Table 1 . Example of a nursing care plan and common actual and potential problems encountered with encephalitozoonosis .
Activity of life ( AOL ) |
Current routine |
Actual problem ( examples ) |
Potential problem |
1 . Eat adequate amounts Type of food / bowl ? Food allergies ? |
To be provided by owner |
Lack of appetite due to condition |
Gut stasis / ileus
Metabolic disturbances
|
|
|
|
Weight loss / malnutrition |
2 . Drink adequate amounts Bottle or bowl ? |
|
Unable to drink adequately due to head tilt ( polydipsia should also be considered ) |
Dehydration |
3 . Urinate normally Substrate / grass ? Litter tray ? |
|
Polyuria |
Urine scalding
Pain
|
4 . Defaecate normally Presence of caecotrophs ? |
|
|
Urine scalding may affect normal caecotrophy |
5 . Maintain body temperature Indoor / outdoor ? |
|
|
Pain associated with encephalitozoonosis may increase body temperature |
6 . Groom self Do they get groomed ? |
|
Head tilt affecting normal grooming |
Urine scalding ± pain may affect grooming |
7 . Mobility Normal exercise routine ? |
|
Ataxia , head tilt affecting normal mobility |
Risk of injury
Inability to eat / drink / groom
|
8 . Sleep / rest Where ? Hide box ? Bedding type ? |
|
|
Pain / neurological symptoms may increase or decrease sleep |
|
|
|
Delayed healing |
9 . Express normal behaviour Has condition affected behaviour ? |
|
Neurological , renal and ophthalmic signs affect ability to express normal behaviour |
Depression
Stress
|
|
|
|
Poor hygiene |
Phacoemulsification ( removal of the lens ) can be performed and is the gold standard treatment for cataract formation associated with E . cuniculi infection [ 21 ] . However , it is not chosen by many owners due to costs , anaesthetic risks and the intensive aftercare required . Sanchez et al ., as cited by Baney et al . [ 21 ] , studied owner perception of cataract surgery in pet rabbits . Owners of rabbits with bilateral cataracts reported a decrease in activity , curiosity , playfulness and social interaction . Following cataract surgery , the owners reported improved vision and positive behavioural changes [ 21 ] .
For acute neurological signs , steroids may be indicated to suppress the central nervous system granulomatous inflammation , though this may affect the patient ' s immune system and exacerbate systemic disease [ 15 ] . The use of midazolam or diazepam for such acute neurological signs can reduce the impact of ataxia / circling / rolling [ 23 ] . Furthermore , the patient ' s environment should be adapted to prevent accidental trauma , including the use of soft padding , non-metal cage barriers and removal of any heights . However , rabbits should still be given the ability to express normal behaviour , and suitable gnawing toys and hides should be available .
For owners with multiple pet rabbits , there are two options for managing rabbits that may have had contact . The majority of owners , with only a few rabbits , will opt to treat all rabbits with fenbendazole for 4 weeks and assume infection , whereas owners with multiple or large groups of rabbits may opt to test all rabbits and isolate any that test positive [ 12 ] . However , particular care should be taken with regard to housing , and the remaining negative rabbits should be re-tested after 4 weeks , due to the parasite ’ s life cycle .
Volume 38 ( 1 ) • February 2023
53