Mucoid Enteritis

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Runestonez

Runestonez

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Well I wanted a Japanese Harlequin buck so badly...we actually brought him home that and his brother a Magpie last Sunday.

Well our boy Finn passed away Saturday around noon after developing soft cecals with mucus the evening before. He was still eating and drinking that night and scooting around. So we were watching him but not overly worried...we were thinking that it may have the been the introduction of romaine into his diet the night before...he never really developed any bloat...he suddenly became lethargic and died 30 minutes later.

Our Magpie boy Guffy looked fine...eating, drinking etc...and never presented with diarrhea. He looked like he might have gas though so we gave him Ovol...again we assumed it was the veg. About 2 hours after Finn died Guffy started pooping out a thick almost clear mucus. We had a prescription the vet had called into us for Finn...buthe had died before we could give it to him...so when Guffy got sick we started him on the anti-biotics right away. He immediately started to bloat and stopped eating...he would nibble here and there but stopped drinkig water a little while later. I have had good results keeping him hydrated with a syringe right now. He refuses to eat although tonight he was nibbling some dandelion leaves...

This is what we have doneso far:
-.5ml of Ovol every 3 hours (we increased it to every 1-2 hours)
-.5ml Novo-Trimel every 12 hours
-.14 Metacam every 12 hours for pain management
-as much pedialyte as he will take(usually 3ml every 1-2 hours)
-and as much excerise as he will tolerate (about 5-10 minutes per hour)
I have given up massaging his tummy as it was so distended earlier I was causing morepain then helping.

His swelling has gone down a bit(very little bit)but he is tired and listless...Ihave read a lot of articles that advise to keep doing fluids andworry about food later and then others that advise high fibre right now...I am looking at a bunn that looks like he is going to pop...and is passing periodic plugs of mucus. He has been trying to eat on his own...and I don't know if I should interfere or just keep an eye on him.The mucusis clear and colourless,very thick too. Guffy never really developed any diarrhea..he went from gassy to mucus.

Any advise would be appreciated...I looked for a vet here but no specialists within a 2 hour drive of us...I am hoping I can keep him out of shock till morning when our vetopens.:tears2:

Thanks
Danielle
 
Benebac! Also, see if you can get a cecal from one of your healthy adults. First try offering it, if he won't take it then mash it up in some pedialyte and make him swallow some.

Use a vibrating toothbrush (or a ride on the washing machine, etc.) to help move gas out. This worked very nicely with Dora.

How long has it been since he's eaten? If it's been some time, I'd give some heavily diluted Critical Care or pellet mush with the next pedialyte. Not much, just so his gut has a little bit of solids to work on.

If he wants to eat on his own, let him.

Also, is he eating the same pellet brand that the breeder was feeding?

I'm so sorry you lost Finn already. Mucoid Enteritis is very fast and deadly. Hopefully Guffy will pull through like my Dora did.:hug:

Edit: Also offer a heating pad/warm rice sock. He may be having trouble keeping himself warm due to the illness and it will feel comforting to him.


 
So sorry... :(

Does he sound like a half-empty thermos when you gently shake him?

Keep him warm, and depending on how much he's eating (and its great that he is trying to eat), I think Critical Care would be helpful, but not sure you'd have any and a pellet slurry isn't the same. He needs a buffer in his stomach for the Metacam not to cause any damage.

Keep pushing the hay and the fluids.

Here's part of Pam Alley's article, it seems to be the best I've run across..

http://www.showbunny.com/gastrointestinal.htm

excerpt:

Mucoid Enteropathy

A second common diarrheal complex is what was formerly called mucoid enteritis, named that for the clear jellylike stools which appear as the disease progresses. As time and research have shown, mucoid enteritis was not entirely accurate as a name, so the title mucoid enteropathy was adopted to take in the many ramifications involved.

Mucoid enteropathy, or ME for short, affects usually young fryers on a high carbohydrate, low fiber diet, although there have been cases when a different diet composition was used. The initial signs appear as a slight listlessness and lack of appetite, combined with an insatiable thirst. The affected animal will commonly sit hunched, with its head high and front feet in the water crock. With automatic watering systems, the animal will again sit hunched directly beneath the valve and hold the head high. As this continues, grinding of the molar teeth will begin and a very liquid diarrhea will erupt.

