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

[auburnette]

Still trucking on - we have reduced metacam to 1x a day on Mark's advice but she will be on sulfatrim for a while. We noticed a few abnormal poos over the weekend, very small (still well formed) and wetter than usual (not cecals though). We're watching carefully as could be a variety of causes -we gave cisapride on Saturday evening due to the abnormal poos which I guess could have speeded things up, she is off it again now. They've probably also had more wet food than usual (lots of wet forage as it is the thing that is going down best) and of course there is the stress of the twice day meds...

She seems pretty good at the moment - very keen for pellets yesterday evening this morning, and right now on webcam she is eating hay after having been flopped out on her side. Hard to tell if she's eating enough to maintain her weight, both bunnies are not eating their hay as well as usual as we have increased the amount of forage available and probably also inadvertently increased pellets to try and induce Honey to eat :/ I would like to get them back eating their hay properly but worried that Honey won't eat enough hay of her own accord to keep weight on her. Argh. This is stressful, I wish she could tell us if she were feeling more normal!

 

[thumps_]

Still trucking on - we have reduced metacam to 1x a day on Mark's advice but she will be on sulfatrim for a while. We noticed a few abnormal poos over the weekend, very small (still well formed) and wetter than usual (not cecals though). We're watching carefully as could be a variety of causes -we gave cisapride on Saturday evening due to the abnormal poos which I guess could have speeded things up, she is off it again now. They've probably also had more wet food than usual (lots of wet forage as it is the thing that is going down best) and of course there is the stress of the twice day meds...

She seems pretty good at the moment - very keen for pellets yesterday evening this morning, and right now on webcam she is eating hay after having been flopped out on her side. Hard to tell if she's eating enough to maintain her weight, both bunnies are not eating their hay as well as usual as we have increased the amount of forage available and probably also inadvertently increased pellets to try and induce Honey to eat :/ I would like to get them back eating their hay properly but worried that Honey won't eat enough hay of her own accord to keep weight on her. Argh. This is stressful, I wish she could tell us if she were feeling more normal!

First - Yes, it is incredibly stressful. You have a really good team going - yourself, Honey, & your vet. The 3 of you are winning.
I agree totally that the small wet poohs went through the colon too fast - everything crossed that it was the cisapride.
Your move towards fresh forage is excellent on 2 counts. Remember that wild rabbits rarely live near water & rely totally on plant juices +/- dew for fluid intake. So this means that Honey doesn't have to fill up her tummy with water = more "space " for their natural nutrition which is best suited to their GI tract & their metabolism. Honey will either know or learn within 24 hours what forage is best for her. (A bit of tough stalky grass without brown spots on is also good if there's some on the allotment)
I know what everyone says about hay & it is excellent advice for healthy buns, but your forage will provide both the necessary fibre (especially the leafy twigs) & a wider range of nutrients/minerals & vitamins without upsetting the GI tract microorganisms. It is allowing Honey more scope to treat herself.
(I say this from experience of Thumper whose caecum stopped working completely for 10 months = impossible for a rabbit to live more than 2 months. By allowing him to chose his own forage he kept going without losing weight for a further 18 months. I hadn't a clue what he'd eat next! I'm confident that Honey will also do what's best for her with the forage)

Your best index of how much she's eating is how much is coming out. I think you'll find that when energy intake, or ability to process her food goes down she'll be less active. Back to digging - needs lots of energy was a real wowee!!
My buns - totally different temperament, with different chronic illness are free ranging house buns. The best sign that they are under the weather is that they stay near their "safe places" or spend more time there. At the very top of a rabbit's mind is "must avoid being caught by a predator" so if they're less fit/ill they tend to stay near safety.

When you come through this you'll be able to tell us what types of forage rabbits with a liver infection want to eat - please?

 

[auburnette]

Thanks so much for the helpful words thumps, this thread has been so informative (and also quite therapeutic as we've dealt with this!).

I was worried about her today but she was whizzing around as usual when we got home and keen for food and attention...a big relief as we are only on metacam once a day now so she can't be feeling too bad.

