English Spot Mini Rex Bunny with gi distress care

Question
Greetings Dana:  Last week our five year old female English Spot, Sparklie, succombed to gi stasis after 24 hours of suffering.  She had many episodes of stasais throughout her years and I was always able to treat them here and with the help of the vet but this time neither of us could save her.  She went fast.  I am thinking she had a lot of scarring, etc. that caused her to leave us so suddenly.  We are mourning her passing.

She was bonded with a male English Spot and female English Spot Mini Rex named Coconut.  Coconut has had many many bouts of stasis although hers usually resolve in a couple of days whereas Sparklie had longer bouts.  Earlier this year, Coconut began to have loose stools and lost weight very quickly but stayed alert and active.  I took her to our rabbit savvy vet and she prescribed Benebac for her. That resolved the stool issue but she continued not to gain weight.  She receives a plate of fresh greens, unlimited timothy and mixed grass hays and limited amount of Oxbow T pellets daily.  I did remove the pellets off and on as she would suffer short bouts of not eating and seeming to be gassy/in pain until I massaged her quite a bit and syringe fed a green slurry mix with pumpkin.  She is currently in a very difficult bout of stasis.  I found your presentation from August 10, 2015 the night Sparklie passed as I could not sleep and knew Coconut was fragile.  I appreciate all the information you shared.

My questions are these:  I have never given an enema to a bunny and purchased the bulb that you suggest but the video you had on youtube does not seem to be available and I am also having a difficult time finding her anal opening.  I see the opening that looks like an "x" but maybe that is her vulva?  It is right at the end of her tail which leads me to my next question. . .

Her tail is constantly full of dried yukky poop.  It is smeared on it.  I wash her weekly but it is stressful for her and I just washed her bottom three days ago and do not want to stress her by washing her again but she is very stinky.  Any suggestions on how to clean just her tail and to clean it more thoroughly.  I usually have three water changes when cleaning her and use an unscented pet shampoo on her.

I see that you use mineral oil and lactulose as a preventative.  Where do you purchase the lactulose?  Can I use olive oil instead of mineral oil?  She definitely has ongoing gut problems as her stools go from big to little and inbetween and, obviously, the cecatrophes must be malformed since she has this mess on her tail.  

Would you suggest more pellets for her to gain weight?  The problem is that when I increase those, she seems more prone to stasis?  I did purchase the Kaytee Rainbow Exact food to help her gain weight but she does not like it so I put Benebac on it to get her to eat it and have only gotten her to eat two pieces in the past few days.  I also give her 1/2 of the Oxbow digestive tablets every day for the past month.  I cannot say they are helping.  I am always concerned that something is disturbing her digestion since she has stasis so often.  

Do you recommend fresh pineapple juice for stasis?  My vet always does but now I see that it is not recommended and I did not hear you recommend it in your presentation nor do I see it her.  It seemed to work with my earlier rabbit stasis cases.  I also used the cat petromalt but see that is not recommended anymore.  Comments?

Thank you for any help you can offer me with her. I truly appreciate it.  

Sue
Exhausted rabbit owner in Eau Claire

Answer
Dear Sue,

I am sorry for the delay in answering.  The AllExperts site has not been very reliable of late, and I was not getting notifications of pending questions.

I hope Coconut is feeling better.  I do have some questions that might help us figure out what is going on.

1.  Given their color patterns, it is possible that your bunnies have a congenital condition sometimes called "megacolon", though it is not really like that seen in cats.  It is a failure, during embryo development, for the blastomeres (embryo cells) of the neural crest to migrate properly and develop into the normal innervation of the GI tract.  The same population of cells also gives rise to pigment cells, so the dark stripe on the back and spots on the white field are evidence of this patchy cell migration.  Not all "spot" (a.k.a. "Charlie") bunnies have this condition, but it is far more common in them than in solid colored rabbits.  So my question:  are your bunnies' fecal poops round and shaped like normal "cocoa puffs"?  Or are they rather larger, misshapen, and sometimes hard/rubbery?

2.  Has anyone thought to look at their teeth through all this?  This is a *very* common trigger of chronic GI slowdown and ileus.

3.  The messy bottom is a sign of chronic cecal dysbiosis.  This can happen if the GI tract slows down due to pain/stress/illness.  You can read more here:

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

While some people mistakenly believe this is due to giving a bunny a diet too rich in fresh
greens, this is almost never the problem.  However, it could have something to do with diet,
if bun is getting the wrong type of food.  Please check that here:

http://www.bio.miami.edu/hare/diet.html

If you're giving your bunnies Oxbow, though, their diet is probably not the problem.

Possibly the second most common cause of GI tract sluggishness is pain/stress from dental disease,
such as molar spurs or other dental problem.  Please read:

http://www.bio.miami.edu/hare/dental.html

You will need an experienced rabbit vet to help you, and you can find one via the Vet
Referral Listings linked here:

http://www.rabbit.org/vets

if you're not sure your current vet is up on the latest.

Obesity can also contribute to the messy bum problem, as a pudgy bunny will have more
trouble reaching around her big belly to get her cecotropes fresh from the chute.  Instead, she'll smear them around and get them on her feet as she struggles to reach and eat them.  You said your bunny is too thin, so I'm guessing this isn't the problem, either.

Rex bunnies are prone to being overweight, as they spend less energy making those long,
proteinaceous guard hairs other rabbits make.  So there's more energy left over to store as fat!  This is something to consider.

While you and your vet are working this out, you can safely clean bunny and keep him comfortable with the techniquesdescribed here:

http://www.bio.miami.edu/hare/buttbath.html

Unfortunately, the video we had on Youtube was owned by someone who's not me, though it was my hands and my bunny's bum "starring" in it.  The anus is the opening closer to the *back*, just in front of the base of the tail. As described in the text, it's the one that "winks back at you" when you probe it.  The vulva doesn't really move much.  

http://www.bio.miami.edu/hare/enema.html

I hope this helps you get to the bottom (sorry) of the problem and get it under control.

Dana