RE: Odd rabbit case with seizures and periocular alopecia

Mark Rowland — Wed, 28 Aug 2019 21:38:45 GMT

so at a N:L ratio you have an inflammatory picture.

I would start on metronidazole/penicillin/meloxicam for a month the re assess

Goodluck Mark

RE: Odd rabbit case with seizures and periocular alopecia

HMC — Tue, 27 Aug 2019 11:43:09 GMT

Hi Mark,

Bit of a delay posting this sorry. I did a manual PCV soon after the last post and it was 38% (at which point I stopped really worrying about bone marrow suppression). We opted to complete the course of the sulfatrim and then repeat the routine bloods and also to do the first of a paired E. cuniculi antibody titres [results below].

Clinically the rabbit is fine. The lethargy does seem to be a subjective thing and mild if present. The periocular changes are not alopecia but change in fur colour (we had based the clinical dx of alopecia on owner's description and photos). No more seizures reported.

My questions are: what could be causing the hyperglobulinaemia, hypoalbuminaemia and low urea? and should I be doing anything about these?

It is interesting that the E. cuniculi titres are negative!

Many thanks in advance for any help : )

Hannah

Here are the BT results:

(SPR) Rabbit Profile (HAEMA) Haematology (VCBC)

Full Blood Count WBC 5.8 x109/L 4.5 - 12.0

RBC 5.13 x1012/L 4.00 - 8.00

Haemoglobin 12.0 g/dl 10.0 - 17.0

PCV 38.8 % 32.0 - 50.0

MCV 75.6 fl 55.0 - 78.0

MCH 23.4 pg 17.7 - 23.5

MCHC 30.9 g/dl 29.0 - 37.0

Platelets 380 x109/L 250 - 650

Differential % Abs Interval

Neutrophils 54 % 3.1 x109/L 1.6 - 6.6

Bd Neutrophils 0 % 0.0 x109 /L

Lymphocytes 39 % 2.3 x109/L 1.1 - 7.2

Monocytes 1 % 0.1 x109/L 0.1 - 1.2

Eosinophils 1 % 0.1 x109/L 0.0 - 0.6

Basophils 5 % 0.3 x109/L 0.0 - 1.0

(FILM) Film: Film: Degenerate cells approximate results only Platelet count appears adequate in smear.

Total Protein 54.3 g/l 50.0 - 71.0

Albumin H 39.1 g/l 27.0 - 36.0

Total Globulin L 15.2 g/l 20.0 - 33.0

Urea L 4.2 mmol/l 9.0 - 22.0

Creatinine 67 umol/l 54 - 150

CK 351 U/l@37C 140 - 372

Triglycerides 1.44 mmol/l 1.40 - 1.80

AST 17 U/l@37C 5 - 50

Gamma GT H 14.6 U/l@37C 0.0 - 5.0

LDH 200 U/l@37C 0 - 300 (BAPO)

Bile acid post prandial Bile Acids post feed 8.2 umol/l

Total Bilirubin 3.0 umol/l 0.0 - 12.0

E cuniculi IgG/IgM

IgM.....< 1:80

IgG.....< 1:80

Comment

Results pending: E cuniculi serology E.cuniculi titres Titre of <1:80 - Negative, no indication of infection. Titres of 1:80 - 1:320 - Indeterminate Positive. Re-test in 2-4 weeks checking for a rising titre. Titres 1:320 - 1:640 - High Positive, if signs are present start therapy and re-test in 2-4 weeks. Titres >1:640 - Very high Positive. If typical signs are present then probably diagnostic. Treat. IgM appears before IgG, so if there is an IgM titre this would suggest recent exposure (and possible disease). Please note rabbits are very variable in the production of antibodies post EXPOSURE and titres cannot be accurate predictors of disease, only exposure.

RE: Odd rabbit case with seizures and periocular alopecia

Mark Rowland — Tue, 06 Aug 2019 23:05:59 GMT

Hi Hannah

Its so good to see people really thinking about EC. its actually quite fascinating.

You are on the money. Fenbendazole is immunosuppressive in all species, Rabbits are sensitive to immunosuppression which doesn't help them if they have EC. Killing EC relies on a cell mediated response not a humoral one, that's why clinically active EC rabbits have high antibody titres but are still ill. Fenbendazole probably weakens EC but it also weakens the immune response. In the original papers describing treatment of EC with fenbendazole in rabbits, the success rate was similar to that with steroids (not cool).

Clinically EC symptoms are associated with the inflammatory response to EC in the CNS. It normally lives in the kidneys.

I have seen lots of "fitting in young rabbits not ec related.... Or is it?

Are these bunnies not mounting an immune response because they were infected in utero?

Lots more but its late...

Wait for the bloods but consider phenobarbitals if all normal.

Keep us posted

Mark