Issue

[bunniekrissy]

Lately Sonicka has been having some intermittent runny cecals and some occasional urine staining on her rear end. She doesn't get badly soaked or urine burned, but slightly wet and has stained fur. Her ears have also been looking droopier again (months ago she was treated with antibiotics for the possibility of an ear infection after her ears were drooping, and they seemed to perk up again.)

So I brought her to the vet, got a urinalysis and fecal test done which both came back normal. Then we did blood work and I just got the results today. Also, the inside of her ears look perfectly normal. Also I have been giving her benebac daily for the last 2 weeks after 2 nights of runny cecals in a row, and there has been one more full incident of runny cecal in that time and 1 very tiny incident (very small amount).

Her liver enzymes were just slightly elevated, and one type of white blood cell count was slightly elevated as well, but nothing indicating an unchecked infection, according to the vet. They said these things can probably be explained by her digestive system developing unbalanced bacteria levels. Everything else was normal. Vet said if it were something like EC she would have expected to see some other more abnormal results from the blood panel.

(P.S. - the nearby vet I was hoping would be good with rabbits did not pan out. When I asked how many rabbits they see per week, the receptionist said they mostly see cats and dogs but have helped "quite a few" rabbits ... gee, that's great since the business card you sent out says exotics, rabbits, and birds. So the vet we saw is the one we've been seeing who treats a lot of rabbits including for the largest rescue group around here, but she does seem to be unaware of some of the latest in rabbit care according to things I have read here.)

Here is what they recommend:
-Gradually switching her to an all hay and veggie diet (she currently gets Oxbow bunny basics T pellets also)
-continue benebac
-reglan (I know ... not the treatment plan I had hoped to hear from them)
-bloodwork again in a month or 2

Any thoughts?

 

[Maureen Las]

Do you mean runny fecals (regular rabbit poops) or runny cecals (the little grape like cluster of poop that they eat ( or both )
If she is having runny cecals (or fecals) there is the possibility of a parasite like coccidia ( or worms )which often doesn't show itself in one fecal sample....Then again usually with parasites the eosinophil count may be elevated
I had a bun with a tapewom which went undiagnosed until his neuter surgery; the surgery disturbed the worm and Rudy passed a portion of it the day following surgery; he had previously had a normal fecal test
The urine staining and wet behind on Sonicka are really not normal at all. however, congrats on getting a vet who did thorough testing on her ...
If she had renal problemsit would have shown up in the lab work; if she had a bladder infection that would have shown up in the urinealysis.
It is possible that this is the beginning of a yet undiagnosed problem so having repeat blood work in a month or so is a great idea.
How old is Sonicka and exactly what have you been feeding her daily?
I am not sure why the vet would prescribe Reglan which is a gut stimulant. I have heard of it being used for diarrhea in a rabbit ( rarely) but it seem to me finding the cause of the diarrhea is the most important problem rather than jumping to a gut stimulant

Did the vet tell you why he prescribed Reglan. if not I would call and ask him.

Also does she live inside or out ?

Does she have access to a yard where she eats grass and weeds etc.

 

[bunniekrissy]

I mean cecals. It has only happened overnight and she has normal poops the rest of the time.

She is 5.5 years old. I have been feeding her oxbow timothy hay, oxbow bunny basics T, and a small amount of veggies (usually parsley or romaine lettuce).

The vet did say it was a gut stimulant and that the intention was to deal with the bacterial imbalance issue but did not explicitly explain how she expected it to do so.

Sonicka is indoors and has not had access to a yard.

As far as the urine, I have not seen her with a wet behind again during the past couple of weeks, the last time I saw it was during the previous week.

Thanks for the reply.

 

[bunniekrissy]

Also, her appetite and activity levels have been normal.

Edit for one more thought: I suppose it is possible that what has seemed to be urine on her was actually from the runny cecals. I know her fur is now badly stained which is definitely from the runny cecals this time, even after a butt bath, and sometimes the color of the two substances can be quite similar. After consideration I was sure it seemed like urine, but you never know...

 

[Maureen Las]

I personally would not give the gut stimulant at all although I would give the benebac andI also would give a hay only diet for a few days and cut out the veggies altogether

I will try to find the article re. giving reglan for diarrhea but I don't think that your rabbit actually has diarrhea and to be honest I don't understand the rationale behind the Reglan.

http://www.medirabbit.com/Safe_medication/GI_stimulation/motility_diarrhea.htm

 

[bunniekrissy]

I'm double-posting since I'm not sure if you saw my edited post above before replying.


