Bunny having health problems :(

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Hello,
I found this community in the hopes to get some insight on my 6 yo male bunny, Gatsby’s health issues. He has been to the vet 4 times in the last 3 months for having diarrhea/irregular shaped soft poops, weight loss, and recently he has started getting bald spots at the base of his ears/top of his head. He has been on two rounds of antibiotics, had two fecal samples come back negative, and is currently taking a GI motility drug 2x a day and a anti inflammatory 1x a day which has helped slightly with the diarrhea. His sister from the same litter is perfectly healthy and about twice his weight now. He is perfectly spunky and eats plenty of Timothy hay, oxbow pellets, and leafy greens as well as some digestive support treats. I give him butt baths about 1x per week to help keep him clean but it is a pretty nasty situation with lots of feces and hair loss on his tail and bum. The vets don’t seem to have any real answers for what the problem is other than he’s not absorbing nutrients properly? Any help or insight would be greatly appreciated! <3
 

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Has he had a blood test to check kidney and liver function, or any xrays? I'm presuming the vet ruled out coccidiosis with the fecal test?

Is the odd poop his cecotropes only,, or is it both the fecal poop and cecotropes? How long has he been with you and did the problem only start 3 months ago, or was there ever any odd poop before that?

What amount of pellets, hay, veg, and treats does he get per day? Have you ever tried any changes to his diet to see if that helps? How much does he weigh now and what was his previous healthy weight?

Where the fur loss is, is there any sign of dandruffy or scaly skin?
 
Has he had a blood test to check kidney and liver function, or any xrays? I'm presuming the vet ruled out coccidiosis with the fecal test?

Is the odd poop his cecotropes only,, or is it both the fecal poop and cecotropes? How long has he been with you and did the problem only start 3 months ago, or was there ever any odd poop before that?

What amount of pellets, hay, veg, and treats does he get per day? Have you ever tried any changes to his diet to see if that helps? How much does he weigh now and what was his previous healthy weight?

Where the fur loss is, is there any sign of dandruffy or scaly skin?
Thank you for your response! He had X-rays done initially and they said everything looked normal…they did not perform blood tests though. Maybe that is the next step? I’m not sure exactly what they tested for in the fecal sample, but I had it done by two different vet clinics and they both concluded “negative” whatever that means. I forgot to mention he has also been sneezing since all of this began. The vets said his teeth looked good. I have had them both since they were babies and neither ever had any strange poops. It came on suddenly with diarrhea and I took him to the vet immediately thinking it was an emergency situation. He used to weigh about 4.2 lbs and now he is 2.5. They eat unlimited Timothy hay, get a cup of pellets to share once a day, and get a large handful of mixed greens in the evening (same as always). Upon the first vets recommendation I cut way back on pellets and greens for the first week of him having these issues which I think caused some of the weight loss (and ultimately I think was a mistake because it didn’t cure the issues). I noticed flakey skin behind the ears and pointed it out to the vets and they all said they didn’t think it was serious, but now has turned into bald spots. I appreciate your help!!
 
If he hadn't been with you for the last 6 years, and with no previous poop issues, I would have said there's a good chance it's megacolon. It's a digestive disorder that 'charlie' colored rabbits can be born with. That's pretty much what a megacolon rabbits poop can look like, and your rabbit has the 'charlie' coloring (mostly white, less than 10% color).

https://www.medirabbit.com/EN/GI_diseases/Mega/mega_en.htm

https://wabbitwiki.com/wiki/Megacolon

But your rabbit is older with no previous history. It may be possible to acquire it, like after a serious digestive illness that damages those same nerves as in a megacolon bun, so that might be a slight possibility. But I'm wondering if there might be something else going on here.

Did you make any food changes just previous to this? Any stressful events or changes around this time? Have you noticed any changes to his breathing, deeper, faster, or more labored? Do his third eyelids protrude at all, particularly when his head is lowered? Does he consistently try and rest with his head elevated, or seem to hold his head up higher than usual?

What antibiotics have been tried so far? Was the xray of his belly? Did it show the chest area at all? Have you noticed any fur loss and dandruff anywhere else, like around the hind end?
 
