# wet butt and light spot inside eye, Possible EC



## SnowyShiloh (Dec 14, 2009)

I'm quite worried about Skyler. For reference, he is an almost 2 year old neutered male Dutch bunny. He lives indoors. His food is Zupreem Nature's Promise timothy pellets (about 2 tablespoons per day), unlimited timothy hay and veggies about 3 times per week. He's been acting fine and his litterbox skills are the same as normal. His poop is fine. His pee smells the same as always. He's as hungry as ever. Weight is normal. Is that enough background info?

About 3 months ago he had a UTI. I noticed he was drinking more water than normal, peeing outside his litter box, and his butt was wet. He was on Baytril for 2 weeks and got better! Stopped peeing in the wrong places and his butt got dry, an his water intake went down.

Tonight I picked him up out of his cage, and his butt is wet again. Oy. He had a bath because I didn't want his skin to be burned. The bath was traumatic for him. He went into a daze/trance and would alternate between fighting mightily with his heart racing, and being completely blank eyed and limp. It was scary! I had to forge on though because he still had soap on his butt and I didn't want it to hurt his skin/make him sick from licking it. The good news is that once I put him down, he started acting normally again. I cleaned his litter boxes and put his litter box grates in the boxes, which keep him from sitting right on the litter. I'd taken them out because they were originally in there to prevent digging in the litter, but he stopped digging and had taken to pulling the grates out and flinging them around the cage.

So, that right there warrants a vet visit ASAP to me. I found something possibly even scarier on him though. One of his eyes has a lighter spot in it. It's in the pupil, right on the edge to the iris. It's a lighter brown and in the eye rather than on it. I'd get a photo, but I don't know if it will show up on my camera and he's had a traumatic enough night as is.

Gosh, am I worried about him. UTI and eye thing. What does the eye thing mean? Cancer? Tumor? Cataracts? 

Of course this is finals week at school, and I'm going to be out of town for an entire month starting December 23rd. If he's really sick, I'm going to cancel the trip, which will not make my family happy (do they give refunds for tickets this late?), but I couldn't forgive myself if he got sicker or died while I was gone. Paul will be here to take care of him, but still.


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## tonyshuman (Dec 14, 2009)

Hi, I would make a vet appt soon, especially because you're leaving town soon. 

Here is a pic of an eye with a corneal ulcer:
http://www.medirabbit.com/EN/Eye_diseases/Differential/Corneal_ulcers.htm

This is a condition I think I've seen in some rabbits at the shelter, it doesn't really have a treatment and isn't painful:
http://www.medirabbit.com/EN/Eye_diseases/Disorder/Lipidosis_cornea.pdf

This is a disease where part of the eye grows over the iris: http://www.medirabbit.com/EN/Eye_diseases/Disorder/pseudopterygium.PDF

And this shows a healed corneal abrasion scar: http://www.medirabbit.com/EN/Eye_diseases/Disorder/Corneal_ulcers.pdf

I have seen white things in the eyes before, like discolorations on the iris, in healthy, recently vet-checked bunnies at the shelter. The fact that it hasn't been there before to me means it needs a look before I say don't worry about it.

I kind of worry a bit about EC. The reason is this persistent issues with the urinary tract, plus it can have neurological signs. IF the vet mentions EC, make sure you get him on one of the newer antiparasitics. Marquis (ponazuril) is what Randy has had success with. The older drugs don't work as well, and many of them have names that end in -bendazole, or -azole.

It might help if you look at those pics and see if they look like Skyler's eye.


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## SnowyShiloh (Dec 14, 2009)

Thanks for the reply, Claire! I looked through the Library section on eyes last night after posting here. Of the things you posted, it kind of looks like the lipidosis, but the picture isn't that great. He's fed a good diet though, the thing is light brown, and it isn't raised. I looked at it again, and a good way to imagine what it looks like is those glass marbles that are clear or some other see through color but have a more solid color swirled inside them. You can see the solid color inside. Does that make sense? And it isn't just a dot in his eye, there's a dot a millimeter or two across on the edge between his pupil and iris, then it has a "tail" that kind of goes around the inside edge of the iris, making the edge of the pupil look irregular.

I'm quite certain this won't show up in any photo because you need a good light to see it and his eyeball is shiny already. 

Either way, I made an appointment for him tomorrow at 4:30. It's with a new vet at a different clinic than he usually goes to, I'd heard good things about her from another bunny person but she left town for a couple years and has recently moved back!


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## tonyshuman (Dec 14, 2009)

Glad you got an appt with a vet that may be better! I have seen stuff like you're describing before. It sounds a lot like what a few shelter bunnies have had. They didn't have any special medical notes about it, so it may just be nothing, but like I said, the fact that it's just shown up means it should be checked out. Good luck at the vet!

edit: I did some more internet digging (opthamology is NOT for me! Yuck!) and found this picture 





at http://www.fecava.org/files/ejcap/EJCAP 17-3 p242-252 Rabbit and rodent ophthalmology.pdf.pdf
WARNING DO NOT LOOK AT LINK IF YOU ARE SQUEAMISH
there are a lot of very VERY gross pics of rodent and rabbit eyes: this one is about the least disturbing of them all!

So I wonder if it's EC... Not a good sign of course, but it could be the lipidosis too.
:?:nerves1

If it is EC, though, we'll make sure your vet hears the latest treatments!


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## SnowyShiloh (Dec 14, 2009)

Uh oh Claire, that looks like it. That looks like a more advanced version of it though. Will my boy be ok?? 

Thanks for looking through the photos, I tried too and did a GIS of corneal lipidosis but in the first page didn't see anything that looked right- just things that looked horrifying.

Worry worry. Time to read up on EC.


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## SnowyShiloh (Dec 14, 2009)

Claire, I feel like barfing. EC can cause renal failure too, which I'd imagine could be showing itself as his urinary problems. The last vet cultured his pee though and said it had some bacteria in it that would cause a UTI. EC is one of those things that most bunnies have in them, right? Are my other babies at risk?? Should I call the vet and tell her about EC before our appointment? I'm going to print out some stuff to bring tomorrow. Where to start..


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## SnowyShiloh (Dec 14, 2009)

I should add that Skyler has also lost weight. He was a bit overweight before and I was slowly cutting back on his pellets. The vet last time said he felt like a healthy weight (I don't think he's lost anymore since then), so I really hope the weight loss is the result of his diet change rather than another sign of EC.


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## tonyshuman (Dec 14, 2009)

Don't worry, EC can be treated or at least managed. I'll try to get Randy's attention to this thread as he has had some success with a different antiparasitic drug than is typically used for EC, called Marquis (ponazuril). I too was worried when I saw pee issues and also eye isues. Urinary issues are one of the earlier signs of EC. However, the fact that I've seen it on healthy shelter rabbits may mean that it's nothing. 

I would bring any previous vet info that you have. It is possible that he just has a very nasty urinary bacteria that won't go away, and the eye thing is unrelated. 

Randy will probably be able to comment on the eye thing, whether he's seen it in bunnies with EC and at what stage of the disease he's seen it in. It's possible that they only see this in later stages, after other neurological issues set in, which would say to me that this is something else. He may also know whether it is worth it to have an EC titer done as well.

I know you got Skyler from RAL Rabbitry. I have seen some rabbitries that say they have no EC in their stock--particularly rabbitries that supply lab animals--verified by EC titer. I don't know how big an operation she has or if she's ever checked to see if there's EC in her barn. It's usually safe to assume that he has been exposed to it, but there are the rare rabbitries that say they don't have EC in their population.