After a period of 12-48 hours at this stage, the young animal will be extremely weak and begin discharging a clear, jellylike substance that may even be formed into stoollike pellets. The definitive diagnostic method for mucoid by the average rabbit breeder is to pick the animal up and shake it gently. If ME is present, this movement will produce a sound like a half-full Thermos bottle.

Dehydration in ME is a killer; animals provided with sufficient subcutaneous or IV fluids have a better chance to recover. Feeding straight fiber sources to encourage gut peristalsis recovery has been proven to be of value. If palpated, some animals will have a distended and doughy to hard cecum.

Preventive measures have varied over the years; from copper in the feed to a very high fiber level. A high incidence of ME is normally diet related; the precise cause is not yet known.

A finding linked to the impaction of the cecum is a pleural effusion, or fluid accumulation in the lungs. Animals with this phenomenon might recover in time also; but this result is doubtful.

Outlook is poor, few animals recover from this disease, and of those that do, virtually none do as well as they might.

It does seem to vary in incidence between geographical areas; perhaps this is something which might be intriguing to study.

. . . Persistence, patience, and lots of good clean oat or grass hay seem to be the best and most available remedy and preventive at this point in time.
 
Did your vet do a culture of Finn's fecals before choosing an antibiotic? Ask if Clostridium is possible. If so, Guffy will need Metronidazole (Flagyl) also. Dora was on that plus a sulfa drug for her multiple bouts.
 
It's only available in huge amounts though.:( Maybe for rehabbers or a group of breeders sharing together. My vet knew of a similar toxin-binding product but it was only available in 10 lb buckets from human hospitals, which is why they didn't use it. I had asked when Dora was having her problems.
 
Sorry I should have mentioned we do have him on a warming pad...


We dose him with Ovol, pedialyte and now I have added the timothy pellets we brought home from the breeder(she feeds plain timothy pellets and we hadn't finished moving the boys over toMartins yet) So at least it has fibre...I mixed it with pumpkin and pedialyte and syringe it to him.

We put him back on the warming pad for 10-15 minbutes and then we take him out to make him move around.

I was using our massager (I would put him on my lap and put the massager on my legs and let it jiggle him that way):)

We haven't been to see the vet yet...they are closed today and we have no vets that will handle rabbits. We are going in first thing in the morning.

Finn didn't jiggle, but Guffy was...that has pretty much stopped now. I was listening for tummy sounds and heard alot of popping like can of pop someone had opened...that was when I increased the frequency of Ovol to 1-2 hours instead of 3-4 like we were. Since then the popping has stopped and there are gentler gurgles now.

I know the breeder uses a laxative when this occurs but in the abscence of a vet and with a bunn that hadn't passed either mucus or poops in 24 hours...I started dosing him with cisapride every 12 hours. He seems to strain when trying to expel the mucus...so I hope tonight will see a change for the better.

Unfortunately, our other kids (who leave cecals EVERYwhere, have suddenly decided to eat all theirs. buggers) Hopefully someone drops some!


 
The one thing about cisapride is that it has relatively few interactions and can be used safely with Metacam for pain relief...we have used it frequently before on one of our girls who had frequent bouts of stasis when she was younger. We had to weigh himand calculate the dosage...but we had to do that with the metacam too.:)

Today was one of those days where you are damned if you do...and damned if you don't. The cisapride was a personal call and one thatI agonized over for hours first. I did find credible sources who recommended cisapride in these cases...it is a gentle motilty agent and can be used long term if necessary. It seems to have helped but the vet can make the call to pull him off tomorrow morning if necessary. Guffy hadn't passed anything for over 24 hours and I felt it was necessary to intervene as he would go into shock before we could get him to the vet tomorrow.

We do make sure that we give Guffy his pedialyte first before the Metacam...but up until now he has been totally off food. He still really won't eat and won't drink...but is fine with a syringe...so we will start syringing slurry too.
 
