Megacolon and Gut-flora Advice, Please...

[Gabby]

Marietta wrote:

Gabby it's so relieving to see that your bun has reached the age of a ...senior citizen, though he's been having GI stasis problems throughout his whole life! My Vitto only had 1 GI stasis bout, but it was a serious one and, at that time, I had reached the point of being certain that I'd lose him. It was an awful 2-week period that I dread to remember...

Out of curiosity, how do you know that Stormy is alergic to cats? Does he sneeze when around them? What about when he's close to dogs?

Marietta

actually i had not thought about that, but yes when he was a year old i was sure he wouldn't reach 2 years old having the bout so bad. So I'm glad then to have shared that yes they can reach a full age with intestinal issues.



I do not have any cats, I only have dogs, and Stormy has always been find around them.

On trips to the vethe would stay the day since I was working and he couldn't leave until I did. he would stay in the cat ward, and the first day his eyes got a bit red and runny. an hour after being home fine. 4 seperate days in the cat ward and the worst was when the cat ward was nearly full and his eyes became very red very puffy and runny(that was the last day he stayed there), and he seemed a bit congested. now mind you we use yesterdays news for the cats, so i know it wasn't a litter issue. and after returning home, he would be back to normal after an hour or 2.

I asked the vet what do you think the chances are he's allergic to cats. She said" I'd say he is, next time he comes in run him home after his xrays, then come back to work, or bring him in when you are not working so he can go home promptly. "

and on those days that i took him home right afterno reaction, and he never entered the cat ward, but stayed away from the cats in the breakroom until i took him back home.

 

[Marietta]

Amazing! Never heard of a bun being allergic to cats! Poor Stormy! Runny eyes must be so annoying to him! Thanks for sharing this info!

Marietta

 

[Jenk]

Thank you for the detailed information, Randy. For sake of ease, I've replied directly within your previous post.


ra7751 wrote:

Couple of quick thought here. The liver enzymes were probably due to stress from the vet visit. We have seen that happen often. I have the advantage of being able to pull blood here so I have seen that.

It's possible, but her liver enzymes were off per two separate tests. Granted, she was likely stressed during the second time around, too. But some of her enzymes were double what they ought be. (I can't recall right now which ones they are.) Per the vet, the second blood test reveals a decrease in her liver enzymes, butstill-elevated ALT levels.

Has this rabbit been dewormed with something like Fenbendazole? If not, it might be a good idea. Keep in mind that a fecal is not perfectly accurate. Coccidia is difficult to treat. Sulfanomides and/or Albon can help it from reproducing but the rabbit's own immune system is the only way to get rid of these little protozoa.

Zoe put on Albon for two weeks as a result of herfirst wellness check-up. Since then, she's had at least two (possibly three) other fecal floats which did not indicate a Coccidia issue.

Ihave used ascorbic acid (Vitamin C) but you really would want to be careful. It is water soluble and the excess is excreted in the urine. The idea is to acidify the gut. You are already doing that by using the Bene-Bac. The bacterial strain L Casei that is contained in BB is one of the best at stabilizing pH in the digestive system. Many think it's the bacteria in Bene-Bac that does the trick....it's actually the change of pH induced by the acidophilus strains. If you used Baytril orally, it might take some time to get things back in order.

Zoe's been on Bene-Bac throughout her latest antibiotic treatment. (Her last dose of Baytril was March 28th.) Right now,she receives a daily (.6 mL) dose of adandelion milk thistle tincture (for her liver values) and a (.5 mL) dose of Bene-Bac . Her vet mentioned possibly stopping the Bene-Bac treatment around April 19th. But would it do her any harm to continue her on it beyond this point?

You might want to discuss with your vet an alternative antibiotic should one be used. The use of antibiotics in gut issues is very controversial in the vet community...but I have found it to be very effective especially in pre-emptive strikes with stasis and/or ileus. But Metronidazole (Flagyl) is very good at controlling the primary pathogens at work with gut issues.

I will ask Zoe's vet about the use of Flagyl for any potential future gut issues.

Prevotella is an interesting bacteria to be cultured here. What were the other two? And just wondering here...has any x-rays been done to take a look at her molars? Just a thought.

Besides Prevotella, an abnormal count of Bacillus and Enterococcus (sp?) were found.

