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?
 

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