Hang on--we'll figure out what it is, and get it taken care of! :bouquet:


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## SnowyShiloh (Dec 14, 2009)

Claire, I was thinking about Jesse too. If he does have it, I'd guess he got it from there. I'm not "blaming" her AT ALL since I know tons of bunnies have it, I'm just hoping her bunnies are all okay!!

Since EC is behind so many bad things, does this mean he will get those bad things? Will he have neurological problems and get paralyzed eventually? Is he more susceptible to head tilt now? How long can bunnies with EC live? Will he be happy? He seems like his normal happy self so far. He's a sweet boy and doesn't deserve this.

Claire, thanks for being such a big help so far! I really appreciate it.


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## ra7751 (Dec 14, 2009)

See if there is any way you can get a picture of the eye. Could be an ulcer....I have an excellent treatment for those that few vets are aware of. But I have to consider EC here. Lipidosis is a symptom of EC. It will sometimes look like a snowstorm in the pupil....and it will start filling in the pupil as EC progresses. I would certainly run a full CBC with EC titer....and there are only a few labs that can titer EC. The titer will be positive since all domestic rabbits have been exposed but it's the interpretation of the findings plus follow up titers in a few weeks. I would also ask for a full urinalysis....a cytology at a minimum. And if your vet has access to Ponazuril....it would certainly be advisable to start on that drug.

I will tell you that not many vets have ever encountered areal case of EC. Might not be able to interpret the titer labs and probably would want to use one the "bendazoles"....which have traditionally been the most common treatment...but mostly ineffective. And whatever is done.....DO NOT give any steroids as some vets are prone to do. If this is EC, you don't need to do anything to bring down the immune system. I am always available to discuss EC treatments with vets if they are willing....they just need to know that I am not a vet.

But don't get too upset before you get a diagnosis....might be something quite simple to deal with.

Randy


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## tonyshuman (Dec 14, 2009)

If it's EC, you've gotten it pretty early in the process. He may be more susceptible to infections, or have paralysis and other neurological symptoms. However, aggressive treatment with antiparasitics (like Marquis) may control the parasite. I know when we think about EC, it's all sadness and heartbreak and terrible stories. I don't think that's always the case. Long-term treatment with strong, new drugs seems to have much better success than they used to have with the -azole compounds. Some bunnies even did get treated with the -azoles back in the day.


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## tonyshuman (Dec 14, 2009)

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

(thanks Randy!)


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## SnowyShiloh (Dec 14, 2009)

Thanks for replying, Randy! Here, I got a decent photo of the eye. It took a while!






The light brown thing is the main spot. If you look, you can see that the border between the iris and pupil is pretty "clean" except for the lower right side, where the light brown dot has kind of a tail making the border look ragged. It's all in the eye, the surface of his eye is perfectly smooth.

What do you think of the picture, Randy? And Claire does it look like what you've seen?

I will pass on everything you said to the vet tomorrow, Randy. I've only worked with this vet once before, but she was very nice. My friend works with her on a weekly basis (she has a rat rescue) and said this vet is very open to new treatments and always goes home to research stuff. This vet has also worked with a rabbit rescue and spayed over 200 girl bunnies so she knows some about rabbits too.

Edited to say that most of the weird lines on his eye are just glare. The only part of his eye that looks different is the brown spot and the area beneath/to the right side of it.


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## ra7751 (Dec 14, 2009)

I have seen that before....it's inside the pupil and it most likely will continue to grow and will most likely involve the other eye too. That is usually a sign of EC. Keep in mind that looking ata picture is much different than actually seeing it....so don't jump to conclusions before your vet can do a PE. But I would certainly do the tests I mentioned.....CBC w/EC titer and a urinalysis. Keep a very close watch on the left rear leg for any signs of a neuro marker. The earliest presentations of EC are urinary incontenance and avery slight paresis in the left rear leg. Sometimes it may appear that the leg is being stretched or they forget how to use that leg and it drags....and it may be very slight. And push the hydration. If it is EC, being able to administer fluids sub-q will be very important in supporting the renal system. If you don't know how, have your vet teach you. And I can teach you our push method once you master the needles.....pushing is much quicker and less stressful.

If this is EC, I agree with Claire that you have probably caught it early. Even if the tests are indeterminate, I would highly suggest starting on a full round of Ponazuril. It's a fairly inert drug in the overall picture so it won't hurt. Might even add some Panacur in there for good measure.

Randy


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## tonyshuman (Dec 14, 2009)

It's hard to tell. It looks like it's in the pupil and the uvea (the colored part of the eye), and like it's more in the eye itself, rather than on the surface like a corneal ulcer would be. The vet can stain the eye with a dye to make sure it's not an ulcer, but I agree that you should have an EC titer done if possible, and look into ponazuril. Thanks for the pic. It really doesn't look as bad as the ones I've seen online, but it does look more like the lipidosis/EC thing.

I seem to remember the shelter rabbits having more of a discoloration in the uvea itself--the colored part, like part of their uvea lost pigment or never had pigment there. I don't remember there being white on the pupil itself. However it's been a few weeks since I looked in depth at one.


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## SnowyShiloh (Dec 14, 2009)

Thanks so much, you two. Now it's all I see when I look at his eye, I can't believe I didn't see it before! How quickly do they grow? Will he go blind? If he does have EC, how long will he live? I wish we could go to the vet tonight. 

I will write down all those things you said to have done, Randy, and print out some info to bring along. I will be keeping a really close eye on that left leg too.


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## SnowyShiloh (Dec 14, 2009)

My brain has been so full of this EC talk that it took a while for me to make the connection. Rory had urinary incontinence at the same time as Skyler. His went away with Baytril (he was treated for a UTI). Do you think Rory really had a UTI or is he showing the same EC symptoms, just earlier on than Skyler? Should I take him to the vet too or do I just need to wait? He got better with the Baytril and has only had 1 pee incident, about a week ago.


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## ra7751 (Dec 14, 2009)

I would wait and see what the diag is. The thing with EC is that many vets will misdiagnose it as a UTI. They will start Baytril and it seems to resolve. But it's not the drug, it's the immune system making a counter attack. Baytril isn't very effective against most bacteria these days....and UTIs and LRIs are particularly difficult to treat. Most exotic focus vets have abandoned Baytril as there are numerous abx that are safe and more effective.

Randy


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## SnowyShiloh (Dec 14, 2009)

Randy, thanks! Should I keep my eyes peeled in case Rory shows the same symptoms as Skyler?

Also, what is the eye thing called? Will Skyler go blind? How definitive of a diagnosis can I expect from the vet tomorrow? I'm supposed to be out of the state from December 23 until January 21st. Should I cancel my trip? My fiance was going to take care of the bunnies while I'm gone, but I'm afraid this could be too much for him.


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## tonyshuman (Dec 15, 2009)

I think since it appears to be early, he may not lose vision, etc.

Certainly watch Rory, but often another disease can cause EC to turn into an active infection. The stress on their system reduces their ability to keep EC in check, and leads to an active case.

The vet can take blood for an EC titer, which will take probably a week to get back. I don't know where the nearest EC testing facility is for you; He can start Skyler on ponazuril right away, if he has it, and that should be pretty simple to administer as I think it is oral. I wouldn't cancel your trip yet. I think the vet would want to treat for at least 2 weeks before taking another EC titer to see if the treatment is helping.


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## tonyshuman (Dec 15, 2009)

The best place to look for a veterinary diagnostic lab is at a vet school, and there aren't any in AK! Nearest state with a vet school is WA. That doesn't necessarily mean nobody in AK does the EC titer. Your vet should know who to send it to. It may take longer since it may have to go out-of-state.

