Boon the megacolon Bunny

***EDIT: I have written here that Boon was diagnosed and treated with / for a C. diff (Clostridium Difficile) infection - while he was treated for a Clostridium infection, it was **NOT** C. difficile. C. Difficile can kill a rabbit in a matter of hours because it produces toxins. Dogs, cats, humans are much more likely to get C. difficile and they usually get it after taking broad spectrum antibiotics like Penicillins and Cephalorsporins. Boon was effectively treated with Flagyl for a different kind of Clostridial infection; one more common to rabbits and less invasive than C. diff.

Hi everyone,

Sorry for not making a proper introduction first. I am from the US and am really impressed with the knowledge on this forum!! I need help so badly! I have a little dwarf hotot mixed rabbit that I rescued as a baby, his name is Boon. He is a year and a few months old and has suffered from recurrent bouts of GI stasis (about 3 in this whole year). He's very sensitive to diet, and lives mostly on hay, with very little pellets, and some green leafy veggies. He is also on daily BeneBac.

In October this year he had a very severe bout of GI stasis during a molt. He eventually passed the mass, and was on his usual motility meds (CIsapride and Reglan) but afterward he had really malformed poops so his old vet put him on Bactrim for 14 days. During the last 3 days of his Bactrim course, his night poops (cecals) turned to water. We weaned him off his motility meds. This was sometime in November this year.

Basically, ever since then - I wake up to a watery mess on his bed, with normal looking poops in his litterbox. I was told not to worry about it, but his appetite has gone down to nothing, I have to force feed him a lot, give him subcutaneous fluids, and his belly constantly feels doughey and gassy (no blockages, xrays fine). He does poop. He slows down during the day, seems to be in a lot of pain and refuses to eat all morning but usually by evening he does poop, eat some hay and his greens, a teaspoon of pellets, and drinks water. His appetite is just so... gone, though, for every day, and I can't stand seeing him in pain for most of the day too. The lethargy is scary, makes me think he is dying.
The vet shrugged it off and suggested an oral exam. His oral exam was great! His molars were slightly overgrown but they were trimmed down. This was 2 weeks ago, no change, vet stumped, now Boon acts like he is in constant "tummy ache" mode and passes a lot of foul smelling gas. His poops are okay when he does go at night, but his night cecals continue to be water.

Switched back to our local vet here.... she doesn't know what to do for him...

so....

I got fed up and took some of his regular poops to this local rabbit experienced vet and she said she found "moderate" overgrowth of Clostridium bacteria!!!! - in his normal poops - his cecals are too watery for me to collect a sample.

at first she wanted to prescribe Bactrim for this, but I told her that he developed watery cecals while on Bactrim and I am wondering if perhaps this may even be why he is having this problem in the first place.
I know in humans, a lot of common antibiotics can cause Clostridium infections, (e.g., C. Diff) so why not a bun? I asked if maybe it'd be better to treat him for the Clostridium. She agreed, and said that she will likely prescribe Flagyl (metronidazole) but she needs to find out what the dosage is and how often.
Since he is on the proper diet, has had bloodwork, xrays and dental works, which all comes out normal, this Clostridium stuff is new and I am betting it happened when his cecals turned to water while on the Bactrim in November.

After almost a whole month of not needing motility meds his anorexia has caused me to reinstate his Cisapride. (He never really responded well to Reglan, so we usually use Cisapride during Stasis episodes, and for no more than a few weeks and we wean him off when he gets back to normal)...... but this isn't a really typical stasis episode, this is more like chronic gas and cecal problems with no appetite, tummy ache, and runny cecals.

I am aware that no one is giving me medical advice I just really need some help with info on Clostridium in rabbits and water cecal diarrhea and just whether or not it sounds like this could be his problem, or if he is just "one of those bunnies" with chronic GI stasis and he is just shutting down completely and will have to be put to sleep? I don't want to resort to that but he has pretty much been in pain and needing to be force fed ever since that Bactrim.

am I on the right track here? My worst fear is making his current problem even worse. Please help.

Sorry this will be a rushed reply

It does sound like antibiotic induced enteritis

You can see the dose rate for Metronidazole here a long with other links re Clostridial overgrowth/enteritis

http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Metronidazole.htm

http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm

http://www.medirabbit.com/EN/GI_diseases/Generalities/Enteritis_en.htm

http://books.google.co.uk/books?id=...nepage&q=rabbit clostridial enteritis&f=false

Have sick Rabbits here myself and so no time to type out a proper reply

Hope your Bun can recover from what is obviously a serious problem

Oh, I do hope he is having regular pain relief

Hello and welcome Nova to RU.:wave:

I've no experience on this topic, but Jack's Jane has a wealth of experience so good advice has been given.

I hope Boon improves.:thumb:

We used this for bluebell but unfortunately as we used tablets I've no idea what dosage he was given.

Hope your bun improves soon. ((HUGS))

Those links have been the most helpful thing I've been given by anyone ever

Thank you SO much!

