Lethargic Lop- No immediate Vet Care available

Discussion in 'Health & Wellness' started by HenryandCo, Apr 10, 2017.

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  1. Apr 10, 2017 #1

    HenryandCo

    HenryandCo

    HenryandCo

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    We have a 2 year old male Holland Lop that is suddenly (last day or 2) lethargic. He is still eating a little, and seems to be drinking a lot of water. (?)
    He is my 8 year old daughters treasured pet, and she takes very good care of him. She had him out in his run in the grass 2 days ago, and while he was alert, I noticed he didn't move around as much as normal. I thought he was enjoying the rare sunshine....
    He is on a diet of Pfau Rabbit pellets, Orchard grass hay, and fresh water daily. He does go out to an outdoor run in our field when the weather is nice, and munches on all sorts of (unsprayed) weeds. He occasionally gets small pieces of carrot, apple, banana, and lettuces as treats. (This has been his feeding routine for over a year) Anyway, today she brought him to me and said something was wrong. I noticed his eyes were slightly closed, and he had poop stuck to his bottom. I cleaned it off, and noticed it looked a little mucousy, and that it had a red, bloody tint to it. I cannot find anything else wrong with him. Eyes are clear, no injuries....
    I called 7 vets within an hour and a half of me that sees exotics, and the first one that can see him (on an emergency basis) isn't available until THURSDAY. (Today is Sun)

    I am hoping someone has advice here on what I can do for him myself in the meantime. I've made him an appointment, but am worried he won't make it that long. We've given him a romain leaf, which he happily ate, and a piece of banana - but I'm not even sure if we should be doing that? We are also holding water in front of him in a bowl about every half hour, which he drinks from better than his bottle.

    **POOP UPDATE:
    He has pooped again - smaller, wetter pellets than normal, but no blood/mucous this time....
     
  2. Apr 10, 2017 #2

    JBun

    JBun

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    Jenny - Health & Wellness Mod Staff Member Administrator Moderator

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    Bloody mucous in the feces can be an indication of an extremely serious health problem, one that is considered an emergency. It's called mucoid enteritis and it can be due to the coccidia parasite. This can be fatal if left untreated or not treated early enough. Your rabbit really does need to be seen by a vet, a rabbit savvy one if at all possible. If you can get a hold of a rabbit savvy vet but can't be seen right away, describe the bloody mucous droppings, say you are concerned about coccidiosis and ask if you could at least pick up a prescription to treat it prior to your appointment.
    http://rabbit.org/vet-listings/

    If there is absolutely no vet that you can get your rabbit to soon or get the right medication from, if you can find the correct medication at a farm store to try treating this, that's what I would do if in a similar situation but really only as a complete last resort. But coccidiosis is just a guess as to what is going on based on your description of symptoms, and it's possible that it's some other health problem entirely.
    http://www.medirabbit.com/EN/GI_diseases/Generalities/Enteritis_en.htm
    http://www.medirabbit.com/EN/GI_diseases/Protozoal_diseases/Cocc_en.htm

    It's also important to provide supportive care(preferably under the vets instruction) of syringe feeding food and water if a rabbit isn't eating very well on it's own. If he is eating well enough on his own, usually it is recommended to restrict sugary/starchy foods as this can worsen digestive issues, and feed only hay and dark leafy greens(preferably ones the rabbit is already accustomed to eating to prevent further digestive upset).
    http://www.rabbitwelfare.co.uk/pdfs/SyringeFeeding2014.pdf
     
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  3. Apr 10, 2017 #3

    HenryandCo

    HenryandCo

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    Thank you for the info JBun. I am going to read up on the links now, and will make sure he doesn't get anymore banana.
    As far as trying our local farm store for a coccidia treatment...is there a certain product I should look for? I googled, and found that CORRID can be used, however, all other info I'm finding doesn't specify a certain med, and only say to take them to the vet. We are in a rural area, and all the vets I called today say they don't have an "Exotics" Dr on staff. The vet I found that can see him on Thursday is an Exotics Emergency Vet over an hour from us. I did ask every office I talked to if they had any suggestions for me in the meantime, and they all said the doctors on staff were not secure enough in their knowledge of rabbits to offer any.

