flare-ups would be periods of symptoms, indicating the parasite is reproducing the the bun. There truly is a lot that even vets don’t know about EC. In the past, treatments didn’t actually cure the infection, so it was more likely for a bun to have constant flare ups, as the drugs never actually cured the disease. The current drug, fenbendazole (panacur) is thought to actually kill the parasite, although it may still be able to “hide” in the brain. There’s some more info on this here: http://www.medirabbit.com/EN/Neurology/cuniculi/pyrimethamine.htm

 

. . . 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.  

[Bam]

No, sorry, I was being unclear. The URI is caused by bacteria, in your case staphylococcus. But the reason why these bacteria could cause a URI can be because your bun’s immune defense was suppressed by EC.

A flare up is when the ec parasites for some reason start to multiply inside the cells (ec is an intracellular parasite) until the cells burst and their contents spill out. This causes the rabbit’s body to react with inflammation. This inflammation causes EC symptoms, which vary widely in severity. At least this is how ec is currently believed to cause the symptoms we see, but there is still a lot that isnt understood about this illness.

Some vets do recommend routine treatment with 9 days of Panacur every 6 months for EC rabbits after their initial course of 28 days. I’d say it’s more common nowadays that the vet wants to see the bun before prescribing more Panacur, which means they wont treat until there are signs of a flare up. Side effects of Panacur are rare, but there is one serious possible side effect (bone marrow suppression).

It’s great that you ask lots of questions. We will try and answer them, at least so you know what you want to ask your vet. It can be good to write down the questions, so you dont forget what you wanted to ask bc of stress during the vet visit.

ETA: Haha, took me so long to write this that Dana had answered before I’d sent it 😄

[DanaNM]

lol!

. . . 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.  

[Em]

Oh no sorry, that was my bad with my poor wording choice – I knew you meant that the URI was the (potential) first sign of him actively fighting EC on the basis that his immune system was compromised from the EC which then lead to a URI developing from his poor immune system. I know you’re not saying that a URI is a symptom of E.cuniculi, so don’t apologise, you were fine with your wording! I just can’t speak apparently lol

 

thank you guys for your endless advice. I will indefinitely be back to wreck your heads with my further questions, as he has an appointment next week as his exotic vet will be hopefully back then (or at least early following week if not). Probably gonna proceed with further scans and blood work and tackle this from there. So far he continues to improve, so at least we are going forwards, which is a positive! I hope it is only uphill from here.

[Em]

just thought I’d update this in case someone with a similar experience happens upon this post while googling;

Wolf continues to thrive. Still has that stubborn URI (on his second round of antibiotics now, definitely gonna need a third and possible change but we’ll see) but in terms of his hind limb weakness, you’d never think that just under 3 weeks ago he was totally paralysed and I really feared I was going to lose him. You can barely tell he ever had a problem; if you didn’t know him, you probably even wouldn’t notice it.

I haven’t proceeded with any scans on the basis I’m afraid of putting him under anaesthetic when his breathing isn’t 100%, but we did proceed with the blood test for EC. Apparently it can take 4 weeks for a result, so we have about 3 more to go before we hear anything back.

Im still continuing daily panacur. I’ve cut back metacam to once every day, sometimes skipping a day or two (depending on how worked up he gets). My vet originally told me to stop it altogether but then changed to saying to continue it. But so far I’m very happy with where we at right now. Vet wants to CT him anyway to be sure but I honestly firmly believe it’s without a doubt EC.

[Bam]

Thank you so very much for this update! It is very valuable!

Im so glad to hear he’s doing so much better with his hind end! It does seem very likely that the cause of the paralysis was/is EC. The improvement seems too swift and radical for the paralysis to have been due to arthritis/joint inflammation.

EC causes inflammation, so it makes total sense that your vet to want to continue the metacam. In a human or dog, corticosteroids would work, but ä for rabbits corticosteroids should be avoided except as a very last resort. Rabbits are as a species very sensitive to corticosteroids.

If you get the EC under control, it will greatly improve your bun’s chances of beating the URI.

Fingers so very crossed for him and you 🤞🤞🤞

 

[Em]

Blood tests results are back and no surprises, he levels were off the charts positive for active EC infection.

I might get treating his companion as a precaution and treat them regularly as a precaution too going forward now that it is confirmed he definitely has it.

thankfully, he’s doing great otherwise but now treating his URI just got a whole lot more difficult now that we know he has EC. But, he’s a little trooper and we’ll try whatever we have to to get him through it. He’s acting himself and bouncing around living his best life, his breathing just becomes horrific whenever he has to get groomed or have his nails trimmed.