Boon started his first dose of Flagyl today. Already he has some energy and a little bit of an appetite back!!!!

However - In the one official link that mentions Flagyl to treat Clostridial infections, it says 20mg per kg for 3 weeks.

Boon weighs 1.3kg

The vet prescribed 28mg to be taken for 2 weeks.... I'm concerned that the information provided is the correct information about keeping him on the Flagyl for 3 weeks, but my vet prescribed it for only 2. I intend to call her about this and perhaps send her the link (she is a friend on my Facebook list - but I never really talk to her, I'm afraid she won't be 'allowed' to talk to me about Boon outside of the office, as she doesn't own the practice, she is just one of the practicing veterinarians).

I sure do hope your 3 sick buns feel better soon! Both my brats are going through an unexpected molt, as they had their "big" molt in October which causes Boon's latest big bout of bloat which resulted in the Bactrim in the first place. I really despise that Bactrim, and am just disgusted that the vet prescribed it *again* even though the bacteria she found in his stool was Clostridium and Bactrim doesn't treat Clostridium. Flagyl does.

Nova said:

Those links have been the most helpful thing I've been given by anyone ever

Thank you SO much!

Boon started his first dose of Flagyl today. Already he has some energy and a little bit of an appetite back!!!!

However - In the one official link that mentions Flagyl to treat Clostridial infections, it says 20mg per kg for 3 weeks.

Boon weighs 1.3kg

The vet prescribed 28mg to be taken for 2 weeks.... I'm concerned that the information provided is the correct information about keeping him on the Flagyl for 3 weeks, but my vet prescribed it for only 2. I intend to call her about this and perhaps send her the link (she is a friend on my Facebook list - but I never really talk to her, I'm afraid she won't be 'allowed' to talk to me about Boon outside of the office, as she doesn't own the practice, she is just one of the practicing veterinarians).

I sure do hope your 3 sick buns feel better soon! Both my brats are going through an unexpected molt, as they had their "big" molt in October which causes Boon's latest big bout of bloat which resulted in the Bactrim in the first place. I really despise that Bactrim, and am just disgusted that the vet prescribed it *again* even though the bacteria she found in his stool was Clostridium and Bactrim doesn't treat Clostridium. Flagyl does.

Click to expand...

I would send the link to the Vet at her office rather than via FB. That will keep it all 'official' from her point of view. Hopefully she will agree with the suggested treatment protocol

I really hope Boon will respond well to treatment now and that he will recover

JAck's-Jane,

Thank you - I agree. May even print it out and take it to the office as the office staff doesn't communicate to the vets well, though it is a bit of a drive.

I wrote an expert regarding Boon. She told me that the Clostridium was probably more likely a result of his disease rather than the Bactrim, and that the Flagyl will be a "temporary fix" and that his genetic predisposition to chronic slow gut motility (otherwise known as Cow Pile Syndrome) is probably the reason why this bacteria had overgrown.

I just do not want to believe this. He developed cecal diarrhea during the last few days of being on Bactrim and his tummy has been gassy and doughey ever since. He has struggled with his appetite every since. And his cecals have been water ever since.

Not to mention, between his stasis episodes, his poops look pretty darn normal.

http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm this link really describes Boon's situation "spot on" as you guys would say, and suggests that the bacteria itself can cause the anorexia and lethargy / intermittent diarrhea. Says stress and bad diet can do it too but he is on a strict diet and kept away from stress. Only thing he deals with is a genetic predisposition to bouts of Stasis because of the breed genes in him.

Really hope it's the infection casuing the GI distress - not the other way around!!!

Feeling very discouraged now --- those few days of inflated hope and excitation are falling

Thoughts?

Nova said:

JAck's-Jane,

Thank you - I agree. May even print it out and take it to the office as the office staff doesn't communicate to the vets well, though it is a bit of a drive.

I wrote a Ph.D expert on rabbits about this issue and her response kind of upset me. She told me that the Clostridium was probably more likely a result of his disease rather than the Bactrim, and that the Flagyl will be a "temporary fix" and that his genetic predisposition to chronic slow gut motility (otherwise known as Cow Pile Syndrome) is probably the reason why this bacteria had overgrown.

I just do not want to believe this. He developed cecal diarrhea during the last few days of being on Bactrim and his tummy has been gassy and doughey ever since. He has struggled with his appetite every since. And his cecals have been water ever since.

Not to mention, between his stasis episodes, his poops look pretty darn normal.

http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm this link really describes Boon's situation "spot on" as you guys would say, and suggests that the bacteria itself can cause the anorexia and lethargy / intermittent diarrhea. Says stress and bad diet can do it too but he is on a strict diet and kept away from stress. Only thing he deals with is a genetic predisposition to bouts of Stasis because of the breed genes in him.

Really hope it's the infection casuing the GI distress - not the other way around!!!

Feeling very discouraged now --- those few days of inflated hope and excitation are falling

Thoughts?

