Feeling lost...

[Lindissima]

Hello everyone,

I don't know if I need to get advice or just vent...
I have read many posts on here and have received great information.

I live in Costa Rica... I feel like no one here knows anything about proper care for rabbit pets. Just to find quality pellets and hay is an hours drive away and I still don't consider these products to be the quality that she deserves. The closest vet is also an hours drive away and I don't have a car so I have to depend on others for a ride if I need to take her.

A little history:
I'm pretty sure she was taken from her mom at 3 weeks old... she was sooo tiny when we got her. It was a split second decision to get her.. my partner and I were looking to get some chickens so that we can have fresh eggs etc. When I saw her, I fell in love instantly... we left the shop and within an hour I had to go back and get her. I realize now that my decision wasn't very well thought out or researched beforehand and I really didn't know what I was getting myself into.

At about 2 months old, she started to have squishy cecotropes and was loosing weight rapidly.. I took her to the closest vet and they tested her feces and found a parasite. We treated her for it (with dog wormer) and it seemed to get better. Although she wasn't putting on much weight she was eating normally and acting happy. I learned a lot about rabbit diets in this time and adjusted to the best of my ability... like I said the food quality here is horrible and when I finally did find some pellets that were what I considered the best quality comparatively, its a scavenger hunt to find a place that has them in stock so I buy as many as i can at a time without them getting too old before she can eat them. Same with hay... I had to search everywhere for hay that wasn't just intended for livestock.

At about 4 months old, she started showing signs of digestive issues again and still was what I would consider underweight so we decided to take her back to the vet. Can I just say that the vets here have no idea what to do with a rabbit. The vet said to give her probiotics and see if that helped... it did a little bit and her poops went back to normal but she still wasn't gaining weight at all. Also, its tough to tell when they're young and growing whether they are underweight or just growing quickly. She seemed to be happy and enjoying life so I tried not to worry about it too much.

I went back to the states for about a month to visit my family and she stayed here with my partner. When I got back from the states, (she was about 6 months old at the time) I noticed that she had lesions in her eyes... one being way worse than the other. To the point that she couldn't really see out of the one. I asked my partner when it started and he said he never noticed. So back to the vet... this time I tried to find one that was more familiar with rabbits even though it was slightly further away. We got there and the first thing he did was reach inside the carrier and pull her out by her ears... I was livid. They don't see them as pets, they are livestock and no one takes their bunny to a vet around here... I live in the middle of nowhere in a small village. He looked at her eyes and said that there was pressure inside the eye that was pushing the tissue through her corneas. He gave me some steroid eyedrops and said to come back in a week if it was not better but that he had little hope for improvement. Nothing got better in that week and I researched everywhere to try to solve this myself since he seemed so incompetant and unsure. I read tons about E. Cuniculi and the pictures I was seeing of eye symptoms matched hers exactly. I had to pressure the vet to treat her for the parasite and the only thing he could come up with was Panacur for horses. He says that he adjusted the dose for an animal of her size so it should be fine.

She is currently on day 25 of the Panacur regiment.. her eyes have only gotten worse. I think she is totally blind in the one eye now and the other one is very cloudy.
Two nights ago, I noticed that she seemed to be walking funny.. like she was losing her balance or her legs weren't working quite right like she would trip. I have read about the symptoms of E. Cuniculi and know that leg paralysis is one of the things that can happen with EC so I became more worried and stressed out about it. The very next morning, her head was starting to tilt and I could tell she was feeling some vertigo. She was still eating some but not nearly as much as normal.

Today, when she tries to walk she ends up going in circles sometimes or tripping and falling. She has been shaking her head a lot and scratching at one of her ears (the down ear). It seems to really bother her if I touch it too much.

Now I have no clue what to do... I don't know if the head tilt is caused by the EC that she is attempting to fight off or if she now has an inner ear infection. I'm so scared to take her back to the same vet. I have searched and searched and found one animal hospital that claims to deal with exotic pets but it is a 5 hr bus ride there and 5 hr bus ride back because I don't have a car. I don't know if I should put her through the stress of a trip all the way there.. I am afraid it will weaken her immune system so that she cant fight the EC. I don't even know if they will have an answer or know what to do... especially if I need to make multiple trips there.

I feel so horrible... I feel like the worst bunny mom ever. I feel like this is somehow my fault for not doing good research before getting a bunny and making sure that there is a knowledgeable vet nearby that I can go to if I need to. I think she's probably had a better life than she would have if she would have been purchased for meat. The store we got her from was an agricultural place where they sell chickens, rabbits, ducks, etc. For farming and not for pets.