If he hadn't been with you for the last 6 years, and with no previous poop issues, I would have said there's a good chance it's megacolon. It's a digestive disorder that 'charlie' colored rabbits can be born with. That's pretty much what a megacolon rabbits poop can look like, and your rabbit has the 'charlie' coloring (mostly white, less than 10% color).

https://www.medirabbit.com/EN/GI_diseases/Mega/mega_en.htm

https://wabbitwiki.com/wiki/Megacolon

But your rabbit is older with no previous history. It may be possible to acquire it, like after a serious digestive illness that damages those same nerves as in a megacolon bun, so that might be a slight possibility. But I'm wondering if there might be something else going on here.

Did you make any food changes just previous to this? Any stressful events or changes around this time? Have you noticed any changes to his breathing, deeper, faster, or more labored? Do his third eyelids protrude at all, particularly when his head is lowered? Does he consistently try and rest with his head elevated, or seem to hold his head up higher than usual?

What antibiotics have been tried so far? Was the xray of his belly? Did it show the chest area at all? Have you noticed any fur loss and dandruff anywhere else, like around the hind end?
 
I have definitely considered megacolon as well, but the vet brushed it off and said that was a “cat issue”. A few years ago he went to the vet for gi stasis (not eating/pooping) and was kept for 24 hours administering fluids. Maybe that is related? I didn’t get to see the x rays but the vet said “his belly looked normal and they didn’t see any obvious obstructions” so not sure if they looked at the chest. Nothing comes to mind that obviously would have triggered this, but his appetite declined greatly with the start of the diahreah so I had him eating critical care 4x a day for about a month before he started losing interest in it, weaning off it, and going back to enjoying his normal diet (which was always offered as his sister lives with him). With this came him having more energy and really acting like his normal self (other than all of his icky symptoms). I can’t remember the name of the first antibiotics, but he took them for 3 days. When that didn’t help he was given Orbax for 10 days. Someone recommended probiotics (Bene-bac plus) so I am waiting for that to arrive in the mail in the next few days. There is very little information about treating megacolon so I really appreciate your insight!
 
It's definitely not just a cat issue. I've had 3 rabbits that had it. And you can see in the articles I posted above that it's a known medical issue with rabbits. Which leads me to believe that maybe that vet isn't particularly knowledgeable about rabbits.

If you have other options for a better and more knowledgeable rabbit vet, that might be worth looking into and getting a second opinion, if you feel it would help. There's a couple listings for your area, but even if a vet is shown as seeing rabbits, doesn't necessarily mean they're a really good rabbit vet. So it might take a bit of research to find a really good one. It may also take traveling a bit to get to a better rabbit vet. For more advanced testing if needed, UC Davis is a possibility, though a bit of a drive.

https://wabbitwiki.com/wiki/Choosing_a_rabbit_veterinarian

https://wabbitwiki.com/wiki/Nevada

https://rabbit.org/care/rabbit-vets-near-me/

Along with the links I posted previously on megacolon, here are a few more, the first ones from well known and reliable rabbit organizations.

(LINKS MAY CONTAIN GRAPHIC MEDICAL RELATED PHOTOS)

https://houserabbit.org/rabbits101/health/illnesses-and-diseases/megacolon-syndrome/

https://rabbitwelfare.co.uk/wp-content/uploads/2023/05/RO-Spring-17-Megacolon.pdf

https://rabbitwelfare.co.uk/wp-content/uploads/2023/11/RO-Autumn-23-Megacolon.pdf

https://vgr1.com/megacolon/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093750

With the GI stasis happening so long ago, I don't think it's likely to be related. But your rabbit getting diarrhea, that could have sparked this long term condition. True diarrhea in rabbits is usually caused by pathogenic bacteria. The bacteria can release toxins that essentially permanently damage the digestive tract, if it's not just outright fatal which is most often the outcome. So pretty incredible your rabbit survived if this is what happened.

Because the diarrhea was at the start of this, I'd be inclined to think this was the cause of your rabbits current GI issues. That your rabbit didn't start out with megacolon, but started out getting diarrhea somehow and developed permanent digestive damage resulting in ongoing megacolon type symptoms. If this is what's going on, usually changes to the diet can sometimes help improve poop quality, digestive function, and nutrient absorption. At least it did for 2 of my megacolon buns.