Click to expand...

Has he actually had a definitive diagnosis of 'Cow pile syndrome' ? In other words did he have the classic symptoms BEFORE the Bactrim ? The passing of 'cow pile' poo, weightloss etc ?

There is a very long thread on here that may be useful for you to read through

http://forums.rabbitrehome.org.uk/s...ection-of-GI-tract-presenting-as-dysautonomia

No veterinarian has really "officially" diagnosed with anything, and we've been to one exotic animal specialist, and two very experienced rabbits vets.


October 11th, 2011: I had two buns 6 months old - Phenom, spayed female, and Beau, male. Beau went in for a routine neuter and died during surgery. Reasons unknown. Dumped that vet. Phenom lonely and developed aggression despite lots of attention.

October 20th 2011: I coincidentally discovered Boon as an infant with a litter of his infant siblings at a local pet store that is run by teenagers. I turned the pet store in to the Department of agriculture as there is a law against selling rabbits and chickens under 12 weeks of age. I rescued the infants because the staff at the store didn't know why they couldn't eat their pellets (it was because they needed their mother's milk). By the time the Dept of agriculture got to the store, all the rabbits had already been rescued. I contacted my local rabbit rescue shelter and sanctuary and the owner took his two siblings while I kept Boon. Initially all of them grew up fine.

November 1st 2011: Took Boon in for an initial exam with a new local rabbit experienced vet. Vet guessed his age at date of checkup to be about 5 weeks old, and though very tiny and underweight, seemed to be healthy. Vet warned that weaning too early can result in immune system problems.

Jan 2012 4 months old: Boon's first bout of stasis - didn't last any longer than 3 days and he was approximately 4 months old. His stomach felt enlarged. He recovered well with just some Cisapride for a few days after seeing our local rabbit experienced vet. Boon's brother developed chronic Snuffles (Bordetella confirmed with nasal culture). This one became a sanctuary bun at the rescue. Boon's other brother grew up fine, no health problems to speak of, and was later adopted out to a wonderful lady.

After the brief stint of stasis in Jan 2012, Boon had normal poops, no sausage poos or anything, very active, and a great appetite until----

May 2012: went through a very big molt, as it began to get hot here, despite our air cooling he still molted and went into a very scary bout of bloat. His actual stomach was 3 times the size it should have been with an impacted colon. This cleared up after an enema at the local vet's office which released 12-15 large dehydrated sausage shaped poops. Was on Cisapride and Reglan for 2 weeks. Weaned off over a week after the enema got things moving.
At this point, the local vet (and myself) was concerned that he had 2 episodes of true stasis and he was less than a year old. I also wanted to get him neutered so I could bond him with our spayed female, Phenom, whom he really likes (and she likes him too, which is great considering what happened to BEau).
Local vet referred us to an exotic animal specialist 3 hours away.

June 2012: Boon was doing good!

During this time of doing well, we went to consult with the exotic specialist for an evaluation in light of his stasis bouts at such a young age. Normal poops, normal appetite. But we did bring him in to the exotic specialist for an exam and the specialist wanted to do bloodwork, xrays, scopes, dental exam, and neuter all in one day and keep him overnight at the hospital with an IV. I felt that would be too much stress for all in one day, and asked that the xrays, bloodwork and stool sample be done that day, and we would schedule the dental exam and neuter for a separate day. The specialist agreed.
xrays - revealed his CECUM was mildly distended/swollen
Stool sample - fine
bloodwork - all fine except slightly low blood serum albumin

Exotic vet recommended we have him on BeneBac daily to help with his Cecum. Also recommended neuter to "decrease his sexual frustration" and then an oral exam. So started him on Benebac daily and scheduled his neuter / oral exam for July.

July 2012: Well it was just tooooooo hot so we cancelled. Taking things one thing at a time, Boon was having some occasional, intermitten days with GI slowdown (some sausage shaped poops) and I felt it was unwise to put him under GA (general anesthetic) for surgery and dental at the time. I cancelled and said I'd reschedule in the fall.

I had no idea things would get so much worse after his neuter in the fall. Read on.

August 2012: Boon doing good. Normal poops. Huge appetite. Tons of energy.

September 21 2012: Boon was still doing pretty good with bouts of slowdown intermittently, but he was spraying everywhere and pooping lots around Phenom's pen.Phenom really liked Boon and he liked her back and I wanted to bond them, plus the exotic vet recommended a neuter to help his stress levels. I figured to do the neuter locally to avoid stress of 3 hour drive to exotic vet. Boon gets neutered without complication (some stasis after the GA for a few days but he recovered) on September 21st 2012. Decided to schedule the thorough oral exam under GA in October.
His hormones didn't calm down until late October.

