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Wasting of my bunny

22 10:35:05

Question
QUESTION: My precious Bun is 8 years old and I realize that this is aged for a rabbit.  She started looking thin and having some soft poop..some normal.  I took her to a vet and they did blood work that came back as high liver enzymes.  Everything else was in the normal limits.  She put her on prednisone and a vitamin to support the liver.  She stopped having the soft stools for a time..but after the prednisone was gone...she really did not improve.  She continues to have a hearty appetite..cleaning her bowl.  She has unlimited hay..which she eats as well.  She loves carrots and lettuce and bunny treats from the store..but if I give these to her, she has increased soft stools.  Is there anything I can do to help her support her liver and maybe pick up a little weight?  Otherwise, she is happy and lively.  She has free run of the laundry room and makes the most of it!  Thanks for your time..Paulette Carpenter

ANSWER: Hi Paulette,

This is one of the sad parts about having a rabbit.  Things like this do start to happen as they enter the autumn of their lives.  But that is not to say that she can't still have a healthy lifestyle and enjoy her twilight years...and hopefully enjoy them for a long time.

High liver enzymes are a normal part of aging.  If possible, could you send me the rest of the blood panel values.  There can be several "markers" in them to indicate some other issues that are not well known even in vet circles.  I would also like to know her breed and weight.  Many times when we see high liver enzymes coupled with a GI issue, we need to look at body weight.  Not specifically high or low...but just over time.  Fat (and calcium for that matter) is metabolized differently in a rabbit.  They are very prone to a condition known as Hepatic Lipidosis.  This will give a scewed liver value.  Another thing, has she been spayed?  Obviously if she has not, the risk of that procedure would far outweigh any possible benefit at this point in her life...but something to be taken into account.

I am always very cautious about using steroids in rabbits.  They suppress the immune system.  Not saying your vet was incorrect in prescribing them because they are very valuable tools when used properly.  We do generally back them with a broad spectrum antibiotic to help support the immune system.  What vitamins are being used?  I have used the vitamin powder that is put on their food..but I don't use the stuff that goes into the drinking water..it only contaminates the water.

If this rabbit were in our rescue, here are some of the things I would do.  Remember, I am not a vet so these suggestions should be discussed with your doctor and she is in the best position to determine treatment.  The first thing I would do is deworm her.  You can have a test, a fecal float performed, but we have found it to be less than 100% accurate.  Worming is ususally a pretty straight forward and safe treatment....and treating is cheaper than actually doing the test.  I would take a look under a microscope.  Coccidia is another parasite that is common.  Symptoms are ususally a soft stool and sometimes a very pronounced odor especially with coccidia.  We even had hookworms in a rescue this past spring.  I would not have a problem doing a fecal culture.  It probably is not the cheapest test in the world....I think it runs about $85 or so in this area.  It will test for bacteria in the GI tract...the bad bacteria is what you are looking for.   The two strains that are possibly causing this concern are Clostridium and/or E Coli.  I generally treat that with a drug called Metronidazole (Flagyl).  This is a very nasty tasting drug and should be flavored if used...and it is still nasty tasting.  But it does the job.  But the culture should show sensitivities so treatment is based totally on that finding.  I would totally remove the carrots and treats.  Carrots have a lot of sugar and can play havoc in the cecum.  Too many greens can also do that.  And high protein, like too many pellets, can also do that.  It's a complicated and detailed explanation...but in a brief description, the cecum is a "holding" area for beneficial bacteria, vitamins and undigested food.  Usually during the night, the rabbit will stimulate itself and excrete "cecals".  They look like strands of grapes and are very moist and smelly.  We call them "night poops".  I think the term for eating these is copragaphy if my spelling is corrent.  If a rabbit is overweight, on a screen floor or has mobility issues and can't reach their rear end, they can't eat the night poops.  They lose the nutrition and bacteria and that can lead to digestive system problems.  I would suggest using a probiotic.  It is a product that "replaces" the good bacteria in a sick or ailing animal's GI....same as some people do with yogurt when taking antibiotics.  Do not use yogurt with a rabbit under any circumstances.  That idea is still in many vet reference manuals and is completely wrong.  I use a product called Bene-Bac but there are others out there.  This product does not add true beneficial bacteria to the gut.  What it does is use the bacterial cultures contained in the product to stabilize the pH in the gut and set up a favorable environment for good bacteria.  I have found products with cultures of L Casei are most effective. You also have a classic problem here of needing to increase calories (mainly proteins)to gain weight but added proteins also cause gut problems.  My feeding suggestion is to continue the umlimited hay.  Get some high quality alfalfa hay and start mixing that in, a little bit at a time, with the regular hay.  Make sure you are using very high quality pellets.  Many of the commonly available pellets are nothing but junk food.  Remove the carrots and forever ban "treats".  I would offer a very limited amount of greens.  Dandelion greens and kale are very nutritious...but only a couple of pieces a day.  Canned pumpkin, not the pie filling, the true canned pumpkin, is very nutritious and has lots of fiber.  Most rabbits will eat it easily.  But like everything else, don't overdo it since hay should be the primary diet.  You might also want to look into using a product called "Critical Care".  It is a powder you can mix and syringe feed...or we mix it in the pumpkin.  It is made specifically for herbivores like rabbits that are having health issues.  You can check it out by visiting www.oxbowhay.com  If you call them directly, you will have to provide vet contact info and they will most likely confirm your vet care.  They want to make sure your rabbit is being properly taken care of before selling you this product.  And you can ask your vet about giving her what I call a "Push Up".  It is an injection of B Comp. It is given IM and does sting a bit...but the benefits are huge.  Nearly all the wildlife rescues get a shot coming it.