The fur loss could be a separate issue, like fur mites, which cause fur loss and dandruffy skin. Or maybe the skin is fine, and your rabbit either has rubbed the fur off somehow, is starting a heavy molt, or possibly his sister overgroomed him there. Or it could be related to poor nutrient absorption and nutrient deficiency.

So presuming this is acquired megacolon that your rabbit has, diet and sometimes meds, is usually how it's managed. There's not one specific diet though, as it can vary depending on how an individual rabbit is affected. If you look at the vgr1 article, it goes into detail about some of this.

For my rabbits, they were the most sensitive to any high sugar/carb food. Grains, fruit, sugars in meds, grains and sugars in pellets, all would cause their poop to get worse. It would usually cause their fecal poop to become more irregularly shaped and sticky with mucous, and digestive upset issues. So both rabbits were on a strict hay and select greens diet, and did really well on this diet, maintaining a healthy weight and active life.

My one rabbit that was born with this condition, he was also sensitive to the quality of hay he was fed. If the hay was too leafy of a cut, his fecal poop would get really moist and more log shaped. He had to have a medium coarse cut to maintain the best consistency in his fecal poop and best digestive motility. So he was always fed second cut timothy hay, that was a good mix of leaf (nutrients, protein) and stem (indigestible fiber).

These are all things I learned by trial and error. By seeing something wasn't working and trying something else. I had tried multiple brands and types of pellets, before determining that none could be tolerated. I always used a gradual approach, starting with very small amounts, and closely monitoring for any signs of digestive pain or upset. But what diet works best for your rabbit may be different than what worked for mine. Some rabbits do better on a higher protein more nutrient dense diet because of the poor absorption.

My suggestion would be to try and find a vet with knowledge about megacolon in rabbits, and preferably some experience treating it. Or even a vet that at least has knowledge that it is a real disease for rabbits would be a step up. When you call, specify you're looking for a rabbit vet knowledgeable about megacolon in rabbits, not cats. Diet is likely going to be your primary way of dealing with this, but having a knowledgeable rabbit vet working with you, they may know of some beneficial medications that might also help.

I don't know if a no pellet diet is appropriate for your rabbit or not, but if you feel your rabbit does need to stay on pellets, it might be worth trying a no grain pellet. Selective Naturals has one, Sherwood has one, there may be others. Any high quality pellet with no added grains, fruit, sugars, molasses, etc. Then a gradual transition so you can monitor for digestive upset, weight loss, or any other negative effects. If you find a pellet that your rabbit does really well on, it may be worth trying to gradually increase pellet amounts to help your rabbit get some weight back on. But monitor for increasing pellets causing a worsening of symptoms as well.

It might also be worth trying other brands of hay, in case there's something off with the hay you're currently using. Small pet select seems to have good hay, and there are other specialty companies that cater to providing high quality hay options for small pets. Maybe experiment trying different cuts and types. But I would suggest avoiding grain hays, due to the seeds carb content. Make sure whatever hay you use has absolutely no signs of mold (black or white spots, white dust, dampness, odd color, musty or sour smell), as that alone is toxic to rabbits.

You're looking for the right balance of what hay works best for firming up the fecal droppings, and balance of what hay and pellet combination provides sufficient nutrients for maintaining health and weight as much as possible. It's never going to be perfect. Your rabbit will always have the problem. But with the right diet for your individual rabbit, you can help minimize the negative affects of megacolon.

This is all just my opinion and a guess as to what might be going on based on the photos and description. I could be wrong and it could be something else. Liver problems can sometimes cause abnormal poop issues like this. So can heart issues and thymoma, which is why I was asking some of those other questions. So if your rabbit is having other abnormal symptoms not related to the digestive issues, like the unusual sneezing episodes and fur loss, it may be worth seeing that your vet looks into these other possibilities.

You are your rabbits advocate, and sometimes we have to be the ones making sure our pet is getting the correct and appropriate care. Not all vets are good vets, and there are much fewer good and knowledgeable rabbit vets available to us. A vet that says they treat rabbits, isn't necessarily a vet that is truly knowledgeable about rabbits. It took me a few tries going to several so called exotics vets, before I found one that really was knowledgeable. So if you feel you need to find a better vet, I suggest doing so. A really good rabbit vet can make all the difference in getting better care for your bun.
 
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