October 28th 2012: Boon's hormones begin to calm down. I thought this would be a GOOD thing. It wasn't. During this time Boon stops spraying but also stops pooping around Phenom's pen and keeps his poops in his litterbox - however - both Phenom AND Boon go into a huge molt and and with the huge molt Boon goes into a bout of stasis. Cancelled oral exam until bloat passes. Started him on Reglan. Took him to local vet for enema. No poop production after enema, but when we took him home, the warm enema must have helped stimulate his colon as he eventually passed the mass of food and hair, but he had severely malformed, mucous covered stools for days afterward and a low appetite / doughey tummy (mucoid colitis). By this time, we decided to have him see the exotic specialist again for evaluation.

November 1st-ish 2012: exotic specialist called us and told us he refuses to see Boon ever again due to "too many past cancellations." (which was inaccurate, wrong on so many levels, but I needed to find another exotic specialist).


November 2nd-ish 2012: Found another exotic specialist 3 hours away in the other direction (Pittsburgh). Got him in to be seen ASAP.
New "exotic specialist" in Pittsburgh claims he is actually not an exotic specialist despite what his office staff told me, but that he has a lot of experience with rabbits, so he saw Boon anyway. Did a partial oral exam which revealed "slightly" overgrown premolars. Recommended tooth trim after he gets thru this bout of stasis. Prescribed Bactrim to help kill off the bad bacteria causing the mucoid colitis - but did not look at Boon's stools - just "guessed" that Bactrim would be the right antibiotic. Took an xray to ensure there was no blockage, so added Cisapride.
**after this bout, Boon's stools became very irregular in shape and size and his appetite went downhil.
**I believe this Pittsburgh vet suspected Coccidia even though he didn't examine Boon's stool. Despite past stool samples being Coccidia-free.

Mid-November 2012: Boon had made what seemed to be a recovery (or at least a partial one) from the acute bloat episode in October, HOWEVER, on day 12 of his Bactrim course, I woke up to watery cecal diarrhea in his bed, with normal stool in his litterbox.
This issue had never gone away.
Called the Pittsburgh vet about it. Vet advised me to stop the Cisapride and Reglan, finish course of Bactrim. Felt the motility meds were the cause, not the Bactrim - I disagreed. but whatever.
Weaned him off both Cisapride and Reglan, finished Bactrim.
Boon continued to do "okay" but also continued to have cecal diarrhea every night with a lowered appetite for his usual amount of pellets, so I began to have to syringe feed him Critical Care daily to supplement his hay and teeny amount of pellets he would eat daily. At this point we felt his teeth should be addressed ASAP. Boon's abdomen constantly feels like dough.

....Continued from previous 2 posts

December 1st-ish 2012: Boon's abdomen constantly feels like dough with low appetite and cecal diarrhea. Energy levels had gone down, very unlike his usual personality of energetic happiness. Still has bowel sounds. goes to see our local vet and she felt that since he was eating hay okay, but not interested in pellets, that perhaps dental was the problem afterall. He'd gained about 40grams, probably because I was forcing Critical Care on him daily. She puts Boon under GA and trims his premolars, HOWEVER, she said she strongly felt that they were not the cause of his anorexia. She said there was no irritation and the overgrowth was so very mild, it almost didn't even need trimmed, but she trimmed them anyway.
Boon goes into a stasis after the GA - put him back on Cisapride. (No Reglan this time, as it never seemed to help in the first place).

December 2nd 2012: Boon has a bit of a bloody nose. Local vet said this could be from the nasal intubation.

December 3rd 2012: Boon has a full on snuffly nose and no change in his GI troubles (except for stasis brought on by the general anesthetic).

December 5th 2012: Boon's stasis improves and he goes back to just his usual GI/appetite troubles, plus Snuffly nose intermittently.

December 9th 2012 - Still has snuffles, but it goes away every other day or so. Despite being on Cisapride, Boon continues to have a doughey feeling abdomen, no interest in pellets, very low appetite, large gas bubbles in abdomen, watery/gassy/doughey abdomen with a cecum that felt like it was just full of water and air (I could make gross **** noises with his cecum area when I pushed on it lower right side of him when I hold his back against me). Grinds his teeth in pain. Generally no appetite during the daytime, lethargy, but usually around evening he perked up and got an appetite. The cecal diarrhea continues to be int he back of my mind.

December 10th 2012: Boon goes into ANOTHER MOLT. Begins shedding a lot. :shock: Still has interest in hay. Seems to go after food but when I give it to him he goes into pain, so cut his pellets down from a teaspoon a day to a half teaspoon a day, supplementing his hay diet with Critical Care daily.

December 11th 2012: - Phenom goes into a molt as well.
Boon Still living on hay and critical care, doughey gassy abdomen, cecal diarrhea, no appetite, gas, pain, even developed lethargy which is NOT LIKE BOON. I was just beginning to think the worst, perhaps putting him to sleep. The cecal diarrhea continues to be in the back of my mind.

