Insatiable appetite, lots of output - normal or no?

[kirbyultra]

That would be devastating. I just quickly read the library post about EC... How accurate is the titer usually?

If it is EC then I would worry about Kirby too But, then, I am jumping to conclusions. I wanted to write up an update so far about Penny's condition in the last 36 hours.

Sunday she was still peeing everywhere and getting it all over herself. As of yesterday, she only had an accident once early in the day. And miraculously, she doesn't seem utterly obsessed with water anymore. She left some in the bowl (and I only gave her a fraction of a bowl of water). She even left Kirby's water bowl alone which is full! Not a fluke either as she's done it again today. She had 1 accident on the floor early this morning, but it's possible that she just got carried away while chewing on some hay in the new location and let one go :shock: She is not dragging it around on her tail as far as I can tell from examining the floor.

It's a pretty dramatic turn of events. Either she understood my desperate plea when I begged her not to pee on Sunday night, or the baytril is actually working... or I don't know what else it could be. It's only been about 36 hours so maybe it's to soon to tell but the two most troublesome symptoms, water intake and the peeing everywhere, has decreased significantly.

She still eats like there's no tomorrow, but that is ok, it's just hay. I have to wonder... what's up?

About the hind leg weakness: She's pretty lazy, always lounging around on her side. But what's really quite telling is that she is *very* clumsy. The few times I've seen her binky, it's like someone installed springs in her legs but didn't tell her how to operate them. Twice I saw her binky sideways into the wall (*Thump*, it looked like it kinda hurt.) As fun and wacky as binkies look to us, I've never seen a bunny binky so poorly coordinated. They usually have a firm grasp of their surroundings and how to avoid harm. Not my Penny. When she climbs up and down the ramp in Kirby's bunny condo, she is very shaky and bumbly. You can hear her bumble up and down from the next room because she makes a huge racket. I've seen Kirby and Toby get accustomed to using the ramps and I know it's tricky the first 5 or 6 times, but they quickly get the hang of it. Not her. Maybe it is her leg. :? But, when she thinks I have food, which is every time I walk into the room, she has no problem periscoping on her tippy toes to greet me. :?

 

[tonyshuman]

Unfortunately, the EC titer isn't extremely accurate. It can give you an idea of how likely it is that she has an active case. Unfortunately, the baseline values for each animal can be different. For instance (I'm making up numbers here) if it gives you a value of 100, that can mean an active infection in some rabbits, but might mean nothing in others. It's better to use as a comparative tool within a single bunny over time. For instance, if it's 100 one day, and then a month later it's 120, that would mean that it's getting worse and you might start to see some symptoms. If it's 80 a month later, the infection is decreasing.

Don't worry about it spreading between the buns. They've all been exposed to it, either before they met Penny or in the time she's been there. The spores are shed in the urine (which is why early stages of the disease have urinary symptoms) and I'm pretty sure they can go into the air when the urine dries. Plus they probably have been exposed to it since birth. Our Benjamin had a positive EC titer at about 6mo of age, and he had been from a breeder to a shelter to a rescue group to us, so it could have picked it up in any of those places or even all of them. The only bunnies that don't test positive on an EC titer are ones bred in some selective, ridiculously clean lab animal facilities.

So, if you get the titer done, and it's in the middle-range or higher, I would start her on Marquis (ponazuril) immediately and see if that improves it. If you catch it early it can be at least held at bay and you don't have to sorry so much about the disability that comes with it. The bendazole antiparasitics won't cross the blood-brain barrier and treat any parasite in the brain, which is where it causes the most damage.

 

[kirbyultra]

That makes sense. Thanks again Claire, that puts my mind at ease somewhat.

I didn't want to turn this into a vet discussion but I got sort of agitated by my vet's reply (via receptionist) regarding the cost of the xray. So he said she thought that a sonogram would be better to see what we suspect going on in her bladder, and it'd cost in th neighborhood of $400+, while if I wanted to get xrays it'd cost ~$250. I haven't heard of getting a sonogram in my previous consult with her and I don't want to badmouth her good reputation but it just seems like we're going down more and more costly routes of diagnosing this. The person at my rescue said it was odd that she wouldn't do the xray in one shot when I asked for it last time I was there with penny. I suppose if I make an office visit cost this steep I'd want a patient back too.... I'm not suggesting that that is what is going in but the thought has wandered into my head a couple times.

Add on top of that when Toby had gi stasis they gave him motility drugs... He is fine, thank god, but after reading what Randy said about the class of drugs for rabbits it really begs me to reconsider my options.

