Unusual mycobactrial infection of GI tract presenting as dysautonomia.

[basirascal]

I have only just caught up with this thread I am so very sorry that you have lost your beloved Thumper. My thoughts are with you. You did so very much for him RIP Thumper.

 

[thumps_]

Judy, sorry, being really dim here. So is the condition he had different to what you thought? Has it helped you getting these results? Sorry for the questions, just want to understand!

Yes, the cause of his condition is different from what we thought. Rather than his gut not moving properly because the nerves had been destroyed = progressive paralysis, it couldn't move properly because bacteria had invaded the gut wall & the inflammation made it "stiffer". So we were spot on about which parts of the gut weren't working.

Could we have diagnosed earlier? IMO NO.

Although TB can be cultured in the lab, it only grows using specific techniques. (The culture medium is malachite green & has to be incubated for 3 weeks before any colonies show) So we have to actively look for it separately from all the other bacteria.
It's possible to take a faecal sample & stain it & see the bacteria directly but only if they are in large numbers. Thumper's form of the condition would have led to small numbers of bacteria being shed intermittantly. The overwhelming chances in this situation is that you take the specimen when the bugs aren't being shed - so there's nothing to see, & you think there's no TB when there really is. (False negative)

Had he been diagnosed earlier he would have had to be PTS there & then, because he could give it to humans. Fortunately the only humans in close contact with him have been me & the vets who treated him. (We've contacted all except my last 2 vets this evening)
We now all have to have a medical check to ensure we're not infected. It's treatable but takes a long time. I needed special ABx for 2 years to treat the early human form of the disease when I was a child. (It used to be called "consumption")
Humans need prolonged, close contact to get infected, & are only susceptable to a few types. There's no risk to those who walked into my home occasionally.
The overwhelming likelihood is that no one's caught TB from him. But because TB is serious in humans, & not to be taken lightly. We have to warn everyone we know to be at risk, to have simple tests done.

So yes the pm has potentially saved several humans from a very nasty illness.
I interpret "unprecidented" as not previously documented/seen in this form. So it's incredibly helpful for vets to know that this can happen.
When we know the type, we may get a clue about how he got it.

 

[Jenova]

So it was an infection in those areas that caused them to deteriorate. Is this something that could potentially be affecting other rabbits who show his symptoms? If so, and if it is possible to pass it on to humans, his PM could save a lot more people than you realise.
I really hope you get to the bottom of exactly what was happening with him.

 

[Alibunmum]

Thanks Judy! I find it incredible that his symptoms and disease you thought you were managing we're rare but the actual problem probably rarer still. There's no room for ifs buts or maybes in this story, only the incredible strength and bravery of a small bunny and his amazing owner. I am glad he got to live his life longer rather than being pts in case of the remote possibility he infected a human. I now have fingers crossed that your health is ok.

How are you keeping Judy? I am sure your life has changed beyond all recognition. Is anything helped by the fact you are not out in all weathers searching for food for Thumper. I know you would much rather have him than not but I wondered if there was a small benefit to you. Take care xx

 

[thumps_]

So it was an infection in those areas that caused them to deteriorate. Is this something that could potentially be affecting other rabbits who show his symptoms? If so, and if it is possible to pass it on to humans, his PM could save a lot more people than you realise.
I really hope you get to the bottom of exactly what was happening with him.

Absolutely Jenova. It was an infection.
I feel that we now know what was happening to Thumper.

As far as I understand it, this is the 1st. case of this precise form of the illness in rabbits.
I honestly can't make assumptions about other rabbits on the basis of Thumper alone.
We need to give the vet world time to discuss it with each other.

The results of the next tests will give us an idea of how potentially easily it is passed on to humans.
Of course I'll be able to contribute to that knowledge when I've had tests myself, to see if I've caught it.
If I'm clear, after a huge exposure to his faecs I think it reasonable to say that the risk of rabbit human spread is very low indeed.