    If he is our only rabbit - how would he have gotten coccidiosis? From what I understood, it is passed from rabbit to rabbit? Also, he is over 2 years old - would it have shown up before now?

    Again, thanks for the info and links. Going to read up.
     
    Last edited: Apr 10, 2017
  4. Apr 10, 2017 #4

    HenryandCo

    HenryandCo

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    Update: I've read up on the links, and think Mucoid Enteritis seems to fit his symptoms and his stool appearance the best. I went to our local farm store, but they have nothing for treating coccidia in small animals - only ruminants and cows. The staff looked into options and tried their best to help - but just didn't have anything that would work for such a small guy.
    There is one vet in my area shown on the above linked document, and the office is closed today, but the website shows that she is in the office on Wednesday, so I will call in the morning and see if Henry can get in to see her first thing Wed. It's one day earlier, but still far too long, IMO.

    I can't believe that of all the Emergency vets I called today(8!) not one has an "exotics" Dr. on staff, and that the vets that do, don't have someone available before Wednesday! So frustrating! I'm so very worried about Henry. And my daughter is already in tears. She will be absolutely heartbroken if he doesn't make it. :cry1:
     
  5. Apr 10, 2017 #5

    JBun

    JBun

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    Corid is one treatment, though not the best one. Usually vets will prescribe a sulfa antibiotic like Albon, but you usually can't find sulfa antibiotics at the farm store. The best med for cocci is ponzuril(toltrazuril is related), but it is rx and not all vets carry it. Livestock vets are the most likely to have it as it's a med used to treat horses. That might be one option is trying to see if a large animal vet will help with the medication for your rabbit.

    This link has the medication info for treating cocci if you want to take a look. Treatment info is toward the bottom of the page. Amprolium is the medication name for Corid.
    http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Coccidiosis_Hedgehog.htm

    Keep in mind that I am not a vet and am only making my best guess as to what might be going on based on the symptom of bloody mucous in the feces. There are other possibilities, cocci is just the most common to cause such a symptom. And sometimes even without medication coccidiosis can clear up on it's own, but it can also go the other way even with medication. It's just depends on the severity of the illness and the rabbits own immune system.

    Cocci eggs can be picked up in the environment. It can also be something that naturally resides in their digestive system at non symptomatic levels, then something happens(stress, low immune system, high starch diet, etc) and the cocci essentially takes over to the level of causing disease.
     
  6. Apr 10, 2017 #6

    JBun

    JBun

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    You might want to try calling the other vet you found near you, as soon as they are open tomorrow. Even if the vet isn't in they should be able to contact her and could possibly at least get your rabbit on treatment right away. I've found with vets sometimes you need to be very insistent to make sure you get the treatment your rabbit needs. You are your rabbits best advocate. You really need to stress that this is very much an emergency and that your rabbit needs to be at least started on treatment immediately. Make sure to mention the bloody mucous stools and the lack of appetite for several days previously. Wednesday is too long to put off something so serious, and if this vet is any good then she should know how serious this is. She could at least advise the vet that is in the office on Monday on how to treat your rabbit.
     
  7. Apr 10, 2017 #7

    Aki

    Aki

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    Have you told the vets that it was an absolute emergency and that you thought your rabbit could be dying? I don't know how it is in your country, but in France vets have slots each day reserved to emergencies, that's why you always wait so much in the vet's sitting room - I mean, if your cat got run over by a car or a fell of the top floor, any vet would take him immediately and not wait for 4 days before treating them. I would call back vets and insist, saying that your rabbit looks weak and unresponsive, talk about the blood and the mucus (doesn't matter if it's not there anymore), and that you need to see someone NOW. If the front desk person doesn't cave, ask to speak to the vet directly and insist again. Talk about your crying daughter if you have to and ask what you can do in the meanwhile if they really can't see you because you just can't leave the rabbit like this. The window to treat a sick rabbit is often very small - a lot of ailments can be treated, but if it's taken early and a lot of rabbits die from something curable because they didn't see a vet soon enough. A vet knowledgable concerning rabbits KNOWS that and won't make you wait, especially when you have a problem linked to guts. Whenever one of mine (I have an 8 year old rabbit too, who had gut stasis twice last year) looks unwell to me, I get a vet appointment immediately and I always get one on the same day (by now, the vet knows me... I think he probably finds me annoying and crazy, but it saved my rabbit twice).
    I hope you find someone today and that Henry makes it.
     