[DanaNM]

I’m glad you got some answers, and it’s very good he’s in good spirits otherwise. Sending vibes that he can kick this URI and beat the EC!

. . . 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.  

[LBJ10]

I’m glad you got confirmation and you are continuing to see improvement. As for the URI, would the vet agree to trying a different antibiotic?

[Em]

Yeah we are going to try a different antibiotic. We’re looking into options to decide our best approach, now that we’re armed with the knowledge that it is definitely EC (before he thought he might potentially have something else going on causing the hind limb weakness, but I’ve believed it to be EC all along).

His mobility isn’t a concern to me anymore, as he’s doing so great, now it’s just a matter of getting his URI under control which has so far proved a total pain

[Em]

hi guys,

Back again with perhaps a stupid question. Wolf finishes his treatment this week (I decided to treat for 5 weeks vs 4 weeks as he has tolerated it very well). I have cleaned their area with a 10% diluted bleach solution, but they are also allowed playtime outside in the garden – how do I get rid of spores outside? How long do spores last in the environment?

I’m absolutely terrified of the thought of him having a potential relapse as I’d imagine it’s more severe the second time round and I want to be as proactive as possible in terms of minimising this risk if I can.

we are still fighting the URI also. We’re swapping to a new antibiotic this week (marbfloxacin) so fingers crossed he responds well to that and we can kick this thing to the kerb.

[DanaNM]

There really isn’t a way to deal with spores in the environment, unfortunately. I’m not actually sure how long they last in the environment though. The best you can do is be on alert for a relapse of symptoms. It’s not uncommon for EC buns to need another round of treatment occasionally.

Fingers crossed he does well with the new antibiotic!

. . . 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.  

[LBJ10]

Technically, EC spores can exist in the environment for a long time. Can a rabbit actually become infected this way? Much less likely than, say, a rabbit actually living with another rabbit that is actively shedding spores in their urine. At any rate, I wouldn’t worry too much about him becoming “reinfected”. Treatment for EC doesn’t necessarily cure them completely. It sends the EC into remission. So a relapse is more likely to occur “from within” when there is a dip in the immune system.

[Em]

Right, so basically just be prepared that we could face a relapse regardless. Hopefully not, I don’t think I could handle it again to be honest.

He’s had 4 full days of his antibiotics so far, this evening he gets his 5th dose, and I haven’t heard any improvement. He’s on a 10 day prescription so feeling very discouraged, as I would have hoped to see improvement by now. My vet wants to re-swab and run another culture sensitivity if this doesn’t work as he is concerned about resistant bacteria. I’m hoping it doesn’t come to that as the poor guy has been poked and prodded so much already. 🙁

[LBJ10]

I always had more luck with azithromycin when dealing with a stubborn URI. Every bunny is different though. It’s going to depend on what the bacteria actually is.

[Em]

Hope it’s alright to continue to update this thread – it’s useful for myself too for time stamps/remembering dates, so if it could help someone else out I guess that’s a bonus!

The marbfloxacin did absolutely nothing. No improvement at all. He also hasn’t got any worse, and the vet said his lungs actually sound very good – it just seems to be all in his sinuses. So, we’re proceeding with a CT scan of the head and chest. Depending on results of that, he might have to get two tiny holes drilled into his nose for them to drain the infection and relieve his breathing going forward. Sounds like a brutal surgery to me, but I was assured it’s not as bad as it sounds and that they recover very quickly.

while under anaesthetic they’re also going to take a deep swab of his nose and run a culture sensitivity test because so far no antibiotics are working and there’s concern for antibiotic resistance if we just keep throwing everything at him and crossing our fingers.

good news, he’s gained a whole 200g since finishing his treatment for EC and I’d say 95% of his strength in his hind legs has recovered. So hopefully that’s behind us, and all we have to do is get this stubborn URI under control.

[DanaNM]

That’s great he has gained strength and his lungs sound good! Def a good sign. Hopefully you get some answers from the CT.

And yes please do continue updating this thread! We love updates, and they can be very educational for other members. Having it all in one thread makes it much easier to keep track of the full story. 🙂

. . . 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.  

[Em]

I also forgot to mention;

I brought my other rabbits (who lives with him) for a general check up; she’s started on antibiotics for an occasional sneeze/wet nose (she’s on the same thing he was to see if it does anything for her while we wait for his results). But also during her check up the vet discovered she has slight cataracts when examining her eyes. I asked if this had any relation to the fact her brother had/has EC and if it would indicate that she too had it, but he told me no and it was just due to age (7.5).

