Epilepsy, Seizures, Cramps & More

First Aid Tips

  • Make the environment safe (use pillows or blankets to cushion the area, or remove nearby objects).
  • Calm and gently stroke any tame animals nearby.
  • Dim the lights and cover the animal having the seizure with a blanket.
  • If possible, film the seizure or observe it closely so you can describe it in detail afterward.
  • Write down how long the seizure lasts.
  • Once it’s over, check the body temperature. If it’s too low, gently warm the animal.

If the seizure lasts longer than 5 minutes or if multiple seizures occur within 24 hours (a cluster):
Don’t waste any time – seek emergency veterinary care immediately, day or night!

It is very helpful for the veterinarian if the caregivers pay attention to the different seizure phases:

Before the seizure (pre-ictal phase):
Changes in behavior (e.g., withdrawn, restless)

During the seizure (ictal phase):
– Generalized seizures (affecting the whole brain): Lying on the side, paddling movements or sudden muscle stiffness, autonomic signs (loss of urine and feces, drooling)
– Focal seizures (affecting only part of the brain): Twitching of a specific body part (often the face) or absence seizures (brief loss of awareness)

After the seizure (post-ictal phase):
Often disorientation and ataxia (uncoordinated, unusual, or exaggerated movements); in some species, also increased hunger, thirst, or temporary blindness.

Example:
This rabbit shows signs of choking while eating – frothing at the mouth, bulging eyes, and struggling to breathe.

Symptoms

Seizures and cramps can present in many different ways. For example, a rabbit may show uncontrolled paddling movements with its feet, fall over to one side, not respond to touch or voice, swallow, lick, or bite uncontrollably, twist its body, suddenly turn to one side, lose consciousness, bump into objects as if blind, drool or urinate involuntarily, hold its head tilted, bob its head, or show signs of muscle stiffness or limpness.

Causes: What can trigger such symptoms?

Parasites

  • E. cuniculi is often mentioned as a cause of seizures, but it is actually a rare trigger and significantly overdiagnosed.
  • Coccidiosis (especially in young animals)
  • Toxoplasmosis
  • Nematode larvae (Baylisascaris procyonis, larva migrans)
  • Mites (extremely intense itching)

Viruses

  • RHD (Rabbit Hemorrhagic Disease, also known as Chinese Rabbit Plague)
  • Herpes simplex virus
  • Rabies (extremely rare and currently not present in Germany)

Fungi

  • Mycotoxins/mold toxins (from grain, hay, straw, vegetables, or fruit – especially with improper or moist storage and transport)

Central Nervous System Disorders

  • Ear infections (otitis media or interna)
  • Toxoplasmosis
  • E. cuniculi is often mentioned as a cause of seizures but is actually a rare trigger and frequently overdiagnosed
  • Various severe illnesses
  • Head injuries (traumatic brain injury)
  • Conditions affecting the head area

Organic Causes and Severe Underlying Diseases

  • Kidney disease (e.g., azotemia)
  • Hypothyroidism
  • Acute gastrointestinal illness accompanied by severe pain
  • Liver disease (hepatic lipidosis, ketosis)
  • Pregnancy toxemia
  • Overheating/heatstroke

Cardiovascular Diseases

  • Heart disease – often first appears during warm weather!
  • Heatstroke
  • Respiratory diseases
  • Stroke

Blood-Related Changes

  • Electrolyte imbalances (sodium, magnesium, calcium)
  • Low blood sugar (hypoglycemia)

Vitamin and Nutrient Deficiencies

  • Vitamin E and beta-carotene deficiency
  • Folic acid deficiency (e.g., as a side effect of certain medications)

Poisonings

  • Medication toxicity (e.g., lidocaine, enrofloxacin and other fluoroquinolones, penicillin, and PLACE antibiotics if given orally)
  • Lead poisoning
  • Insecticides
  • Fertilizers
  • Cannabis (e.g., passive smoke exposure indoors)
  • Other types of poisoning

Mechanical Causes

  • Foreign bodies or (congenital) malformations in the throat area (seizures with gagging, etc.)
  • Tumors/neoplasms or abscesses that impair the central nervous system
  • Arteriosclerosis and mineralization of major blood vessels
  • Mineralization of cerebral blood vessels / arteriosclerosis
  • Irritations (e.g., petting the fur against the grain, hay in the perineal pouch, foreign objects in the throat)

Congenital Malformations

  • Epilepsy
  • White Vienna rabbits – and white rabbits with blue eyes in general – are often more sensitive to loud noises and visual stimuli. Due to the lack of melanin, their inner ear may also be affected, making them more prone to seizures.