Night of December 11th 2012: Had an idea. Local vet's office was still open, so I collected some of his sausage poops from his litterbox and took them in to the local vet to examine under a microscope.
She found a "mild dysbiosis" of "mild overgrowth of Clostridium." She mentioned that chronic GI Stasis issues can cause this---- recommended Bactrim----BUT I then told her----- I don't think Bactrim is a good idea, as he developed cecal diarrhea ever since he was on it in early November and I have this gut feeling (no pun intended) that his November course of Bactrim caused the Clostridium overgrowth because he never really made a complete recovery from his October bout of bloat, only a partial one. I told her I did some research and felt that Clostridium could be the cause, not the problem. So she prescribed the Flagyl.

December 13th 2012 (yesterday): We finally obtain the Flagyl (vet had to look up dosing guidelines). Boon has his first dose of Flagyl along with his Cisapride and pain control as needed (Metacam). Within HOURS his energy levels perk up, he suddenly becomes interested in more food. So of course, I lowered his Critical Care while cautiously increasing his pellets back to 1 teaspoon per day.

things were looking up!!!

December 14th (today) 2012: I wake up to find not watery cecals in his bed but very dark brown rusty colored liquid in his bed. True diarrhea. He has it all over his bottom feet. NO NORMAL STOOLS IN HIS LITTERBOX. I freak out!!!! Gave him 50cc Lactated Ringers Solution. He seems to be in pain.
Gave him Metacam, called vet.
Vet sys to keep him on the Flagyl. Says she nor any of the other vets have no idea what is causing his stasis, but it "could be something neurological or just one of those bunnies." She also told us, if no improvement over the next few days, she will be available if we decided to put him to sleep and over the rainbow.

afternoon:
He seems to be hungry for something? but every time I give him his leafy greens, he eats them very slowly.
He ate a fair amount of hay this morning, however, still no poop other than the dark rusty colored diarrhea from this morning.

His abdomen currently feels bloated, firm and distended with large moveable gas bubbles surrounding his cecum area. No longer doughey, but the opposite.

When I listen to his abdomen, I do hear bowel sounds.

About a half hour after administering his medication, he hunched up back in pain.

2 things I feel worth mentioning here -
Boon seems to go into a full blown bloat during *every molt*. He just went into a molt starting a couple of days ago. Phenom did too. This was unexpected as they had gone thru a big molt when autumn began.
INCIDENTALLY Boon also just started the Flagyl yesterday, as well.

This is where I am now. It is heading into evening. And I am psychologically wrecked over this. I am literally sick about it. I don't know what to do. I don't want to put him to sleep, but I will I have to. Please, somebody help my Boon.

Another rushed reply sorry, I have read all your posts about Boon's history

Just a couple of links for you to read and I'll come back later to post a better reply

http://www.cottontails-rescue.org.uk/gutstasis.asp

I cant access the full article on here, but your Vet may be able to find it elsewhere. It is the one about Rabbit Dysautonomia by K Whitwell and J Needham published in the UK Veterinary Record in October 1996

http://www.researchgate.net/publica...eropathy_in_UK_rabbits_dysautonomia_confirmed

ETA- I have PM'd 'thumps_' to alert her to this thread, I am sure she will offer advice as she has so much experience having nursed Thumper for so long.

Oh Nova....I'm so sorry. I'd hoped the flagyl was going to save the day.
I will pray for you and Boon. I can well imagine how things are going around in your head right now.
If anyone can help with advice it is Jane or Judy (thumps). These folks are marvelous and get me pointed in the right direction.
I pray something can be done to help Boon. (((((((((((((((hugs))))))))))))))))

Oh but my heart goes out to you & little Boon, Nova.
Big cyber ((((Hugs))))
Thank you for such a comprehensive post, which will take me a while to digest fully.

Thumper's thread is huge because when I started it, we only expected him to live for about another 2 months & that was from a group of vets in an exotics center!

If I may comment on 2 symptoms. Inappetance + picking up food & dropping it, can be caused by poor caecal emptying, even though it looks as if the problem is in the mouth.

My input to RU is mainly using wild plants to help buns with gut problems. I am not a herbalist & have no training in the use of herbs. I was taught by Thumper & now Benjie.
Because it's Christmas the post is slow, anything I send you will take a long time to arrive.

There are a couple of things to discuss with your vet.

Pain relief is very important for both gut problems & snuffles. A Non Steroidal Anti Inflammatory (NSAI) is commonly used in the UK called metacam, although it's not the best for abdominal pain, it's all we can use. It's usually prescribed to be taken x1/day but much better pain relief is obtained if the same dose is given x2 daily. (Rabbits metabolise the drug very quickly)

Some species of clostridia make toxins which slow down the gut further. I don't know what type Boon has. If toxins are a problem we can give cholestyramine, to bind them up & inactivate them. It also inactivates many drugs, so has to be given about 2 hours after the last drug was given.

Your vet may consider e-mail or faxing an exotics center of excellence for rabbits. I'm sure you have your own in the USA but we can advise you of those in the UK if necessary.