  8. Apr 11, 2017 #8

    HenryandCo

    HenryandCo

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    Yes, I stressed that he seemed quite sick, and most of the receptionists I spoke to agreed that a rabbit shouldn't wait very long, as they are fragile creatures. It wasn't that there were vets knowledgeable about rabbits, and they were full....I was calling every ER vet within 2 hours of me, and getting referrals from every office I spoke to...it was that none of the vets knew anything about rabbits, as they are considered "exotic".

    I called the office this morning, and the vet was on vacation, but they called another office and hour and a half from me (In Oregon. I'm in SW Washington) that saw rabbits, and I took him in. The vet did an exam, and said his belly, kidneys and liver felt normal, and she wasnt feeling any kind of stasis, and that whatever it was was likely caught early enough that he would be fine after a round of anti-biotics, anti-inflammatories, a pain med, some sub-Q fluids (he was a little dehydrated), and some Critical Care recovery mush, which I am feeding him with a syringe. Hundreds of dollars later, she sent him home with me. She gave him a 90% chance of recovery, and wasn't at all worried about the possibility of parasites...or coccidia, even with the report of bloody mucousy stools. I paid for a fecal, but he hasn't gone all day, so I took him home with a collection cup and will have to take a sample all the way back to them when he goes.
    However, I'm not relieved. He seemed more stressed and lethargic after they brought him back from getting his Sub-Q fluids. He won't eat or drink at all on his own, and only ate about a third of the prescribed amount of replacement mush. He won't swallow anymore. Just lets it sit in his mouth, or spill out. Also, he's grinding his teeth...even though he was given pain meds 5 hrs ago.

    I've called the vet back to report this, and they said I could bring him back in for xrays or bloodwork, but warned that this would be quite expensive, and might not save him, depending on what is wrong.

    Do you think it's crazy that she doesn't think it's enteritis or coccidiosis? Would you take him back for diagnostic tests if he were yours? I was thinking about taking his fecal back to our farm vet nearby - assuming it's the same process as detecting Coccidia in our goats/sheep, and not driving 3 hrs roundtrip to get it to them. ??
     
  9. Apr 11, 2017 #9

    RavenousDragon

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    What meds exactly did you get if you remember? He could potentially be stressed from the car ride/vet visit and hopefully will perk up soon. How often are you feeding the Critical Care?

    As far as I know, the process for detecting Coccidia is the same for all species- but I'm not 100% sure on that.

    How is he doing?
     
  10. Apr 11, 2017 #10

    JBun

    JBun

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    I'm a bit concerned about your rabbit not wanting to swallow. Often when a rabbit gets to the point where it will no longer swallow and allows the food to just drip out of it's mouth, that rabbit is usually in a very critical state(unless it's just getting too much food). I can't say that this for sure is the case with your rabbit, but that has just been my experience when a rabbit is reported to be at that stage.

    I'm not sure blood work or xrays will make a difference if it is coccidiosis. If it isn't that and is something else then they might. A fecal float might detect cocci eggs if that is what your bun has, but then sometimes it can also get missed. It might be worth seeing if your farm vet will do it. Though if the antibiotic your vet put your rabbit on is a sulfa antibiotic, that is the treatment for cocci, so a fecal float wouldn't be absolutely necessary at this point.

    If the antibiotic isn't a sulfa abx, I think I would call up your vet and request to switch to a sulfa antibiotic, this way if your bun does have cocci, this will help treat it. And you don't have to go back to their office to get it. You should be able to request them to call it in to a local vet office or even a human pharmacy, though you may need to be insistent with them that this is what you want to do. If you do a human pharmacy you will need to make sure they have a sulfa suspension available and that the suspension doesn't contain xylitol(sweetener) before you talk to your vet and ask them to call a prescription in.