Please, no panicking here. We don't want to see a single rabbit PTS unnecessarily. It's a treatable illness in humans, but awareness of the possibility is a huge help in diagnosis. I'm not ruffled by the thought I could have caught it - I just think - "grief if I have any more pills I'll need 2 breakfasts. 1 of pills & another for food!":lol:

We're all participating in the process of learning something new about rabbits on this thread. Like all research at the beginning we have a theory which fits the facts at the time. Then we get new information which blows our theory out of the water & we start again, & go on, & on, until we get something which fits all the facts.

 

[Jenova]

Absolutely Jenova. It was an infection.
I feel that we now know what was happening to Thumper.

As far as I understand it, this is the 1st. case of this precise form of the illness in rabbits.
I honestly can't make assumptions about other rabbits on the basis of Thumper alone.
We need to give the vet world time to discuss it with each other.

The results of the next tests will give us an idea of how potentially easily it is passed on to humans.
Of course I'll be able to contribute to that knowledge when I've had tests myself, to see if I've caught it.
If I'm clear, after a huge exposure to his faecs I think it reasonable to say that the risk of rabbit human spread is very low indeed.

Please, no panicking here. We don't want to see a single rabbit PTS unnecessarily. It's a treatable illness in humans, but awareness of the possibility is a huge help in diagnosis. I'm not ruffled by the thought I could have caught it - I just think - "grief if I have any more pills I'll need 2 breakfasts. 1 of pills & another for food!":lol:

We're all participating in the process of learning something new about rabbits on this thread. Like all research at the beginning we have a theory which fits the facts at the time. Then we get new information which blows our theory out of the water & we start again, & go on, & on, until we get something which fits all the facts.

I just still can't believe how much you and Thumper have done for rabbit medicine. I know that through my vets trying and succeeding to treat Grim we have saved two other rabbits' lives. One is my sister's rabbit Dexter and the other is an unknown who my vet talked to my sister about. I know without Grim being ill those two rabbits at least would not have made it. But what Thumper has done is so much more and it's all through you. You've given up so much but he truly will live on forever in all the rabbits he saves. If I were religious I would say he should be made a saint. And you too.

 

[thumps_]

Thanks Judy! I find it incredible that his symptoms and disease you thought you were managing we're rare but the actual problem probably rarer still. There's no room for ifs buts or maybes in this story, only the incredible strength and bravery of a small bunny and his amazing owner. I am glad he got to live his life longer rather than being pts in case of the remote possibility he infected a human. I now have fingers crossed that your health is ok.

How are you keeping Judy? I am sure your life has changed beyond all recognition. Is anything helped by the fact you are not out in all weathers searching for food for Thumper. I know you would much rather have him than not but I wondered if there was a small benefit to you. Take care xx

I'm absolutely delighted he got to live a full life.
It was by far the best outcome for me too. Had we known earlier, I would have been willing to take the risk myself, but suspect that there would have been no choice cos of legislation. I don't think I could have hacked that. The only people I needed to contact are my HH & 1 neighbour+ her dog.

I've been at far, far greater risk of incurable illness eg Serum Hepatitis, HepatitisC, HIV Aids, & the worst form of drug resistant "human" TB from my job all my life. There was even greater risk at sea, as life boat doctor. The successor to my job was killed by loose superstructure while being winched down to a stricken trawler in a gale. Similarly the Lerwick Coxswain was killed during winching in high winds.
We know the risks are there, accept them before we train, & take appropriate precautions as necessary.
(No I did not keep a banana with a condom on it in my white coat pocket :lol

I honestly didn't notice going out in all weathers but guess I'm used to that too! :lol:
I was very tired, & was starting to wish someone could stay over to medicate & feed him for 2-3 days so I could have a complete rest. Thankfully it never got to screaming pitch. Love's a strange thing!

 

[Jack's-Jane]

Judy thank you for messaging me and as I said in my reply, the path' results are a complete shock. Thumper is still teaching us all. We owe him so much

Both you and Thumper have shown such courage throughout this journey towards better knowledge and understanding of Rabbit Medicine.