PS Do you have insurance? It might be good, although a bit suspicious to get it...


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## SnowyShiloh (Dec 15, 2009)

Claire, I don't have bunny health insurance. It would be nice though! I can't stop thinking about poor Skyler. He got a new toy today and has had a very happy day with lots of cuddles and play time. 

I hope we can get this figured out soon. I wonder how they send the blood for titers? Does it matter if the samples freeze? It's well below 0 here so I can't imagine the sample won't freeze.

I talked to my mom on the phone, she's the one who got my plane ticket with frequent flyer miles. She understands how much I love the bunnies and is going to look into changing my plane ticket so I'll only be in Washington for a few days and not go to Louisiana to see my dad at all.


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## mouse_chalk (Dec 15, 2009)

I've just read all of this Shiloh. Obviously I can't add to Claire and Randy's knowledge but I just wanted to say good luck at the vets and I'll be thinking of you and little Skyler.

:hug:


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## Luvr of Wabbits and Polar Bears (Dec 15, 2009)

*tonyshuman wrote: *


> The best place to look for a veterinary diagnostic lab is at a vet school, and there aren't any in AK! Nearest state with a vet school is WA.


Since she is in AK, rather sending sending it across Canada to the US it would likely get sent to U of S vet college(University of Saskatchewan) assuming they do it. 

ray: that your boys get over what they have fast


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## tonyshuman (Dec 15, 2009)

I would assume that most vet schools have the ability to do the titer, so it probably will be U of S, although there may be some issues with shipping biologics across borders. They can probably put the sample in an insulated cooler to keep it from getting too cold; I'm not sure on the specifics, but yes the blood shouldn't be frozen.

Best of luck at the vet today. I understand that you don't want to be away from him for too long. If you can get vet insurance on such short notice, I would recommend it. The titer itself is about $100 here, and urinalysis is also expensive.


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## SnowyShiloh (Dec 15, 2009)

Just wanted to stop in really quickly to say we're leaving now!


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## tonyshuman (Dec 15, 2009)

fingers crossed!


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## SnowyShiloh (Dec 16, 2009)

We just got home. The vet confirmed that it looks like EC to her. I decided to wait until she'd examined him before telling her about what you guys (Claire and Randy) thought it was, and before I could tell her, she told me she thought it was a parasite called E. cuniculi. You can imagine how upset I am about this, but I'm glad we have a good vet who knows what she's doing. All the tests she decided to do on him are the ones that Randy said she should do. We did a blood test on him today, but his bladder was empty so he has to go in again tomorrow. We decided not to do the titer for now because they're so darn expensive and she said the results wouldn't affect how she treats him. She wants to have a test done on him that will see if he has gallstones and measure something with his kidneys (sorry I forgot what it was called) but I think she said we'd do that in a couple weeks depending on the results of his blood tests. Sorry I don't remember exactly what she said, my head is spinning.

The good thing is that she said his kidneys felt fine when she palpated them. She looked in his eye and said it's a glaucomena uveitis or something, and that it looked like his retina was attached to the front of his eye or something. Sorry, I'll ask her tomorrow again what it was. His other eye looks clear so far. She said his vision is already reduced in the bad eye.

As far as peeing on himself goes, she thinks it's the beginning of paresis and that he's peeing on himself because he isn't sitting properly when he goes. The urine test will show if he has a UTI though.

On top of everything else, the poor guy's stomach was excessively full and his abdomen was firmer than it should be. I noticed that when I picked him up to go to the vet. She thinks it may be because yesterday I fed him a dried apricot half as well as a piece of pear and said it would be better not to feed him fruit or carrots anymore. Is this gut thing related to the EC or unrelated? The good thing is his poop is fine.

He was acting rather lethargic at the vet. Very still and tranced easily, his heartrate and breathing were normal. He's more active at home thankfully. It could be because his stomach hurts, or because he was stressed, or she said it could be because of the EC.

I think I covered everything. She's going to look into the Ponazuril and will get us started on Panacur. Randy, she read what you wrote (I printed it out) and agrees with everything who said. 

Again, I'm glad I have this forum to help me, as well as a vet who I can trust to help guide Skyler and I through this illness. She said we will pretty much be working to support his quality of life now rather than trying to make him better, because of course that isn't possible. We should have a better idea of how long he will live when the results of his tests come back.

I'm so very sad about my boy and can't believe this is happening to him. No bunny deserves something like this, but he's so young and such a lovely little baby.


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## ra7751 (Dec 16, 2009)

The kidney test she is referring to is the BUN (Blood Urea Nitrogen). A high value represents a decrease in the efficiency of the kidneys in removing toxins. I would discuss your husbandry protocols with your vet to find a diet that is as low in proteins as possible but still potent enough to maintain overall body conditioning. Hydration is essential....as I mentioned, learn how and when to do sub-q fluids. This will help support the kidneys.

EC rabbits are also quite prone to bacterial infections. These infections are due to the stress to the immune system caused by the EC. The immune system will see the EC as the primary threat and will make that the center of attack. That leaves those lurking opportunistic bacteria such as Pasteurella, Staph and Pseudomonas (the most common) to make appearances. These infections will not respond to old school drugs such as Sulfa or Baytril. And you will have to be aggressive in attacking these roving infections. Head tilt is a common issue blamed on EC....but it's not the EC, it's the compromised immune system allowing a bacterial infection in the ear.

And I know you won't miss this one....but old fashioned TLC means a lot. Yoda, one of our long term EC rabbits, lived over two years with active EC and in severe renal failure....and we were able to give him a high quality of life. And now we have an even more effective drug....and I personally know so much more about this affliction and how to respond to it.

Will be very interested in your next visit to see what the BUN levels are. And if your vet needs any info that she can't find...I will be happy to talk with her....but she sounds like she is on top of her game.

Randy


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## tonyshuman (Dec 16, 2009)

Oh Shiloh, I wish I could give you a hug! This is really sad. I know how special Skyler is to you, and I remember how he stood out from all his littermates!

I think he'll have a very good life with you. This vet sounds like just the type that will be able to help you a lot. He may be sick, but I know he has many happy days ahead of him. Please don't worry; there will be bad days and good days, but I think there will be many more good than bad and he will still be very happy to live with you.

There are lots of people here who have experience with this disease and other things that come with "special needs." Things like beddings to absorb urine, things to put on his skin to keep him comfy, and things you can do to help with mobility like massage. It's not going to be easy, but we are here for you. :bunnybutt::hug2:


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## SnowyShiloh (Dec 16, 2009)

Thanks for the information and encouragement, Randy and Claire. I would have been a complete mess at the vet office today if the EC diagnosis had come without me having any idea. I have a friend who doesn't have any bunnies, but wants to get one someday and is great with animals. She has offered to help me with him in any way and is going to help me give him fluids when he starts to need them.

Do you guys have any ideas for how I can spoil him as much as possible? I think my bunnies already have pretty good lives, but I want to pull out all the stops for him, especially while his mobility and eyesight are still decent. I'm going to sew him a Christmas stocking and stitch his name on it later this week. I know he doesn't specifically care about having a stocking, it's more for me I guess, but we will stuff it with toys for him. I want to create lots of memories with him and get lots of cute pictures of him. 