    I actually am surprised the vet didn't take bloody mucous stools more seriously since it can be an indication of such a serious problem, and makes me wonder how rabbit savvy this vet was. Unfortunately it can be quite difficult to find a good rabbit vet. Even when they are exotics vets and supposed to be experienced with them, I've found this isn't always the case. And you still have to pay the bill.

    Vets are most often pretty expensive. I usually don't ever walk away without having paid a few hundred dollars. When you need lots of meds to give, the cost really adds up. Then if you need diagnostics, that's another few hundred. I've found rabbits can be pretty expensive animals, as they are a somewhat fragile animal and can be more prone to getting sick.
     
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  11. Apr 11, 2017 #11

    HenryandCo

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    He is on .25 mL Meloxidyl (Oral) Every 12 hrs with food
    and .35 mL Enrofloxacin Strawberry (oral) every 12 hrs with food

    He's supposed to get 1.5 TBSP of the Critical Care, with water, daily. He had about 2.5 tsp at his first feeding before he quit swallowing, and I am just about to try to get another 2 tsp down him now so I can give him the second round of meds.

    I'm not noticing any difference from my last update yet, except more teeth grinding when being handled. Not better, not worse. Still hasn't pooped.
     
  12. Apr 11, 2017 #12

    Ivythelionhead

    Ivythelionhead

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    How's he doing now?
     
  13. Apr 11, 2017 #13

    Aki

    Aki

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    I'm really surprised the vet didn't do an xray when you brought Henry - you can't be sure there is no blocage or stasis without it and it's the first thing a vet normally does when you bring a rabbit with a gut problem. Then again, medical care (for humans and animals alike) is a lot cheaper where I live.
    No pooping and grinding his teeth (does he stay hunched, a bit like a hen on a nest?) indicate a stasis, I'm also a bit surprised you didn't get gut mobility drugs like Reglan - a rabbit not pooping is serious. Also, antibiotics don't really help with that (they can cause stasis in the first place), but I guess the vet didn't really know what the problem was and tried to strike as many things as possible.
    Mucus in the stools can happen with stasis, when the guts stop working for a while or slow down a lot, bacteria multiplies in the guts and when the rabbit passes stools again they can be coated in mucus. That's probably what the vet thought of and why she didn't really took it into consideration. I don't want to alarm you, but I think she was a lot more optimistic that she had any right to be. I had a rabbit who had the same symptoms as yours 4 years ago and he passed after a few days. I never found out what he had despite seeing two different vets, I suspected mucoide enteritis too, but it is rare with adult rabbits, and generally the rabbit has diarrhea which wasn't the case with my rabbit. Coccidia was another possibility, but I never understood how my rabbit could have caught that (we lived in a flat in Paris, so he was not in contact with any outside animal) and it's supposed to be very contagious - my rabbit lived with another bunny and stayed with her until he died and she never caught anything and is still in perfect health today.
    What I'm trying to say is that the whole thing sounds really serious to me. I would try to see another vet (one who knows what they are doing) and prepare your daughter for the worst outcome (also, it might sound a bit morbid, but if your bunny passes away and that you think of getting another bunny to soften the blow, desinfect EVERYTHING Henry touched with something like ammonia 10% just in case it was really coccidia).
     
  14. Apr 11, 2017 #14

    HenryandCo

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    I just finished giving him his third round of meds and feeding. When I fed him last night, I noticed he had more fight in him, and resisted the syringe more than before. Same today, and he's swallowing more at a time. And he had the energy to wash his face between syringe fulls. He still refuses to drink or eat anything on his own. Critical Care in a bowl, apple, spinach - nope.

    BUT, he pooped during the night. Mostly dry pellets, from the looks of it, but smaller in size. I cleaned him up, and am watching for a fresh batch of poops for the vet, as her instructions said she needed a "fresh sample". Then I'll run those an hour and a half to her.

    I would say I am encouraged by his activity today...although not sure I can say I think he'll recover, since the problem has yet to become obvious. We set him down on the floor, just to see what he would do, and he hopped off into his favorite room, but promptly laid down again against the wall, like he was very tired. Better than yesterday....

    Here he is after eating this morning, waiting for meds, like the sweet boy he is.