On the herbal side.
Echinacea helps to reduce high cortisol levels released by pain or stress. The cortisol is a potent cause of gut slow down, & suppresses the immune system. I have the gelatin capsules of echinacea About 800mg /capsule & give may snuffles bun Benjie a pinch from an opened capsule, daily.

Bramble/ Blackberry leaves help gut motility both by the fibre content & the tannins they contain help to stabilise the gut microorganisms. We have to be careful about using tannins in rabbits (or humans for that matter). I will only use leaves which are eaten by the European wild buns in large amounts. There are several different tree & shrub leaves which help bunny tummies. The buns seems to know what's best for them.
You may be able to buy either bramble leaves or a mix of eg bramble, raspberry & strawberry leaves in a pet shop as we can.

Please feel free to pm me. If you send me an address where you can collect from. I don't need to know your real name, I'll try to get some of "Thumper's special blackthorn" leaves to you.

Sorry I got carried away answering on Thumper's thread.
This is what I posted.

Yes, we're sure that Thumper had Mycobacteria avium (a form of TB) which affected his gut. It was a total surprise. Not only was histology & bacteriology done at post mortem, but they even DNA typed the mycobacteria - M avium homini suis. unfortunately there wasn't enough tissue to confirm the typing by repeating it. It was the 1st. recorded case in a rabbit.

I'm shocked that a vet should refuse to see Boon. It's perfectly possible to narrow down the diagnosis to a point where management would be the same anyway, as in Thumper's case.
Ultrasound examination of the gut will show which parts are moving properly & which aren't, & will show swelling of the gut wall.

Thumper came to a point where he needed gut motility drugs all the time. In the UK at that time the only drug we could use for poor lower gut motility was ranitidine (Zantac) when this became ineffective we used Domperidone which is related to metaclopramide but unlike metaclopramide is effective throughout the whole length of the gut, and importantly does not cross the blood brain barrier so it doesn't cause the nasty neurological side effects of metaclopramide.

At the time no one knew the correct dose to use for a rabbit. (This work was done by vet. Francis Harcourt Brown in Halifax, Yorkshire England) My vet Marie was fantastic. She was happy to let me continue to gradually increase the dose of domperidone as necessary, to keep him comfortable, & his gut moving. Because he was comfortable without any side effects, he eventually took over twice the recommended max dose.
It was simple for us - unless we increased he'd die in stasis, if we increased, he'd have a bit longer of good quality life.

His 1st. symptoms started when he was about 16 weeks old & he lived to be about 6 years 4 months.
Caecal dysbiosis was an ongoing battle for us but I'm fortunate to live next to fields & could get the wild plants that buns eat. Most are very common in this country & even found in overgrown places in cities. Although all of them can be found in the USA, USA is a big place with huge differences in climate, habitat, & presumably public access to rural areas. Many of the plants can be bought on the internet. There are slight differences in the common names of plants between the USA & UK. To prevent confusion, I need to tell you the latin names of the plants.

The most dramatically effective for dysbiosis is blackthorn leaves (Prunus Spinosa) but they cannot be bought.
Thumper (& Benjie) showed me that it only works when the leaves are gathered in a short 6 week period between the time when the berries ripen & the leaves fall. (I'll send you all my surplus)
Amazingly Thumper's caecum began to fill again having hung useless for 10 months (Ultrasound confirmation) until he started to eat fresh blackthorn, when it started to fill again. Also the thickened caecal wall returned to normal.
Later when I was required to lower his domperidone dose by a subsequent vet, I could only achieve this by giving him powdered dry blackthorn leaves. I managed to almost 1/2 the required dose.

Next most helpful & used by country folk for this problem in rabbits for generations is Bramble (Blackberry) leaves - (Rubus fruticosa). Raspberry (Rubus idaeus) is identical as are the blackberry x raspberry fruits eg tayberry. These can be bought.

Hawthorn species - Crataegus monogyna & Crataegus laevigata leaves & dethorned twigs were best for both buns from 1st appearance in spring through until late summer. These can be bought.

Some buns prefer other tree leaves eg Hazel, Coryllus avellana - the one with hazel nuts! or Silver Birch, Betulla pendula.
Willow, Salix sps contain salycylates (aspirin like substances) in varying amounts. Because I'm often giving my buns related drugs eg metacam, I don't allow them access to more than a morsel, but use their appetite for willow as an indicator that they need me to restart metacam.

Hi again Judy :wave:

Boon has been pooping and eating all day but his "problem" remains. Still for the most part living on Critical Care and a variety of hay and veggies. His full blown stasis of yesterday didn't last more than about 8 or so hours, he pulled through as he always does after working the gaseous feeling bulge down his belly it's just that....ever since his last big bout in October (and then the Bactrim) he never made a full recovery. IT's as if his nerves truly are damaged. Will they repair? Stop and start and spark again? I've done a lot of research but the info out there is so limited (and thanks to Jack's Jane I found some very helpful info).

But alas, he is no longer in stasis. so maybe the Flagyl isn't bad after all. Hopefully, it is killing off that Clostridium! However his belly still feels doughey and he still can't tolerate pellets, etc.

