Please help. I cannot get ahold of the cecal dysbiosis. So discouraged and scared for my rabbit.

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DKaralunas1969

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Hi all,

It’s been years since I’ve been an active participant! I’ve been spending the last few weeks just lurking, researching, trying to find some answers to a beloved bun with a pretty complex medical history.

I don’t even know where to start with Jojo. She came to me about 7 years ago as a failed bond, a Craigslist bunny. She had an eye infection that her previous owner could not get ahold of despite multiple antibiotics, and the eye was removed. Other than that, perfectly healthy.

Her first 4-5 years were uneventful, she was very active, ate everything put in front of her, and had ideal poops. She did start slowing down, off the vet we went where she had a head-to-tail exam, and it was found she has chronic urinary sludge. So I began watching oxalates, and calcium, I took her completely off pellets and gave fluids as needed. We were managing it pretty well.

About a year and a half ago, she started hiding, with occasional food refusal. Obviously something was wrong with her, I took her to three vets (all exotics), but none could find a thing wrong. Xrays, labs, all came back fine. Well, she wasn’t fine. A couple weeks later I woke up to her unable to use her back legs. I raced her down to Angell in Boston….. again, not a thing on her diagnostics… her EC titer was within a range, not showing active infection, her organ functions were perfect, all her xrays showed were was an enlarged bladder. She was stabilized there, and they sent me home where the hope was she would recover use of her legs (she has about 50% strength presently). Well, on the way home from Angell, I kept getting small whiffs of something akin to rotting fish. When got her settled, I realized it was coming from her… it was her urine. She had a raging bladder infection that three vets had somehow missed. It took three rounds of different antibiotics to get rid of it. The third was after a sensitivity test. My theory is that Jojo had a stroke due to an untreated UTI.

So here we are, present day. She has lost a drastic about of weight, going from 6.8 to about 4.8 pounds. I had the bladder under control, her issue now is cecal dysbiosis. The issue is ONLY localized to her cecum. There is no intestinal stasis. She eats hay for hours and as the big, golden, and plentiful fecal pellets. But her cecals are another story. She does produce “normal” ones, but in general, they are pasty and/or liquid.

So onto my issue: when I attempt to hay-fast her, her weight starts to plummet. When I try add calories, the exacerbates the dysbiosis. EVERYTHING makes her dysbiosis worse: any form of oat (including hay), alflalfa, clover, pumpkin, all the “healthy” ways to add weight to a rabbit. Greens are bad too. Like with oat, she starts creating brown liquid along with the "brownie batter"

I don’t know what to do. I have an emaciated rabbit that desperately needs calories, but I can’t give them to her. I think her cecum is so dysfunctional, she has a malabsorption issue that is contributing to the weight loss. Should I just hay fast her for a month to reset her cecum and not be concerned with the inevitable weight loss?

Please help. Her vets have all but written her off. She still has so much love and life left in her, I can’t give up on my girl.
 
By 'hay fast', do you mean take her off veggies/herbs, or are you also feeding fruit, grains, or other high carb foods? Any forage plants? She's on a no pellet diet still? What's the cut and quality of hay she's being fed (eg soft leafy, mix of mostly soft with some crunchy stems, mostly mature hard stems)? And is she eating at least a couple of piles of it, compared to the size of her body, per day?

I presume liver and kidney function was normal in the blood tests? Have you tried probiotics at all?
 
By 'hay fast', do you mean take her off veggies/herbs, or are you also feeding fruit, grains, or other high carb foods? Any forage plants? She's on a no pellet diet still? What's the cut and quality of hay she's being fed (eg soft leafy, mix of mostly soft with some crunchy stems, mostly mature hard stems)? And is she eating at least a couple of piles of it, compared to the size of her body, per day?