Thank you BOTH

 

[thumps_]

I just still can't believe how much you and Thumper have done for rabbit medicine. I know that through my vets trying and succeeding to treat Grim we have saved two other rabbits' lives. One is my sister's rabbit Dexter and the other is an unknown who my vet talked to my sister about. I know without Grim being ill those two rabbits at least would not have made it. But what Thumper has done is so much more and it's all through you. You've given up so much but he truly will live on forever in all the rabbits he saves. If I were religious I would say he should be made a saint. And you too.

Speaking for myself, my halo doesn't stay up very long yet, like the angel emoticon!
Most people who know me know I like many different sorts of music, but particularly that from the 16th century.
I've hesitated to post a piece which I find calming, & somehow seems to say many things about his life to me.
I call it Thumper's tune.

It's modern, based on an old form. The words are 16th. century spanish by Saint. Teresa D'Avilla.
A simple tune (the ground bass) is repeated twice, & keeps on repeating. At each double repetion 1 or 2 solo instruments/voice "do their own thing" in perfect harmony with the choir's ground bass. (I quite like to make up my own tunes too & do a sing along of me own!)

So as not to offend those who are distressed by religious imagery but of poorer sound quality there is this version.
http://www.youtube.com/watch?v=lBfWfzZRnYA

Much better sound & slightly different, with stills of christian symbols from various denominations..
http://www.youtube.com/watch?v=6B5AuCaDSwM

The translation is "nothing can trouble, nothing can frighten, those who seek God shall never go wanting".

I interpreted it with a twist, remembering the many times I was in an absolute blind panic, & would ask Marie "What'll I feed him when we run out of .......? " and she'd look back at me in total calmness & confidence replying, "You'll find something".
You know she was always right too.!!!!

 

[poppymoon]

truly amazing. i'm shocked at the results but not surprised in a way if that makes sense:?

we knew a looooong time ago that thumper was extremely special and already, you and he have helped so many bunnies with gut problems but this new finding is something else!

i hope that your own health doesn't suffer but i know that even if you do need medication for a while, it will all have been worth it as thumper did lead a very full and happy life - i'm very fortunate to have met him during the summer and in all honesty, he did not appear 'ill' in any way - his condition and playfulness was awesome

i can't put into words what i mean very well but i think that for helping so much with the health and understanding of our complex little bunnies, all i can say is :thumb:

 

[Hoppit!]

Oh Judy. There is really nothing I can say. Please remember that we are all here for you.

 

[thumps_]

Thank you Poppymoon & Hoppit.
Yes, he had a good summer this year. He was such a cheery little soul & had a good life span at 61/3 years.

To put it into context, the chances he's given anything to me are as vanishingly small as the chances of a sober adult being killed by traffic when crossing the road attentively. I'm honestly not worried about that side at all.

Much on my mind is his dramatic response to Blackthorn/Sloe leaves & how he went 10 months with a non filling thickened caecum which "miraculously" started to fill & the thickening disappeared when the leaves became effective. I just think it's well worth investigating the properties of those leaves properly.
There's a bit of explaining to do there!

 

[prettylupin]

I can not believe I've only just seen this update :shock:

I am in total shock, I honestly never in a million years thought they'd find TB!! :shock::shock: I saw a fair amount of the human form in India and was coughed all over by a febrile infected infant on a ward. Many of the orthopaedic patients were TB in the bone etc. Until you wrote it down I never even considered the risk to yourself but am certain you will be fine, please let us know this is the case when you find out.

Blimey, that little rabbit of yours was a real one in a million in so many ways! No wonder he was so poorly, I hope some of the vets who suggested his illness was at times 'behavioural' and attention seeking are now eating their professional hats! This just shows once again how incredible you were at keeping him going through such serious infection. He led a full happy life thanks to you, and of course the support you got from Marie. xx

 

[thumps_]

I can not believe I've only just seen this update :shock:

I am in total shock, I honestly never in a million years thought they'd find TB!! :shock::shock: I saw a fair amount of the human form in India and was coughed all over by a febrile infected infant on a ward. Many of the orthopaedic patients were TB in the bone etc. Until you wrote it down I never even considered the risk to yourself but am certain you will be fine, please let us know this is the case when you find out.