Re forage the order of preference has been bramble, raspberry leaves, strawberry leaves. She has gone off the apple leaves a bit now although will still eat them.

Fresh grass and coriander have also gone down really well. She would eat all of these things in preference to hay and pellets but the bramble is a huge hit - i hand fed her about 30 leaves this evening and she would take more if I'd collected it! I'll get another load in the morning.

 

[thumps_]

My turn to apologise. To me, with no vet training at all, I suspected liver infection, septrin, stasis prone = probable hepatic coccidiosis, but I didn't want you to Google it & get the fright of your life. I didn't realise that you were so aware of the severity of the problem Honey has, & is now overcoming remarkably well.
Yes, it's been really really tough - not only the damage to the liver from the coccidiosis but also keeping her out of stasis because stasis on its own (lack of energy foods) causes liver damage in its own right (hepatic lipidosis). You & the team have done absolutely brilliantly.

I have some very strong advice for you, specifically for the liver damage. I know nothing about herbal medicine except what my rabbits have taught me - (what they eat in certain circumstances & Googling the nutritional & medicinal properties of their preferences. Obviously they may have these preferences for totally different reasons which we don't know about!)
I think that Mark recommended a "liver tonic" of milk thistle seeds & dandelion root - as did Mighty Max who has a vast experience (far more than I do)
As someone rooted in orthodox - pharmaceutical medicine I'm very excited by this, because it seems that these herbs actually help the damaged liver to regrow without scarring. Orthodox medicine has nothing approaching this.
As a tip from giving Benjie echinacea. There is no way I can get a liquid form of echinacea into him. He smells it & goes ballistic! If I put a pinch of powder (no smell) in a (basil) leaf & wrap it into a parcel, he wolfs it down. Honey would probably take a powder wrapped in a small bramble leaf.

With the forage, the brambles are really interesting. I'm not surprised she has changed from the apple.
I'm also interested that coriander was one of Thumper's favourites for a long time. (Thumper was at incredibly high risk of hepatic lipidosis, for 4+ years but at post mortem, there was no sign of past liver damage from stasis, just the small amount was expected from his last 48 hours when the only forage he could get through his scarred, weak gut was all smitten with mildew)

I give you the same advice my wonderful exotics vet once gave to me re Thumper & his forage - "Go with the flow". "Trust him".

I also say to you, that Honey has a serious illness and it is can be BOTH treated with Septrin and has been detected early. Yes, you've been in a very tight situation & every day, although there may be small ups & downs, you are coming through it, & with every hope Honey will make a full recovery.
For Thumper it was "no goes" from the start, BUT became how long could we stave off the inevitable giving him good quality of life? The spin off was helping buns like Honey getting through their own tight situations & through to the other side.

ETA I once read that the nutritional value of brambles is slightly more than winter grass. As a rough estimate the bramble leaves have an equivalence to top quality hay, & more indigestable fibre than grass.

 

[auburnette]

That's great to hear re the bramble. I found a fat one this morning right in the front garden - she enjoyed that! She eats the stems too although i do dethorn them.

This morning's salad was bramble, strawberry leaves, fresh grass, romaine, rosemary, celeriac tops and also some small bits of celeriac root (they are homegrown so have long thin roots off the main bulb). I guess the root is probably sugary but not too worried about it upsetting her stomach alongside all the other stuff ( she actually loved it more than Treacle which must be a first).
Re liver tonic we got one from Trinity but it has a meaty flavour (as its meant for dogs and cats) and I've never seen Honey look so unhappy as when we gave that! She hated it far more than the drugs. So we've gone back to basics and got milk thistle seeds and dried dandelion root and letting the bunnies eat them directly. They seem to love them now - Honey was dubious about the milk thistle at first but Treacle went mad for it and think it encouraged her as both rabbits eating them well now. Only thing is I'm not quite sure how much to give, presumably not that much esp of the dandelion.

We have 1kg each of milk thistle and dandelion so also wondering if i could make some sort of crunchy ' liver treat' with hay, pellets, milk thistle, dried bramble and dandelion. Not sure how I'd get it all to stick together though!