My bunnies eventual deaths has always been at the front of my mind. I think and worry about it every day. I've had 2 previous bunnies die and did not handle their deaths well. My fiance actually didn't want me to get anymore rabbits ever after Tallulah died, but I convinced him that I love their lives more than I hate their deaths. If I had to pick between Skyler dying without warning let's say a year from now, and me knowing he was going to die young, I would probably pick the knowing. I certainly wish he didn't have to deteriorate like this beforehand, but at least this way I can start preparing for his death. I already have. Cinnabun died in my arms literally 2 minutes after I found him in his cage on morning, and he'd appeared healthy when I went to bed. Tallulah died one evening after we'd spent the afternoon at the vet. Both their deaths were pretty sudden, so it's really weird trying to get used to the idea of Skyler having something like this and that he won't be here in 5 years.

Sorry this was so long, I should probably post things like this in my bunny blog since they don't specifically have to do with his treatment.

What other bunnies on the forum have suffered from this? I read Pippi's thread, he didn't have the eye thing though.

Oh and something I forgot to mention in my previous post is that the vet said he doesn't have as much tone in his anal sphincter as she would have expected. He pooped on the couch tonight and the night before last, which he hasn't done since he was a baby.


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## JadeIcing (Dec 16, 2009)

I'm here if you need me I know the feelings that go through you. *hugs*


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## Maureen Las (Dec 16, 2009)

I'm really sorry about Skyler's diagnosis 

He may be able to do well with this illness for a long time with proper treatment and I am sure that he will get that from you 

I think a Christmas stocking is a nice idea for him 

:hug:
Maureen


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## naturestee (Dec 16, 2009)

:hug:


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## ra7751 (Dec 16, 2009)

It's not all gloom and doom. Caught early, this can be managed. I would urge your vet to get on the Ponazuril as quickly as possible. The Panacur has a problem in penetrating the blood/brain barrier.....and the brain is where the drugs need to be. Ponazuril does penetrate the barrier. I have had several rabbits with active EC. Yoda, who was one of the most spoiled rabbits in the world, lived a good life for a very long time after his infection initially presented. The keys to managing this condition are quickly bringing the parasite to a stalemate....the Ponazuril will help that. Lots of supportive care like you already do. Keeping a close watch for any secondary infections and treating them aggressively when they happen....and above all, support the renal system. The spores shed by the shedding protozoa causes pitting and scarring in the kidneys....keep that renal system flushed out. And remember you will see all sorts of horror stories and "treatments" for EC. I have seen them all.....stay with your vet and do clinically proven treatments. It will add to the quality and length of life. Let me know is I can help you or your vet with any treatment.

Randy


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## SnowyShiloh (Dec 16, 2009)

Little man and I are back from the vet again. He went to have urine drawn since his bladder was empty yesterday. We got the Panacur, he gets .3 mL once a day for 28 days. Randy, the vet said she's going to research the Ponazuril and then get back to me on Friday. She did a little research on it last night. I trust your judgment and want to use it, so if she's reluctant, perhaps you could e-mail her or something? 

She said we should have the results of the urinalysis sometime between tomorrow and Friday and the blood work by Friday. 

Rory peed a little bit outside his litter box again while we were gone. It's like he knows exactly what to do to worry me. I will be keeping an extra close eye on him in addition to Skyler.

Randy, your encouragement is really helpful. It's good to know he can still have a happy life. How much should the results of the blood test and urinalysis tell us?


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## tonyshuman (Dec 16, 2009)

Here's a review on Ponazuril, mostly what it has been used for and studied in. It appears to be safe in rabbits, and crosses the blood-brain barrier, but this paper doesn't say anything about its effectiveness in rabbits.

Ponazuril


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## tonyshuman (Dec 16, 2009)

This paper would probably be useful, although I haven't found a full copy of it yet. 

Exotic Mammal Renal Disease: Diagnosis and Treatment


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## tonyshuman (Dec 16, 2009)

The technical term for the eye issue is phacoclastic uveitis


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## tonyshuman (Dec 16, 2009)

There are a lot of articles recently published on EC in rabbits, although they focus mostly on diagnosis of the disease and I can't find any that mention ponazuril except for the one I posted the link to earlier. In addition, my school doesn't have subscriptions to all of the relevant journals so I can't read them all. I don't know if there have been systematic studies of ponazuril in bunnies with EC; however I did find info that treatment with the bendazoles is only about 50% effective, and I'm sure Randy can speak to the effectiveness of Ponazuril.


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## Luvr of Wabbits and Polar Bears (Dec 16, 2009)

SnowyShiloh wrote:


> What other bunnies on the forum have suffered from this? I read Pippi's thread, he didn't have the eye thing though.



My girl Monsters was diagnosed with EC we did the Pancur for 28 days. Didn't seem to help much at all. This all happened before I was active with the forum. She lived for just over a year.

Once/If Skyler becomes disabled I would talk to Arlette(screen name as well) who isnt active but knows a lot about taking care of disabled bunnies.


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## ra7751 (Dec 16, 2009)

Keep pushing for the Ponazuril. It is the best chance to "stalemate" the EC. And a blood test is like a crystal ball to what is going on inside. The main things we are worried about with EC are the kidneys...but also the liver, O2 levels and glucose. And I would suggest doing blood work on regular basis and chart the levels...and I mean on a real spread sheet to you can visually see what the critical levels are doing. You will also need to keep a close watch on the ears as they are the most prone to infections. Many people believe that EC causes head tilt....it doesn't. Ear infections (and trauma) cause head tilt. The most likely place the first secondary infection will present is in the ears.

And again I caution against doing too much "research" on this condition as there is so much misinformation even in well known publications. I have learned so much just by "hands on" experience and my work with exotics focus vets (I live near a major vet school). The school has one of the top equine programs in the country....and pretty much what works with a horse will work on a rabbit. Ponazuril is actually made for a condition called Equine Protozoal Myeloencephalitis (EPM) which is a protozoan infection that is closely related to EC. It's presentations in a horse are very similar to EC in rabbits. So if you do much research on this, you will get much better clinical information by researching the horse information....not so much the rabbits. Much of the rabbit information is just shy of folk tales.

But stay in contact with your vet and keep pushing to get that Ponazuril going. And I will be happy to consult with your vet either by e-mail or by phone (I think the time difference will make things work out that I can talk in my evening and her work day). Stay aggressive.

Randy


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## SnowyShiloh (Dec 17, 2009)

Randy, I will push for the Ponazuril. I will either call the vet this afternoon or wait until tomorrow (since she was going to call me then anyway). I think she will be very open to talking with you, and I can't tell you how thankful I am for your knowledge and willingness to help. Thank you also to Claire for looking up info and to everyone who has offered good wishes for him.

Bad news though. This evening when I got home from class, I checked him out and he had a tiny bit of green on his nostrils. I wiped it off and hoped it was just hay dust or something. It's now 4:30 in the morning, and he has more green. He doesn't have a snotty nose per se, but it's like when he had a URI last year. I suspect it's from the stress of going to the vet twice combined with the EC weakening his immune system. Does that sound like a fair assessment? What do we do now? Poor little guy can't catch a break. It's like once we heard "E. cuniculi" his body started tossing all kinds of bad stuff at him.

Sorry I didn't post in the thread earlier, I had 2 finals today and I have another one in 3 1/2 hours so I'm busy studying. I have been reading PMs and posts to this thread though.


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## SnowyShiloh (Dec 17, 2009)

It's too late for me to edit my previous post, but of course I'll be calling the vet about the runny nose this afternoon. My brain is mush from worry, extreme lack of sleep, and studying. The vet works in Fairbanks for 3 weeks of each month and California for 1 week of each month and I think she's leaving for California this weekend.