Blimey, that little rabbit of yours was a real one in a million in so many ways! No wonder he was so poorly, I hope some of the vets who suggested his illness was at times 'behavioural' and attention seeking are now eating their professional hats! This just shows once again how incredible you were at keeping him going through such serious infection. He led a full happy life thanks to you, and of course the support you got from Marie. xx

It's much on my mind that there's a very remote possibility I've given it to him!
I had human pulmonary as a child, picked up early on mass miniature XR. I also had the full treatment - parenteral streptomycin then PAS & INZ for 2 years. It was back in the early days of effective anti TB therapy & it was uncertain how effective it was long term. We were advised to watch out for reactivation later in life.
I've always had a massive "naturally aquired" immunity to human TB.
I'm too old to "reactivate"lol & TBH I'd have fallen off me perch long ago if I'd had reactivated human TB of 6 years duration.
We just have to wait patiently & see what the type is. I've no worries whatsoever about me.
Of course I'll tell RU what happens -you all need to know.

Yes, there's a part of me that can't resist a mental dig in that direction too.
My halo fell round my ankles as I imagined a certain "gentleman" who accused me of making a "perfectly normal bunny ill by overdosing him with drugs" & might be described as "positively luminous on rectal examination", needing a colonoscopy round to his own caecum! I leave it to the realms of fantasy though! I honestly don't want any harm to come to anyone from this.

ETA I should add that the histopathology doesn't suggest human TB either.

 

[prettylupin]

It's much on my mind that there's a very remote possibility I've given it to him!
I had human pulmonary as a child, picked up early on mass miniature XR. I also had the full treatment - parenteral streptomycin then PAS & INZ for 2 years. It was back in the early days of effective anti TB therapy & it was uncertain how effective it was long term. We were advised to watch out for reactivation later in life.
I've always had a massive "naturally aquired" immunity to human TB.
I'm too old to "reactivate"lol & TBH I'd have fallen off me perch long ago if I'd had reactivated human TB of 6 years duration.
We just have to wait patiently & see what the type is. I've no worries whatsoever about me.
Of course I'll tell RU what happens -you all need to know.

Yes, there's a part of me that can't resist a mental dig in that direction too.
My halo fell round my ankles as I imagined a certain "gentleman" who accused me of making a "perfectly normal bunny ill by overdosing him with drugs" & might be described as "positively luminous on rectal examination", needing a colonoscopy round to his own caecum! I leave it to the realms of fantasy though! I honestly don't want any harm to come to anyone from this.

ETA I should add that the histopathology doesn't suggest human TB either.

Highly unlikely but even if this is the case how on earth were you ever to know, coupled with the fact that Thumper had an amazingly long, happy life with you, something that would never have been the case had you not taken him on all those years ago.

Yes, I too was thinking of the suggestions that were made that you were overdosing him with drugs and had caused an iatrogenic disorder! Anyway, it doesn't matter now, but atleast you can rest assured that you knew your bunny better than anyone all along.

ETA How are you getting on yourself? Did you bury his lovely casket?

 

[MimzMum]

I've had to read these updates a few times today because I can't believe what I'm seeing. But I totally agree that this was better hidden so that he wasn't pts. I wonder if anything could've been done anyway about the underlying TB since it was an unknown strain. How hard to imagine that we are at once thankful and yet saddened that the true cause of his illness was not apparent.
Judy I will add my prayers that you do not succumb to any opportunistic infection that may be lingering. It does sound unlikely from what you've told us. My prayers also for your veterinary teams.
And dear Thumper continues to break ground for human and rabbit medicine. He was in exactly the right place at the right time...as are all of God's creatures.