I feel so lost... every time I see her walking crooked or bump into something I just break down crying. I don't know if she's in pain but if she's not eating normally there's a good sign that she is. I feel so bad for her. I love her so much... I work from home so she cuddles with me all day and gives me ALL the kisses. Since the head tilt started she just sits in the corner or under the table and is hardly active at all.

I don't want to wait to act on this if it is an ear infection... but I'm scared that I know more than the vets do about rabbit care even being a first time rabbit owner and that the bus ride will be very stressful to get there.

Anyways, thanks for letting me vent. Its hard to deal with the difference in culture here. If I was still living in Seattle, there would be a great vet right down the street who knew what they were doing and plenty of great choices for food... but we are doing the best with what we have.

 

[JBun]

I think you're looking at an inner ear infection and not EC. Which means your rabbit needs to be put on a rabbit safe antibiotic immediately, today. Because of the severity, I would want the most effective and quickest acting antibiotic. And I've found that to be azithromycin. But be aware some rabbits digestion is sensitive to it, that could result in serious digestive upset. But the most I saw with my rabbits is some initial stomach cramping that subsided after a couple of hours and they went back to eating normally after that.

So this is what I would do. Continue with the panacur at the dose of 20mg/kg(might be a bit difficult knowing the dose when using the horse wormer). Start azithromycin suspension at 30-50mg/kg, once a day. Then a meloxicam suspension(NSAID) at 0.5-0.6mg/kg, twice a day, to reduce inflammation. This is usually what knowledgeable rabbit vets will do when the cause of the head tilt can't be determined to be an ear infection or EC. This way you're covering your bases with the antiparasitic, antibiotic, and anti inflammatory.

https://www.vgr1.com/metacam/
https://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
But with the head shaking and ear scratching, my opinion is that this isn't EC at all but a possible retrobulbar abscess that maybe started in the eyes and has now spread to the inner ear. If this is the case, you need to get those antibiotics going immediately and I would definitely do the azithromycin suspension, with it having the best chance of being the most effective quickly, as it is very good at penetrating tissue and bone, which some other common rabbit antibiotics aren't as good at. For my rabbits, I ended up having to do the highest 50mg/kg dose for a month, for it to completely clear up the infection. The lower 30mg/kg dose for 2-3 weeks was tried and the infection ended up coming back.

I would try calling your vet and ask them to call in a prescription of azithromycin suspension at a local pharmacy that you can pick up. If you have a walmart pharmacy, they may carry it. They do here in the US. The meloxicam, you may be able to pick up a suspension from your vet(Metacam), or if you have a compounding pharmacy, they can make up a liquid suspension from meloxicam pills.

You'll also need to make sure your bun continues to eat and drink enough, or you'll need to start syringe feeds. You can make a pellet mush with warm water and a use a large tip feeding syringe, or if you can get a hold of some Oxbow critical care for herbivores(maybe from a vet).

And don't beat yourself up. You're doing the best you can in difficult circumstances without access to reliable vet care. If you can get the azithromycin and meloxicam started today, I think you will see a drastic turn around in a couple of days, if the bacteria involved is sensitive to the azithromycin. If it isn't, then you may need to try a different antibiotic like penicillin g procaine/benzathine injections(injection only, never oral). But I think your best chance is with the azithromycin.

https://wabbitwiki.com/wiki/Medicating_your_rabbit
https://wabbitwiki.com/wiki/Head_tilt
GWexotics: E. cuniculi in rabbits

Medirabbit: ear infection clinical signs and treatment

E. cuniculi associated uveitis

 

[JBun]

Just to add, if this did start in the eyes and the eyes are permanently damaged, once the antibiotic starts taking affect and gets the infection and head tilt under control, at some point you may need to have a surgery done on your rabbits eyes and have them removed. With this you would need to find the best rabbit vet possible. I had to have a rabbits eye removed, and she did just fine. So your bun can still have a great life if this does have to be done. But the most important thing right now is getting that infection and inflammation knocked down.

If you want more of an opinion on your rabbits condition and what's going on, if you want to post a clear close up photo of the eyes, and a video(upload to youtube, etc, then share link here) of your rabbit walking, that may help give us more of an idea of what's going on.

 

[Lindissima]

Thank you so much for all of the information.. I'm looking into the medications you recommended now. I think I might be able to get that azithromycin suspension from the pharmacy without a prescription but they will not be open until Monday. There are no 24 hour pharmacies here and no Wal-Mart pharmacies.

I tried to get some phots but they're not super clear since its hard to get her to hold still. I will try again later to see if i can get a better one. I also added one so that you can see the tilt. Its not too extreme at the moment but I would hate to see it get worse. The eye with the worst lesion is her left eye... the one that is tilted down. This is also the same side that she has been sctartching at with the ear... her left ear.

 

[JBun]

The bad eye, have you noticed any bulging of the eye or maybe any lumps around the eye or ear base?

