Expert: Dana Krempels, Ph.D. - 11/1/2009

Question
QUESTION: My rabbit Cookie can't stand up. She tries but she only uses her front feet. Are her back legs paralyzed or does she just not have enough energy? She is eating and drinking the banana and I will try the mushed food pellets with her in the next hour. I feed her every hour but should I feed her more often?

ANSWER: Dear Lily,

You mentioned yesterday that she had a head tilt.  Please read these immediately:

www.rabbit.org/health/tilt.html

and

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

But if she also is suffering from hind limb weakness, please read this:

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

Both these signs can be caused by a parasite known as Encephalitozoon cuniculi, which can be treated with Panacur (fenbendazole) and/or ponazuril from a rabbit-experienced veterinarian:

www.rabbit.org/vets

I can't tell without seeing her whether the back end weakness is due to illness or just weakness.  But if she is eating and drinking her banana mush, then she should be able to regain her strength.  Feed her as much as she'll take of the pellet mush, but don't force her to take more than she wants at any time.  You can check how receptive she is every few hours, and also keep food that she likes close by and available (try fresh herbs such as cilantro, kale, parsley, etc.) so she can nibble even if you're not right there.

Be sure to provide enough water for her to drink, since dehydration also can cause weakness.

While she's immobilized, be sure to keep her on soft, absorbent bedding that will wick away any pee so she won't get urine burn.  This condition should be treatable with the proper medications, so PLEASE PLEASE PLEASE read those articles above, so you'll know what to ask the vet and not just agree to euthanasia that is not necessary.

I hope she'll hang on and continue to improve, but I think you need to ask the vet about fenbendazole (NOT albendazole!) and/or ponazuril.

Dana



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

QUESTION: She is drinking/eating the banana/pellet mush. The vet did say that the bacteria in her brain is causing some of her nerves to be dysfunctional. He said this last Thursday but I was a little traumatized when he said that very few rabbits survive this. Would this have something to do with her not being able to walk? He also said that we caught it early but I am not so sure. She is not able to walk yet. I am continuing to feed her every hour and I have made her as comfortable as possible. She going to the bathroom more often than before. I gave her some lettuce yesterday and very little of it remains. She can't really move because when she does she can only go around in a circle. She does have a little movement in her feet. she can move them up and down but she is not walking which is really bothering me. I have reread the sites that you sent to me. As before, my vet is not in until tomorrow but I will call him first thing in the morning. Cookie is a mini-rex and usually has a big appetite but right now, it is small which I think is due to her illness. Do you have any other suggestions or comments for me? I have called many of the other vets, but they won't take her because she does not visit there. I have tried the site www.rabbit.org/vets but I cannot find any that will take her.

Answer
Dear Lily,

The microorganism in her brain is not a bacterium, but rather a protist, and specifically a microsporidian parasite known as Encephalitozoon cuniculi.  It's not true that few rabbits survive this, although if the bunny is not treated, the prognosis is poor.  But if your vet is not aware of the more current (and effective) treatments for E. cuniculi, then you should seek the advice of a vet who is:

www.rabbit.org/vets

I can't believe that NONE of the vets on that site will see her, unless they're closed.  You must insist on this, because this condition requires the help of a vet who is experienced with rabbits.  (I've never heard of a rabbit vet on that list who would refuse to see a rabbit as a patient; not sure what you mean by this.)

If she has E. cuniculi, this would explain not only her head tilt, but also her inability to walk.  And if the vet says you caught it early, the treatment with Panacur (fenbendazole) and/or ponazuril (preferably both!) must be begun at once for best results.  I cannot recall what medications you said Cookie is now taking, but if it's only antibiotics, then that's not going to help with E. cuniculi.

If she is urinating and drinking excessively, and the urine is very dilute, then it is possible that the parasite has caused kidney damage (E. cuniculi sets up shop not only in the central nervous system (brain and spinal cord), but also in the kidneys, where it can do significant damage).  

Do not expect her to regain the use of her legs quickly.  This can take weeks of treatment and physical therapy.  If you have not read this, READ THIS NOW:

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

I am sort of getting the sense that you have not read the articles I sent you, and if you don't, then you will not get the answers you need.  PLEASE read those articles.  These are also important:

http://www.rabbit.org/journal/3-2/e-cuniculi.html

http://www.eid.ac.cn/MirrorResources/8230/treatment.shtml.1.html

I hope this helps. But now you have some reading to do, so that you can be the best possible advocate for Cookie.

Dana


Cookie's best chance of surviving and getting better is if YOU educate yourself about her condition so that you will know what to ask the vet.  If possible, bring printed versions of the articles above to the vet, and leave them with him/her to read, if s/he is willing.  This is too important to leave to chance.