I presume liver and kidney function was normal in the blood tests? Have you tried probiotics at all?
Hi there,

Yes, taking her completely off of everything for a good month, for a full factory reset. I should have mentioned her current food plan. She is on 15 grams of pellets (50% Oxbow Adult, 50% Sherwood Timothy), split into three feedings, so 5 grams per meal. As of June 1st, I've switched her to mostly first cut hay, with a dusting of 2nd cut on top. She definitely eats the size of her body per day, probably more, and she poops twice as much as my other 2 rabbits that are much larger than her. I just took her off of outdoor forage yesterday, I was rotating a dandelion leaf, some wild mint, a little piece of willow, a bit of raspberry bramble/leaf and wild rose... more for enrichment than calories. But it caught up with us, after 6 days of little bits of outdoor forage, she had blackish liquid covering her leg yesterday. That being said, the quantity of the bad poops is definitely decreasing since switching to mostly all first cut. 2 months ago her bedding would be destroyed after an episode of cecal diarrhea, now it's just her back leg and hiney that I need to clean up.

I had her vet do a complete and thorough check on her teeth, they are beautiful. Liver, kidney tests were perfect, much to my shock, she is quite old and quite disabled! Fecal floats were fine, not parasites or worms.

I have tried Benebac. Major brownie-batter blowout the following day. I'm not sure if it was the probiotic itself, or the medium it's in, or simply timing.

She gets fluids regularly too, so I know it's not a chronic dehydration issue.

The only thing we're really missing as far as cecum motility is her lack of movement due to her disability.

Other than that, she's a happy, hungry, and (relatively) healthy rabbit, and SO very loving. But she is an absolute medical mystery!
 
What a time you've been having! All I could think of honestly would be good quality hay only diet for a couple of weeks as you've said, to see if that make a difference.
Have you tried a different probiotic too? We get Fibreplex over here, not sure if you can get it where you are. I think it's quite high in sugar though 🤔
 
Since you've seen improvement with feeding the first cut hay, I think that might be your answer. Indigestible fiber is the best thing to correct digestive imbalances in rabbits, which is what coarse first cut hay has a lot of. But this also needs to be balanced with high nutrient protein rich hay or food, to provide the necessary balance for good health and prevent unwanted weight loss. Which your bun is getting from the added pellets.

I think just continue with the hay and limited pellets, and be cautious with the greens and forage. You have a bun with a very sensitive digestive system, and so it's going to be a delicate balance with her diet, to keep it progressing in the right direction. The worse the imbalance, the longer it can take to get it back on track. You've tried everything and are doing the things that I would normally recommend for this issue. Keep up with it and hopefully you'll continue to see improvement.
 
Since you've seen improvement with feeding the first cut hay, I think that might be your answer. Indigestible fiber is the best thing to correct digestive imbalances in rabbits, which is what coarse first cut hay has a lot of. But this also needs to be balanced with high nutrient protein rich hay or food, to provide the necessary balance for good health and prevent unwanted weight loss. Which your bun is getting from the added pellets.

I think just continue with the hay and limited pellets, and be cautious with the greens and forage. You have a bun with a very sensitive digestive system, and so it's going to be a delicate balance with her diet, to keep it progressing in the right direction. The worse the imbalance, the longer it can take to get it back on track. You've tried everything and are doing the things that I would normally recommend for this issue. Keep up with it and hopefully you'll continue to see improvement.
Thank you. I guess I just needed to hear I am doing the correct thing, and with time she will improve. I live in rural Vermont, the closest exotics vet is 90 minutes away and she is booked out for months. It's scary; I have adequate vet care but I certainly do not have *prompt* vet care.

I was on Medirabbit today, and stumbled across an article on administering EVOO for rabbits. It specifically mentions the intestine (see below), not necessarily the cecum -- I can't imagine they would use it interchangeably -- but I'm wondering if this is a potential calorie source for her. I know it's used in the horse-world for underweight and elderly horses. Any thoughts on this? Maybe just a quarter teaspoon over her pellets?

"Even if controversial, virgin cold-pressed olive oil has several properties that help against constipation or diarrhea. Its presence in the intestine stimulates the secretion of digestive fluids such bile, lightly stimulates peristaltic movement of the intestine and lubricates the intestinal wall. It does, furthermore, promote the growth of healthy intestinal bacteria."

http://www.medirabbit.com/EN/GI_diseases/Generalities/Enteritis_en.htm
Thank you again for your feedback!
 

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