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## ra7751 (Dec 17, 2009)

I think you are on the right track....a combination of stress from the travel and the EC affecting the immune system. It's a bit pricey, but it works....ask your vet to start Zithromax. It has to be dosed at a higher amount than dogs or cats. Most vets don't know how valuable Zithromax is against Pasteurella (and many other pathogens). It does cause a bit of an upset GI for a few days. I would suggest you acquire a probiotic such as Bene Bac (availble in powder or paste) to support the pH in the gutand it can be found at many pet stores, vet clinics and many online vendors. I would also suggest looking up a company called Platinum Performance and purchase a product called BioSponge. It is very effective at containing enterotoxins from GI upset....and your vet might be interested since it can be used in other species especially parvo dogs. It binds the toxins from a bacteria called Clostridium. I can pretty much assure you that your vet has never heard of this product as it is a horse product.....but a rabbit gut and a horse are almost identical.....and this product really works.

Randy


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## tonyshuman (Dec 17, 2009)

He wasn't eating any green veggies at the time, was he? If not, it's probably time for the Zithromax.

I would also get some of the BioSponge--I bought some online not long ago to have on hand just in case. They sell a dog/cat version at www.entirelypets.com


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## SnowyShiloh (Dec 17, 2009)

I just got home from my last final exam. Incidentally, I stopped on the way home and bought a bunch of different green veggies and Skyler is chowing down right now. He didn't have any yesterday though that would have made him green. I'm thinking the green could be from his hay, my 100 pound bale just ran out so Paul bought one of the bags of Kaytee hay and it's fairly dusty. Maybe he has hay dust on his nose! Regardless, his nose is running either green or clear (if clear, with hay dust in it).

The vet clinic doesn't open until 3 pm today, 4 hours from now. I will call then. Zithromax is actually what cleared up his URI last year.


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## tonyshuman (Dec 17, 2009)

I've seen the hay dust get in the mucus too--I hope that's what it is. Glad Skyler's got a good appetite!


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## ra7751 (Dec 17, 2009)

As far as the BioSponge, I would suggest buying directly from Platinum Performance. It is much cheaper. I prefer the powder as it has more possibilities to administer. The powder can be mixed in a formula for hand feeding (for babies) and it can be spread directly on greens (as we do for older rabbits and squirrels). Here is a link to the site.

http://platinumperformance.com/animal/equine/products/productcategories/product.cfm?category_id=162

This might be a situation in which your vet might be willing to split the costs with you as even 4 pounds is a lot of BioSponge.....and the clinic can use this in any species that is presenting diarrhea due to a bacterial imbalance caused by Clostridium. Even though it's not labeled for humans, it should work with humans as the testing was done _in vitro _(not suggesting anyone actually take it).

This is a great product. We have had baby squirrels and rabbits come into rescue with "blow out diarrhea" and this stuff quickly resolves it. And that is really something special when you have GI compromised cottontails come it. We are sold on this product. We will be doing a presentation on it's use to the state wildlife symposium that is upcoming. I can't say enough good things about BioSponge.

Randy


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## Pipp (Dec 17, 2009)

Skyler is so lucky to be Shiloh's bunny. With her, the vet, Randy and Clair on the case, he couldn't be in better hands. 



sas ray:


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## mouse_chalk (Dec 17, 2009)

*Pipp wrote: *


> Skyler is so lucky to be Shiloh's bunny. With her, the vet, Randy and Clair on the case, he couldn't be in better hands.
> 
> 
> 
> sas ray:


I couldn't agree more.

Shiloh, I'm so sorry it was the news you'd been fearing. I am so glad that Skyler is with you though- I know he'll have the best care possible. It sounds like the vet you're with now is much better and I'm sure that between her and Randy, you'll have the best help possible for him.

You know where I am if you ever need to chat.

:hug: for you and adorable little Skyler, I'm thinking of you guys!


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## SnowyShiloh (Dec 18, 2009)

Aw thank you Pipp and Jen. It means a lot to me. Jen, we haven't chatted since like September because you never show up on my buddy list anymore! I wonder what's up with that?

Randy, I will definitely see about ordering the BioSponge and if the vet clinic would like some of it too. I'm going to get some Benebac and Critical Care too. I meant to pick some Critical Care up from the vet yesterday morning but I forgot to ask for it :disgust:

I feel like a terrible bunny mom because I didn't sleep for about 36 hours because of Skyler and studying and finals, and I finally got to sleep at noon today. I set the alarm for 3 so I could call the vet when they opened, but I completely slept through it and didn't wake up until 10 minutes ago (it's 7:30). Good thing they open at 8 am tomorrow. 

Something interesting has happened with Skyler though. As of right now as well as 7 1/2 hours ago right before I went to bed, his nose is clean. No sign of green or dampness. I will be monitoring it through the night. Could it be that the stress of the vet trip caused his nose to run a little, and the hay dust (he has about 3 pounds of hay in his cage, seriously) made the clear mucus look green? But now he's not stressed anymore so it went away? Tallulah used to look like she was crying and her nose would practically drip when we went to the vet because it stressed her out so badly, and Phoebe Mae's nose actually WAS dripping with very thin, clear fluid after the card ride home when she was a baby, but she didn't show any further signs of being sick and has actually only been to the vet once, the day after we got her for her health certificate to fly home with me.

What do you guys think? Is it the beginning of something bad and we should treat him with Zithromax even if his nose doesn't run again, or should we not treat him if he doesn't show anymore signs of it?


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## tonyshuman (Dec 18, 2009)

That hay thing makes sense. My guys noses run a bit when they're stressed (I just cut nails and that makes them run a bit). I think if there are no more signs, no worries for now.


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## SnowyShiloh (Dec 18, 2009)

Thanks for your input, Claire! I really hope that's what it is.

Can anyone recommend the book "When Your Rabbit Needs Special Care" by Lucile C. Moore and Kathy Smith? Here it is on amazon.com: http://www.amazon.com/dp/159580031X/?tag=skimlinks_replacement-20

I'm about to place a big order of bunny toys from the Bunny Bunch Boutique. The Bunny Bunch is a bunny rescue in California, the one my vet works with. I usually order from Busy Bunny but buying from the rescue helps get them money. I saw that they have Apple-Banana flavored Critical Care by Oxbow for sale. Would this be a good choice for Skyler or would the fruit in it be bad for him since the vet said not to give him fruit? I can't find the list of ingredients anywhere online. Is $12 a good price? It doesn't say what size the bag is on the website, but I'm going to assume it's the smaller bag.


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## ra7751 (Dec 18, 2009)

I would get your vet's opinion since she has had "hands on". With EC rabbits, I do tend to modify my rules on antibiotics since I know there will be infections. Normally I don't use antibiotics unless I have a confirmed bacterial infection. The rules change with EC rabbits. I will do "pre-emptive" strikes with antibiotics since I know what will happen. Not exactly the proper way to use antibiotics, but you have to do what you have to do. The thing with this is to use different antibiotics over time. I use a variety of drugs that I know act in different ways against most of the pathogens a rabbit usually presents. In addition to Zithromax, I have rotated drugs such as Zeniquin, Metronidazole, Penicillin, Convenia and Chloramphenicol. I have used Docycycline in a couple of instances with a bacteria called Peptostreptococcus. You notice that I didn't mention any sulfa drugs or Baytril since they are notvery effective and sulfa has been linked to some serious GI issues.Zeniquin is a flouroquinolone like Baytrilbut hasn't shown resistanceissues....yet. But I would let your vet make any decision on using antibiotics since she is there to actually see what is going on.

Randy


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## tonyshuman (Dec 18, 2009)

I know angieluv and TreasuredFriend like that book.

