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Recurrent stasis- thoughts on possible causes? Diagnosed hepatic coccidiosis - FIXED

auburnette

Young Bun
Hi everyone

One of our bunnies is just getting over her third bout of stasis in less than 8 months- thankfully she seems to be bouncing back well but with the recurrence we think there must be an underlying cause. Both the other times she was moulting quite heavily so there was a possibility it was connected but this time there is no moult so we are thinking something else must be amiss.

Background: Honey is about 3 years old, mini lop, correct weight for her size. She is one of two bonded girls (the other, a standard Rex, has never had any health problems). They've always been fed a pretty good diet of hay, veggies and minimal pellets, but since the second stasis episode a few months ago we have cut pellets and veggies to almost nothing (just as the occasional treat) and changed the hay over to Oxbow Timothy, which both bunnies love and eat very well. The rabbits exercise a lot and have a large outside run connected through to their indoor house.

Both bunnies have outside access and are up to date with all vaccines (combo myxi/RHD and RHD2, which they were vaccinated for about 3 weeks ago).

The second time Honey had stasis the emergency vet thought that molar spurs were a possibility. They suggested a dental procedure which would have been approx £400 (!!!) which given we had already spent £450 on that particular episode we were reluctant to agree to without more conclusive evidence that dental was her problem. We arranged for her records to be sent back to our usual vet. She's been examined twice since by relatively bunny savvy vets using the thing they put in bunny's mouth - and both vets thought her teeth looked fine.

Is there a way of x-raying her/putting her under GA to see if dental is actually the cause of the problem, once she's over this bout of stasis? (preferably without spending £400?! we're near Sevenoaks, Kent)

This time our usual vet has also prescribed Baytril in addition to the metacam/zantac/emeprid and we have ordered blood tests to see if anything is showing up there. Results due on Wednesday. We don't worm our rabbits and they do have access outside so wondering whether she could have picked up a parasite/infection?

Also wondering if bladder issues (sludge?) could be a potential cause and how that could be detected if so. She doesn't get many any more but we did use to be generous with leafy veg like beet toppings. She isn't great at drinking water and will often drink in massive drinking sessions and then spend a while without drinking. We are thinking of adding a bowl as well as their bottles to their cage.

Basically, just wondering how we can work our way through eliminating the various causes with a view to stopping this happening again. :D She's bouncing back well this time and was back on the hay within an hour of returning from the vets, but the second time she had to be admitted for 2 days, IV fluids, the works...
 
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Hi everyone

One of our bunnies is just getting over her third bout of stasis in less than 8 months- thankfully she seems to be bouncing back well but with the recurrence we think there must be an underlying cause. Both the other times she was moulting quite heavily so there was a possibility it was connected but this time there is no moult so we are thinking something else must be amiss.

Background: Honey is about 3 years old, mini lop, correct weight for her size. She is one of two bonded girls (the other, a standard Rex, has never had any health problems). They've always been fed a pretty good diet of hay, veggies and minimal pellets, but since the second stasis episode a few months ago we have cut pellets and veggies to almost nothing (just as the occasional treat) and changed the hay over to Oxbow Timothy, which both bunnies love and eat very well. The rabbits exercise a lot and have a large outside run connected through to their indoor house.

Both bunnies have outside access and are up to date with all vaccines (combo myxi/RHD and RHD2, which they were vaccinated for about 3 weeks ago).

The second time Honey had stasis the emergency vet thought that molar spurs were a possibility. They suggested a dental procedure which would have been approx £400 (!!!) which given we had already spent £450 on that particular episode we were reluctant to agree to without more conclusive evidence that dental was her problem. We arranged for her records to be sent back to our usual vet. She's been examined twice since by relatively bunny savvy vets using the thing they put in bunny's mouth - and both vets thought her teeth looked fine.

Is there a way of x-raying her/putting her under GA to see if dental is actually the cause of the problem, once she's over this bout of stasis? (preferably without spending £400?! we're near Sevenoaks, Kent)

This time our usual vet has also prescribed Baytril in addition to the metacam/zantac/emeprid and we have ordered blood tests to see if anything is showing up there. Results due on Wednesday. We don't worm our rabbits and they do have access outside so wondering whether she could have picked up a parasite/infection?