 

[Lindissima]

No.. it doesnt seem to be bulging or leaking at all... the white spot just continues to grow over time.

 

[Lindissima]

I did some research on the retrobulbar abscess that you mentioned... and I don't think this is the issue..
I could be wrong but the eyes dont seem to bother her at all other than loss of vision, there is no bulging or weeping, and they dont seem to cause her any pain.

 

[JBun]

It was looking like an infection, but now I'm not so sure it isn't EC instead. Looking at the eyes, it does look like it could be EC induced uveitis. I wonder if she's shaking her head and scratching at that side not because of an ear infection but because the eye itself hurts. That might also be causing her to have the slight head tilt and the circling, is from pain on that side, and not necessarily form EC neurological symptoms. But there's no way for you to know for sure, if it's definitely EC or an infection. An abscess behind the eyes and/or in the eyes, won't always cause bulging of the eyes, so infection is still possible.

I would still want to give antibiotics just in case there is an infection. And the meloxicam is going to be really important in bringing down the inflammation, whether it's an infection or EC. But if it is the eye that is causing pain, then that eye will need to be removed. So that's something you are going to have to seriously look into if things don't turn around with the meds.

But for now I would still start with the antibiotic and anti inflammatory as soon as that becomes possible. Maybe also an antibiotic eye drop(ciprofloxacin, gentamycin, neo/poly, etc) in case there is infection in the eye. Then it's covered with abx two ways. Then just see how that goes. Who knows. Maybe there is an underlying infection and you'll start to see real improvement after the meds are started. And maybe the eye won't end up needing removing. I think those meds are still your best path forward at finding a possible solution in your current difficult circumstances.

 

[Lindissima]

Thanks again for all of your advice... Im going to go first thing on Monday and try to get these things... (fingers crossed I don't need a prescription or appt). I will call the vet first to see if he can help me to 'call it in' or whatever he needs to do to get them. I don't know why he never mentioned the meloxicam before... I asked about anti inflammatory meds but he said it wasn't necessary.

I'm a little afraid to calculate dosage myself but I think I can manage with the links that you sent me. She weighs 1.34 kg. I think I will try this for a week or two and monitor symptoms... if there's no improvement or if it gets worse I will seriously consider the long bus trip to the animal hospital in the city. Maybe in the meantime I can try to figure out a ride.

 

[john.thorpe1952]

I cannot add anything to the advice,because those already helping you are absolutely wonderful and more experienced with the medications than I am.I just had to say how much we all admire you for the help you're giving this little soul,and please don't beat yourself up because in incredibly difficult circumstances you are doing a heroic job which quite frankly,most of us would not know where to start in terms of our practical options. You are a heroine to this little animal and regardless of the outcome,you have nthing to reproach yourself for- if there were more people like you in the world it would not be in the mess it's in now!

 

[JBun]

Once you get the meds, if you want to post here what their concentrations are(mg/per ml) then I can share what I would dose for a rabbit of similar size. With the azithromycin, the concentration I've used is 200mg/5ml, and for meloxicam 1.5mg/ml.

I want to bring up again, that rarely, some rabbits don't react well to the azithromycin. If it's minor stomach cramping that subsides in a few hours and the rabbit goes back to eating normally, then it's usually fine. But if it's more severe symptoms of diarrhea (where no normal fecal balls are being produced) in any amount, or loss of appetite for more than just a few hours, then it needs to be stopped immediately if there's diarrhea, or if continued loss of appetite, syringe feeding will be needed.

Azithromycin oral suspension

Meloxicam oral suspension

 

[Lindissima]

Continue with the panacur at the dose of 20mg/kg(might be a bit difficult knowing the dose when using the horse wormer)

So I think the dosage has been too low this whole this WHOLE TIME... uuughh
The vet told me .15 mL of the Fenbendazole... she weighs 1.34 kg.
If 1mL contains 100 mg then she only been receiving 15 mg per day.

Being that today is day 26 of 28 what do I do? Do I start back at day 1 giving her .27 mL as what would be required for her to be getting 20 mg / kg? Ive heard that EC can become resistant to this medicine so I want to keep that in mind as well...

I don't know what to do...

Here is what shes currently receiving: it is a 10% concentration

Brand Name: Fenacur
Antiparisitario Interno
Fenbendazol micronizado 10%
It has pictures of a cow, horse, pig, duck, sheep, dog, cat, goat and a couple others that I cant tell what they are.

 

[Lindissima]

Once you get the meds, if you want to post here what their concentrations are(mg/per ml) then I can share what I would dose for a rabbit of similar size. With the azithromycin, the concentration I've used is 200mg/5ml, and for meloxicam 1.5mg/ml.

