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Rabbits - GI Problems: Symptoms & Treatment

Expert: Dana Krempels, Ph.D. - 11/7/2009

Question
QUESTION: Dear Dr. Dana,

I need your help in determine best course of action and appropriate dosage.

I have a four year old neutered male mini Dwarf rabbit (Honey). For the past four days he has been suffering from some worrisome intestinal issues.

Date of Birth: November 28, 2005
Surgical History: Neutered @ 16/5/2006 in UK in The Veterinary Center London NW10 5LE
Vaccination History: 27/3/2006 against Myxomatosis – 31/3/2006 Cylap against VHD 21/4/2007 Baytril

Weight: 0.85 kg in March 2006 around 1.4kg in November 2008.

General Conditions:
For the past 2.5 years Honey has had a continuous hair loss problem so much so I could not hold him for long period because hair in our mouth. Moreover, for the past 2 years his front teeth keep growing until they were too long. I will cut them especially since they appear to grow in separate directions and he is unable to completely lock his jaw. His appetite has been excellent. I also noticed some tears in his eyes from time to time

I will brief you on the symptoms:

Day1: I noticed Patches of very yellow smelly urine in the floor and when grabbed him a clear sticky crystal of jelly in 2.5 cm stuck to his bottom. At this point his appetite was less than normal. I also noticed an increase in his hair loss. I did not notice any droppings or urine.

Day2: In the morning I noticed Crystal clear sticky jelly of 1.5 cm of clear slightly yellowish with a 3 crystal drops size and 4 crystal clear sticky drops with fresh blood on them. In the evening, I noticed 7 Crystal clear sticky drops of jelly sticky with fresh blood on them. Throughout the day Honey continued to lose hair at a more accelerated rate and stopped eating and drinking. Ears felt cold to touch. I did not notice any droppings or urine.

Day3: In the morning I noticed Very sticky threads of jelly blood in dark red color, clear not frothy. Complete loss of appetite and no normal dropping or urine observed. but on the evening GI sound audible as gurgling but no signs of pain. Continued accelerated hair loss. Rushed him to a vet, temperature was 37.4C. Honey remained with the vet for one day for tests and observation. No eating no drinking no droppings.

Day 4: Vet massaged intestine and honey excreted 4 to 5 cm of Very sticky jellied blood and dark red color, clear not frothy. Dr. informed us that it is from rectal not bladder which Ruled out urinary system problem. He checked his eye vessels and found no sign of jaundice or any liver problems. The Vet’s diagnosis was Coccidia. But he did not confirm it due to lack of laboratory facilities. Temperature remained 37.4C. Vet informed us that Honey cried out when they were trying to shave him and check his intestine. He resisted them which is a sign of strength.

In the evening, he was quite in his box after he noticed that he was back home. We offered three pieces of cheerios which he gladly took. Once placed in his pin he went straight to the water and drank thirstily. He griped a small piece of banana but nothing more. He looked like he was going to urinate but he did not. Continued hair loss. Ears slightly warmer and when walking raises his rear end. And when sitting doing tried to sit on his rear.

Day 5: In early morning, possibly the night before, noticed very sticky jelly bloodied in dark red color. Clear not frothy. No urine or drops. The food looked touched but not much. Neither the water. Much More Audible Gurgling sounds continue but No signs of pain when it happens he is moving around or sitting peacefully. He also ate a little amount of hey. Ears seem normal.

He shown signs of wanting to go out of his bin and curiosity. Late on day 5, we gave him tablet of Roni-Plus. One drop of feces but it was not but more dark jellied blood with bubbles in it. Just before that more gurgling.

Treatment

On Day 4 the Vet administered Roni-Plus “Pantex Holland B.V” dosage was one tablet 3 times per day for 5 days on empty stomach as the vet said it is better.

Other treatment that is available but not administered.

1- Amprolium: They say it will not treat or eliminate only suppress Coccidia.

2- Trimethoprim Sulfa: Some it will, some say not

3- Coxuril? Baycox “Toltrazuril”: I read that it is used for chickens. Is the same type used for chickens can be given to rabbits? And if so at what dosage? I read once a day, 1 ml (25mg) / kg for 2 days after 5 days repeat it for 2 days also.

4- Appertex “clazuril” : Some say it will help and some say not

I am confused about my options we are running out of time. And we keep hearing different things on the Internet and from local vets.