Also wondering if bladder issues (sludge?) could be a potential cause and how that could be detected if so. She doesn't get many any more but we did use to be generous with leafy veg like beet toppings. She isn't great at drinking water and will often drink in massive drinking sessions and then spend a while without drinking. We are thinking of adding a bowl as well as their bottles to their cage.

Basically, just wondering how we can work our way through eliminating the various causes with a view to stopping this happening again. :D She's bouncing back well this time and was back on the hay within an hour of returning from the vets, but the second time she had to be admitted for 2 days, IV fluids, the works...

Hello

It is not possible for a Vet to get a 100% view inside the mouth of a Rabbit whilst the Rabbit is awake. See this link for information about Rabbit Dentals :

http://www.medirabbit.com/EN/Dental_diseases/Differential/Rabbit_dentistry.pdf


However, as your Doe appears to recover from each stasis episode I suspect that the primary cause may be more likely to be bladder related, have you ever noticed any 'chalky wee' ?

Just prior to the stasis episodes what is your Rabbit's poo output like ? Does she eat all her cecotrophs ? Intermittent GI tract problems/stasis could be related to gut dysbiosis and/or a poorly functioning cecum.

If travelling to Maidstone is doable for you then Mark Rowland at Trinity Vets is an excellent Exotics Specialist Vet and you wont be charged £400 for a Dental !

http://wildpro.twycrosszoo.org/S/00dis/Miscellaneous/Caecal_ObstructionRabbit.htm
 
...another thing, I don't think she is a megacolon candidate. She actually does have the markings (white with spots/brown butterfly marking) but her poos are always smaller than her much larger bonded mate and they're usually nice and round :thumb:
 
Hello

It is not possible for a Vet to get a 100% view inside the mouth of a Rabbit whilst the Rabbit is awake. See this link for information about Rabbit Dentals :

http://www.medirabbit.com/EN/Dental_diseases/Differential/Rabbit_dentistry.pdf


However, as your Doe appears to recover from each stasis episode I suspect that the primary cause may be more likely to be bladder related, have you ever noticed any 'chalky wee' ?

Just prior to the stasis episodes what is your Rabbit's poo output like ? Does she eat all her cecotrophs ? Intermittent GI tract problems/stasis could be related to gut dysbiosis and/or a poorly functioning cecum.

If travelling to Maidstone is doable for you then Mark Rowland at Trinity Vets is an excellent Exotics Specialist Vet and you wont be charged £400 for a Dental !

http://wildpro.twycrosszoo.org/S/00dis/Miscellaneous/Caecal_ObstructionRabbit.htm

Thanks, this is really helpful. We may well visit the vet you suggest to follow up re the dental query. We haven't noticed any unusual wee but it's hard to keep track with two bunnies using the same litter tray - may try monitoring that more closely.

She always eats her cecals. Our usual vet did mention that a probiotic might be worth trying - I just want to know what the cause is so we can try and address it!
 
Hi everyone

One of our bunnies is just getting over her third bout of stasis in less than 8 months- thankfully she seems to be bouncing back well but with the recurrence we think there must be an underlying cause. Both the other times she was moulting quite heavily so there was a possibility it was connected but this time there is no moult so we are thinking something else must be amiss.

Background: Honey is about 3 years old, mini lop, correct weight for her size. She is one of two bonded girls (the other, a standard Rex, has never had any health problems). They've always been fed a pretty good diet of hay, veggies and minimal pellets, but since the second stasis episode a few months ago we have cut pellets and veggies to almost nothing (just as the occasional treat) and changed the hay over to Oxbow Timothy, which both bunnies love and eat very well. The rabbits exercise a lot and have a large outside run connected through to their indoor house.

Both bunnies have outside access and are up to date with all vaccines (combo myxi/RHD and RHD2, which they were vaccinated for about 3 weeks ago).

The second time Honey had stasis the emergency vet thought that molar spurs were a possibility. They suggested a dental procedure which would have been approx £400 (!!!) which given we had already spent £450 on that particular episode we were reluctant to agree to without more conclusive evidence that dental was her problem. We arranged for her records to be sent back to our usual vet. She's been examined twice since by relatively bunny savvy vets using the thing they put in bunny's mouth - and both vets thought her teeth looked fine.

