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Rabbits/ponazuril treatment for E.C.

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Hi Dr. Krempels,

One of the bunnies in our sanctuary is suffering from a case of E.C.  we took her to Specialized Care (veterinarian for exotic pets only) the blood test showed a 'moderate' amount of E.C.  I have no idea what a moderate amount is but she said it is not likely an acute attack.  We have started the bunny on the ponazuril.  How long would it normally take to see results?  I have seen nearly immediate results when treating for coccidiosis and I was wondering if the ponazuril actually kills the parasite?  Do the bunnies return to normal after treatment?  Although she is eating, drinking and pooping normally it is killing me to watch her try to get around.  She crawls rather than hops but every once in a while she loses her balance and flops over like a fish and she has a huge fit that looks like a seizure (although I know it is not she is just trying to get her balance).  Before her E.C. attack she had a chronic sneeze for over a year.  She has a deep nasal culture that showed nothing.  She was treated with Baytril and Zithromax and still sneezed.  She never had nasal discharge but we did not put her up for adoption because we did not want a new owner to have to worry about her health issues.  I read an article somewhere on a local HRS site that sometimes they use metacam with the ponazuril to reduce swelling.  

I guess my questions are:

1.  How long for ponazuril to show signs of improvement?
2.  How long will she need to take the ponazuril?
3.  What is the shelf life for compounded ponazuril (it is refrigerated)
4.  Is it possible for the sneezing to be related to the E.C. somehow?
5.  Is there any reason to believe that metacam may help?

I want to learn as much as I can about the bunnies so that I can get them proper care and treatment.  Had I not noticed the very subtle shaking of her head I may not have caught this illness as quickly as I did. Thank you so much for dedicating so much time to helping all bunnies.

Sincerely,

Angela

Answer
Dear Angela

1.  How long for ponazuril to show signs of improvement?

It's pretty much impossible to say.  If this is really E. cuniculi, and not, say, an inner ear infection, then it depends on whether the parasite has caused neurological damage (not generally reversible), or if the abnormal behavior is due to inflammation (will be helped by metacam, and possibly the ponazuril).

No one really knows if ponazuril or Panacur (fenbendazole) actually kills the parasites.  Ponazuril supposedly kills a very similar parasite in horses, but no research has been done on rabbits, to my knowledge.

2.  How long will she need to take the ponazuril?

This, too, is unknown.  If she improves and you take her off and then she gets worse, it could be a lifelong (if intermittent) thing.

3.  What is the shelf life for compounded ponazuril (it is refrigerated)

The Bayer site indicates that it is quite stable.  But there should be an expiration date on the tube.  (Most medications are good for long beyond their "official" expiration, though, with a few exceptions (e.g., metacam).

4.  Is it possible for the sneezing to be related to the E.C. somehow?

Not likely, but the "medium" titer for E. cuniculi could be a Red Herring.  Many rabbits have antibodies for the parasite, but do not show signs of illness from it.  Others may have the parasite and not have a significant titer, but no other pathology can explain their clinical signs (e.g., head tilt, hind limb paresis).

The sneezing *could* be indicative of an intracranial infection, though.  And that could be causing E. cuniculi-like signs.  It's very difficult to know for sure, especially with an inner ear infection that may not be visible even with an otoscope exam.

5.  Is there any reason to believe that metacam may help?

Yes, if the problems are partly due to inflammation.  The metacam will reduce this, and could help.

Unfortunately, we're still on the cutting edge of treatments for E. cuniculi, and most of what we know is anecdotal.  I hope your little gal gets better soon.

Dana

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Dana Krempels, Ph.D.

Expertise

I've lived with companion rabbits for more than 35 years, and consider them members of my family. I can answer any questions about the biology and health of rabbits, from the commonplace to the unusual. But please note:

RULE #1:
THE INTERNET IS NOT THE PLACE TO SEEK HELP IN AN EMERGENCY.

...it is an EMERGENCY.

Find a rabbit vet at www.rabbit.org/vet for immediate help, and don't risk your bunny's life by spending time asking questions online! If you can't get in touch with your vet, read these Emergency Sick Bunny Instructions.

If you have found a wild baby rabbit, please read these EMERGENCY INSTRUCTIONS FOR WILD BABY RABBITS and then use this link to FIND A LOCAL WILDLIFE REHABILITATOR who can give you the right advice.


RULE #2:
Help me help you! Please make your subject line informative if you have an urgent question. then LET ME KNOW IN THE SUBJECT LINE so I can give your question highest priority over non-urgent questions. If you don't do this, then I can't guarantee timely assistance!

For all the best, most accurate rabbit health, care and behavior information, visit The House Rabbit Society.

Experience

I have been rescuing and rehabilitating domestic and wild rabbits for about 30 years. I have written articles for many rabbit rescue publications, as well as for the veterinary journal, Exotic DVM. I own EtherBun, the internet's largest listserve dedicated to health, care, and behavior of domestic rabbits.

Organizations
Houserabbit Adoption, Rescue, and Education, Inc. (H.A.R.E., Inc.) president National House Rabbit Society (Board member)

Publications
Exotic DVM
Warren Peace (Journal of the House Rabbit Society of Miami)
Various newsletters of the House Rabbit Society, nationwide

Education/Credentials
Ph.D - Biology
B.S. - Biology
B.A. - English

Awards and Honors
Lightspan Academic Excellence Award for web site on rabbit health and biology
(http://www.bio.miami.edu/hare)

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