I know uveitis is associated with EC, and I asked the vet and he said it’s not that it’s just cataracts. But I googled it and apparently cataracts can be associated with EC? Is this true and should I be concerned?

sorry for what might be a dumb question. I know she’s older, I’m just so paranoid about getting a potential infection under control from the second i suspect it as her brother absolutely terrified me and I thought I was going to lose him.

she shows absolutely no signs of having her eyesight compromised for what it’s worth. She is always straight over to anyone begging for a snack the second she hears a crinkle

[Bam]

Cararacts can be a sign of EC. It’s often seen in v young individuals that have caught ec in the womb, but it can occur later in a buns life too. Typical of ec cataracts is that they progress v rapidly.

For chronic therapy-resistant sinusitis they drill holes into the sinuses of humans too to drain them. The surgery is called FESS. I have a friend who has had it done. It does sound a bit brutal, but its done under anesthesia and considered minimally invasive and wont leave any scarring on the face. It’s very difficult for antibiotics to reach into the sinuses, since their narrow outlets can/will get swollen shut due to inflammation. Thus chronic sinus infections are often not readily responsive to oral antibiotics.

As Dana already said, we do love updates! It’s very educational and great for people who are looking for info about their own buns.

[LBJ10]

Cataracts is associated with EC, but it can also be old age. The difference is how rapidly it develops. Cataracts caused by EC will show up very quickly, like practically overnight. Cataracts due to age develops slowly over time. My bunny had Cataracts that developed due to age. He could still see fairly well up until the end of his life, then he couldn’t really see anymore.

[DanaNM]

Cataracts can be EC, age, or both. In a case where a bun is both old and has EC, it can be hard to assign them to one cause or the other. I would keep an eye out for other symptoms, such as excessive urination, head tilt, or hind leg weakness.

. . . 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.  

[Em]

I feel like the worlds worst rabbit owner, honestly. It really feels like everything that could go wrong, is going wrong.

because he was on so many antibiotics along with the metacam, his stools weren’t the firmest and factor in the occasional incontinence with the EC he needed bum baths pretty much daily. We’ve been having exceptionally warm weather here recently and he’s a sun worshipper, so instead of stressing him out with the hair dryer I let him dry in the sun. Thinking that that was the  best way to dry him as it involved no stress so was best for his EC.

I had no idea what a terrible idea that was.

my poor boy got flystrike. As if he doesn’t already have enough to deal with.

I almost got sick when I found the maggots in his fur. I keep him immaculate, and diligently keep up with keeping his bum clean, and I feel so stupid for not knowing that even clean damp fur attracts flies. It seems like common sense and yet it didn’t cross my mind, not even once.

 

I rushed him to the emergency vets immediately and they were just so lovely even though I felt so terrible and guilty. Thankfully they said I caught it within hours of it happening, and he only has a small wound on the base of his tail and another on his underside. But the severity of it isn’t lost on me.

I feel like I just keep failing him. 🙁 he’s doing really well, thank God. All this happened last Saturday. He’s having his CT scan this Thursday. Hoping for some good news for once. He’s had to overcome so much already, it’s just not fair.

[DanaNM]

Oh how terrible 🙁

Don’t beat yourself up, I cared for a geriatric bun who also had EC and incontinence for almost a year, and it can be very hard to keep up with the cleaning. He crossed the rainbow bridge a couple months ago, but as we were going into warmer weather I was so terrified of fly strike. You caught it early which is great, please give yourself some grace. Caring for a disabled bun is very hard, you are doing amazing with him.

Sending some vibes for some good news with the CT scan.

. . . 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.  

[Bam]

I’m very sorry this happened to you, but you caught it very quickly! According to Richard Saunders, famous British rabbit vet, full-blown flystrike can develop in as little as 6 hours in a heatwave. You caught it early and took swift action, and that’s admirable.

It is difficult and very stressful to care for a disabled bun. I’ve never had to deal with flystrike, thank goodness, but I’m in a cold climate where the risk obviously is a lot lower.

Fingers crossed the CT yields some good news!

 

[LBJ10]

I agree with the others. You were doing your best and sometimes these things happen. The fact that you are taking such good care of him meant that you were able to discover the fly strike right away, before the maggots could do any serious damage.

[Em]

Back with another update;

 

we’ve had to start back on panacur. I wish we would have started it again proactively a week ago but the emergency vet did not think it was necessary given he had just completed his treatment.  He’s had a flare up of his EC symptoms and his mobility is down to about 50% now.