The Flagyl seems to have helped his watery gaseous belly but it still feels doughey.

Despite the Flagyl Boon also continues to struggle with appetite (though he does seem eager to eat food, just not pellets, and when he does eat, he eats small quantities at a time), still has cecal diarrhea, slowdown, some lethargy but today he was quite the spunky little boy. Thank you for mentioning that the going after food but turning it away can be a problem with the cecum - prior to the exotic vet dumping me he did mention that boon's cecum felt distended. and that was on a day when Boon was fine and eating and pooping like a piggy! It is proof I am on the right track - I wonder how to effectively manage a dysfunctional cecum - I guess I have found the right person!

Not sure if I ever mentioned this too but ever since the day I brought him home he has an addiction to licking people's skin - a salt thing or just a very affectionate boy? Love him so much

It is very early here in the US, so I do not have time to respond fully in a PM - however earlier I read your responses in full and I will be PMing you shortly with my address! Hopefully within the next day or so.
You've no idea how absolutely grateful I am for anything that can help my little boy, even if his dysautonomia is classic Cow Pile syndrome (he fits the "look" genetic profile). I do hope your help is not too much to ask for or a bother. I hope to find these things that helped Thumper, on my own here locally somehow too,

I have been wondering if Echinacea can help!! I went to the vitamin store looking for some, but would have -no- idea how much to dose him with. He has a full blown Snuffle problem ever since he was intubated intranasally for his dental trim. I wonder how much to give him---? A pinch of a capsule containing x amount of mg of Echinacea?

I'd LOVE to be put in contact with rabbit specialists. I didn't think such a thing even existed. As I'm sure some of you are aware, there is no such thing as animal health insurance for anything other than dogs and cats here in America, and Boon's emergency visits have piled high, so I do have to be careful with that - at the same time, though, if there are perhaps professionals on an academic level who are interested in this phenomenon and interested in learning about it for future treatments, I'd love to be put in contact with these people. even if they are from afar. And ESPECIALLY if they can help me with Boon. And a Rabbit Specialist veterinarian would be a-m-a-z-i-n-g if one out there exists, I am just not sure how to look for one----help?

also, thank you for recommending the foods - I just have no idea where or how to look for these items, at what time of season, etc. I am from Western Pennsylvania. I have Multiple Sclerosis, so getting around is very very difficult - is there a place to buy such things such as the leaves?

I've heard of Domperidone being an effective treatment for Gastroparesis in humans - something which I ironically am afflicted with! I developed Gastroparesis after I caught a virus and had an adverse drug (med) reaction when I was 14. Who knows, maybe it had also something to do with the onset of my MS at age 20. (I am now 26).
Anyways - I don't want to start Boon out on a dose very high. If I can get my vet to RX the Domperidone, what has your vet recommended as a starting doage calculation? Boon weighs 1.3kg. Also not sure what to do w/ the Cisapride if I initiate Domperidone therapy. I guess the vet can surely find that out...hopefully.... I understand you are not giving medical advice over the net. I am just tryng to help my vet to help my Boon.

I do need to find a more specialized vet for Boon. I can't find one anywhere. Need help. I love my local vet and she has been patient, compassionate and has shown great mercy for Boon, sometimes not even charging us the full cost of things like needles and syringes, and talking with me over the phone--- it's just that what Boon is dealing with is beyond her scope of practice.

I AGREE that Metoclopramide is a nasty drug, with those weird funky central nervous system side effects, not just that but also so ineffective. Boon has been on Cisapride for a couple weeks out of every other month or so his whole life. He's been on it for about a week now again (basically ever since his tooth trimming). I don't plan to wean him off again unless he showed some kind of miraculous full recovery for a long time....

I was reading where Cisapride became ineffective after several months to years of treatment of megacolon in cats. I'll have to find the link to the book excerpt if you are interested---this is why I worry about the meds, I worry that they will stop working and his disease will become refractory. (and also, at this point I'm worried that our local vet didn't prescribe the Flagyl for the recommended period of time {3 weeks} to treat the Clostridium. I do know Clostridium produces toxins, though my local vet has never heard of Questran at all and I've brought it up a few times, she is so unfamiliar with it -- the PhD rabbit expert Dana Krempels mentioned it could possibly slow his gut down somehow (perhaps by binding contents, not sure) so I am not sure if the risk is worth the benefit right now as far as Questran goes BUT I am all for trying to find a veterinarian to comply with the prescribing of the Domperidone, it seems to be effective for human gastroparesis, treats the whole GIT and also does not come with those nasty CNS side effects you mentioned (and being that I suffer from a demyelinating CNS disease, I know that CNS effects are the worst!!!) I really hope I can find a vet who would be willing to work with me on this, and be open to prescribing the Domperidone, obviously don't want to start him out at the high doses but may have to work our way up to them.

Currently we already increased his Cisapride to 3x daily and we've never had to do that before.