I don't know about the price for Critical Care, but I think it will be fine to feed him. It may have a bit of fruit or sugar in it, but they make it to sustain ill rabbits or rabbits that can't eat on their own, so it should be balanced enough in terms of carbs, proteins, and fibers to give to him. The reason the vet doesn't want him to have lots of fruit is the sugar.

Randy is right that the vet can best determine what's up with his nose.


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## ra7751 (Dec 18, 2009)

The Critical Care is good stuff....the only Oxbow product I use. It can be fed exclusively...it's that good. A good way to feed it and do some TLC is to mix it into a paste and spread it on a leaf of lettuce. Roll it up like a burrito and hand feed it. This is something I do with head tilt rabbits in teaching them orientation as they recover.

While it's OK to plan ahead...don't resign yourself to anything yet. I have seen rabbits go into remission....that is why I would really like to see that Ponazuril get in there quickly. Most of the changes you need to make in having a "special needs" is just common sense.

An alternative to Critical Care is American Pet Diner's "Critter Be Better". It is like a true probiotic food that comes in a powder and a pellet. This product actually contains more bacterial cultures than Critical Care. The powder form is quite course and somewhat difficult to mix....but it can be sprinkled on greens. I have not used the pellets since I only use it for baby cottontails.

Randy


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## SnowyShiloh (Dec 18, 2009)

Thanks, Randy. I will get the vet's opinion. Would you mind PMing me your e-mail address so I could pass it on to the vet this afternoon?

Also, my mom was able to get all her money except $150 back from the plane tickets! I will be staying here with Skyler the whole time and won't be spending Christmas with my family. I'm glad I will be able to be here for him.


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## SnowyShiloh (Dec 18, 2009)

The vet just called. She called well after the clinic closed for the day an stayed on the phone for a good 20 minutes. She said the blood work hasn't come back yet, but the results of the urinalysis show that he does NOT have a UTI (thank goodness), but his urine is diluted some. She is leaving for California tomorrow but will have the clinic fax her the blood work results, then she will call me. She gave me a list of things to watch for in Skyler and to call the clinic ASAP if I see them so they can call her.

As for the runny nose, she agrees that it was likely the stress combined with the hay dust and doesn't think we need to medicate him for it right now.

As for the ponazuril (which I'm finally pronouncing correctly), she has decided not to give it to him at this time. She said she has done extensive research on it (which I believe), looking at studies and talking to rabbit gurus and posting on vet forums, and she doesn't think it would be a good choice. She said that ponazuril affects a different kind of parasite than E. cuniculi and that it would be a reasonable treatment for coccidia (which is incidentally what Tallulah died from, would have loved to have ponazuril a year and a half ago!), but that none of the research she did/people she talked to showed it really helping rabbits with EC. She doesn't want to prescribe something that could hurt him. She said she's pretty adamant about not using this drug on him. Randy, I gave her your e-mail address. She's going to talk to a couple more people about it when she's in California. She wants to continue with the Panacur and put him on fenbendazole instead. She said if he starts getting worse, she will consider trying the ponazuril on him, and if she finds any evidence that satisfies her that it could be could for him, she will prescribe it. I can't change her mind on something like this or force her to prescribe something.


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## ra7751 (Dec 19, 2009)

That isn't good. Every vet should know that you have to treat this parasite in the brain. Panacur (which is Fenbendazole) doesn't cross the blood/brain barrier...Ponazuril does. And the parasite that Ponazuril is made to treat is almost identical parasite in horse known as EPM. And E Cuniculi is technically a coccidia. If you can get in touch with her, ask her to Google Dr. Dana (pronounced like Donna) Krempels....she is one of the heads of the Biology Department of University of Miami (FL). She also runs the House Rabbit Society in South Florida. She started using Ponazuril just after I did....and I think she has also run Ponazuril and Panacur together. Time is important since the damage is continuing in the brain. This is one of those situations in which most vets have not actually seen E Cuniculi and are relying on old outdated information....I have worked with several on working a protocol with Ponazuril. If there is any way you can get in touch with her....please have her contact either me or Dr. Krempels....I will even send her my personal phone number.....that is how important it is to attack this aggressively.

Randy


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## mistyjr (Dec 19, 2009)

Well, I hope Bun is a okay...


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## SnowyShiloh (Dec 19, 2009)

Randy, the vet office is closed now and she will be unreachable by me until she gets back in a week except for when she calls me with the test results.

This is such a toughie. Randy, I utterly respect you and want to do what you say is best. I also respect the vet and don't want to nag her about this since I really don't know much about rabbit health. She's been very patient with all my questions so far. I can't force her to e-mail you or call you or anything like that (


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## Maureen Las (Dec 19, 2009)

How is he doing? :?


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## SnowyShiloh (Dec 19, 2009)

He seems pretty normal so far. He hasn't peed on himself since he got a bath a few days ago and when he's out of his cage, he runs around like normal and hops up on the couch 20 times to cuddle with me. He loves the Panacur is enjoying being extra spoiled. I'm so glad he seems to be doing ok so far.


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## Maureen Las (Dec 19, 2009)

Yeh I'm glad that he is doing OK also 
Ihope that it continues


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## SnowyShiloh (Dec 20, 2009)

Rory is definitely going to the vet when she gets back in town. He's continuing to pee outside his litter box every couple of days. Please, please let him just have a UTI and not something worse!


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## Maureen Las (Dec 20, 2009)

ray:

Is his butt wet all the time or is he just peeing outside the box.?

:hug:

Maureen


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## SnowyShiloh (Dec 21, 2009)

Maureen, his butt isn't wet at all thankfully. He's just peeing outside the box sometimes. The urine today seems to have had a white tinge to it. I didn't actually see the wet spot right after he went, he peed while we were out (on unfinished wood that's on the shelves in his cage) and the spot was mostly dried/absorbed into the wood but it seemed to have a white cast to it. Just as a reminder, he had what was diagnosed as a UTI back about 4 months ago, the same time as Skyler, and was given Baytril. The vet (not the vet I'm using now) did not actually test his urine though. 

I SO hope it's just a coincidence that he's doing this again! Two active EC bunnies would be horrible and I would be so paranoid about the other 2 having it too. That would pretty much be my nightmare. I'm trying not to jump to conclusions, and it's probably just a UTI, but the mind can't help wandering...


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## Maureen Las (Dec 21, 2009)

My rabbits pee alot outside of their boxes. they either sit outside the box and eat the hay inside the box or are marking..it has always been their normal messy way of life.
it may be that you are really frightened and that you are looking at this really closely. 
it may not be anything serious right now 

the white marks from the urine are normal sediment. 

if his whole butt was wet that would be serious ( Gabriel had that when his kidneys failed) 

Iwouldn't overworry at this point.


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## SnowyShiloh (Dec 22, 2009)

We're still waiting for the results of Skyler's blood test.

The vet suggested that I shave the fur off his stomach and groin since he pees on it. His butt has been dry so far, but he's been peeing on his tummy and the fur is all hard. Poor guy. Paul doesn't want to let me use his hair clippers ("no bunny pubes on my clippers" :rollseyes) so is going to buy Skyler his own.

I may be dumb, but last night I realized his eye is worse than I thought. The pupil on his "bad" eye is much smaller than the one on his good eye. Like half the size. The thing has covered the perimeter of his pupil or else is keeping it from dilating/constricting. Poor baby.


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## Flashy (Dec 22, 2009)

Is it possible that Rory is acting that way because he senses your stress and is reacting to it?


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## SnowyShiloh (Dec 23, 2009)

Ooh Skyler has me worried. First of all, his water consumption is WAY down today. He normally drinks a good 2 cups of water every day (if not more) and he drank about 1/3rd cup today. Also he feels heavier than normal and his stomach feels firm. And finally, he has a runny nose. Most definitely calling the vet when they open in 6 hours. Our vet is still out of the state, but hopefully something can be done.