 

[thumps_]

That's great to hear re the bramble. I found a fat one this morning right in the front garden - she enjoyed that! She eats the stems too although i do dethorn them.

This morning's salad was bramble, strawberry leaves, fresh grass, romaine, rosemary, celeriac tops and also some small bits of celeriac root (they are homegrown so have long thin roots off the main bulb). I guess the root is probably sugary but not too worried about it upsetting her stomach alongside all the other stuff ( she actually loved it more than Treacle which must be a first).
Re liver tonic we got one from Trinity but it has a meaty flavour (as its meant for dogs and cats) and I've never seen Honey look so unhappy as when we gave that! She hated it far more than the drugs. So we've gone back to basics and got milk thistle seeds and dried dandelion root and letting the bunnies eat them directly. They seem to love them now - Honey was dubious about the milk thistle at first but Treacle went mad for it and think it encouraged her as both rabbits eating them well now. Only thing is I'm not quite sure how much to give, presumably not that much esp of the dandelion.

We have 1kg each of milk thistle and dandelion so also wondering if i could make some sort of crunchy ' liver treat' with hay, pellets, milk thistle, dried bramble and dandelion. Not sure how I'd get it all to stick together though!

Wow! Honey does go for the brambles doesn't she?

re making a liver tonic biscuit it's a good idea re going back to basics. Try pm ing "Hugo's There" who's a lovely lady on here, & runs a special rescue - permanent home, for elderly, sick, unwanted rabbits. She can advise you about making a biscuit format if you tell her the problem, but you need to go steady on the starch to avoid upsetting the gut micro organisms.

I understand re the celeriac side roots - not too much starch in them & plenty of fibre - should be fine in small quantities as long as there are no uneaten caecals.
I wonder why Treacle is diving into the milk thistle seeds?

Is Honey making any progress with her weight & how are her poohs?

calling on people who use herbal medicine for buns - please help us with quantity of milk thistle seeds & dandelion root for rabbits & ideas about how to give them or any recipes for bunny herb biscuits.
(My apologies to members with experience in this area & who I don't yet know. I've been away for a while)

 

[MightyMax]

Wow! Honey does go for the brambles doesn't she?

re making a liver tonic biscuit it's a good idea re going back to basics. Try pm ing "Hugo's There" who's a lovely lady on here, & runs a special rescue - permanent home, for elderly, sick, unwanted rabbits. She can advise you about making a biscuit format if you tell her the problem, but you need to go steady on the starch to avoid upsetting the gut micro organisms.

I understand re the celeriac side roots - not too much starch in them & plenty of fibre - should be fine in small quantities as long as there are no uneaten caecals.
I wonder why Treacle is diving into the milk thistle seeds?

Is Honey making any progress with her weight & how are her poohs?

[U]calling on people who use herbal medicine for buns[/U] - please help us with quantity of milk thistle seeds & dandelion root for rabbits & ideas about how to give them or any recipes for bunny herb biscuits.
(My apologies to members with experience in this area & who I don't yet know. I've been away for a while)

Hi thumps. I use the formula I referred to earlier, and I would (personally) be wary of too high a dose of milk thistle to begin with because of it's detoxifying properties. Too fast a liver detox means faster 'die off'/toxins released if that makes sense?

 

[auburnette]

Re Treacle she's never met anything edible she didn't like :roll: it's a bit of a challenge especially at the moment where we are trying to build Honey back up as Treacle is the dominant rabbit and will often steal food from her or hog it all. Honey manages to hold her own normally but it would be easier if she had more space/time to eat at the moment before it all gets snaffled! Also I don't want Treacle eating too much! :?

We'll be careful with the milk thistle - I guess the concentration of active ingredients is maybe a bit lower from the seeds themselves as they haven't been crushed up and have their husks. Maybe no more than a teaspoon of seeds between them and similar of the dandelion root? I wouldn't want to give too many seeds as they are starchy anyway.

Honey's poos are good at the moment, size back to normal and good colour/shape, also there are lots of them!