I'm curious to know why you say thatPrevotella is "interesting" to be cultured. Even the vet, who works solely with exotics, said that he is not overly familiar with Prevotella. (When I Googled it, I found articles that a bit more technical than I'd like.)

To my knowledge, the x-rays did not include head shots. I realize that the oral exam done by rabbit-savvy vets isn't the same as x-rays, but the vet does thorougly examine Zoe's mouth during every visit. (He performed an extra-thorough one when Zoe was knocked out for her x-rays.)

What specific molar problems, though, could be contributing to such a bacterial overgrowth as Zoe's?

Randy

 

[Jenk]

Hi, Marietta.

My reply is within your original post (below).

Marietta wrote:

Jenk, I don't believe that you're gonna have GI issues if you add several types of hay to Zoe's diet. It could be a good idea, since variety will make her be even more interested in hay and eat more.

I'm considering trying brome or oat hay first. But if you've an opinion on which one might be best, I'm all ears. :biggrin2:

In regard to veggies, in general dark leafy lettuce is okay for buns, however, in case of a rabbit with intestinal problems, like yours and mine, I don't know if lettuce would be a good choice, I don't give my Vitto lettuce at all. I give him one cup of a mix of endive, wild chicory, dill and parsley daily or per 2 days. I try to avoid any "garden veggies" and prefer the kind of greens a rabbit could find in nature, this is why I opt for herbs and wild leafy greens.

I'm leery of endive because Zoe developed problems after I gaveher a small amount of it for a few days. Granted, it could've been an issue of her already having gut-flora problems that happened to become symptomatic around the time that I gave her endive.

The vet has said that he wanted me to put her on more "gentle" forms of lettuce, such as green- or red-leaf lettuce. That's what she normally gets, although I've used romaine at times, too. Again, though, she only gets a very small amount of greens.

Since you avoid giving Zoe pellets, how does she maintain her weight?

That's a good question. I'm guessing that it's namely the hay, though; she eats like a horse, and we give her tons of eat daily. She never runs out, though it gets pricey to go through about a 40 oz. bag each week. Ironically, Zoe has slowly gained in weight throughout her many vet visits. She hovers around 4 lbs.

Hay is very low in calories, compaired to pellets. Also, how did you determine that pellets are the culpit for her GI issues and not veggies? It would be much better if pellets were not the problem, since they provide a balanced diet to rabbits. I have no experience on a non-pellet diet, maybe other members, could tell us if this kind of a diet could possibly cause any long term issues, like e.g. lack of any vits., minerals, etc?

It just seemed that pellets caused her main issues due to the timing of things. I even took her off of veggies and gave her a micro-amount of pellets; she became gassy/ gurgly.

I've heard from a few other rabbit owners (and Zoe's vet) that some rabbits simply can't deal with the carbohydrates and protein in pellets;thus, they're best kept on hay and veggies.

I notice that some of Zoe's poops seem more moist than normal (for lack of a better term) after she receives veggies. But they're still formed. And she also still produces her more normal-consistancy poops (i.e., drier to the touch) throughout the day.

Marietta

 

[Marietta]

Jenk, that was a very good and very detailed description of what's going on with Zoe, so now I have a full picture of the situation. Given her pellet-digesting problems, I'm pretty sure that if you stickto a lot of hay as you do (you are fortunate that shelikes eatingtons of it!), she won't have any problems. It's impressive that she's actually gaining weight by eating mainly hay. She must be a monstrous hay eater, would love to see her munch!!!

In regard to your question on hay types, any type of hay that is not high in proteins (alfalfa is, as you probably know) is good for her. It could be anice idea to ask her vet if the lack of pellets would constitute a somehow "poor"diet nutritionally-wise over the years. I would be interested to learn what a rabbit savvy vet's opinion on this would be.

I wish that Zoe stays away of tummy troubles! I wish the same thing for my Vitto, too!

Marietta


P.S.: I edited to add that I'd love a picture of Zoe eliminating piles of hay!!! Hehe!

 

[Jenk]

Marietta writes:

It could be anice idea to ask her vet if the lack of pellets would constitute a somehow "poor"diet nutritionally-wise over the years. I would be interested to learn what a rabbit savvy vet's opinion on this would be.