I want to bring up again, that rarely, some rabbits don't react well to the azithromycin. If it's minor stomach cramping that subsides in a few hours and the rabbit goes back to eating normally, then it's usually fine. But if it's more severe symptoms of diarrhea (where no normal fecal balls are being produced) in any amount, or loss of appetite for more than just a few hours, then it needs to be stopped immediately if there's diarrhea, or if continued loss of appetite, syringe feeding will be needed.

Thank you SO much! I will let you know as soon as I can...

And I will be keeping an eye out for any signs of diarrhea or loss of appetite for too long. If she does show signs, I will stop the anti biotic immediately.... is there a different one that I should try if the azithromycin causes her trouble? What would be the next step for meds if she doesnt react well to it?

 

[Lindissima]

I cannot add anything to the advice,because those already helping you are absolutely wonderful and more experienced with the medications than I am.I just had to say how much we all admire you for the help you're giving this little soul,and please don't beat yourself up because in incredibly difficult circumstances you are doing a heroic job which quite frankly,most of us would not know where to start in terms of our practical options. You are a heroine to this little animal and regardless of the outcome,you have nthing to reproach yourself for- if there were more people like you in the world it would not be in the mess it's in now!

Thanks for your encouraging words... it has bee a rough few weeks and I just love her sooo much. <3

 

[john.thorpe1952]

I don'tknow if the following info will be of any practical help,and indeed you may already be aware of this organisation,but in case not here it is : Animal Love Rescue Centre,Route702,32km San Ramon to La Fortuna,Alajuela,Costa Rica
[email protected]
Tel:+50624479331
I hope it might be a good contact for you,since their vets deal with,among many other things,rabbits. Best wishes from England on a very wet day!

 

[john.thorpe1952]

Just one afterthought,which is probably superfuous.Given that rabbits are such inherantly sensitive creatures,regardless of veterinary treatment,a lot of cuddles,soft words and reassurance can work wonders for their moral and their physical condition.I'm sure she isn't short of love (obviously),but don't be afraid to give her a lot ofphysical affection.

 

[JBun]

So yeah, a 1.34kg rabbit would get about 27mg, and I would just round that up to 30mg. So 0.3ml once a day. Because she is still not doing well, I would continue the fenbendazole for another 2 weeks at least.

If you have to switch antibiotics, you could try oral enrofloxacin or smz/tmp, though if there actually is an infection, I'm not sure how effective they will be at the start. Usually these ones take a bit longer to start knocking down a bacterial infection, and so may need to be given for a longer period of time to completely get rid of it. Pen g procaine/benzathine injections would be the next best(if the bacteria is sensitive to it), though with it being injections, I don't know if you want to try that or not, as it would have to be given every other day.

 

[Lindissima]

I don'tknow if the following info will be of any practical help,and indeed you may already be aware of this organisation,but in case not here it is : Animal Love Rescue Centre,Route702,32km San Ramon to La Fortuna,Alajuela,Costa Rica
[email protected]
Tel:+50624479331
I hope it might be a good contact for you,since their vets deal with,among many other things,rabbits. Best wishes from England on a very wet day!

Thanks for this! I think I have heard of them... I wish they werent 9 hrs away... but they may have some inside knowledge about good vets...

 

[Lindissima]

Just one afterthought,which is probably superfuous.Given that rabbits are such inherantly sensitive creatures,regardless of veterinary treatment,a lot of cuddles,soft words and reassurance can work wonders for their moral and their physical condition.I'm sure she isn't short of love (obviously),but don't be afraid to give her a lot ofphysical affection.

Yes... I have been keeping this in mind... I work from home and she usually hangs out next to me most of the day. Since shes been hiding a bit more under the table etc and because her vision is not so good, I have been just talking to her more through out the day and taking lots of breaks to give her love. Thanks for the reminder of what I can give her in this moment..

 

[Lindissima]

So yeah, a 1.34kg rabbit would get about 27mg, and I would just round that up to 30mg. So 0.3ml once a day. Because she is still not doing well, I would continue the fenbendazole for another 2 weeks at least.

If you have to switch antibiotics, you could try oral enrofloxacin or smz/tmp, though if there actually is an infection, I'm not sure how effective they will be at the start. Usually these ones take a bit longer to start knocking down a bacterial infection, and so may need to be given for a longer period of time to completely get rid of it. Pen g procaine/benzathine injections would be the next best(if the bacteria is sensitive to it), though with it being injections, I don't know if you want to try that or not, as it would have to be given every other day.

Okay... I have switched to .3 mL for yesterday's and today's dose and will continue this for 2 weeks while monitoring symptoms to see if there are noticeable change. I will feel it out as to how long I want to continue after those 2 weeks depending on how things unfold.