Is there a way of x-raying her/putting her under GA to see if dental is actually the cause of the problem, once she's over this bout of stasis? (preferably without spending £400?! we're near Sevenoaks, Kent)

This time our usual vet has also prescribed Baytril in addition to the metacam/zantac/emeprid and we have ordered blood tests to see if anything is showing up there. Results due on Wednesday. We don't worm our rabbits and they do have access outside so wondering whether she could have picked up a parasite/infection?

Also wondering if bladder issues (sludge?) could be a potential cause and how that could be detected if so. She doesn't get many any more but we did use to be generous with leafy veg like beet toppings. She isn't great at drinking water and will often drink in massive drinking sessions and then spend a while without drinking. We are thinking of adding a bowl as well as their bottles to their cage.

Basically, just wondering how we can work our way through eliminating the various causes with a view to stopping this happening again. :D She's bouncing back well this time and was back on the hay within an hour of returning from the vets, but the second time she had to be admitted for 2 days, IV fluids, the works...


Hi there and welcome to RU :wave:

I'm sorry to hear about your rabbit, but it sounds like you are now determined to get to the root of this issue.

I think the teeth is a good place to begin, even though as you say she is a good hay eater. A vet can only see about 50% into a rabbit's mouth to check the cheek teeth with an otoscope, unless your vet is capable of doing 'conscious dentals' - where a GA isn't necessary.

An X-ray at the same time would be useful, though not conclusive.

The vet can also express your rabbit's bladder and send the wee off for urinalysis to check for bacteria, deposits and sludge. If you suspect bladder sludge, then at the time of the dental, you could get them to X-ray the bladder too.

I hope you manage to find some answers :D
 
...another thing, I don't think she is a megacolon candidate. She actually does have the markings (white with spots/brown butterfly marking) but her poos are always smaller than her much larger bonded mate and they're usually nice and round :thumb:

Are her poos very small ? Is it weird to ask if you could post a photo of an example of them !!?? It's just that if she have a chronic 'sluggish' gut motility this may be a clue to the cause of the recurrent stasis episodes.
 
...another thing, I don't think she is a megacolon candidate. She actually does have the markings (white with spots/brown butterfly marking) but her poos are always smaller than her much larger bonded mate and they're usually nice and round :thumb:

Did someone mention megacolon? The vet? It's not something that your post would make me automatically think of x
 
Megacolon not mentioned by the vet, no - just mentioned it as it sometimes comes up in context of discussing recurrent stasis. I don't think she exhibits any of the signs.

Right, sounds like we've got a plan - will wait to see if anything flagged in the context of her bloodwork first. They are doing white blood cells, liver and kidney function and blood glucose - I would expect the blood glucose to be completely unhelpful but if she has an infection hopefully it will show up in the WBC screen and she can stay on the Baytril.

If that comes back clear I think we'll go and see Mark Rowland and do urinalysis first and then a GA for dental exam and x-rays if the urinalysis doesn't show up anything.

Re poos I don't have a picture right now (lol- I understand why you ask!) but they are usually about 2/3rds the size of her bondmate's . To be fair though Treacle (other rabbit) is about 3kg and Honey is 2kg. They are well shaped, good colour and plentiful usually, but noticeably smaller.

I've also just ordered some Bio-Lapis and the probiotic pellets as presumably can't hurt to try her on these!

Madam is now busy running around in between eating hay - at least she managed to have her problem in-hours this time. :roll: Think we will keep her on metacam for the time being if vet can be persuaded to prescribe extra. We tried zantac/emeprid at home before taking her but didn't have metacam - the SC fluids and metacam at the vets seemed to make a world of difference as she was pretty much normal as soon as we got home.
 
Megacolon not mentioned by the vet, no - just mentioned it as it sometimes comes up in context of discussing recurrent stasis. I don't think she exhibits any of the signs.

Right, sounds like we've got a plan - will wait to see if anything flagged in the context of her bloodwork first. They are doing white blood cells, liver and kidney function and blood glucose - I would expect the blood glucose to be completely unhelpful but if she has an infection hopefully it will show up in the WBC screen and she can stay on the Baytril.

If that comes back clear I think we'll go and see Mark Rowland and do urinalysis first and then a GA for dental exam and x-rays if the urinalysis doesn't show up anything.