You're absolutely right. I'll have to ask him that burning question.


Marietta writes:

P.S.: I edited to add that I'd love a picture of Zoe eliminating piles of hay!!! Hehe!

I'm not up-to-speed on posting images, but I need to catch up; that way, I can provide plenty of Zoe (and Emma) pics. (I refer to them as my chocolate-chip [Zoe] and caramel-colored [Emma] bunnies. :biggrin2

 

[ra7751]

Umm....I am not a vet...but if there is any way you could e-mail me a copy of her culture....I would really like to take a ganderat that one. Those bacterium have made things even more interesting to me. I have a "gut" feeling here on this one.

As far as fecal floats....they are not perfectly accurate. Coccidia is easily found....not so easily treated. Looks like "fried eggs" under a scope....easily noted. Other parasites are harder to detect, but generally easier to treat. If this were my rabbit.....I think I might run a course of Fenbedazole (Panacur) just on a hunch. And I would most likely run about a 10 day course of Metronidazole (Flagyl). In the real world, most rescues we admit have both coccidia and worms....and we treat routinely without a fecal. That is based on the fact that fecals are not perfect and that treatment is less expensive than inconclusive testing.

I suspect the elevated liver values might be a symptom of something else rather than a primary issue. I am not a huge fan of herbal treatments, not totally against them either, but I don't like to run both herbal and conventional treatments at the same time.

The Bene-Bac is a very valuable tool to help maintain the pH in the gut. It can be used daily and can't hurt....I use it with all our incoming mammal wildlife rescues. We do have some rabbits with this IBS....and they don't handle pellets or greens very well. A rabbit can live a perfectly healthy (and in some cases a much healthier) life on high quality hay. Nature never intended a rabbit to ingest the proteins contained in pellets. Look at cottontails (I know they are different species but the inner workings are the same)....they live very healthy lives off grass (and that is what hay is) and things like bark. Something that might be of help is to offer some oat hay. Good stuff. The key to a hay only diet is to offer only top quality hay of known nutritional value.

As far as molar issues....rabbits are very prone to molar root abscesses. They can lead to some difficult to diagnose and treat problems. These issues are sometimes not visible to the naked eye. An x-ray or MRI is needed to take a look at the soft tissues surrounding the molars.

But in my non-professional opinion....I would deworm using something like Fenbendazole and would talk seriously about runninga round of Metronidazole. Ask your vet about a bacteria known as Clostridium. Just another one of my thoughts.

Randy

 

[Jenk]

Randy writes:

...If there is any way you could e-mail me a copy of her culture....I would really like to take a ganderat that one. Those bacterium have made things even more interesting to me. I have a "gut" feeling here on this one.

I will ask the vet's office for a copy. I may need to have it faxed, but then I could at least type out the results. (And I should have it on hand for myself anyway.

...Coccidia is easily found....not so easily treated. Looks like "fried eggs" under a scope....easily noted. Other parasites are harder to detect, but generally easier to treat. If this were my rabbit.....I think I might run a course of Fenbedazole (Panacur) just on a hunch. And I would most likely run about a 10 day course of Metronidazole (Flagyl). In the real world, most rescues we admit have both coccidia and worms....and we treat routinely without a fecal. That is based on the fact that fecals are not perfect and that treatment is less expensive than inconclusive testing.

One issue for menow is the number of medications that Zoe's been on in her eight short months of life.I'm worried about throwing yet something else at her delicate system, although I understand that Coccidiosis (if still an issue) would still require treatment, regardless of how many med's she's taken.

Before I do anything, I'm going to do a Google search on the side effects ofPanacur and Flagyl. I just want to be aware of what to possibly expect.

I should also mention that Zoe was a pet-shop baby (please don't berate me too much on that point) who was removed too early from her mom. She was just a month old when I brought her home; soher immune system wasn't prepped for the removal of Mom's milk, the stress of going to the pet store and then moving intomy home a day later.

I suspect the elevated liver values might be a symptom of something else rather than a primary issue. I am not a huge fan of herbal treatments, not totally against them either, but I don't like to run both herbal and conventional treatments at the same time.

Earlier in your post, you mention having a hunch; now you mention a suspicion. Would you please share it with me now (prior to receiving a copy of Zoe's lab results)? I'm on pins 'n needles here.

