Cerebral thromboembolism secondary to infective endocarditis in a pet rabbit (Oryctolagus cuniculus)
2022
Solanes, Ferran | Bassan, Tiziana | Cobos, Alex | Frau, Maria | Martorell, Jaume
Central vestibular disease is one of the most common problems in pet rabbits. Encephalitozoon cuniculi infection appears to be the most frequent etiology, but other causes have been described. It is known that infective endocarditis can cause thromboembolic disease affecting multiple organ systems in dogs. Secondary embolism from bacterial endocarditis commonly occurs, mainly in the spleen and kidneys, but cerebral thromboembolism disease secondary to infective endocarditis has rarely been reported in dogs, and not reported in rabbits. This case describes this pathology in a pet rabbit. An 8-year-old, neutered male rabbit (Oryctolagus cuniculus) presented with mild hyperthermia, left head tilt, and rolling. Despite hospitalization and treatment for encephalitozoonosis, the rabbit died 8 days after presentation. The body was submitted for necropsy. Radiographic examination, complete blood count, serum biochemistries and abdominal ultrasonography were unremarkable. Magnetic resonance imaging did not show any abnormalities in the central nervous system. An Encephalitozoon cuniculi serology demonstrated elevated IgM and IgG titers (1:320, 1:1280 respectively). Histopathological examination revealed multifocal necrotizing and suppurative myocarditis, with multiple emboli in the kidneys, lungs, and central nervous system (CNS). Polymerase chain reaction, immunohistochemistry, and Ziehl-Neelsen staining of samples from the CNS and kidneys were negative for E. cuniculi. Due to the positive predictive value of 92% of indirect fluorescent antibody technique for E. cuniculi serology, a false positive result was suspected. Based on the results, a final diagnosis of cerebral thromboembolism secondary to infective endocarditis was proposed. This is the first report of this process naturally occurring in rabbits. It should be included in the differential diagnosis of central vestibular syndrome in this species.
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