    20170411_091112.jpg
     
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  15. Apr 11, 2017 #15

    HenryandCo

    HenryandCo

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    Funny thing is, he only grinds his teeth when I'm getting ready to, or when I'm feeding him. I have been trying to set the Critical Care mix in a bowl and see if he is interested before syringe feeding, and he'll scoot up to smell it, then grind his teeth and lay back down. Like he hates the stuff. Ha. But the vet said it tastes like strawberries and bananas and they usually love it. :dunno:

    He WAS hunched up, the first day, but yesterday he was sprawled out in his enclosure. I took that as a bad sign, but maybe it's a good sign? Or better than being hunched?

    ***I'm worried about him becoming dehydrated again. How much water should I be getting into him daily? I have to mix some into the Critical Care to get it in the syringe - but probably only 10 Tbsps/day. (Broken up into 2 feedings) How much more should I try to get into him throughout the day?
     
  16. Apr 12, 2017 #16

    RavenousDragon

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    I would suggest not trying to force water into him. You could try water with a TINY bit of apple juice to get him to drink it willingly, but rabbits are prone to aspiration. Critical care, if mixed as per the instructions, SHOULD have enough water to keep him going. You might have more success with getting enough into him by breaking it into more feedings (if possible- and I know it isn't always!). With my own rabbits, if they are in ileus (when the gut stops moving), I try to feed them every 2 hours, but much smaller portions each time. They seem to do better with that (this is completely anecdotal and not supported by any research that I have done or anything- so take that with a grain of salt).

    Keep offering veggies, all his favorite things like you have been doing. Hay is the MOST important, but I definitely use treats to see if they are feeling better at all. The tiny poops are pretty common with ileus as they are coming out of it (so long as he continues to go in the right direction).

    Enrofloxacin is generally though of as a safe antibiotic in rabbits, and is pretty effective against most bacteria (albon would be better for coccidiosis specifically, but since your vet didn't know for sure what was going on, she probably just went general).

    Good luck and keep us updated!!!
     
  17. Apr 12, 2017 #17

    Aki

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    I do syringe feed water when I encounter a stasis problem, as hydratation is really important ('dry' guts can lead to build up and blocage). But it is true that you have to be careful not drowning your rabbit - I use 1ml syringe for water, it takes forever to administer but it's a lot less risky than bigger ones (you can deliver small quantities in the mouth, which means the rabbit has the possibility to swallow and it won't go in his lungs). I generally give 10 - 15ml a day (2 -3 syringe with the meds).
    But if you give very runny critical care, you don't need as much (I'd give a syringe of water after the CC for good mesure).
    Pooping is good, I'm glad he is feeling a bit better. Small poops are normal and should continue for a few days. None of my rabbits ever liked Critical Care, the fact that it's associated with syringe feeding (which they all HATE) doesn't help. I agree with Ravenous Dragon, keep on offering everything he normally eats. Making them eat hay on their own again is the hardest part, but once you are at that point it means they are on the road of recovery. I usually try to tempt them with fresh grass first as it is more appealing than hay but it helps the guts to work too (long fibers are what count, in the end).
     
  18. Apr 12, 2017 #18

    Ivythelionhead

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    This sorta happened to Iris and she refused to eat anything I gave her so I called my vet and was told to give her a slice of orange and I did and she started eating again, I'm not sure if your bunny will and if orange would even be good for him at this point but it really helped Iris get over her problem whatever it was, hope your bunny continues to feel and get better.
     
  19. Apr 15, 2017 #19

    HenryandCo

    HenryandCo

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    I wondered about that. I would likely only do it as a last resort then. He has started drinking out of the bowl again, but still won't eat pellets or hay. He has also started eating fresh veggies, but I'm not giving him much of them, so he's still on the Critical Care twice a day.

    The fecal came back from the vet - no parasites. :confused2: I have no idea what the problem was. Maybe he ate something he shouldn't have when he was out in the grass the day before, but we're just glad he's recovering.
     
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  20. Apr 15, 2017 #20

    RavenousDragon

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    Sometimes, parasites don't always show (if the parasite isn't in the exact right life stage at the time)- so it's still a possibility. Keep up with everything you are doing and although he may not like you much now, he will (someday) appreciate it.
     

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