Slightly Impacted Cecum

[sidney_bunny]

Hello,

I have a nearly 4 year old male neutered rabbit. He is 2300 grams and a bit overweight for his size. My vet says that his Cecum is firm but not hard. He has been largely asymptomatic. Does anyone know the trick to clear this?

During week 1, he had a less aggressive appetite and some messy cecotropes. He normally finishes his food before the next feeding but started to take several hours to finish his pellets but always finished in time. This is rare for him. He devours everything and is usually begging for more. He gets 1/8th cup Oxbow pellets twice a day and greens twice per day. All else is perfectly normal.

I took him to the vet on the 3rd day and my vet said his cecum felt a bit firm. They tested his poop for parasites. All good. CBC and chem panel resulted in normal findings. He has a slightly high temperature and his white blood cell count was slight elevated but that seems to be normal with him. We suspect he ingested some carpet fibers.

I started bene-bac and increased his fluid intake by adding juices. Within 2-3 days, his appetite was back to normal.

One week later, the follow-up vet visit still showed the firm cecum. Everything was still normal.

Today is the 3rd week and he suddenly started to act like he was in pain. No teeth grinding but some odd sounds. I thought there was something wrong with his back legs based on the way he was moving. He was also stretching and pushing his stomach to the ground. He also urinated a bit on a blanket on my bed, which never happens. He seems to be better a few hours later. During this time, he was still eating his pellets from the AM, drinking, and eating some hay. He did not want to return to his cage most of the day except for brief period of time. He's been hanging out on the bed.

Am I missing something? Anything I can do?

Thanks so much and sorry for the long post.

Bill

PS - all poop has been looking good and the volume is normal.

 

[JBun]

Did the vet give you a gut motility med or metacam for the pain? What type of hay do you normally feed?

Fiber and hydration are the most important things to improve gut motility. If your rabbit drinks from a bottle, offer a water dish as well, because rabbits usually drink more from a dish. Also wetting down his veggies before giving them to him, will help give him that little bit of extra fluid. A little bit of juice as a temporary measure, can sometimes be helpful to get a rabbit drinking more, but it's not good long term and can actually worsen gut motility issues, as the added sugar slows things down and can contribute to overgrowth of harmful bacteria. Cutting out pellets and any sugary starchy treats(fruit, carrots, grains, etc), as they contain sugars and carbs that worsen motility issues and bacterial overgrowth, will usually help to increase gut motility, then feeding unlimited grass hay and dark leafy veggies(ones that he is used to preferably). The fiber in the hay and the moisture in the veggies, will help increase motility, and also limit the ability of harmful bacteria to feed off of excess sugars. When changing the diet though, you do need to ensure that he is continuing to eat hay and veggies really well.

If you didn't get a gut motility med or metacam for pain, you may want to ask your vet about getting them. A rabbit in pain doesn't usually want to eat. You may also need to syringe extra fluids or learn to give sub q, and you may need some Critical Care food mix, in case he won't eat well on his own.

Make sure he stays warm, as their body temp will usually decrease in these cases. Also encourage him running around, as that also helps motility. Sometimes gentle belly massages also help. But check with your vet first, to make sure belly massages are ok with an impacted cecum.

http://rabbit.org/sluggish-motility-in-the-gastrointestinal-tract-2/
http://rabbit.org/disorders-of-the-cecum/
http://rabbit.org/gastrointestinal-stasis-the-silent-killer-2/
http://rabbit.org/how-to-massage-your-rabbit/

 

[sidney_bunny]

Thanks for the reply.

1. No gut motility or pain medicine. He wasn't showing any signs of pain prior to the two appointments. It did not come up. She mentioned she did not prescribe something for his stomach because his poop was good. I'll ask again tomorrow at the vet.

2. We're using water dishes. We have this three story cage and put water on every floor and I kept some plain water too. Thanks for the note on the fruit juice mix.

3. I'll figure out how to adjust the diet. Since he never stopped eating or ate any less food, I need to figure out how to monitor his input with a diet change. My #1 indicator has been monitoring how many hours to finish the pellets.

4. I feed him American Pet Diner 1st cut and 2nd cut timothy hay. I put one basket of each kind in his cage. I put some 1st cut in the front of the litter box because he likes to munch there and never soils that part of the box. The pellets are timothy Oxbow. I recently added Oxbow's new timothy-only compressed hay stacks as well.

I am beginning to think the theory on ingesting carpet fibers might be wrong. It sounds like I need to look closer at his diet. He weighs too much but I never feed him the typical bad foods. He never gets human food. I was providing these tiny Oxbow strawberry cubes for rabbits. They are like 1/8th of an inch and maybe 1 every few days. He gets lots of exercise. Maybe the 1/4 cup per day of pellets is too much? Maybe I've feeding too many veggies? I do provide an inch piece of carrot once per day.

