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Unusual mycobactrial infection of GI tract presenting as dysautonomia.

thumps_

Wise Old Thumper
Original thread title - Dysautonomia/no caecal motility/caecum working again p63/passed away 15/11/11 p194

Recent events leading to an ultrasound of Thumper's tummy are on
http://forums.rabbitrehome.org.uk/showthread.php?t=223824

Thumper has had very long standing dental/stasis issues perhaps as early as 16/17 weeks old. Regular dentals & a very high fiber/low nutrient diet (like a wild rabbit diet) gave us good control of his bowels, until this winter.
I have been unable to regain control of his gut with dietary measures and short courses of zantac.

He had an ultrasound of his tummy today. The caecum wasn't contracting & just lying flaccid partly caved in on itself. The lining was inflammed. He'd a bit of sludge in his bladder but managed to pee it out on his own steam.

We do not know whether the nerves to the caecum have stopped working or whether the muscles have stopped working. It's immaterial apart from advancing our knowledge about bunny illness, because we can't do much about either!!
We're starting with a month's course of zantac + the NSAID metacam to reduce the inflammation.

As well as that, we have to get through a dental every month. Spinning it out to every month tips him to the verge of stasis. His fluid intake is very low because of his teeth.

There is interesting current research trying to find a link between amines which affect blood vessels & which are produced by a malfunctioning caecum in rabbits, & dental disease. It's the same concept as laminitis in horses hooves, but affecting the dental pulp vessels instead.

We need all the support we can get for this last fight.
 
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Oh Judy I am so sorry to read that Thumps's caecum is not doing its job properly, you must feel very upset about this. :cry: It's good to have a diagnosis and it means you can feel positive that you know what to tackle now and where but I totally understand how significant this finding is and how worried you must be. :cry:

I have everything crossed, and i'm going to make Poppy and Nino cross their paws in a minute too, that the suggested treatment course does the trick in time. We are all thinking of you here at this difficult and worrying time.
Vicky, Poppy and Nino xx
 
I have no real knowledge here, but this may help. I know many causes of laminitis are related to cushings or pre-cushings disease in horses, whether this in anyway related to amine levels I don't know.
There are also links suspected between laminitis and diabetes in horses.
I know this may well be useless, but it may help find a link with Thumper's problems, I hope so.
 
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Sending huge vibes for you and your Thumper! The dedication you show to him is amazing and I hope against all hope that his ceacum will get better with the meds! Come on brave Thumps if you can deal with a dental a month you can get through this too!
 
see judy, you just KNEW there was more to it - you are one heck of a brilliant bunny companion (or should i say slave).

is there any chance of recovery or will this just need to be treated with meds to alleviate some of the issues?

thoughts with you both xxx
 
i am thinking of you and thumper Judy, spend loads of time doing your usual bunny things hun, i guess prepare for the worst and treasure each day that dont happen and what ever happens ill be here on the other end of a pc just like you have been for me xxxxxxx
 
Just to clarify, these are two separate issues (generally, not necessarilyfor Thumps!):
1) Dysautonomia- disruption to the nerves, often affecting the intestines. Seen with Key-Gaskell syndrome in cats, grass sickness in horses and proventricular dilation syndrome in parrots. PDS has been demonstrated to be an excessive and damaging auto-immune response triggered by a virus but none of the others have definitive cause. Dysautonomia has been reported in bunnies and appears to have a familial link.
2) New theory relating to dental disease - not proven but similar as pathology noted with laminitis in horses. Excess carbohydrate is fed in concentrates and reaches a normal caecum. The bacteria in the caecum are designed to break down low energy, low carb material but changes in food they get changes their metabolism and products. New chemicals are produced be abnormal fermentation (vasoactive amines) that affect blood flow in small vessels. Rabbits are not designed to have these as part of their metabolic by products and so are not equipped to cope with them. The blood vessels in the tooth 'root' are believed to be highly susceptible to blood flow alterations and repeated changes in blood flow lead to alterations in tooth growth, eruption and strength and structure of surrounding tissue. The duration of the cause required to cause changes is not known, it's all very theoretical at the moment but certainly it start many months before changes in the teeth are seen. May all be proven to be rubbish in a few months or years but certainly the theory is fascinating!
 