[align=left] Edit for one more thought: I suppose it is possible that what has seemed to be urine on her was actually from the runny cecals. I know her fur is now badly stained which is definitely from the runny cecals this time, even after a butt bath, and sometimes the color of the two substances can be quite similar. After consideration I was sure it seemed like urine, but you never know...

Yeah, I don't understand how a gut stimulant would be helpful either.
[/align]

 

[Maureen Las]

I didn't read the post ; we were writing at the same time
I wish Randy would comment on this post

Matter of factI will send him an email

Seems to me that either metronidazole ( which has anti- inflammatory properties ) or even the biosponge would be helpful in this situation .

http://www.entirelypets.com/platbio15cc.html?aff=shareasale

 

[ra7751]

My first thought on this, and I don't mean to flame the vet, but it sounds like the vet is inexperienced with rabbits. Many vets claim to be "rabbit savvy" but get their info from the VIN....basically a discussion forum for vets.

Fecals are notoriously inaccurate. If I have any thought of worms/parasites, I treat without a fecal. I do a slide and look for coccidia which is quite common. I treat coccidia a bit different as I have found that the traditional treatment, Albon, is not that effective. I use Marquis (Ponazuril). This drug is also the most effective treatment against E Cuniculi. I also question your vet's comments on blood work and EC. The blood test for EC is a titer....checking for antibodies. I know of no vet clinics that can run that titer....only a few labs in the US can run that. In my non-professional opinion, gut motility drugs like Reglan are totally inappropriate for use in rabbits period. If I used any drug for the GI issue, it would be Metronidazole (Flagyl) which is effective against a nasty anaerobic bacteria known as Clostridium. This bacteria is the primary cause of diarrhea in all mammals. I also use a horse product, BioSponge, to manage any enterotoxins produced by decaying bacteria and Clostridium.

I would certainly get back to a basic diet....lost of hay, limited pellets and fresh water. And if you can get a copy of the labs, I would be happy to look them over and see if something stands out. Liver enzymes are usually elevated just due to the stress of a vet visit. I would also get an abdominal x-ray as this problem can be cause by bladder/kidney issues such as sludge....and that is quite visible on conventional rads.

Randy

 

[bunniekrissy]

Thank you Randy for the response. A couple of questions.

Is there a difference between the treatments you mention of true diarrhea and runny cecals? I have only seen normal stools during the day so I am pretty sure the issue is only with the cecals.

Secondly, will bladder sludge not show up on the urinalysis? They mentioned checking several different aspects of the urine and I thought it sounded like sludge in the urine was one of them.

As far as the EC, no they definitely did not send it out for a titer. I think what the vet said probably was more in relation to parasites in general and the "eosinophils" angie mentioned above, though I was not familiar with the term the vet used so it has escaped my memory.

I know I haven't found an ideal vet. I am at a complete loss to find one who really knows all the newest protocol. There are rabbits at the office almost every time I am there, so she treats many of them, but she may not know the newest, most accurate info. I do have one new vet recommendation to check out from a friend. He is listed on an exotics vet association website under "Exotic Companion Mammal Practice (ECM) Specialty" and my friend who has a ferret was really impressed, but who knows if he is as experienced with rabbits, even though it lists rabbits as one of the species he sees.

 

[cirrustwi]

Just wanted to say that I completely love Randy's answer! :wink

Bladder sludge can be easiest to detect on x-ray. I always like to see an x-ray when there is a possible urinary issue, mostly because I've seen issues that just don't seem to show on a urinalysis.

True exotic savvy vets are just difficult to find. I work for an exotics vet and I take Tim to him, but I have a back-up who is the only person I take my reptiles to. At work, we see a lot of small mammals, but not too many reptiles. My reptile vet is just a fabulous exotics vet in general. I know he treats dogs and cats, but I've only seen that a couple of times. He's also an amazing teacher. (Just too far away to drive to daily.)

Good Luck!

Jen

 

[tonyshuman]

Although the hay-only diet is mostly for fecal diarrhea, it would help with a cecal bacterial imbalance as well in my opinion because the "good" bacteria in the cecum thrive on high fiber and the "bad" cecal bacteria thrive on carbs and proteins. Reducing those and increasing the fiber should promote the growth of the good bacteria.