Thank for the links!

 

[JBun]

It is possible he ingested some foreign object, and that is the cause. We all know how our house bunnies like to chew on things they aren't supposed to But diet could certainly be a possibility as well. Some rabbits can just be extra sensitive to food. I have one rabbit that can't have pellets or any sugary treats, or he develops GI stasis. Less often some rabbits seem to be sensitive to certain veggies, often the cruciferous ones, but that is less common than foods with carbs and sugars causing issues. After your bun is back to feeling better, it might be good to eliminate that strawberry treat and carrots, and just use leafy veggies as a daily treat. Cutting back pellets may be helpful as well, especially if he is overweight. You just want to make sure to feed enough to keep him at his ideal weight, but also you want him staying healthy and not have pellets causing digestive problems.

With my rabbit that doesn't get pellets, I monitor his daily food consumption by whether or not he eats his veggies, as well as feeding a measured amount of hay(though still unlimited). I've kind of calculated how big of a handful of hay that he eats each day. Then if most of it is gone at the end of the day, I can be sure his eating is alright. With your bun not being well, and not knowing how much he'll eat, if possible, you could try putting in small handfuls at a time, and just keep checking on him to see if that handful gets eaten, and replenish if needed. Then you'll know he's eating it and how much.

The gut motility med is just to increase movement through the gut, which may also help get things moving in the cecum. And metacam is always good to have on hand, especially for a rabbit experiencing digestive problems.

 

[sidney_bunny]

Do rabbits who ingest a foreign object literally pass it out the other end? or I am waiting for it to break down and then leave his system? Of course, all of this presumes the carpet fibers went to the cecum in the first place. It's been at least three weeks since he injected any carpet and I'm not certain he did in the first place. Sidney has been under close supervision since all of this began.

Thanks again.

 

[JBun]

Non digestible fibers, like carpet, have to either be passed out or surgically removed. Surgery on a rabbits cecum is certainly something to be avoided if at all possible, as the fatality rate seems to be pretty high. Hopefully with a change of diet you'll start seeing some improvement soon. I don't know how long it can take with an impacted cecum, but with hypomotility, usually you can see an improvement in the first day or two.

I also can't stress the importance of hydration too much either. You want to closely monitor his consumption. Lots of nice leafy veggies will help, but if he isn't drinking very well, then you may need to help supplement his water intake.

 

[Imbrium]

I missed this thread before; just got caught up... how is your bunn doing? Any improvement?

If you feel the need to supplement his water intake, you could try giving some unflavored pedialyte in addition to water (unflavored is the only kind without an artificial sweetener (which shouldn't be given to pets) in it).

 

[sidney_bunny]

He has not had any obvious pain issues since earlier this week. His poop isn't quite as large and as much as I'd like but he's behaving normally. I will schedule another follow-up appointment after Christmas.

Thanks for following up!

 

[Imbrium]

Poor little guy... have you tried any dietary changes yet (like temporarily cutting out either veggies or pellets) to see if you can isolate a problem kind or type of food?

 

[sidney_bunny]

I am reducing the pellets and making sure I don't exceed a handful of lettuce twice per day. He's gotten overweight and we don't understand how. That's why we're reducing pellets to about 1/8 per day instead of 1/4 cup.

I do have one update. A test did come back and it showed he has a minor level of Clostridium in his system. The vet said it was not enough to treat given everything else going on.

8 months ago he had a mild case of giardia and antibotics took care of that. The current test does not show a problem with that anymore.

 

[sidney_bunny]

Not sure if this is a breakthrough or not... I'll search the archives in a few minutes.

I was looking at the litter box and saw two pieces of poop stuck together. Although a disgusting job, I separated and examined them carefully and realized there was a very long chunk of his hair. It's more than 1" long and it's quite a bit all together. In fact, the bulk of the mass was hair rather than whatever is normally there.

Is this normal??

 

[Imbrium]

That is not at ALL normal... however, the fact that it's coming out of your bunny is an incredibly good sign! Inappropriate amounts of hair coming out of your bunny is a hell of a lot better than it being stuck inside - that means all the hay and water (and hoping and praying) is doing its job and pushing things through. I really hope that was the only problem all along and he'll truly be back to himself now!

I know dissecting poop is inherently a bit gross, but be glad it was bunny poop and not cat poop - hard, dry and odorless FTW! On the plus side, you're speaking exclusively to people who have come to regard poop as an acceptable and routine topic of conversation; something one might make small talk about or discuss at the dinner table, lol (unless there's non-bunny folks around to look at you like you're crazy, that is).