 

[thumps_]

Oh Treacle is one of those rabbits, who doesn't self regulate food

How is Honey? is there any news?

 

[auburnette]

Honey is very well at the moment, eating enthusiastically - hay consumption has gone right up to normal levels. We've taken her off the metacam with no problems. Milk thistle is going down a treat and both bunnies seem to be tolerating it well. Hopeful of a normal blood test in two weeks' time

 

[MightyMax]

Honey is very well at the moment, eating enthusiastically - hay consumption has gone right up to normal levels. We've taken her off the metacam with no problems. Milk thistle is going down a treat and both bunnies seem to be tolerating it well. Hopeful of a normal blood test in two weeks' time

Sounds good and I'm glad she is doing well. Hope the blood test goes well

 

[thumps_]

Honey is very well at the moment, eating enthusiastically - hay consumption has gone right up to normal levels. We've taken her off the metacam with no problems. Milk thistle is going down a treat and both bunnies seem to be tolerating it well. Hopeful of a normal blood test in two weeks' time

Great news! To me, the return to normal hay consumption means that Honey can both absorb & process her food normally now. Fantastic.

 

[auburnette]

Just one last update to this thread to confirm that Honey's blood test came back with ALT within normal range and all other parameters normal Her fur has improved dramatically - hadn't even realised how rough it had got but now it is lovely and soft again. She also has her cheeky personality back.

So to summarise in case it helps anyone:

Adult female rabbit, sporadic GI stasis which would then resolve after the usual treatments
Fur clean, but in retrospect quite rough feeling with a lot of shedding
Mostly bright but with episodes of lethargy/withdrawn-ness during and around the stasis

Blood test showed inverted white blood cell relationship - suggestive of infection (note our original vet did not pick this up)
High ALT, bilirubin
Did fecal test but not sure if this showed coccidia (the hepatic form doesn't necessarily show up)

Treatment - Sulfatrim (course was over a month long)
Metacam for pain in the short-medium term
Milk thistle and dandelion root to support liver (we ended up feeding the seeds and root directly as she hated the tincture)
Lots of feeding to keep weight on - mainly did not need to syringe feed
Bramble, strawberry, raspberry leaves (things that are high in tannins)

Honey's fur improved significantly over the course of the antibiotics. She also got livelier and livelier (although not fully back to normal until we stopped the antibiotics - she hates having syringes fed). At the end of the treatment blood test and liver enzymes all within normal ranges.

We also managed to claim on insurance as liver conditions not covered by the 'gastrointestinal problem' exclusion on Honey's policy!

Planning to keep going with bramble leaves etc as they are popular with the rabbits and can only be a good thing

Wishing everyone good luck with their buns' health

 

[Jack's-Jane]

Just one last update to this thread to confirm that Honey's blood test came back with ALT within normal range and all other parameters normal Her fur has improved dramatically - hadn't even realised how rough it had got but now it is lovely and soft again. She also has her cheeky personality back.

So to summarise in case it helps anyone:

Adult female rabbit, sporadic GI stasis which would then resolve after the usual treatments
Fur clean, but in retrospect quite rough feeling with a lot of shedding
Mostly bright but with episodes of lethargy/withdrawn-ness during and around the stasis

Blood test showed inverted white blood cell relationship - suggestive of infection (note our original vet did not pick this up)
High ALT, bilirubin
Did fecal test but not sure if this showed coccidia (the hepatic form doesn't necessarily show up)

Treatment - Sulfatrim (course was over a month long)
Metacam for pain in the short-medium term
Milk thistle and dandelion root to support liver (we ended up feeding the seeds and root directly as she hated the tincture)
Lots of feeding to keep weight on - mainly did not need to syringe feed
Bramble, strawberry, raspberry leaves (things that are high in tannins)

Honey's fur improved significantly over the course of the antibiotics. She also got livelier and livelier (although not fully back to normal until we stopped the antibiotics - she hates having syringes fed). At the end of the treatment blood test and liver enzymes all within normal ranges.