The Pedialyte will help with the kidneys but the Metacam can also cause ulcers in the stomach. I've had both problems happen here. I just lost Radar ultimately to the ulcers, although I think they were caused by lack of food and stress, not the Metacam.

I'd still look at syringe-feeding pumpkin or Critical Care if its been 24 hours.

Haven't read the rest of the thread closely, but Acidophilus can be used if you don't have Benebac.


sas :pray:
 
I just finished the 10pm feeding and dosing.:D

He actually ate 5ml of slurry, 1ml of pedialyte and .5ml of Ovol!
So we have put him back on his warming pad for now and will try again at 11:30pm again. I have never been so happy to see a bunny eat! :D

It is strange...he refuses to eat out of his bowl or drink out of his bowl and will not touch the slurry either unless they are in a syringe! He was purring when we left him...I know it is early yet...but I finally feel like I can breathe a bit easier. (a bit)
 
Umm....I have a huge concern here. The antibiotic your rabbit is on will make things worse. Use of sulfa drugs in GI events is very old school....we now know better but unfortunately the word is slow to spread due mainly to vets using outdated refernece materials. The primary pathogen found in GI events in many species is Clostridium (E Coli has also sometimes been cultured). Clostridium is an obligate anaerobic bacteria. Baytril or Sulfa drugs are broad spectrum antibiotics but they are ineffective against Clostridium....and especially with Sulfa, will kill much of the remaining beneficial bacteria. This is what kills many weaning cottontails and the reason that most rehabbers don't work cottontails. The climate in a weaning cottontail is the same as a serious GI event in domestics.

We have had some success with lots of hydration, a probiotic such as Bene Bac and the antibiotic Metronidazole. The diarrhea that will come is very dehydrating and is a response to the die off of the beneficial bacteria as well as irritation of the intestinal lining from the Clostridium. There is usually a greenish or yellowish mucus in the fecals. The Bene Bac adds bacteria....but not the right kind of bacteria. What is does is to change the pH. The beneficial bacteria needs an acidic enviroment in which to live.....and a probiotic helps to do this. Contrary to what many may suggest....DO NOT use yogurt. Metrnidazole is effective against Clostridium but it doesn't seem to have the punch it has in the past. But, Metronidazole is just as important as an anti-inflammatory as it is an antibiotic. Gut motility drugs such as Cisapride or Metaclopramide are always inappropriate for rabbits but especially in something like this (my personal experience). In many species, including humans, you want to speed up the GI in order to purge any toxins....but rabbits have a completely different type of digestive system and gut motility drugs always presents very high risks.

I have been testing an equine product that seems to be able to filter and bind the enterotoxins caused by specific strains of Clostridium. A rabbitin a major GI eventis almost identical to a foundering horse. The product is called BioSponge. As noted by others that are aware of my testing, it is available from Platinum Performance or by their distributors. While we only have a small test sample, the results of using this product has been a huge success. It has so impressed my in the small test group that I feel a high level of confidence in suggesting it to others. In our rescue, we are going to use it as a pre-emptive strike in all cottontail intakes and in GI stressed squirrels and opossums. But time is a factor in using this product and you may not have sufficient time to acquire the product unless an equine vet near you has some. I will tell you that there are only a few small animal vets aware of this protocol.....and as far as I know at this time, they are all my volunteers. So don't expect your vet to be aware of BioSponge. But Platinum Performance is very helpful in getting information out about this product so maybe your vet would be interested in learning more about this product.

Fighting this condition is very challenging and there is only a small window of opportunity to overcome it....but it can be done. Good luck.

Randy






 
The vet will have a drug called Questran that can also bind toxins, and it's what people have been using since before BioSponge came out. It may be a good option. Other important stuff has already been said.

I also thought I found the BioSponge online in a syringe like the BeneBac syringe thing, so not a huge amount. I just googled it and found it on a dog/cat products website.
 