I feel like we took 2 steps forward and 100 steps back. All his hard work getting his mobility back feels like it’s been for nothing right now.

I know you guys say it happens, I just feel I could have prevented it if I just didn’t let him outside in the sun. It just seems like it was so easy to avoid all of this and common sense to not let him out, because he loves outside so much, but I didn’t even think twice.

Anyway. Just feeling totally & utterly gutted.

[Bam]

Being out in the sun might have cheered him up, and that’s very important too.

I’m sorry you had to put him back on panacur, but relapses are not at all  uncommon. Some vets like to keep a bun on panacur for 5 weeks or longer rather than the standard 28 days. 28 days is just a standard duration of treatment, its not written in stone.

You really have nothing to blame yourself for, but I know that’s easy to say. I think perhaps the tendency to blame oneself, as concientious, loving and very capable bun owners tend to do, is the brain’s way to try and make sense of things. But honestly, we are humans, not gods. Getting a bit of the  sunshine he loves was perhaps v important for your bun’s will to live and keep fighting. His enemy, the ec, is incredibly powerful and sneaky.

[LBJ10]

Yes, relapses are not uncommon and Bam is correct that sometimes treatment needs to last more than 28 days. I’m sorry this happened, but I don’t think the sun/being outside is necessarily the cause.

[DanaNM]

I’m sorry this happened, and I agree it was not likely due to anything you did. Quality of life is important, and if he loves going outside then I think it’s nice you can do that for him.

 

. . . 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.  

[Em]

Back again with an update;

 

thankfully Wolf’s fur is already starting to grow back in the area affected by flystrike, and the scab at the base of his tail is now starting to fall off.

his mobility has also drastically improved; we’re at 80% now I would say. It’s just the one leg in particular that is a bit weaker but he gets around just fine.

he had his CT last Thursday and all went well thank God, we’re just waiting on results for that. We did take another swab of his nose and it turns out it’s not staph he has like the first culture came back as. This time it’s come back as pseudomonas but it is NOT resistant like we feared. They don’t understand why the marbofloxacin has had no effect on it as it is not resistant, but currently now trying to come up with a new treatment for him. And then when we get the CT, we will know whether or not he will need the surgery on his nose.

has anyone had any experience with this infection and what you’ve found to work?

[Em]

A final update.

my brave boy fought so incredibly hard, but has fought his final battle. I feel he was absolutely failed by vets who simply took too long to treat him.

my previous baby Wolfie. I truly could have not asked for a more kind, gentle & caring soul. I will miss you for eternity my boy. and i will forever ask God why.

 

[Bam]

I’m very sorry you lost him. I was hoping for a better outcome since you recently saw some improvement. You really did everything you could for him, but he was just too sick. You both fought so bravely.

It is very hard to lose a beloved bun.

Binky free Wolfie 💔

Thank you for the update.

[LBJ10]

I’m so sorry. I agree with Bam. He was very sick and fought hard, but it was just too much.

[Em]

Thank you guys also for your advice throughout all this. I do feel like we would have had a different outcome had we not been left waiting so long for CT results. He had 2 weeks with no treatment (I was nebulising him myself with pure saline) and I’ll forever wonder if they acted sooner, they could have saved him. His heart just gave out in the end.

now though, his sister is left alone and due to how suddenly everything happened (he passed at the emergency vets), she didn’t get to say goodbye to him so has no sense of where he is. She has never been without the company of another rabbit, and now I feel like I am back at square one. I’m going to give her time to grieve, as I don’t think I’ll ever be ready to welcome another rabbit, but she is already looking for him and I feel so terrible.

[Bam]

We can of course never know if those two weeks made a big difference for the outcome, but I wouldve been wondering too, and I’m sorry you have to live with that. The saline probably gave him some relief though and it could have prolonged his life.

As for your other bun, try to spend as much time with her as you can. She needs you now that her friend is gone. Its 100% understandable that you are not ready to even think of getting another rabbit.

Maybe fostering could be an option for you after some time has passed. You are clearly an excellent bunny caretaker and your girl bun could perhaps benefit from the presence of another bun in the household.

[DanaNM]

I’m so sorry for your loss. 🙁

I agree with others that he was quite sick… things can start to cascade quickly. You did amazing with him so I hope you don’t beat yourself up.

If your girl starts to show signs of depression I agree with fostering can be very helpful. I fostered after my Bertha passed. I wasn’t ready to adopt another bun at that time and it helped her widower a lot (it helped me as well, so that was a bonus).

. . . 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.  

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