# Urgent; E. cuniculi?



## lnc1991 (Apr 11, 2014)

I have a male rabbit that is about one year old, and he is showing some very bad signs. I noticed that he hasn't moved much all day, has not had any water, and his eyes are sort of rolling back and forth constantly. I took him out of his cage to see what his movement was like, and he has very little balance, a head tilt, weak hind legs, and his head is shaky. He moved about three feet and laid back down and refused to move. Unfortunately, it is completely impossible for me to get to a rabbit-savvy vet, as I live in an extremely rural area. I have read about E. cuniculi before, and am reading about it now. I have called the vet and my area and it was confirmed that I probably need an anti-inflammatory and Panacur. I do have a Tractor Supply nearby, and they have those in stock. I realize that is not recommended to treat a rabbit myself, and to let a professional do as they are trained to do, but as previously stated, that is just not an option this weekend. Does anybody have any experience or advice on this? It is extremely upsetting to see him this way, and I would like to do anything I can to help him.


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## JBun (Apr 11, 2014)

It does seem like e. cuniculi is highly probable, though it's possible it could be something else. But all of the symptoms do match up. Panacur and metacam would be the two meds used to treat EC, though sometimes an antibiotic like baytril, is also given to cover the possibility of an infection being involved. Metacam is an anti inflammatory, and is really the safest one to use for rabbits, but it is rx so a vet would need to call in a prescription for you for a compounded suspension. For Panacur, the liquid fenbendazole is the best one to use as it is easier to get an accurate dosage with. You can get it as Safeguard goat wormer 10%. Dosage for fenbendazole for EC, 20mg/kg for at least 4 weeks, though sometimes a longer treatment period is needed. There is 100mg/ml in the 10% solution, so 0.2cc of the liquid would give you the 20mg/kg, or 0.09cc/lb.

Taking your rabbit to the vet is the best thing to do but I understand you are in a difficult situation. If you can, it would be best to double check all treatment and dosage info with your vet. I have also provided links with info about EC as well as medication and dosage info.

http://www.bio.miami.edu/hare/tilt.html
http://www.medirabbit.com/EN/Neurology/cuniculi/pyrimethamine.htm
http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm


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## majorv (Apr 11, 2014)

I agree with Jenny. We've used the liquid Safeguard goat wormer and for a Tan, which is between 4-5 lbs we gave .4cc. It seems to be pretty easy on their digestive system, too.


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## squidpop (Apr 12, 2014)

Since this sounds like an emergency situation... Would it be better to dose with injectable Ivermectin because it would act faster than the Panacur? The reason I ask is because I had a similar situation recently and vet used injectable ivermectin and it worked. This is what happened. 

When my baby 5 week old rabbit had symtoms of E.cuniculi, and I brought her to my vet she was completely floppy and could only move her ears and whiskers (I truly thought she was a goner) - my vet said- "We could get a test to see if its e. cuniculi but that would take days and this bunny wants to live!" Then he gave a shot of Ivermectin to kill the e.cuniculi (parasite) and a shot of Convenia (antibiotic) and a shot of a steroid. I left thinking.... all those injections into that tiny 350gm baby rabbit-- she's gonna die for sure  But she lived arty0002: She was wobbley but sitting up the next morning- and by the next evening 24 hours later she was back to normal. Its been a month and I've dosed her again with oral ivermectin and she is still fine. 

I later googled what my Veterinarian did and found Barbi Brown's web page on wry neck / e. cuniculi and if you read her "e. cuniculi treatment method" my vet did almost exactly what she recommends- http://www.barbibrownsbunnies.com/ecuniculi.htm 
---- Excerpt from Barbi Brown's rabbitry wry neck page-------
MY METHOD OF TREATMENT

I am convinced, based on my own experience, that Ivomec (a cattle wormer) is the key to stopping the migration of the parasite. Ivomec 1% injectable solution for cattle (given orally) paralyzes the parasite and stops the migration to the brain.

Ivomec 1% injectable solution for cattle given orally at the rate of 1/10cc per pound of body weight. Dosage repeated in 7 days. Then followed at 3 month intervals as a preventative. It is critical that the dose be repeated in 7 days at that appears to be the life cycle of the spore. We generally see improvement in the condition after the second dose of Ivomec.

