Rear End Paralysis

Diamond sitting pretty.

Injuries to the back and legs result in immediate disruption to normal movement. What signs are present depends on the location of the injury, but they may include the following:

• Inability to stand or hop
• Dragging one or both hind legs
• Falling over
• Loss of bladder and/or bowel control
• Pain

In the case of age-related diseases or Encephalitozoon cuniculi (E. cuniculi), symptoms usually appear gradually. Rabbits may not lose control of their bladder or bowel functions, but it may be harder for them to get into the proper position to urinate or reach their cecotropes. That may result in urine scald, puddles on the floor and/or poopy butt.

They may not be able to jump into their litter box anymore or be unsteady when they stand. They may drag their feet when they move. They may struggle to stand up after lying down. They may even lose their balance and fall over. Often times, if these rabbits are still able to hop, their hind end may slant to one side.

These signs may be observed for several weeks before the bunny is finally down on his side. Rabbits will not recover from E. cuniculi or these degenerative conditions, but medication and supportive treatment can greatly slow down the process and extend quality of life.

Diamond was approximately a year old when he suffered a spinal compression due to an overtly playful dog. Fortunately, the injury only affected his mobility and did not compromise his bladder or digestive function.

Sudden paralysis may be caused by trauma to the legs, pelvis or spine. This may include being dropped or jumping down from a couch, bed, the owner's arms or any other considerable height. Improper handling which causes the bunny to panic, twist and kick, may also injure the back.

If the bunny shares his home with dogs and cats, physical trauma may occur with chasing or playful roughhousing. It's important to always supervise interactions between your rabbit and other pets and recognize the body language of each animal, especially if you have an exuberant puppy. 

There may also be a general weakness associated with an infection (bacterial or parasitic) or other illness. Certain diseases like cancer can also affect the bones, making them brittle and susceptible to fractures and breaks. Often the first sign you will see from the rabbit is lameness or an unwillingness to move. The vet can determine the full extent of the problem through diagnostics.

Certain birth defects, such as splay leg, can also affect mobility. The impact of these defects varies. Sometimes these defects can be corrected through physical therapy or surgery, while in other instances, the disability is minor and the bunny can adapt to the inconvenience quickly. 

Poppy (the red-head) had severe head tilt along with rear-end paralysis. Both conditions were most likely related to E.cuniculi.

E. cuniculi is a microsporum parasite that is currently classified as a type of fungus. It is very common in domestic rabbits. Some of the clinical signs seen include cataracts, various renal issues, head tilt, seizures and rear end paralysis. 

Depending on which source you read, 50%-80% of all domestic rabbits have been exposed. However, this does not mean every single one of these exposed rabbits will become sick. In fact, only a small percentage ever show symptoms. Symptoms usually appear when the bunny's immune system becomes compromised either due to illness, stress and/or age.

Although E. cuniculi is common among rabbits, there is surprisingly little information about how to definitively diagnose and treat a suspected E. cuniculi infection. Many vets may preemptively treat for E. cuniculi because diagnostic tests are not always informative and a 28-day course of fenbendazole (brand name: Panacur^®) can be safely used on most rabbits. Fenbendazole will not cure the bunny from E. cuniculi, but it can better manage symptoms.

Further discussion of this disease will be discussed in later articles on this website.

Diamond is being guided through his exercises by a team of physical therapists.

Regardless if your bunny is suffering from an injury, arthritis or E. cuniculi, physical therapy may be of help to your pet. Vets specializing in orthopedics and physical therapy can often palpate structural changes and determine the level of pain the rabbit is experiencing in certain areas, such as neck, shoulders, lower back, knees and hips. Acupuncture, massage, cold laser therapy, targeted physical therapy exercises and underwater treadmill (should your bunny tolerate it) are all options that may greatly improve quality of life.

Most animal rehabilitation clinics primarily handle dogs. However, dogs and rabbits can suffer from the same spinal ailments, such a compressions, arthritis, spondylosis and weakness. If the animal rehabilitation clinic is willing to work with your rabbit-savvy vet, physical therapy can really help your bunny.

Petra (dark brown), Benji (brown and white) and Nat (white and black). At the time of this photo, only Petra had rear end paralysis. This was a temporary pen I would set up for the trio when I cleaned their pen, but still she was lying on towels and pee pads and had tons of cushions to make sure she was comfortable. It was important to make sure she was treated as the queen she thought she was.

Caring for a bunny with rear end paralysis requires a long-term commitment from the owner or caregiver. Keep your vet updated on your bunny's condition, so any potential health dangers such as pressure sores, can be addressed promptly.

Adjustments in the living area will need to be made. It's important to realize that setting up a pen for a rear end paralysis bunny is a work in progress. Every rear end paralysis rabbit is unique and his needs may change over time, so do not worry about "getting it right" at first.

Some points to consider:

1. Litter boxes: You will need a low-entry litter box. Sometimes you need a box where one side is cut away completely, so the entry of the box is flush with the floor. This will probably mean the box will become more of a large hay rack than an actual litter box. I would avoid the temptation of placing your bunny in a litter box and leaving him there all day. The urine does not get wicked away, but rather soaks the fur and skin. Also the hay does not give enough gentle support, which can aggravate your bunny's condition.
2. Flooring: Even if you have wall-to-wall carpet, but especially if you have hardwood floors, you need to give your bunny some extra padding. If you have hardwood, I would line your bunny's pen with rubber or foam flooring pads. If your bunny is still mobile enough to exercise, make sure he can get a good grip on some non-slip area rugs. 
3. Water and food bowls: Be aware of how you offer food and water. If your bunny needs to do push ups to eat and drink, that will not be comfortable. Try to raise the dishes. You may need to use a shallow bowl for water. If knocking over the water is a problem, you may have to use a water bottle or syringe-fed water.
4. Cleanliness: Your bunny may have been a champ at keeping everything in the litter box at one time, but it would be unreasonable to have those same expectations now that he is disabled. Sheets and towels are not the best at absorbing urine and keeping your bunny clean and dry. Microfiber mats, microfleece, fake sheepskin and vet bedding are all good alternatives. Make sure any bedding you use does not have holes the bunny can get trapped in.
   
   I would not recommend using diapers (pet or baby) as the diaper holds the waste close to the skin, causing urine scald and other skin issues. It ends up causing more problems than it solves. 
   
   I'd also stay away from disposable doggie pee pads. Sometimes they are chemically treated so the puppy knows to pee at the same spot every time. It's also easier for a bunny to destroy them.