 

[tonyshuman]

Well, I don't know, but I would imagine that bladder sludge would show up better on an x-ray than a sonogram, but a sonogram might be better for looking at stones. However I am not a vet. I just got the idea that sonograms are good for looking at things that don't show up well on x-rays, like the outlines of organs. Usually stones and sludge show up pretty well on x-ray.

 

[tonyshuman]

Since you're not seeing any sludge in the urine, I would think a stone is more likely than sludge. However this is an interesting article that includes an x-ray of a rabbit bladder full of sludge:
http://www.petcarevb.com/wordpress/rabbits/calcium-metabolism-in-rabbits/

This page talks about how ultrasound is useful to determine stones:
http://www.lbah.com/canine/urolithiasis.htm

This article from Medirabbit shows x-rays and sonograms. Apparently sonograms are useful for stones that are radioopaque (rare in rabbits) or very small ones.

Warning: SURGICAL PICS START ON PG 7, Painful-looking stone pics earlier in the document.
http://www.medirabbit.com/EN/Uro_gen_diseases/Mech_diseases/Urolithiasis.pdf

 

[kirbyultra]

Those are great links. The pictures are helpful. I had no idea the stones in a bunny could be so big and range from smooth to so...jagged!

I suspected that the sonogram would be used for a better look at stones. I've had something similar done for myself a few years ago.

I think I will observe her closely for another week or so before I decide to take it a step further. She seems to be improving a little bit. I saw her loafing today instead of flopping on her side like she has for the past month. ray:

 

[kirbyultra]

It's been 9 days since I last posted and Penny has not had a single accident in those 9 days - knock on wood! She's been drinking water but not as passionately as she did before. She hasn't been dirtying her tail either. I am tempted to say that this is resolved!

I didn't spend the big bucks to get an xray upon seeing her improvement. Among other reasons, I have decided to reduce the # of litter boxes in Penny and Kirby's pen because I want to see all of Penny's output in 1 place. It's just to ensure that I am making my judgment accurately and it's harder when her urine is in 3 different boxes.

The leg thing is still sort of weird. When I watch her hop, she does sort of have a wider gap between her legs which makes me wonder if she was previously housed in some place that had smooth surfaces. Not exactly a splayed leg but she may have had to walk really funny if she slipped around a lot. She's unlike my other rabbits who are instantly deterred by the hardwood floor. She just walks around on it anyway, and she slips around. She does have a lot of good surface with traction now, but I think the leg thing may just be from previous housing problems. If that is the case, I suspect with more time and exercise, her right leg may come back up to speed and be normal again.

 

[kirbyultra]

Digging up an old thread... I just wanted to add to it instead of starting a new thread because of relevancy. I took Penny to the best rabbit savvy vet near me and he had some interesting things to say. I felt like he really heard what I was saying and considered Penny's symptoms holistically rather than dismissing the details I tried to provide. He also looked over Penny's urinalysis and CBC from April.

Basically in the last 2 months I've been experimenting with different vegetables exclusively to see if Penny reacted any better in terms of her poopy butt. She was getting 1/4 cup of pellets throughout the experimentation. Some veggies were better than others but really, the result were pretty inconclusive. The one thing I found really curbed poopy butt was cutting veggies out completely. That's been going on maybe 3-4 weeks now.

He got 2 views of x rays done on her abdominal area and, much to my surprise, Penny's bladder is free and clear of any calcification. There's no build up of any kind in there. Bladder is normal size and shape. He agrees based on the tests done in April that kidney function is within normal range as well.

He tested the reaction and usage of her hind feet and they seemed pretty good. Hips and backbone structure look fine (they were captured in the abdominal x-rays). Penny's "bipedal" motion could just be... Penny being Penny.

The vet suggested that I do a test of just how much she drinks in a 24 hour period if left to drink an unlimited amount of water per day. I'm going to try to fill up jugs with water and keep refilling her crock to see how much she can put away a day. It will not be a pretty day on the floor, that's for sure, but it's a measure of how much she's really capable of drinking.

After that, assuming it's normal, he wants me to try to switch Penny to a hay and fresh greens type diet only (supplement with pellets only after greens have been proven ok). Reason being he thinks the poopy butt is due to an overall excess of protein, and he thinks greens is better to feed than pellets if he had to choose a source of nutrients. -- I know this point is debatable on the forum, but this diet decision was made as a whole between my own observations of my rabbit and my vet's professional opinion, so I'm going to give this a try.

Hmm that's all I can think of for now.