Re poos I don't have a picture right now (lol- I understand why you ask!) but they are usually about 2/3rds the size of her bondmate's . To be fair though Treacle (other rabbit) is about 3kg and Honey is 2kg. They are well shaped, good colour and plentiful usually, but noticeably smaller.

I've also just ordered some Bio-Lapis and the probiotic pellets as presumably can't hurt to try her on these!

Madam is now busy running around in between eating hay - at least she managed to have her problem in-hours this time. :roll: Think we will keep her on metacam for the time being if vet can be persuaded to prescribe extra. We tried zantac/emeprid at home before taking her but didn't have metacam - the SC fluids and metacam at the vets seemed to make a world of difference as she was pretty much normal as soon as we got home.

No I wouldn't worry about megacolon at all at this stage.

Certainly giving probiotics won't do any harm. The acidity of a rabbit's stomach actually kills off the good bacteria, and specialist vets no longer recommend probiotics and prebiotics for this reason, but as you say, they won't hurt her! I always recommend bio lapis if anyone wants to give probiotics, as brands such as Avipro have lots of sugar added which isn't good for disturbed guts :D

Your plan sounds good :thumb:

Mark Rowland is expert and I would also trust him with my rabbits :D

I am glad to hear she's running around - good luck xx
 
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Megacolon not mentioned by the vet, no - just mentioned it as it sometimes comes up in context of discussing recurrent stasis. I don't think she exhibits any of the signs.

Right, sounds like we've got a plan - will wait to see if anything flagged in the context of her bloodwork first. They are doing white blood cells, liver and kidney function and blood glucose - I would expect the blood glucose to be completely unhelpful but if she has an infection hopefully it will show up in the WBC screen and she can stay on the Baytril.

If that comes back clear I think we'll go and see Mark Rowland and do urinalysis first and then a GA for dental exam and x-rays if the urinalysis doesn't show up anything.

Re poos I don't have a picture right now (lol- I understand why you ask!) but they are usually about 2/3rds the size of her bondmate's . To be fair though Treacle (other rabbit) is about 3kg and Honey is 2kg. They are well shaped, good colour and plentiful usually, but noticeably smaller.

I've also just ordered some Bio-Lapis and the probiotic pellets as presumably can't hurt to try her on these!

Madam is now busy running around in between eating hay - at least she managed to have her problem in-hours this time. :roll: Think we will keep her on metacam for the time being if vet can be persuaded to prescribe extra. We tried zantac/emeprid at home before taking her but didn't have metacam - the SC fluids and metacam at the vets seemed to make a world of difference as she was pretty much normal as soon as we got home.

Mark has helped some of my Rabbits, one with a chronic gut problem. He actually recommended pro/prebiotics for him as part of his treatment. He recommended Avipro Plus :D
 
Update on Honey. She bounced back very quickly after her stasis scare on Monday morning and was back to normal by the afternoon. We have kept her on metacam, emeprid and Baytril anyway. She likes metacam but her disgust at the other two is pretty clear when we are administering them!

We went back to the vet today for a check up and for the results of her blood tests. The blood tests showed mainly normal but for three - urea, liver enzymes and another which i forget but something to do with kidneys. The urea and the kidneys were only very slightly out and the vet thought likely a consequence of her being in stasis at the time. The enzymes however were extremely high, something like double the normal range. The vet can't feel any abnormalities around her liver although we haven't done x rays/ultrasound or anything.

The vet thought we could try her on milk thistle and do another blood test in 3 months or so. We're happy to try the milk thistle as she'll probably enjoy eating it and seems like it might be good for her anyway...not sure how to interpret the high results though. We don't think she had been in stasis very long when we spotted it as she bounced back very quickly, but i guess this could also cause elevated liver enzymes? She'd also just had shots of metacam and baytril immediately prior to the blood test (we requested it as an afterthought) but i guess this is less likely to affect the result.

We're keeping her on baytril anyway and finishing the course in case there is an infection. Stopping metacam and emeprid soon though as she doesn't seem to have any need right now.

Still considering more detailed investigations to see if we can narrow down the cause but difficult to know exactly what :/ we're pretty sure it's not her teeth. Her weight is also stable so don't think there's anything chronic going on with her liver right now.
 