Additionally, I wanted to mention, that when I said Beau died during a routine neuter surgery just a few weeks before I found Boon, the cause was unknown - well it was unknown to that vet - but I figured it out weeks later after getting his medical records - that vet used total IV ketamine anesthesia on rabbits and did not intubate. Beau ultimately died from respiratory arrest when his body soaked up all the ketamine. Always make sure your vet uses the gas and intubates!!

Sorry for going on about that, figured I should mention it....

Also, I will continue to use this thread as Boon's progress log. Perhaps I may change the title? Perhaps through Thumper, Benji and now Boon, maybe we all can help future bunnies!!! Will have to ppost some photos of him & Phenom in my siggy line. I am also adopting a third bun come January. He is missing an ear but other than that is very healthy, just unwanted cuz of his deformity He was part of a hoarding situation and his ear was lobbed off by one of the other bunnies. Not sure what to name him yet!

Also unsure if continuing the Bond between Boon & Phenom is such a good idea given Boon's condition but Phenom's poops look so very different Boons, I may be able to have them live together for sure if I can differentiate their individual poops.

Anyways, will PM you Judy, thank you and thanks to Thumper and Benji and Jack's Jane for helping me and my Boon..... continued healing thoughts, vibes, prayers, etc needed for my little guy

Nova

Hiya everyone :wave::wave::wave::wave:

Just wanted to let ya'll know that boon recently finished his 2 week course of Flagyl and his belly no longer feels liquified and putrified with gas and liquid. However, he still has hypomotility issues, is still on his med and supplement regime along with his strict diet. He has much more energy tho and does have an appetite, just cannot handle pellets and does experience episodes of hypomotility.

He has been molting for weeks now - don't know what's up with that.

I've been PMing with thumps_ and she's been so helpful. I'm hoping to get Boon's local vet here to help work with us on a new med. Indeed, Boon's problems do seem very much related to cecal dysfunction, plus he does have the characteristic "piebald" look of the cow pile syndrome / megacolon rabbit. (He's a dwarf hotot mix).

Boon's local vet here is eager to learn and help with this rare condition. will keep ya'll posted. I do have some extensive medical background myself due to having my own health conditions, so this journey shall be an interesting one and because of Thumper, Boon may have another shot at a longer life.

I haven't been able to be around much as I caught a bug on December 18th and it turned into an infection that didn't respond to antibiotics at all, so I'm now on a new antibiotic. what a yucky year 2012 was for me, wishing you all and all the little buns of the world a happy new year

Lovely to hear that Boon is more stable now

I am certain that thumps_ will be of enormous help to you

Happy New Year to you and Boon

Lots of love and vibes to you and Boon.

Hi all,

Boon has been doing splendid on Cisapride three times daily and living on Critical Care twice a day along with a small helping of greens and endless amounts of mature oat hay.

Three days ago his poops got very small, and I was held up at the tax office filling out paper work for two hours too long and so his meds were 2 hours late and his critical care feeding time was also 2 hours late. On top of that, he was beginning to molt.

Three days, 100ml subQ fluids, 2 doses of metacam, an increase in his medication dose, tons of BeneBac later and we had to resort to taking him to the vet tonight to get a shot of Buprenorphine and an enema.

Not a whole lot came out

Ever since he came home he's been a little out of it, acting kind of confused - I assume due to the Buprenorphine.... he goes to eat some hay in his litterbox but then either forgets or realizes that his tummy hurts and hops back out and lays down.

We're at a point right now where he is not even accepting force feedings - the food just falls out of his mouth. However, he still has enough strength to sit up and hop in and out of his litterbox. We've been offering him all his favorite foods.

Unfortunatey when it rains it pours. My neurological problem took a turn for the worst a few months ago because I developed a C. diff infection after being on several rounds of antibiotics for a stubborn sinus infection. I'm guessing I was exposed to the C. Diff in October when boon had it, so we had the vet tonight take a stool sample to look for C. Diff.
THE VET WE SAW TONIGHT is not familiar with Boon or his situation and has only very limited experience with rabbits.

Of course, out of all the weeks in the year, Boon has a stasis episode and his vet is gone for a while. We are in limbo really hoping the enema will have stimulated his colon enough to get things moving again.

In the meantime all I do is cry (not in front of Boon!) and writhe in pain from this C. diff infection that I myself have. I'm actually allergic to Flagyl so I'm on Vanco. I'm not feeling very optimistic; my immune system is **** because of my other health problems and now I'm full of anxiety and depression on top of it all. Eating is a chore for myself, I feel so much for my Boon.

The vet called in a round of Flagyl for Boon since I got the C. Diff infection, she feels it'd be good for us both to be on treatment for it....

I'm at my wit's end.

I don't know where to find or how to identify blackthorn or raspberry leaves.

It will take a compounding pharmacist at least a week to obtain and prepare a Domperidone prescription for Boon. He doesn't have that kind of time.