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Assuming my pet rabbit survives botulism poisoning, what should the recovery process look like? I have researched a lot and either am not finding, or am not understanding the details.

  1. Pet ingests the botulinum toxin
  2. In 6 - 36 hours the pet starts showing signs but can be as late as 10 - 30 days
  3. Symptoms in the pet are generally a descending paralysis, first the head or neck, then fore limbs, etc. Nerves are damaged by the toxin.
  4. Treatment involves antitoxins (problematic) and/or palliative care, as the nerves will regenerate given time.
  5. Recovery...
  6. Weeks to months later the pet has full or nearly full recover.

I am not finding anything solid about step 5, "Recovery..."

  • Is the recovery descending (head gets better first), reversed, or general?
  • Are there milestones in the recovery process (i.e. when 'this' happens things only get better)?
  • What are common difficulties that must be overcome?

A peer-reviewed case study of multiple recoveries in humans and other animals would be great, but I cannot locate one and don't think one exists. The best answer will be from experience, preferable with more than one case.

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Blackwell's Five-Minute Veterinary Consult for small mammals doesn't cover botulism, but it does for the canine/feline version. Being a neurotoxin, I would expect mammals would generally respond to recovery procedures largely in a similar manner, based on the effects also being similar, so:

  • Neurological recovery will generally be in reverse order of appearance
  • Several weeks for complete recovery as nerve damage is regenerated, however I would expect rabbits to take longer as they do not have the natural protections that dogs do that help to weaken the effect.

Backing up the Blackwell info, which is a little thin, from Small Animal Neurological Emergencies (Platt & Garosi, 2013):

  • Full recovery for animals is possible if supported through the flaccid paralysis
  • Muscle weakness can remain for as much as year or more
  • Duration of the disease is usually 2-3 weeks
  • Effects are usually in order of muscle areas most susceptible first and recover in reverse order
  • Respiratory, neck, and forelimbs tend to recover first

Based on your own observations of the progression of the toxin, you should be looking for the signs of the various symptoms letting up and going away, those are your milestones. From what I can tell, botulism poisoning in house pets is extremely rare in general and almost always canine. According to Blackwell, there is only one known case of feline botulism poisoning that wasn't laboratory induced. That means that there's going to be little really good information on the common difficulties as, given the potential recovery period and the possible expense associated with that, I suspect a lot of people choose to euthanize, unfortunately.

As a note, there is risk around botulism from green grass that has been affecting horses and other hay/grass eating animals. It's usually soil borne, so something to be cautious of with respect to feeding rabbits (and guinea pigs for that matter) when the source is unknown or untrusted.

  • Before reading this answer this morning, I noticed what may be slight improvement in head mobility. Very subtle so could also be wishful thinking. Your answer and my morning observations tend to support each other. – James Jenkins Jun 9 '14 at 9:59
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    Onset + 6 days; Definitely seeing head and neck control returning now at 75-80% function. Front limbs improved, chest breathing muscles also seem to be returning (had been 100% abdominal breathing). – James Jenkins Jun 11 '14 at 10:28
  • Onset +8 days; she had 100% head and neck yesterday. Fore limbs are out to her sides, she has maybe 50% control of them but is unable to lift herself. Left rear leg can be extended but she can not pull it back in, so it is mostly straight out to the side or running up her side to her head . Right rear leg seems to function well, she is able to get it under her, but issues with the other 3 make it difficult to determine what function is here. She has maintained bladder control through the entire event. Video – James Jenkins Jun 14 '14 at 12:58
  • 20 days near full recovery. I documented the recovery in an answer to How do I care for a quadriplegic rabbit? – James Jenkins Jun 26 '14 at 10:38

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