The Bene-Bac is a very valuable tool to help maintain the pH in the gut. It can be used daily and can't hurt....I use it with all our incoming mammal wildlife rescues. We do have some rabbits with this IBS....and they don't handle pellets or greens very well. A rabbit can live a perfectly healthy (and in some cases a much healthier) life on high quality hay. Nature never intended a rabbit to ingest the proteins contained in pellets. Look at cottontails (I know they are different species but the inner workings are the same)....they live very healthy lives off grass (and that is what hay is) and things like bark. Something that might be of help is to offer some oat hay. Good stuff. The key to a hay only diet is to offer only top quality hay of known nutritional value.

Other forum members have expressed concern over Zoe's lack of pellets, and I often have underlying pangs of worry about her nutritional needs not being met. Her vet, though,seems to think that high-fiber hay and "gentle" leafy greens are the way to go (over pellets and veggies that are "harder" on the gut).

Do you have any brand recommendations in terms of hay with "known nutritional value?" I'm all "ears." Right now, the girls mainly receive Oxbow hay, though I've purchased Zupreem's Nature's Promise line at times in the past. I know that many exotic vets recommend Oxbow, but I'm not certain that it's considered one of the higher-quality hays.

As far as molar issues....rabbits are very prone to molar root abscesses. They can lead to some difficult to diagnose and treat problems. These issues are sometimes not visible to the naked eye. An x-ray or MRI is needed to take a look at the soft tissues surrounding the molars.

I won't dispute this, but I'm not in a position to put Zoe through more x-rays again just yet. I don't want to radiate the heck out of her, and my wallet is still feeling the sting from her last bout of tests (x-rays, fecal swab and blood work all at once). Ouch!

But in my non-professional opinion....I would deworm using something like Fenbendazole and would talk seriously about runninga round of Metronidazole. Ask your vet about a bacteria known as Clostridium. Just another one of my thoughts.

I was told that Clostridium was not found, per the lab work. I have read somewhat about Clostridium and the fact that the toxins from it tax the liver, which can cause raised liver values. But, again, the vet said that Clostridium wasn't found. I'm totally stumped in this regard. Heck, I'm stumped about Zoe's gut sensitivity all together (except that it seems almost common for dalmatian buns to have megacolon).

 

[naturestee]

My only concern about the no-pellet diet is that you can't feed her much in the way of greens either. I don't know about Randy's cottontails but the ones in my yard eat more dandelions, clover, and garden plants (!) than grass. I actually would prefer no-pellet diets as long as a good variety of veggies and hay can be found.

I was going to mention this earlier, but it would be a good idea to try some veggies with more nutrients in them. I think I saw you're feeding parsley and that's a good one. Kaleand collard greens (closely related) aregreat, soare spinach, mint (and others in that family like basil and thyme)and dandelion greens. Actually mint would be great if you can get it because it's good for treating upset stomachs. Ignore the HRS warnings on calcium in veggies- not only are they generally not an issue but a bun with no pellets needs calcium in particular. The ultra-low calcium diets have actually been shown to reduce bone mass in rabbits, not a good thing since they're fragile as it is.

 

[ra7751]

I really think that part of her problem is parasites. I have seen that all too often. Generally, fenbendazole will take care of most of these type parasites. As far as side effects....we have had rabbits on this drug for as long as 60 consecutive days without problems. I was actually monitoring it's effectiveness against E Cuniculi. Off topic a bit, it's not very effective against EC. But it did prove that it could be used without major concern. I do take into consideration that every medical treatment has the possibility of some type of negative reaction with any one particular individual. I have had a recent event with a "special needs" rabbit....she has worms and coccidia on top of having a brain stem infection from an improperly treated vestibular infection. Obviously, I attacked the brain stem issue first....but I treated for worms before I treated the coccidia. Albon (and sulfanomides) do not actually kill the coccidia...only the rabbit's own immune system can do that so I tend to take care of the other issues that stress the immune system before I treat coccidia.....maybe a bit different than standard treatment but it works.