Other Causes

  • Agonal seizures during the dying process
  • Bacterial infections
  • Febrile seizures
  • …

Diagnosis: What is the cause?

Always consult a rabbit-savvy veterinarian, preferably one who is designated as a specialist! Often, it also makes sense to consult an animal neurologist for specific examinations.

  • Thorough general examination, including temperature measurement
  • Detailed questioning of the caregiver (e.g., exposure to cat or raccoon feces, unwashed garden vegetables, exposure to lead-containing substances such as lead paint)
  • Neurological examination
  • Fecal examination (for coccidiosis)
  • Blood tests (pet profile, E. Cuniculi titer (IgG and IgM) in the blood, toxoplasmosis, etc.)
  • Chest X-ray and heart ultrasound
  • Imaging (at least X-rays; the gold standard is MRI, possibly with a biopsy [e.g., larva migrans, neoplasms, detection of herpes and toxoplasmosis])

Eye and Head Movements: Nystagmus and Scanning

  • Head movements (Scanning): Scanning behavior is often seen in rabbits with visual impairment, particularly albino and Siamese rabbits. It helps with spatial orientation.
  • Eye twitching (Nystagmus): Eye twitching is especially common in middle and inner ear infections. It can also be a symptom of E. Cuniculi. Other causes are also possible.

Treatment: How can you help?

The treatment largely depends on the underlying cause of the seizures and cramps, so it’s crucial to perform comprehensive diagnostics and treat the animal accordingly.

  • If all potential causes are ruled out through blood tests, MRI, and further investigations, phenobarbital (1-2 mg/kg/day, administer cautiously) can be used.
  • Diazepam (Valium) is suitable as an emergency medication if needed. Midazolam is also an option.
  • For age-related seizures, Vitophyllin may be considered.

Tips for Rabbit Care

To avoid falls, rabbits with seizures should be kept on the ground level, without higher platforms. The risk of injury is high, so any potential hazards should be padded or removed.

Stress and discomfort can trigger seizures, so a low-stress environment is important. Pairing rabbits together in a stress-free manner or maintaining a stable group dynamic is beneficial.

Sudden loud noises, petting against the fur, loud music, strong scents (e.g., deodorants, candles, cigarettes), and light flashes can also be stressors, as rabbits have an excellent sense of smell.

Medications should be administered stress-free, ideally through medical training.

Some medications are not suitable for affected rabbits, such as certain anesthetics and MCP (Emeprid). Always consult your veterinary team to assess the appropriateness of any medication being used.

Sources include:

Baley, L., Canas, D., Gruaz, M., van Praag, A. & van Praag, E. (2016). Epileptiforme Petit-mal- oder Grand-mal-Manifestationen bei Kaninchen. Erhältlich bei: medirabbit. com (abgerufen am 3. April 2020)

Butler, K., DeGeorge, B., Dunn, G., VanGyzen, J., Gruaz, M., van Praag, A., & van Praag, E. (2016): Heterochromia of the iris in rabbits belonging to the Dutch breed.

De Matos, R., Russell, D., Van Alstine, W. & Miller, A. (2014): Spontane tödliche Enzephalitis durch humanes Herpesvirus 1 bei zwei Hauskaninchen (Oryctolagus cuniculus). Journal of Veterinary Diagnostic Investigation , 26 (5), 689-694.

Deeb, B. J., & DiGiacomo, R. F. (1994): Cerebral larva migrans caused by Baylisascaris sp in pet rabbits. Journal of the American Veterinary Medical Association, 205(12), 1744-1747.

Gülersoy, E., İyigün, S. S., & Erol, B. B. (2021): An overview of seizures and epilepsy in rabbits: etiological differences and clinical management.

Künzel, F.; Müller, K. (2019): Andere neurologische Erkrankungen von Kaninchen. im Wissenschaftlichen Bericht über die Jahrestagung der Vereinigung Österreichischer Kleintiermediziner (VÖK).

Nachtsheim, H. (1939): Krampfbereitschaft und Genotypus: 1. die Epilepsie der Weißen Wiener Kaninchen. Verlag von Julius Springer.

van Praag, E. Drug induced folic acid (vit B9) deficiency in a hydrocephalus mini lop rabbit.

Tierärztin Melissa Brinkmeier, persönl. Mitteilungen

Tierärztin Josephine Dietzel, pers. Mitteilung