I am going to see about keeping something like bio-sponge on hand from now on...
Usually I don't have any problems pulling rabbit through stasis...But these little guys were 8 weeks though and while one presented with diarrhea at the beginning...the other started off in near stasis (passing a bit of mucus before stopping altogether) so we have had a very long weekend.:(

He started to refuse the pellet slurry thelast time I fed...he took1ml the first time, 5ml the next and only 1ml thelast time. So we were extatic when he hopped into the litterbox and started hunching...he managed to expel a 5 inch long muscus plug with two fully formed good looking poops at the end!:biggrin2:

So it is 3am and were sitting here celebrating slimey poop! Right after he finished he started to eat hay at a good rate and he managed to down a couple peices of dandelion too!

Oh joy! I feel like I can finally take a nap! The last time hubby and I slept was four hours Friday night! We were so tired we started to write things down so we wouldn't screw up meds or imes and things like that!

So I am off to bed for at least 2 hours!

Thanks for the advise!:bunnydance:
 
No more poops yet...still passing mucus though...

We took him to the vet first thing and she is happy with what we have done so far. She is reserved about his chances...the mucus is still thick and nasty...but since we got poops with it last night that means things might be moving along...

We have added a bit of applesauce to things for Guffy to get his blood sugar up a bit...he is a fifty-fifty bunn at this point...he is still trying to eat hay, has been eating dandelion on and off and has developed an attitude from hell...he grabbed my syringe this morning and tossed it...and bit me too for that matter! lol He refuses to eat while on his back...he has decided to eat sitting UP! He gets really bent out of shape about that!

The vet had to palpate his tummy this morning andI got bitten for allowing that too! lol

So he is fighting...our vet is reserved but was happy we decided to start cisapride...when we didn't hear gut noises for 24 hours we decided to give it a try...so she refilled our prescription and we are to continue that...but as long as he is trying to eat and making headway all we can do is keep up the Ovol for the gas and watch and wait...

But he is already looking perkier...so fingers crossed...
 
Hey guys...

Well as of this afternoon...Gufy is still fighting along. He is more doughy than sloshy now...and is trying to eat on his own. I have increased his Ovol temoparily for now...and we added an applesauce rice pablum mix instead of slurry because the vet was worried about his bloodsugar. It really has helped...I was afraid the extra sugar was going to be a problem but it has given him more energy and with his increased activity his gut is moving more and making happier noises.

The independant little cuss is mad as h*ll and zippy enough to make life difficult for me! Add to that I haven't slept since Friday and the rabbit wins most of the freakin fights! He grabbed my syringe and threw it last night...I had spine surgery in August and I still can't bend at the waist..so both of us just sat there looking at it on the floor...I swear he said "HA" in bunnytalk.:grumpy: I hadn't had a chance to give the boys the first trim of their nails before this started and he has scrathed the h*ll out of me, my face, neck, arms and chest! They were poking through my jeans! Baby sharpies are brutal!:grumpy:

I have read just about every article I could find on mucoid enteropathy...wow...very annoying...so many articles with theories and none with a definative cause. Our vets theory is that with their wee ceacums developing their flora the ride home might have stressed them enough to cause a disruption in the normal flora leading to an impaction of the ceacum and the resulting enteropathy. So he has loads of poops in his system and the mucus is a result of the system over producing to move it along...but as to whether or not he will be able to hang in long enough to pass the blockage...she said it is fifty-fifty, but that he is still fighting so if anyone would he would...we were aggressive from the beginning so fingers crossed.

I asked about a different anti-biotic and we discussed the pros and cons and decided to remain with the Sulpha Trimeth for now...if we don't have to blitz him unecessarily we won't. Things ARE moving...albeit slowly...but the vet and I are big on allowing his system to reassert itelf...and since I can feel the obstruction has moved tohis lower abdomen...we wait.

The vet is ordering in the book by Frances Harcourt-Brown for me. She photocopied the pages on mucoid enteropathy for us though...it was an interesting read. The one thing I hate is when you are trying to find a way to save your bunn and all the articles keep talking about the "exceptionally high mortality rate associated with this enteropathy". And then they go on to prevention when all I want is an answer! Sheesh!
 
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