 

[Imbrium]

On a side note, based on the time of year and the size of that mass of hair, I suspect your bunny's going through a molt (or was at the time it was ingested, anyway) - it's a really good idea to brush bunnies at least once a day during a molt and now that you know he'll actually swallow a clump of hair that size rather than doing the logical thing and spitting it out, it may be better to brush him twice daily while he's molting and at least 1-2x a week when he isn't .

Personally, I swear by the furminator (and many others here do as well) - it rakes out gobs of loose/dead hair infinitely better than any other brush or comb I've ever tried. They run around $70 in pet stores, which is utterly obscene, but can often be found on Amazon or eBay in the $20-25 range. I use the one for long-haired cats under 10 lbs since one of my two bunns has longer fur (also, the cat ones were on sale and come in purple, my favorite color ); the "small animal" one and probably the ones for cats over 10 lbs and for smaller dogs are all equally viable - just don't get one for 70lb+ dogs or something, as it'll be huge and awkward. I can produce a loosely piled mound of fur the size of the bunny it came from in < 15 mins sometimes - more hair than I would've thought possible without ending up with a bald bunny!

I use it on both my Holland lop and my lionhead (who have very different coats/hair types) and it works great on both. Gaz (my Holland) disliked it at first but got used to it; Nala was fine with it from the start. Furminators come with a money-back satisfaction guarantee, so if you buy one and don't like it, you can always return it.

 

[sidney_bunny]

Thanks for the response especially so late. His last molt seems to have been more than a month ago. It just wasn't on my radar since he doesn't look like he's molting anymore.

I may try (again) to find some canned pumpkin. I'll have to try Whole Foods this time. Based on what I read, that might be some good extra fiber. I also stopped buying Papaya tablets but will find some too.

Thanks!

 

[sidney_bunny]

Just saw your 2nd post while I was responding. Thanks for the tip on the furminator. I've been using the Zoom Groom soft brush for many years but will try your suggestion. I see one for $18 on Amazon.

I REALLY hope that was the sole clump of hair from 30+ days ago since the molt is not very recent. I will go back and check pictures. I wonder if the molt was actually late October. None of this adds up to the "normal" timelines but we take pictures all the time. It will help me remember.

 

[Imbrium]

Well, for every "normal" there's an "abnormal"... no telling how long something like that could take to make it all the way through (as it could also have been stuck in his stomach for quite a while).

The best I saw on Amazon that wasn't more than about 2'' wide (for the combing blade) is this one at $18.99 w/free shipping... on ebay, the cheapest I see that's an appropriate size is $19.95 w/free shipping, as I suspect the 2&2/3 inch one would be a bit big for a 5lb-ish bunn. Either way, not bad prices

Edit: well, the Amazon one's free shipping if you've got Prime or order $25+ of super saver items... I tend to forget that catch sometimes, as I've been spoiled by Prime.

 

[sidney_bunny]

Yep, I have Prime and placed the order. Thanks

I'm trying not to be too optimistic. I imagine it's possible there's quite a bit more still inside. Assuming he's acting well tomorrow, I will likely be able to get a regular vet appointment on Thursday so she can feel his cecum again. Maybe we'll get lucky and it feels more "normal" based on her past experiences.

 

[Imbrium]

Well, if nothing else, he's at least got less stuck inside him! I really hope things turn around now, though. Don't forget to bring the dissected poop sample with you to the appointment on Thursday

I hope you love your new furminator as much as I love mine!

 

[sidney_bunny]

After I pulled that giant chunk of hair from his litter box, I did not dump the box again. Big mistake. I just changed it an hour before. Now, I'm not sure if he has pooped since passing the fur ball. It did not occur to me that he could now be fully blocked - assuming everything did not come out.

It's also 11AM here now. He won't be that active and it may be normal not to poop until later on this afternoon. I was able to pull him out of his cage to hop around and play for a half hour. It seems he was behaving normal but I am being overly sensitive right now to every little action.

I've since changed the litter box again and am on poop watch. I think it's possible he pooped in this timeframe but he did it in exact the same spot in the litter box. I can't be sure.

 

[JBun]

That is quite a large clump. Can you tell if it is actually his fur or carpet fibers?

You can try canned pumpkin, but with you reducing his pellet amount, he'll be eating more hay now, and the extra hay consumption will help push things through better, especially the first cut hay that you are feeding, as it usually has more stems and more indigestible fiber.

The clostridium is something to keep an eye on, especially with the slow motility going on.

Hopefully you'll see some more fresh poop soon.