We also managed to claim on insurance as liver conditions not covered by the 'gastrointestinal problem' exclusion on Honey's policy!

Planning to keep going with bramble leaves etc as they are popular with the rabbits and can only be a good thing

Wishing everyone good luck with their buns' health

I am so pleased that Honey has recovered so well

 

[roxyroller88]

Happy to see that you got some answers and that she is now doing well

 

[MightyMax]

Just one last update to this thread to confirm that Honey's blood test came back with ALT within normal range and all other parameters normal Her fur has improved dramatically - hadn't even realised how rough it had got but now it is lovely and soft again. She also has her cheeky personality back.

So to summarise in case it helps anyone:

Adult female rabbit, sporadic GI stasis which would then resolve after the usual treatments
Fur clean, but in retrospect quite rough feeling with a lot of shedding
Mostly bright but with episodes of lethargy/withdrawn-ness during and around the stasis

Blood test showed inverted white blood cell relationship - suggestive of infection (note our original vet did not pick this up)
High ALT, bilirubin
Did fecal test but not sure if this showed coccidia (the hepatic form doesn't necessarily show up)

Treatment - Sulfatrim (course was over a month long)
Metacam for pain in the short-medium term
Milk thistle and dandelion root to support liver (we ended up feeding the seeds and root directly as she hated the tincture)
Lots of feeding to keep weight on - mainly did not need to syringe feed
Bramble, strawberry, raspberry leaves (things that are high in tannins)

Honey's fur improved significantly over the course of the antibiotics. She also got livelier and livelier (although not fully back to normal until we stopped the antibiotics - she hates having syringes fed). At the end of the treatment blood test and liver enzymes all within normal ranges.

We also managed to claim on insurance as liver conditions not covered by the 'gastrointestinal problem' exclusion on Honey's policy!

Planning to keep going with bramble leaves etc as they are popular with the rabbits and can only be a good thing

Wishing everyone good luck with their buns' health

This is great news - I'm so glad to hear she is doing so well

 

[Omi]

Really good news

 

[thumps_]

Excellent news. I'm delighted for you both.
Well done both of you!

ETA I think you've done a brilliant job in using plants which are available to wild rabbits as food & which also have properties which help her medicines to work more effectively, maintain optimum GI tract function throughout (difficult when stressed by illness & in pain) promote healing of the liver & a lot more.

Thank you for sharing this difficult time with us so we can learn, & in turn help others.

 

[jerseygirl]

Just one last update to this thread to confirm that Honey's blood test came back with ALT within normal range and all other parameters normal Her fur has improved dramatically - hadn't even realised how rough it had got but now it is lovely and soft again. She also has her cheeky personality back.

So to summarise in case it helps anyone:

Adult female rabbit, sporadic GI stasis which would then resolve after the usual treatments
Fur clean, but in retrospect quite rough feeling with a lot of shedding
Mostly bright but with episodes of lethargy/withdrawn-ness during and around the stasis

Blood test showed inverted white blood cell relationship - suggestive of infection (note our original vet did not pick this up)
High ALT, bilirubin
Did fecal test but not sure if this showed coccidia (the hepatic form doesn't necessarily show up)

Treatment - Sulfatrim (course was over a month long)
Metacam for pain in the short-medium term
Milk thistle and dandelion root to support liver (we ended up feeding the seeds and root directly as she hated the tincture)
Lots of feeding to keep weight on - mainly did not need to syringe feed
Bramble, strawberry, raspberry leaves (things that are high in tannins)

Honey's fur improved significantly over the course of the antibiotics. She also got livelier and livelier (although not fully back to normal until we stopped the antibiotics - she hates having syringes fed). At the end of the treatment blood test and liver enzymes all within normal ranges.

We also managed to claim on insurance as liver conditions not covered by the 'gastrointestinal problem' exclusion on Honey's policy!

Planning to keep going with bramble leaves etc as they are popular with the rabbits and can only be a good thing

Wishing everyone good luck with their buns' health

Fantastic! May her good health continue! Thank you so much for taking the time to give this summary also.