08/09/2015
It is time for my next Wiffle in honour of my 35 day post Panacur treatment blood test for the E. cuniculi (EC) antibodies (IgG and IgM). The presence of IgG antibodies indicates a chronic infection. A study of domestic rabbits, which was undertaken at the University of Edinburgh in 2004, showed that 52% of all pet and laboratory rabbits have likely been exposed to EC at some point in their life. This means that they are carriers and/or have had the active/acute form of the disease, which some rabbits can recover from without medical intervention (Varga, 2013). However, it may be the case that the actual number of infected rabbits is much larger, and a study of 500 pet rabbits in the Czech Republic showed a positive IgG in 68% of their total study group, but in one group, infection was found in 86% (Jekolva et al., 2010). I can expect to have a positive IgG test result, but the one that hangs in the balance is the IgM antibody. The detection of this antibody indicates that the infection is still acute (active) and I hope that this isn't the case. Two months ago, I fell into the category of being one of the ~6% of rabbits in the UK with an acute EC infection.
What is EC? It is a single celled parasite. It is classed as zoonotic - in other words, it can pass between species to humans. However, the only documented cases of human infection have been where (two) individuals have been extremely immunocompromised, and their symptoms of infection have been atypical. Being a parasite, EC needs host cells to survive. Once absorbed through the intestines, the parasite finds these host cells in the brain/central nervous system, kidneys and eyes. The infected cells rupture, forming lesions and granulomas. It is thought that many rabbits can live with EC with only minor, or even no symptoms. However, as in the case of myself, an outside trigger in and older rabbit can suddenly cause a dramatic onset, and for me, the EC manifested itself in neurological complications due to lesions in the brain.
How did I get EC? Sadly, I contracted EC from my late wife, who didn't make it through a routine spay. I know this since, 63 days ago, I had a strongly positive IgM result, but a negative IgG, indicating infection within the previous 35 days. My wife was born at an adoption centre, and had an eye removed due to ongoing corneal irritation and deformation, before I met her (**Alarm Bell One**). She used to urinate lots and lots (**Alarm Bell Two**), and would sometimes drink the water bowl dry. However, the vets didn't think this was anything to worry about. EC is a cunning, clever parasite, which I'm sure has been very opportunistic in its method of transmission. What do rabbits do on meeting? Well, we can't help it, as gross as you humans think it is, we p*e on each other and we lick the other rabbit's wee too. EC is shed in urine and infects the next host rabbit when they ingest it, and hey, it forms granulomas in the kidneys too, causing excessive weeing - oh dear, a recipe for rapid cross infection within a colony.
How did I know that I was ill? The first sign was when I kept missing a step or two on the stairs (**Alarm Bell Three**). My bunny parents had noticed this, but didn't think it was significant. They'd heard to be worried if your rabbit has a head tilt. I didn't, nor did Ffion, so they dismissed this as being unimportant. After two months of having Ffion in our lives, I suddenly went into complete gut stasis after having had a seizure, and I had a tremor (**Huge, Massive Alarm Bells with extra bells on**). The OOH vet sent me back home, but then I became really, really ill and I ended up in hospital for a couple of days. The vets found a trichobezoar (a hairball for normal bunny folks - more on this one in another Wiffle) and looked to cure the common cause - dental disease, which I didn't have. Eventually (and a few vets later - time at this stage was not measured in days, but in vet surgeries), thinking that my trichobezoar was gut related, I was referred to have CT scan. Unfortunately, I didn't make it since the stress of a fairly warm car journey suddenly brought on the EC symptoms (**Final, big, huge Alarm Bell**). At the half way point of the journey, my bunny parents let me have a break and a run in my travel cage. But, I kept stumbling as if I was drunk. Luckily, they were straight onto this, and rushed me to the nearest vet who treated me for heat stroke (which it could have been), but I didn't improve. So, a few phonecalls later, I was on my way to be seen by the most super duper rabbit savvy group of vets. As the trichobezoar (I love that word) was so impacted and large, we had one prognosis, which was that it was a tumour, which had metastasised, causing a brain tumour. The other was EC and the bloods were taken, and treatment started. For a few days we nervously waited as test results came in in dribs and drabs, ruling out this and that. During this time at home, I could barely walk, I couldn't drink without help, I wasn't eating properly and my bunny parents were collecting greenery from the garden every hour to keep me going, and I kept having seizures (my bunny mummy said that these were really difficult to watch). In those few days, I lost coordination and couldn't clean my face standing up, and certainly struggled eating hay - I was flicking my head back to do so, and promptly falling over. We hoped for a result of EC, and after an ultrasound of my stomach ruled out cancer, the high IgG and IgM was confirmed.
I now wait.. I still have seizures and I've been told these may continue. If you believe your bunny is dreaming, it is true, some do, but as a prey species, only 6-8% of a rabbit's sleep time is taken up by REM... Before the EC, I never 'dreamed' and certainly not within a couple of minutes of lying down around the house. I have what is known as partial seizures. These are not as extreme as full tonic clonic seizures where you fit, lose consciousness and control, as with my first seizure. During my partial seizures, I am still aware of my surroundings. My bunny mummy was hoping to catch a video of my seizures to help educate others, but I haven't had one recently - which is a mighty good thing indeed. So, what do they look like? For me, it starts with a flicking of my lips and tooth-grinding, followed by flicking of eyeballs and ear twitching, then a backward and forward, jerking movement of the head, before spasms in my lower body, quite often with me suddenly coming round startled. My mummy was shocked, but not surprised, by the number of cute 'my bunny is dreaming' videos there are on the internet... as these rabbits' heads contort in different directions...
Lessons that my owners have learnt and would like to pass on to all to save other bunnies like me:
- Know you rabbit and know what is normal behaviour. If your bunny becomes depressed, changes their eating habbits or shows any other abnormal signs, please take them to your vet.
- Even if your bunny has the chronic form of EC (maybe slightly or asymptomatic), the parasite can still be potentially shed in, and transmitted by, urine, and so can infect other members of the group.
- Discuss with your vet Panacur treatment on bonding any new rabbit within your colony.
- Be aware of the signs and symptoms (head tilt, tremors, eye and kidney disease, seizures etc., etc. - see RWAF 'Hop to It' info), and remember it just takes a simple stress trigger for the disease to become very acute and dangerous for your bunny. Ask yourself whether the trip up the stair, or the tumble whilst cleaning, or the 'dreaming' as soon as your bunny lies down, are normal. Especially be aware of your bunny's normal eating habits. I suddenly became a massive hay eater and hated my dry pellets - the reason was I was craving indigestible fibre as my gut motility was slowing. NB: Intestinal hypo(low)motility can result from a multitude of illnesses and stresses - One bunny in a study didn't poo for 10 days because their routine was disrupted due to a light being switched on (Varga, 2013, and reference therein) - we can be sensitive souls, but our poos say so much about how we're feeling. KEEP SOME CRITICAL CARE AT HAND AT ALL TIMES.
- Don't be afraid of getting a second opinion from a bunny-savvy vet - trust your gut instinct (no pun intended).
Disclaimer: I am a rabbit and not a vet. I speak from my personal experience and any information provided is gained from reputable, and generally, p*er-reviewed or expert sources. If you are at all concerned about your rabbit, please seek professional veterinary advice asap.