I wonder if it's possible that blackthorn is an old folk remedy for consumption?

Thinking of you as always. Be kind to yourself and remember .....All things work for good... (((((((((hugs))))))))

 

[thumps_]

You're right PL human TB needs a lot of oxygen to live & so it can't infect inside the gut, that needs a different strain - bovine TB.

Yep, I'm as well as can be expected. I'm fine with the casket downstairs on the table. I was just throwing a wobbly at modern sensitivity "bringing him home" & the beautiful brass plaque engraved "Thumper".
I guess being a somewhat "stormy, & feet on the ground" person part of me was saying "That's NOT Thumper. "Thumper" has passed away & is no more."
The other difficult thing was that I've always considered Thumper's feelings as best I could. Well, he lived here too, & had his little rabbit life to lead. I could go out whenever I wished, & he couldn't.
To me it was so simple. If it was HIS playtime why shouldn't I allow him the choice of which game we played together if he could convey preference to me? It was the same with herb treats when he was younger. He could manage a choice of 3, although sometimes he got so excited, I couldn't tell which he preferred, & he got 1/3 portion of all 3.:lol:

It almost tore me apart to make the decision to pts. but amongst all that were considerations, like how to prepare RU at short notice? then breaking the news to others, how to put the now unneeded food to best use?etc.
But my life is far from simple. In & amongst all that I have issues of a thin layer of raw human sewage & a heck of a lot of water spread over my whole garden & drive (5 times since June.) It can take up to 6 e-mails over a period of 3 months to obtain proof that the Water Authority have recorded my phone complaint. The only statistics which will lead to an end of the problem are those of the Water Authority. So I have to ensure those are right. I have to take photographic evidence of each flood, & have to clean up a large garden & my drive afterwards too.

At some point just before Thumper died, the local consultant visited with my CPN & told me to increase my drugs above the max dose. They're incredibly old fashioned drugs so he's not used to them, but they're the sort you don't mess with, especially with someone like me whose had a couple of tricky probs with them in the past!
( FFS send me back to Oxford where I don't have to " supervise" that the consultant doesn't "try to kill me!")
So it's hardly surprising that in all this mess, I was a bit confused about Thumper's ashes. Once I realised that I don't have to consider the "feelings of Thumper's ashes" cos it's not "Thumper" I was fine.

 

[prettylupin]

Oh Judy it never rains but it pours You have so much to contend with at the moment, I am amazed you are keeping your head above water, even if only just. You are such a strong lady

Sending you a huge hug xx

 

[thumps_]

I've been rung by my GP friend this morning. She's had enquiries about the risks of rabbits transmitting TB to humans.:shock:

Please get this in perspective folks.
ONLY ONE rabbit in the UK has had an unusual form of intestinal mycobacterial infection. That was MY rabbit Thumper.
There's plenty of TB surveillance going on all the time amongst animal populations at routine pm's. It's well known that cats, especially good mousers, can sometimes get bovine TB. which is far worse for humans than the sort Thumper seems to have had. There's no issue there, now is there?
You guys all know there's TB in animals cos of all the distress over badgers.

IMO the vets who have done dentals on Thumper need to know because during a dental the high speed burr & water spray could fling the contents of his mouth into the vet's face. If the poor vet opens their mouth at the wrong time, & if Thumper had eaten some caecs just before the dental & if some had stuck on a sharp spur .......
If, if, if, if, - there's NO problem.
I'm not worried, & I've lived for over 6 years with Thumper the ONLY rabbit with this condition. Thumper didn't have the habit of spitting his caecals at me when my mouth was open!

ETA if anyone knows how this has gone viral please can you help to put it right.

 

[Jenova]

I really hope it's not gone viral! :shock:
My guess would be the vets and others dealing with working all this out have been asking around, including GPs. And your friend knows how knowledgeable you are about rabbits so has asked you.

This wasn't enquires from the general public was it? That's pretty ridiculous as Thumper is the only rabbit known to have had this.