Floppy Rabbit Syndrome
This video demonstrate FRS - Frances Harcourt-Brown
Floppy rabbit syndrome is one of the more dramatic and alarming conditions that a rabbit owner can experience. Fortunately, the prognosis for most cases is good with proper supportive care.
First week treatment of a rabbit with Floppy Rabbit Syndrome
This syndrome usually presents with acute onset weakness to flaccid (floppy) paralysis of the skeletal muscles of the body. Seriously affected rabbits may not be able to do anything but lie on their sides, and less severely affected animals may be able to sit up and eat, but not be able to hop around very much. Many owners will find their rabbits in such a state in the morning, or after they come home from work or school.
What Causes FRS?
The cause of this condition is most likely multifactorial and can include:
- A stressful incident may precede an attack, or a pre-existing illness may be the cause.
- Infectious causes - Many rabbits that have been affected by floppy rabbit syndrome also test positive for Encephalitozoon cuniculi, a parasite that is common in rabbits, and can cause other neurological problems. (EC testing is not available in New Zealand).
- Plant or mycotoxin toxicity have been theorised to have an effect as well, but many affected rabbits also do not have access to toxic plants.
- Vit E and/or Selenium deficiency. If the rabbit is deficient in Selenium (which works in partnership with Vit E in the body) or has Hepatic Coccidiosis - which affects the rabbit’s ability to metabolise Vit E - a fat soluble vitamin, this can lead to muscular dystrophy which can present as FRS.
- Hypocalcemia (low blood calcium levels). A condition seen in lactating rabbits.
- Hypoglycemia. (low blood sugars) A common condition in young rabbits recently rehomed with a change in diet and possible secondary coccidia infections. A simple blood glucose test can help to confirm this. Treatment is often successful if aggressive and instigated quickly.
- Hypokalemia. (low blood potassium levels) A rare condition sometimes associated with rabbits diagnosed with Floppy Bunny Syndrome. This may be due to malabsorption or low dietary levels.
- Hypothermia. A decrease in body temperature, often a secondary complication to many conditions, from gut stasis to spinal trauma.
- Hypotension. Low blood pressure is common in collapsed rabbits for many reasons, from gut stasis to heart disease.
- Dehydration. Rabbits can dehydrate very quickly and can hide the initial signs of this critical condition until they collapse and show signs often attributed to Floppy Bunny Syndrome. A simple blood test to measure red blood cell count and total protein in the blood can help diagnose this common condition.
- Spinal cord damage. Rabbits are often keen climbers and even though a fall may have not been observed it should always be suspected. X-rays of the spine and hips should always be considered. It is important not to misdiagnose floppy rabbit syndrome as a spinal fracture, as the prognoses for both conditions are vastly different. Careful palpation and x-rays can help differentiate these conditions, as well as a good history.
- Musculoskeletal pain. Conditions such as arthritis, muscular pain or other spinal conditions may present with similar signs.
However, in many cases an exact cause cannot be identified and at this point in time, the pathophysiology of this condition is unclear.
What Should you Do?
The first thing to consider is to get your rabbit to a vet immediately. Your vet should undertake a few simple blood tests to try to find the underlying cause. A faecal test to check for Coccidiosis would also be wise.
If these tests are not conclusive then consider the following -
a) Further investigation- which may include further, more extensive blood tests and further imaging with x-rays.
b) Supportive care. Many owners choose to invest in time with a high commitment to nursing care. It should be noted that if further investigation has not ruled out more common conditions recovery may not be possible. Nursing care can consist of hydration (fluids either via a IV drip, orally or by injection), feeding (syringe feeding with critical care every 2-6 hours – 60ml of the made- up solution per kg of body weight per 24hours), hygiene (changing of bedding every 2 hours), movement (changing of position and massage every 2-3 hours), pain relief and gut motility medications.
c) Give Vit E. The daily requirement for rabbits is 50-150mg/kg which is equivalent to 75-224 IU/kg. Most Vit E in NZ is sold using IU (International Units) as the concentration standard. For our purposes, 200IU capsules are usually the easiest to find in an emergency at the supermarket or pharmacy. They are also the easiest use to measure out the correct dose. Another good option is a liquid form with a dropper. I would suggest trying a daily dose in the middle of this range. So around 150IU/kg per day whilst the rabbit is poorly.
d) Consider treating for Coccidiosis if the rabbit responds to Vit E.
e) Consider the possibility of EC and treat with Panacur.
The majority of rabbits affected by floppy rabbit syndrome will recover within 2 to 7 days, and it appears that the severity of the condition does affect the length of recovery time.
Treatment is supportive, and this includes anti-inflammatory medications, pro-kinetics to help the gastrointestinal system keep working, keeping the rabbit calm and warm, maintaining proper hydration, frequent supplementary feeding with a formula such as Oxbow Critical Care, and supporting the rabbit on his or her chest with a rolled up towel. Complications of this syndrome include gastrointestinal stasis and hypothermia, which can be minimised by appropriate feeding and housing during this time. Corticosteroids are contraindicated.
Source: with relevant edits - FLOPPY BUNNY SYNDROME - The Unusual Pet Vets
“Floppy rabbit disease” is well known and feared by breeders and pet owners, and unknown by others. Those who have experienced this disease in a rabbit know how fast the onset can be, rarely with fatal consequences.
Floppy rabbit syndrome - General muscle weakness - MediRabbit
“The neurological findings of FRS suggest a lower motor neuron condition and polyradiculoneuritis (inflammation of the nerve roots) is suspected. The cause of FRS has not been determined but the clinical features are similar to Coonhound paralysis in dogs and also has similarities to Guillan-Barre syndrome in people. It is believed to be an autoimmune disorder. Confirmation of the diagnosis is difficult and requires specialised blood tests and post-mortem investigations that are unavailable at this time. “
FRS - Frances Harcourt-Brown