As far as hay....my primary offerings here are Sweet Meadow Farm and Bunny Bale...both are available online. I have heard nothing but good things about Kleenmama's hay. Shippingcosts are a concern with Kleenmama's for those ofus on the east coast. And American Pet Diner has a higher protein timothy hay. I think APD's hay is very high quality....butit costs much more per pound than other equally as good hays. But the thing is....adding protein will upset the cecal balance and that is the battle you are already engaged in....I would try not to open a second battle front. And, not meaning to step on anyone's toes here because I know many here are huge fans of Oxbow....but Oxbow is suggested by many vets because it is a huge profit maker for the clinic. No doubt it is a high quality hay....but certainly is no better than that offered by other suppliers. I buy really good quality hay from a horse farm.....bought it for litter boxes since it's only $12 per bale..but our rabbits love to eat it. And I do have rabbits that get only hay and water....we use pellets only to maintain weight and body conditioning.

And a four week old bunny taken from it's mother....I think you are totally correct in that may be playing a part in her issues now. One of the only legal protections offered to rabbits in NC....it is illegal to offer them for sale or as premiums (like prizes at carnivals and fairs) if they are under 8 weeks old.

Randy

 

[Jenk]

Randy writes:

I really think that part of her problem is parasites. I have seen that all too often. Generally, fenbendazole will take care of most of these type parasites. As far as side effects....we have had rabbits on this drug for as long as 60 consecutive days without problems. I was actually monitoring it's effectiveness against E Cuniculi. Off topic a bit, it's not very effective against EC. But it did prove that it could be used without major concern. I do take into consideration that every medical treatment has the possibility of some type of negative reaction with any one particular individual.

I'm awaiting the remaining results of Zoe's retest (fecal swab and blood work); I've already learned that her ALT liver values are still elevated, while othershave decreased. Whenthe vet calls me to verify the remaining results, I'll ask his thoughts about the possibility of Zoe still suffering from parasites. (I'm not disagreeing with you that she may still have parasites; I'd just like to hear the vet's reaction to the idea--to see if he's close-minded about it.)

And a four week old bunny taken from it's mother....I think you are totally correct in that may be playing a part in her issues now. One of the only legal protections offered to rabbits in NC....it is illegal to offer them for sale or as premiums (like prizes at carnivals and fairs) if they are under 8 weeks old.

The vet has said on more than one occasion that he believes the crux of Zoe's problem is the fact that she was taken from her mom too early (rather than anything else). But I do believe that she suffers from megacolon (same as IBS?) because her fecal pellets vary so much in size/ shape/ consistancy (dryness/ moistness).

Being more knowledgeable about bunnies now, I completely agree that any age under eight weeks is too young. Unfortunately, selling month-old bunnies must be legal in IL because the store from which we got Emma and Zoe isn't the only one in which I've seen itty-bitty babes. (I just saw a lil' bitty thing in another store three days ago. )

Ironically, my husband and I had fallen in love with a four-month old dalmatian Mini Rex at the store (who, it turns out,is Emma and Zoe's older brother). He was the only one for sale at the time and was Mr. Personality. Soafter two days' worth of discussion, we returned to get him only to learn that the breeder (due to the bun's age) had taken him back the day before to keep him as a breeder; in his stead were five baby buns, two of whom included our Emma and Zoe.

I regret having put money toward a practice (selling too-young bunnies) that's just wrong and have learned my lesson. From here on out, I'll only adopt bunnies in need of a good, loving home. (By the time that my husband and I are able to take in another bun, I'll be quite the expert on rabbits, considering all that I've had to learn regarding Zoe's medical issues. )

Jenk

 

[Jenk]

I just discovered a voicemail from Zoe's vet, which was left yesterday. He said that, perZoe's culture,Enterococcus is still present, as well as "mild Staph," which wasn't a resultof the previous culture. He mentioned that Entercoccus tends to be antibiotic-resistant, which I've already read online.

The vet wants to resume Baytril (10 days' worth of.45 mL/ day). He said that he prefers Baytril over other medications when it comes tobunnies, though I'm uncertain as to which medications he's referring. (I'll have to ask.)

When I call the vet back, I'll ask his thoughts on thepossibility of Zoe having some form ofparasite(s)--Coccidia or otherwise--promoting all of the fallout symptoms (megacolon, IBS, gut-flora imbalances, GI statsis, etc.).