I'm going to give him a big salad here in a couple minutes to try to get some water in him.


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## SnowyShiloh (Dec 23, 2009)

I should probably say that the 1/3rd cup of water is over the past 12 hours while he normally drinks about 2 1/2 cups over 24 hours. His water consumption can vary from day to day, yesterday he drank a lot, but this amount is definitely very low. 

Right now he is devouring romaine lettuce soaked in water. Going to give him some thinly sliced celery and cucumber when he's done.


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## SnowyShiloh (Dec 23, 2009)

Skyler ate all his veggies. He seems to have his normal appetite, but tonight and last night he decided he doesn't like the Panacur anymore so I have to syringe it to him. Is it normal for bunnies to lose interest in medication (it's happened with Ned in the past and he was fine) or is it a sign of a decrease in appetite?

His nose has looked clean since he ate the veggies 3 hours ago. I wonder if he got something else in there. His nostrils were never damp, they had a little dark brown-green on them though.

I've seen him drinking from his water bottle but the level hasn't gone down noticeably.


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## Flashy (Dec 23, 2009)

Is it possible the water bottle is blocked?

I have buns go off of medication and I think it may be to do with it first of all being a novelty, and then it gets boring. How about with the panacur, put it on a leafy green (or his favourite food) and wrap it up so he thinks he is getting a yummy. That works well with mine for a whole variety of things (I find basil is good because it smells so strong, but only use it if you know he can have it).

How are you doing?


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## SnowyShiloh (Dec 23, 2009)

Tracy, his bottle isn't blocked. I checked. He does okay with the medicine when I syringe it into his mouth, so I'll probably stick with that method as long as it works. I will try the veggie approach if he decides he won't take it anymore! His little lips are so cute with the white medicine on it and he always wipes his mouth on my shirt.

I'm doing ok. Worried about my boy (and other bunnies) but trying to keep a good outlook. Me being freaked out and mopey won't help him any. Thanks for asking!


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## Flashy (Dec 23, 2009)

Yeh, I thought a bottle blockage might be too easy and obvious and also something you would have checked already, but I thought it was worth a shot. An option might be a bowl if you are worried about him being dehydrated, or want him to drink more. Also, you could try a plain water bowl and a bowl laced with something yummy to encourage more drinking.

It's good he takes it easily, that does help 

I'm glad you're doing ok. It's draining when you have ill bunnies, but you're doing all the right things and they couldn't be in better hands. You know where my PM box is if you need to talk or anything


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## tonyshuman (Dec 23, 2009)

Hope things are good today!


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## SnowyShiloh (Dec 23, 2009)

Whatever is going on with his nose isn't there today, and he has consumed more water but still not as much as normal. His tummy feels even bigger than before. 

I feel like the worst bunny mom ever. The vet opens at 8 am, and I decided to stay awake until 8 so I could call. I accidentally fell asleep at about 7:30 am and managed to sleep until a little after 5 pm  I called the vet as soon as I woke up and the receptionist said she would pass the info on to my vet who is still out of town. Of course the vet is closed tomorrow and Christmas and our vet (the only one who sees bunnies there) isn't even back in town for more than a week anyway. I think the clinic we used to take the bunnies to is closed tomorrow and on Christmas too. I hope my idiocy hasn't just cost Skyler his life or something since he isn't drinking properly and I won't be able to get him to a vet for more than 2 days.

Is giving subcutaneous fluids to rabbits the same as giving them to rats? I have a friend who has given fluids to her rats many times but never to a bunny. She has all the supplies and wants to help me give fluids to Skyler.


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## SnowyShiloh (Dec 23, 2009)

Okay, here's what's going on with Skyler. His skin is not tenting and he doesn't feel dehydrated. He drank about half a cup of water over the last 9 hours. He's eating and playing normally. My friend doesn't feel comfortable giving him fluids since he doesn't appear to be dehydrated, but she will give him fluids if he gets dehydrated (which I'm going to try to keep from happening!) or if the vet says we should.

I haven't heard back from his regular vet yet, but I'm not surprised since it's only been an hour and she's out of the state. She will probably call later tonight or tomorrow (she's a nice vet and calls outside of business hours). 

The plan is to give him simethicone drops, continue to push lots of hay, give him a water bowl in addition to the bottle, and continue to give him high water veggies like romaine, thinly sliced celery and cucumber. I may try some Pedialyte too. Does that sound like a decent plan?

I called the clinic I used to take the bunnies to, and they are open until 2 tomorrow! Bad thing is there are no vets in who are good with rabbits. She made me an appointment, but I'm pretty skeptical of bringing him to a vet who normally sees cats an dogs. It will likely be a pretty expensive vet visit too. Skyler gets freaked out going to the vet and I don't know if it's worth it. I would think she may prescribe gut motility drugs, but I don't want him having that. She may also give him fluids, but my friend knows how to do that anyway. I think it may be better to keep him at home and not haul him to see a vet who doesn't know about rabbits.

What do you guys think?


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## Maureen Las (Dec 24, 2009)

I would assess him in the morning. 
if he is retaining fluids that would be a signifcant problem

but the way that you last described him makes me feel that he can wait until the good vet can treat him..
you are doing most evrything a vet would do other than possibly add a newmedication.


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## tonyshuman (Dec 24, 2009)

I think your plan to keep him hydrated and have sub-q's if needed will work. It sounds like he drank plenty today, and I don't think going to the other vet would help much other than getting him some sub-q's--this is a pretty complex issue, the water retention/intake question, and I'd want a vet that's very up on their game and knows rabbits to handle it.

I think you're doing a great job encouraging him to drink, and checking for dehydration.


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## SnowyShiloh (Dec 24, 2009)

Great news! His tummy is back to normal. I wonder if the simethicone drops helped or if it' just a coincidence? He still isn't drinking much water even though I gave him a cup of water and Pedialyte. 

He's acting completely normal. He was out playing for about 3 hours and was binkying, taunting Rory, investigating the kitchen, getting excited when he thought I was going to give him treats, following me around. He pooped everywhere like normal too and they are of normal size and texture.

I will cancel the vet appointment when they open because I agree he would be better off with me at home. He seems to be doing ok so far.


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## Maureen Las (Dec 24, 2009)

That's great 

Merry Christmas Eve.


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## SnowyShiloh (Jan 3, 2010)

Thought I'd give this thread an update. I'm kind of in a holding pattern with Skyler. The vet doesn't return from her 2 week long trip until Monday. I still don't know what the results of his blood test were- I plan to call on Monday when the vet is there. 

Skyler's eye looks the same as it did and he's showing no signs of paresis, thank goodness. He's drinking more water than he was but still not as much as he was a couple weeks ago. He's acting cheery and spry as ever. Oh and he jumped out of my arms when I was giving him Panacur last night  He can be such a wiggly guy! This is the first time he's ever succeeded in getting away from me when I've held him, he fell about 3 1/2 feet and landed on his feet. He isn't acting injured, thank goodness!


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## Maureen Las (Jan 3, 2010)

Let us know what the lab results are when you get them. he sounds like he is doing a little better


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## tonyshuman (Jan 4, 2010)

It sounds like he's not letting this sickness get him down, which is a great attitude to have!


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## SnowyShiloh (Jan 6, 2010)

I talked to the vet for a good 45 minutes just now. She got the blood test results back when she was in California but had to wait to get home so she could consult all of her books and sources. She said his blood results look normal, EXCEPT for his liver values. His bilirubin levels are up to .9, while .75 is normal. His ALT levels are up to 120 when 79 is normal.

