Treating bunny for coccidia

Question
Hi, Dr. Krempels. I adopted a dwarf or mini lop bunny about a week ago. My little guy is around 8-9 weeks old, and he's being treated for coccidia. Forgive me if this is long. I'm a new "bunny mom" and love my little fuzzy friend.

Yesterday I noticed he had mushy/runny poop (not watery diarrhea, but enough to cause me concern). It's regular bunny poop, not the one they eat. I took him to a vet in our area who advertised care of exotics including bunnies. A fecal test showed he was infected with coccidia. She prescribed Albon (0.3 ml once a day x 14 days, and metronidazole (0.2 ml twice a day x 7 days) to treat him. I took him to the vet literally within hours of this all happening. When I returned home, he was eating fine, pooping in pellets, hopping all over and drinking. This morning it was the same. However, after I gave him the AM dose of metronidazole, he developed soft poop again.

Question: My vet said it could be from the antibiotics and it might take a couple of days for the Albon to start working. She told me to make sure he's still active, eating and drinking, and to keep an eye out for any changes. She didn't seem concerned if he has off-and-on mushy poop for a couple of days. Obviously, if anything changes, I'm to take him to the emergency vet.

1. Does this sound like safe treatment for a bunny with coccidia?
2. Does the appearance of occasional mushy poop warrant an immediate trip to the vet's office?

Thanks so much for your help. I've been reading your articles, and they've been great!
Karin

Answer
Dear Karin,

Runny stool in a young baby like this can be *very* dangerous, and though Albon and trimethoprim sulfa are safe for rabbits, they are not quick remedies for coccidia.  Metronidazole may help, and it will prevent overgrowth of most dangerous Clostridium while the intestine is compromised by the coccidia, but it is rough stuff, and *might* also contribute to the runny stool.

We now use Ponazuril (Marquis, by Bayer) exclusively to treat this parasite.  It kills them in three treatments, and this is essential to preventing potentially fatal diarrhea.

If your baby develops really mushy stool, not just slightly doughy poops, then emergency treatment might be necessary. I have developed a protocol for treating diarrhea in baby rabbits, and since I've used it I have never lost one (these are rescued cottontails and hares; we don't breed rabbits!).

You can find the protocol here:

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

I haven't written it in proper format yet, and it *is* aggressive. But a baby rabbit with diarrhea is at *great* risk without emergency treatment.  I've found that the imodium can help buy you time while other medications kill the parasites or other pathogens.  And subQ fluid are vital to maintain the hydration, since it is usually dehydration that is the proximal cause of death in babies with diarrhea.

I hope this helps.

Dana