This is a lot of info to digest. And there is more to come.  Read over this...and it will take several times for you to digest it.  Discuss it with your vet.  And then get back with me because I know you will have questions.  I think this is a correctable issue but it might take some work.  

Randy

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

QUESTION: Randy...I have read my original question to you and your answer and I left out a lot of "stuff" I see.  Bun is an unspayed Mini Rex.  I said that she was thin, but that is really an understatement.  She is now emaciated, with her backbone clearly visable.  I would estimate that she weighs about 1 pound..if that..down from a chubby 3 pounds.  Perhaps the weight loss has been over the last 6 months.  She also drinks a large amount of water.  She can empty a bottle in 2 days.  She has also stopped using the litter box. She has normal hard pellet poop and at the same time has a couple of soft poop piles every day. Since I don't see the usual "grape" cecum, I assume that the soft pile is the cecum? This morning I thought that she was a little unsteady on her feet.  She still eagarly eats..seems almost frantic to eat..like a diabetic.  She has in the past (perhaps a year ago?) had some GI issues which involved the mobility of her intestines. Then she would not eat and I had to force feed her.  She was put on Reglan, and recovered.  This is much different. Her eyes are clear as well as her nose.  The vitamin that she is taking is just called Val Syrup.

Answer
Hi Paulette,

Ask your vet if she has a lab that can titer for E Cuniculi.  If not, I will get the contact info for you to provide to your vet.  This is a protozoan infection that invades the brain.  It usually presents with some neurological deficiencies that are sometimes so minute that they aren't noticed.  When the spores of the protozoa are shed, they damage the kidneys and cause scar tissue.  That is what I was looking for when I mentioned seeing the labs and looking for "markers".  This scar tissue will lead to renal failure over time...and some of the symptoms do mimic diabetes....nice observation.  A titer for EC is open to some interpretation.  It is best to do a series of titers over a period of several weeks.  The idea is to see the levels of EC antibodies in the blood.  Most vets have never seen a case of EC.  The EC itself leads to a compromised immune system which allows lots of infections and other issues to come into play.

There is couple of things that scare me in your latest post.  And please remember that I am not a vet....this is just my personal opinion based on many years of working with very sick rabbits (and I also can and do call on some of the best vets in the country...nice to live near a vet school).  I am not much on these vitamin supplements.  The thing I hope for is to do no harm.  I am particularly concerned with the vitamins (and also some of those useless antibiotics sold at farm supplies)that are dropped into the water.  Makes contaminated water.  I had never used this product but I did a quick search for it.  I don't like giving rabbits alcohol and this product contains alcohol.  The primary benefit in this product is B vitamins...which is the "push up" I mentioned in my previous response and this is much more safely administered and is more effective by a B Comp injection.  And I don't usually see the words "Reglan" and "recoverd" mentioned in the same sentence.  I will never, under any circumstance, allow the use of either of the gut motility drugs on any of my rabbits as long as there is a breath of life in my body.  None of my vets will use them in rabbits.  There is a lot of controversy about using them.  I don't like them.

It is very possible the elevated liver enzymes is due to the metabolized fat.  Has her teeth been checked?  Especially the molars for spurs or possilbe abscesses?  Do you know how to administer sub-q fluids?  If not, and you are willing to stick a needle, it might be worth seeing what happens with some supplemental hydration therapy.  Something to discuss with your vet.  I would really take a look at the kidney values as it seems something is going on there.

I will continue to mull your comments over this afternoon and do some more research for you.

Randy