She said this could mean many things. She's thinking there's a good chance he has hepatic coccidiosis on top of EC. Tallulah died from coccidiosis a year and a half ago. She said the coccidia starts out in the blood stream then can move into the liver. So it could be hepatic coccidiosis and EC, or hepatic coccidiosis and some random eye problem, or EC and a bacterial infection of the liver, or some other liver disease like hepatic lipidosis. She said that hepatic coccidiosis usually hits bunnies hard and fast, and if he has it, it's mild so far but that it is a scary illness and often fatal. 

The plan is to take in a fecal sample. She's going to look at it under the microscope and send some off to a lab. She said they may not be able to find any coccidia in the poop but it doesn't mean it's not there. We're going to do another blood test in 2 weeks too. Randy, she said she will most likely treat him with Ponazuril if she thinks it's the hepatic coccidiosis.

Poor Skyler! He gets a double whammy of terrible. I'm happy he's still a happy, bouncy bunny and not acting sad. He's drinking more now too, which is a relief.

What do you guys think?


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## tonyshuman (Jan 6, 2010)

Oh gee, I hope it's not hepatic coccidiosis. I thought EC could also cause liver damage, did she mention that EC could be the reason the liver values look off?


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## SnowyShiloh (Jan 11, 2010)

Claire, I looked up EC too and it says it can cause liver damage... I will ask her about it tomorrow when we bring Rory in as well as the stool sample. I would just as soon NOT go around doing random testing on Skyler if it's unlikely he has what he's being tested for. I'm pretty sure she based the hepatic coccidiosis thing solely on the fact that he has elevated liver enzymes, but if elevated liver enzymes is normal for bunnies with EC, why would she think he could have hepatic coccidiosis? Does anyone else know about this?


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## AngelnSnuffy (Jan 11, 2010)

Here is a link from our library here on EC, hope it helps!:hug:

http://www.rabbitsonline.net/view_topic.php?id=14471&forum_id=10


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## tonyshuman (Jan 11, 2010)

I am not sure why she would think he had the coccidiosis. Has he had intestinal coccidia before? Maybe that was part of it. Also, it's possible that she would use a different treatment (rather than the typical panacur antiparasitic) for hepatic coccidiosis, and she would have wanted to add another medication if it's that. I don't know if a fecal test for coccida would tell you whether or not there is hepatic coccida, because I was under the assumption that hepatic coccidiosis stays in the liver and doesn't move to other organs, and all you can do to see if it's there is to do a liver biopsy. Also, if it's EC damage to the liver, there's not a whole lot more you can do than treat the EC.

Big hugs sent your way, hope you get some more answers.


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## SnowyShiloh (Jan 29, 2010)

I thought I should update this since I talked to the vet today. She is interested in doing a liver biopsy on him. She said it's done very frequently on cats and dogs, all they have to do is anesthetize the bunny, make a little slit, and cut off a little piece of his liver and test it. Does this sound like a reasonable thing to do? It sounds scary to me, but I would consent to it being done if it would be helpful. 

Skyler's doing great. The thing in his eye hasn't grown as far as I can tell. He's only peed on himself the once in the past month and a half. He's his regular happy, bouncy, hungry self and hasn't shown any health issues or signs of paresis or anything. I'm so glad that he's doing well so far!


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## Pipp (Jan 29, 2010)

I'd look into whether it would just be a whole lot safer and less stressful to simply try the Ponazuril first.

Find some other professional opinions and research and if warranted, present it to this vet with a firm request. 

I think this vet is reacting to recommendations about clear diagnostics when treating horses. I don't see that being a concern with rabbits, considering how tough EC diagnostics are. 

There are a LOT of rabbit experts pushing it these days and its had a few years of usage to verify basic safety. If it is hepatic coccida, the drug will definitely take care of it, and if its an effect of EC, the drug may possibly take care of it. 

Where's the downside here? 


sas :dunno:


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## tonyshuman (Jan 29, 2010)

I agree, Ponazuril would be the best course.

Perhaps the vet thinks if you treat with it and it's successful, you'll never know if there was hepatic coccidiosis there, and perhaps in the future you might treat the rabbit differently knowing it had the hepatic coccidiosis?


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## Maureen Las (Jan 29, 2010)

*Pipp wrote: *


> I'd look into whether it would just be a whole lot safer and less stressful to simply try the Ponazuril first.
> 
> Find some other professional opinions and research and if warranted, present it to this vet with a firm request.
> 
> ...




:yeahthat:I agree withsas and Claire re.the Ponazuril andI would not do the liver biopsy


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## SnowyShiloh (Jan 29, 2010)

The problem with the Ponazuril is that she HAS done a good deal of research on it, and has not found any evidence that convinces her it's a good thing to try on him. We've talked about Ponazuril several times and she's pretty adamant about not using it. She's talked to other rabbit experts as well and they agree with her. I simply cannot make the vet prescribe something that she doesn't want to prescribe- there's no way around it. If I could somehow get my hands on Ponazuril, I would give it to him and just not tell her, but that's pretty unlikely. Even if we went to the other clinic in town that sees rabbits and got them to prescribe it to him, our vet works closely with that clinic- she's there several times a week and actually used to work for them. I really doubt I'd be able to keep it "secret" and also don't want to damage the relationship with the only decent rabbit vet in a several hundred mile radius.

Good news is that his stool sample came back as negative for coccidia. When I went to pick up Rory and Phoebe Mae this afternoon, she said she wanted to see Skyler again in the middle of February to do another blood test, but didn't mention the liver biopsy (which she had talked about this morning before testing his poop). I'll call and ask if the results of the fecal test satisfied her.


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## Pipp (Jan 30, 2010)

This has probably been covered, but it's probable your vet is taking into consideration the high price of the drug and whether she can use the rest in her practice or maybe share with other vets, this seems to be a common occurrence. Supply companies seem to sell it in packages of four tubes at $200 each. Because its a horse prescription, she has to purchase a lot but will only use a minuscule amount needed for a rabbit.

I ran across a note from a Beagle breeder posted on a website asking people to not call her with inquiries about Ponazuril. She posted a link to a Beagle study for people to show their vets and said she couldn't share her prescriptions. The breeder also posted the URL for a drug company that will supply single tubes to Vets, here:

http://www.heartlandvetsupply.com/cart/product_info.php?products_id=750

This indicates resistance (or lack of knowledge on their part)may cost your Vet close to $1000 to get it. Ponazuril is great for hepatic coccidia, but the jury is still out on its effectiveness for EC. However, its safety has been tested and doesn't appear to be an issue. So it may be safe to try, but ultimately not worth the expense unless it is confirmed as coccidia. 

When your Vet checked with other rabbit vets, did she discuss sharing the drug and the costs with her? Safety? Did they say it wasn't safe? Wasn't effective? Or wasn't worth the financial gamble? 

Dana Krempel also lists the Heartland site as a source of Ponazuril here:

http://en.allexperts.com/q/Rabbits-703/2009/7/coccidia-rabbits-treating-ponazuril.htm

Here's some older dosing info:

http://en.allexperts.com/q/Rabbits-703/2009/1/Marquis-Ponazuril-dosage-2.htm

Hope this helps! 


sas :clover:


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## tonyshuman (Mar 25, 2010)

:bump:
How's Skyler doing lately?


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## Pipp (Apr 12, 2010)

Shiloh, what's the latest on your bunnies? :? 

Its been so long! 




sas :bump


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## Amy27 (Apr 17, 2010)

Any updates?


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