My questions are:

- Is the vet’s diagnosis of Coccidia correct? If not what then?
- Which of the medications listed above will eliminate the Coccidia and not merely suppress it?
- What is the correct dosage?
- If there is something better that the medications listed above please tell me?
- Is there anything else I should be doing?
- What is the best food for his condition?

Thank you for your help. You are doing wonderful and noble job in helping innocent animals.

Layla

IMAGE: Honey

ANSWER: Dear Layla,

This is a worrisome problem, and blood in the stool is pretty rare in rabbits.

To answer your questions:

- Is the vet’s diagnosis of Coccidia correct? If not what then?

Did the vet take a fecal sample and examine it under the microscope for coccidial sporocysts? If not, then the diagnosis is a guess. Not a bad one, but coccidiosis severe enough to cause blood in the intestine would be really, really severe.

- Which of the medications listed above will eliminate the Coccidia and not merely suppress it?

We have found that ponazuril/toltrazuril is by far the best remedy: 3-5 doses completely eliminates the parasites, and we have observed no adverse side effects.

- What is the correct dosage?

Our vets dose at 20mg/kg once per day for five days.

- If there is something better that the medications listed above please tell me?

No, toltrazuril is the BEST.

- Is there anything else I should be doing?

If there is a possiblity of other intestinal parasites, such as nematodes, then Panacur (fenbendazole) or similar product (NOT albendazole! Highly toxic, and has been linked to acute death in rabbits due to radiomimetic properties of the drug) might help.

- What is the best food for his condition?

Hard to say, but it is possible that his dental condition has contributed to chronic GI slowdown, as described here:

www.bio.miami.edu/hare/poop.html

Please also read:

www.bio.miami.edu/hare/ileus.html

and for the vet (if s/he isn't already familiar with ileus):

www.bio.miami.edu/hare/ileus.pdf

If this vet is not really expert in rabbit medicine, I would STRONGLY suggest you find another who is, for a second opinion:

www.rabbit.org/vets

There are several balms that will help soothe a very inflamed intestine, including:

sulfasalazine
sucralfate (if ulcers are suspected)
barium (strange, but true)

Have any diagnostic tests been done to check for a foreign object that might have caused an injury to the intestine? Radiographs? I would ask about this.

Poor bunny. I hope he is better soon!

Dana

---------- FOLLOW-UP ----------

QUESTION: Thank you for the response Dana.

Well I used a Beycox (Toltrazuril) medication and the bloody stool is stopped immediately. However, the biggest problem I am having now is the lack of any poop, for three days now!!! The rabbit has been urinating more than usual but no poop.

I am very concerned especially after I read about GI Stasis online.

The Vet gave him Roni-Plus (10 mg ronidazole and 10 mg amprolium) and some oral laxative.

We also feed him about 70 ml of grounded hey mixed with water. And some pineapple juice diluted in water.

He also tried massaging his lower abdomen and administered some kind of enema but to no avail.

There are some loud gurgling sounds coming from his stomach.

He is not showing any signs of pain and his eating has been sporadic. But his overall movement are slightly below average. He still grooms himself. But no poop!!!!
How long can he stay like this?
I have not been sleeping and I am stressing out.

Answer
Dear Layla,

Glad the toltrazuril helped. But it may be that the stress of all this did trigger some GI slowdown. If you haven't already read this, please do:

www.bio.miami.edu/hare/ileus.html

The single best remedy I've found is the *shallow* enema described in the article. It can jump-start a static gut within minutes, and though you may have to do it a couple times (once a day) until the GI is moving well again, it can both stimulate the gut and help keep bunny hydrated (the lower GI is a site of re-absorption of liquid). But the article above will give many things you can do on your own to help promote GI motility and normal poops.

If the tummy is gurgling loudly, there could be gas, so pediatric simethicone suspension will help. Also ask about pain management (metacam or Banamine). None of the drugs your bunny is being given right now are commonly used in the U.S., so I can't really speak to their safety or efficacy. But as long as the gut gets moving again, I think Honey will be on the way to recovery.

Hang in there. It can take several days before poops start to come down the chute (I know of a bunny who went 14 days with no poop, and he did recover!), and if he's eating *at all*, then the gut is not completely static. Patience and nursing will get him through this, and I hope he will be well soon.

Dana

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