Update on Honey. She bounced back very quickly after her stasis scare on Monday morning and was back to normal by the afternoon. We have kept her on metacam, emeprid and Baytril anyway. She likes metacam but her disgust at the other two is pretty clear when we are administering them!

We went back to the vet today for a check up and for the results of her blood tests. The blood tests showed mainly normal but for three - urea, liver enzymes and another which i forget but something to do with kidneys. The urea and the kidneys were only very slightly out and the vet thought likely a consequence of her being in stasis at the time. The enzymes however were extremely high, something like double the normal range. The vet can't feel any abnormalities around her liver although we haven't done x rays/ultrasound or anything.

The vet thought we could try her on milk thistle and do another blood test in 3 months or so. We're happy to try the milk thistle as she'll probably enjoy eating it and seems like it might be good for her anyway...not sure how to interpret the high results though. We don't think she had been in stasis very long when we spotted it as she bounced back very quickly, but i guess this could also cause elevated liver enzymes? She'd also just had shots of metacam and baytril immediately prior to the blood test (we requested it as an afterthought) but i guess this is less likely to affect the result.

We're keeping her on baytril anyway and finishing the course in case there is an infection. Stopping metacam and emeprid soon though as she doesn't seem to have any need right now.

Still considering more detailed investigations to see if we can narrow down the cause but difficult to know exactly what :/ we're pretty sure it's not her teeth. Her weight is also stable so don't think there's anything chronic going on with her liver right now.

I'm glad you've got the results, and thank you for posting back :D

The anorexia, even a short time, can affect the liver values. Did your vet suggest any other possible reasons/causes?

I am glad you're about to try the milk thistle. I've had good results with that. How are you proposing to feed it?

It's so difficult to get to the bottom of what causes stasis. You're doing as much as you can do to find the reason, and I hope it becomes clear at some point :)
 
The vet didn't suggest anything else, no. He thought the stasis was throwing out the other two results that came back elevated but that the liver enzymes was sufficiently far over the normal range that it maybe indicated some issue there (hence the milk thistle). I'm not sure about this - as you say surely her being in stasis would send it haywire - although this time it was only a 'mild' stasis, less than 8 hours of her not eating (fine at 11pm Sunday, tummy pressing by 7am Monday) and she was back to normal within an hour of fluids/metacam.

We're going to try sprinkling half a capsule of milk thistle on a few pellets to feed it. We normally scatter pellets (they don't get every day) for both bunnies, but we can give them separately. If she won't eat it we might try her on the leaves themselves.

If there was an infection it will hopefully be resolved by the Baytril. Going to be watching her very closely though. Am thinking of calling Trinity Vets to see how much urine analysis and a dental exam under GA would cost. We're probably 45 mins to an hour from Maidstone but she travels well, unlike her bondmate...
 
The vet didn't suggest anything else, no. He thought the stasis was throwing out the other two results that came back elevated but that the liver enzymes was sufficiently far over the normal range that it maybe indicated some issue there (hence the milk thistle). I'm not sure about this - as you say surely her being in stasis would send it haywire - although this time it was only a 'mild' stasis, less than 8 hours of her not eating (fine at 11pm Sunday, tummy pressing by 7am Monday) and she was back to normal within an hour of fluids/metacam.

We're going to try sprinkling half a capsule of milk thistle on a few pellets to feed it. We normally scatter pellets (they don't get every day) for both bunnies, but we can give them separately. If she won't eat it we might try her on the leaves themselves.

If there was an infection it will hopefully be resolved by the Baytril. Going to be watching her very closely though. Am thinking of calling Trinity Vets to see how much urine analysis and a dental exam under GA would cost. We're probably 45 mins to an hour from Maidstone but she travels well, unlike her bondmate...


Thank you for your update.

I think it's a good idea to get a quote from Mark at Trinity regarding those things. I've always found a specialist vet to be roughly the same costs as a normal vet, which is good ..
 
May I make a small suggestion? It's the milk thistle seeds which are said to help the liver, rather than the leaves.
Benjie loves his powdered medicine wrapped up a parcel with a fresh basil leaf. At least we know it's gone in!
 
I never knew that about the rabbit colouring. My only stasis rabbit (occasional and mild) is a white butterfly marked with agouti buck.
 
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