Thank you all for so much support. I don't half need it.
A type of dysautonomia has been suggested, but today we found that it affects the caecum, not the colon.

Halfpenny, there seem to be 3 similar illnesses, equine grass fever, an "aquired autoimmune dysautonomia" in rabbits, & parrot ventricular disease.
About Christmas 08, Neil Forbes with Marie at GWR proved that the parrot disease was caused by antibodies to a virus, destroying the nerves of the parrot's gut. This makes a lot more sense to me than botulism, for several reasons.

The only way to make the diagnosis would be to take a specimen of the caecal wall & examine it microscopically. Thank goodness Marie takes a firm stand against this action. It would not affect treatment one jot, cause unnecessary pain & worse. However when Thumper leaves his body, I am prepared to offer a pm for research purposes.

I suppose it's been a gradually deteriorating situation, 1st. contained by diet, which gradually became stricter, then dentals added in were amazing for a year, but we are struggling now. I had a horrid feeling over winter that he'd deteriorated further, didn't want to face it, & sought solace by the many other folks who had issues with dysbiosis this winter, but I couldn't get him out of it.

I am lacking in knowledge. I had thought that megacolon refers to a lack of nerve supply to the colon. Does this refer to the caecum as well?
The classical large rugby ball shaped poops of megacolon are quite small & rare for Thumps. He's never passed mucus.

Perhaps I need to look into more wild plants which may help, & whether the megacolon diet may help, although I think I've worked out our own version.
ETA No wonder I've had such a fear of giving him any sugars or starch at all!!

He's back on form this evening after his Zantac & yummy metacam. He's drunk quite a lot too. Buns have so much to teach us if we'll listen. He was feeling rough this morning & wanted to lie up quietly, but as soon as he feels better he's making the most out of life. He never lets illness rob him of one second of life more than strictly necessary.
 
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Oh Judy!!
What are we to do about these bunnies????
Noserubs to him....and a huge hug to you.xxxxxx
 
Thumps, I went to a talk last year about grass sickness in horses, sorry I don't know how to post links, but if you search 'grass sickness' by halfpenny, it will show.
It may be of no help, but you never know you may find something similar to compare to your bun's problems or that may have been a trigger.
 
If there is a suspected element of auto-immune involvement here would the use of steroids be of any help? Or is this too risky re. Thumps's current immunity? Or basically no use whatsoever in this case? I was just thinking about the inflammation in his caecum and the deterioration aspect of his illness?
 
Thumps, I went to a talk last year about grass sickness in horses, sorry I don't know how to post links, but if you search 'grass sickness' by halfpenny, it will show.
It may be of no help, but you never know you may find something similar to compare to your bun's problems or that may have been a trigger.

Thanks halfpenny. I remember it, but never manage to get the reference right. Ribbons' mare made a wonderful recovery despite foaling. Marie posted a more detailed account of the viral antibodies theory.
 
If there is a suspected element of auto-immune involvement here would the use of steroids be of any help? Or is this too risky re. Thumps's current immunity? Or basically no use whatsoever in this case? I was just thinking about the inflammation in his caecum and the deterioration aspect of his illness?

I think the whole problem is that there is no low risk way to find out the definative diagnosis at this stage of our knowledge.
I have such a good vet in Marie that I tend to leave the doctoring side to her, & concentrate on the wild plant side & diet, being led by Thumper.
It would be nice if we could help other folk to reach the diagnosis earlier - & delay the process for longer.
 
A massive thank you for all your much needed support.
There are 2 fighters here. Although the other one is having a flop at present.:lol:
 
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