Piperazine (pin worm medication) at the rate of 4 drops per pound given orally at the same time as the Ivomec. Repeat in 3 month intervals. This is to remove additional parasites that might compromise the immune system but does not effect the EC spores.

Steroid injection (Depo-Medrol, Cortisone or similar) at the outset in a single dose of 1/4cc per 5 pounds of body weight. This is only in cases of rabbits who are rolling. Repeated doses may compromise the immune system.

Antibiotic therapy to treat an obvious infectious condition that is suspected of being the original stressor. My drug of choice is Penicillin with Benzathene or Biomycin administered sub-cutaneously at the rate of 1/10 cc. per pound of body weight. This dosage is given every 48 hours for 3 days ONLY.

Probiotics are given if antibiotics are used.

THIS IS ONLY WHAT WORKS FOR ME AND IS OFFERED AS A GUIDELINE FOR YOU TO DISCUSS WITH YOUR VET AND USE UNDER THEIR SUPERVISION.


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## squidpop (Apr 12, 2014)

Also, all that info I posted about ivomec/ivermectin - I met for that to be discussed as an option with your vet when you get there monday- (don't think it would be good to dose on your own). 
and if your rabbit hasn't been drinking- it would be really good to syringe feed some electolytes, and maybe some mushy watery pellets to keep her digestive system going.


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## JBun (Apr 12, 2014)

Ivermectin should not be used for treating e. cuniculi., and is not an effective treatment Ivermectin isn't considered an effective treatment for e. cuniculi, for a few reasons. First, it doesn't pass the blood brain barrier(which you wouldn't want ivermectin to do anyways or it could be fatal), and the brain is one of the organs that the EC spores affect so you need a medication that can safely pass the blood brain barrier to get to the spores. Secondly, ivermectin works by essentially paralyzing the parasite. For this to occur, the parasite has to have a functioning neuromuscular system. E. cuniculi is a single cell organism with no functioning neuromuscular system, therefore will not be affected by ivermectin. Another consideration is giving ivermectin to a rabbit with a compromised central nervous system, that could possibly have a 'leaky' blood brain barrier because of inflammation. Because of ivermectins mode of action affecting the neuromuscular system, if it were to pass the blood brain barrier, it could be fatal. It is dangerous to be giving ivermectin to rabbits with neurological problems.

The only times that ivermectin may appear to work in a head tilt case, is if it is due to ear mites(a parasite affected by ivermectin), or if the rabbits own immune system fights off the infection and the rabbit gets better on its own, which does happen.

Squidpop, in the case of your rabbits improvement, it was more likely the antibiotic fighting off an infection, and/or the steroid reducing the dangerous inflammation, that helped with your rabbits recovery.


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## squidpop (Apr 13, 2014)

Respectfully, if that is true about the ivermectin, why was it successful in Barbi Brown's rabbitry? She still uses it today I emailed and asked her some questions about it. She said she has used it on 100s of rabbits.


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## squidpop (Apr 13, 2014)

Also, for the sake of sharing information- I found this study saying that ivermectin was found to be effective in treating two protazoal infections: giardiasis and cryptsporidiosis
http://www.ncbi.nlm.nih.gov/pubmed/8918027
So, seems that it would follow that it would also be effective in killing other protozoa as well. Also, I think in the case of panacur- it may be much safer but slower acting.


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## bellaterra214 (Apr 13, 2014)

If you have any doubts about treating your rabbit yourself, reach out to any vet in your area. If they only things you need to treat is the e. cuniculi, you should be able to get that treated at any vet office. The injections are all by body weight so any vet should be able to administer it. Ivermectin is used in lifestock (i.e. cattle, horses, sheep...etc) and it an anti-parasitic.


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## majorv (Apr 14, 2014)

Unless you've had the blood titer done to confirm there's an active infection of encephalitozoon cuniculi, then you don't really know for sure what is causing the head tilt. From what I've read there are differing opinions on the best treatment of head tilt/wry neck. One rabbitry claims that they used to use Ivomec as their first treatment and it didn't work as well as panacur, so they have gone back to using panacur. 

The standard treatment of e. cuniculi infections is still fenbendazole (panacur/safeguard). It can be given by itself and it is more forgiving if you dose too much. The only way to know for sure what is causing it is to have tests done. Ivermectin doesn't work on every parasite.


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