Nystatin

Question
Hi there, I have a 2.5 year old dwarf lop long haired rabbit. I shave her regularly, she has and eats unlimited amounts of meadow hay, and has a mixiture of cos, buk Choy and parsely regularly. Every 7-8 months she always seems to get GI stasis.? I recently moved interstate and have changed vets, and am a little unsure whether my vet is rabbit savvy. My bunny was fine on the Tuesday night, eating plenty, but by weds morning refusing to eat. I immediately knew she was sick and took her to my vet. After they gave her metacam she came good again. They analyised her urine and found it to be fine, but when looking st her poo, told me she had WAY to much yeast. They have prescribed me nystatin and this is my second day of use. It hasn't been sitting with me right so I rang my old vet who told me not to use it as bacteria is meant to be in the tummy, I'm very confused and dint know what to do. Could maybe the last 2.5 years all be linked to her having to much yeast and that's why she gets GI so regularly, or should I stop the nystatin? I love her very much And want to do the best thing by her."

Answer
As soon as I read "long-haired" I was going to say that as I'm sure you have heard, long-haired breeds are more susceptible to hairballs which leads often to GI Stasis. How reguarly do you shave her? When you do shave her, do yo brush her afterward to remove the excess fur? That was my first thought, but I don't believe this is the culprit.
Is your rabbit nervous by nature? Does she dart at every loud noise or does she not mind noise or movement so much? the reason I ask, is, as silly as it might sound, rabbits when 'unnerved' about something will sometimes temporarily stop eating. Once again, unlikely, but worth mentioning.
Has your vet done any blood work to rule out disease?
This is somewhat interesting because nystatin theoretically should cure yeast. So it makes me think that her system was fine to begin with otherwise (flora wise) and the nystatin potentially caused the upset. Did your vet reccommend another course of treatment? You sound like you have much more faith in your old vet. Why not go back to them? They seem to be more knowledgable about rabbits.
However, when used when there is no upset to the flora balance in the first place, it might have actually caused the yeast. They use nystatin to treat yeast so I am wondering whether or not you should continue the medication. What did your old vet say? Did they know about the yeast? if not, I would give them a call back and fill them in and ask their advice on the situation now. The use of Nystatin is questionable because it hasn't been 'proven' to work, it's more based on the theory that the use of anti-fungals sometimes works in restoring balance to the gastrointestinal tract. Now I am wondering if you should continue treatment to eradicate the yeast if nothing else, but this is something that a rabbit savy vet should be able to tell you.
And yes, you are right in your theory that yeast could potentially be the culprit.
Don't give yogourt drops or any dairy to a bunny who is susceptible to yeast. The milk starches and sugars can create an overgrowth of yeast in a rabbit with GI stasis. Yeast releases an enzyme that destroys the lining of the intestinal tract.
Yeast breaks down antibodies.
There are various treatments available for GI Stasis. Here is a link below on 'paw talk' about some various treatments available that people have had done for their rabbits. I do not profess to know veterinary medicine and in my experience, force feedings and syringed fed liquids on a regular basis have resolved my case of GI stasis, but a more advanced and re-occuring case should be looked at more closely.
I wish I could give you a more definite clinical answer, but unfortunately it is beyond my training to do so.
Thanks for your question, I hope this helps you.
Here is a rabbit vet directory for the US (I am not sure where you are located):
http://www.animalhospitals-usa.com/veterinarians-directory.html


http://www.paw-talk.net/forums/f27/how-does-your-vet-treat-gi-stasis-36374.html

Lactobacillus in Rabbits
Dietary supplementation with lactobacillus products is often recommended
for rabbits with enteric disease or as an adjunct to oral antibiotic therapy.
Lactobacillus bacteria are not major inhabitants of the rabbit gastrointestinal
tract. Additionally, the low pH of the stomach may prevent live bacteria
from surviving gastrointestinal transit. Research by Yu and Tsen1 showed
only L. fermentaum strains survived gastric juice but were not able to colonize
the intestines. Therefore, lactobacilli used as probiotics are probably
ineffective in rabbits. The value of continuously feeding lactobacilli during
enteritis or stress remains to be shown.
http://www.aemv.org/Documents/EPP-Dec97.pdf