Soft stools, crusty nipples

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DazyDaizee

DazyDaizee

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Aug 26, 2008
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Location
, Massachusetts, USA
My foster rabbit has some issues, I'm looking for some input or ideas of what it could be. She came to me as a special needs case considering her history of diarrhea. I took her to the vet when I first got her (several weeks ago). So here's the history:

At rescue:
-diarrhea?
-increased water consumption
-soiled rear due to urine and feces accumulation
-Treated with Panacur
-Course of Metronidazole and possible Albon
-restricted diet (consisting of mainly hay)

At the vet:
-Baytril, Metronidazole, and Panacur started
-urinalysis within normal limits
-Fecal sample sent to lab. Later Coccidia confirmed.
-Albon started, Baytril discontinued
-recommended diet: small amounts of pellets, unlimited Timothy hay, 1/2 cup veggies each day.
-Molar spurs seen, though not severe and vet wished to wait until she was healthy to sedate for trimming.

At my house:
-Metronidazole given for 14 days
-Albon & Panacur given daily for about 3 weeks now. (Albon was prescribed 21 days, I believe, however the rescue said to treat for 1 month and to continue with panacur in case of E.Cuniculi)
-Followed diet restrictions strictly
-Increased water consumption continues
-Diarrhea actually appears to be soft stools at times with hard stools in between. The soft stools are NOT only cecals. At certain points the diarrhea was pudding like consistency but has since improved to daily soft-very soft stools, with hard stools throughout the day as well.
-History of positioning front end higher than hind end, such as over her cage mate, front paws propped up on litter pan or food dish. This has continued.
-Dirty rear end continues and has been shaved and bathed repeatedly to keep clean. Some minor skin irritation at times.
-Today when I bathed her rear end I noticed four of her upper nipples were very crusty.

Other facts:

-She has a cage mate who is not ill, was treated with a course of Albon due to coccidia in the first rabbit.

-I believe she is 2-3 years old and was recently spayed.

-Very active, seems happy, does not seem uncomfortable.

-Large belly, soft.. some firmer areas in belly, but vet dismissed as normal. Otherwise she is a lean rabbit.

-Very large double dewlap. She may have been overweight/obese at one point, however she's been lean since I've known her.

I will try to answer any other questions, but she is a foster bun, so I don't know too much about her past.
 
Did the vet do a blood panel ; my guess is that she has renal issues which isn't necessarily a bladder infection
her kidney function would show up on a blood panel
 
Yeah.. I'd like to have some bloodwork done.. I'll have to talk to the rescue and see what more we could do diagnostically. Can renal insufficientsy cause the soft stools as well?
 
Bloodwork would be good to check on her bladder, perhaps that's the cause of her incontinence and urine scald. Renal issues usually don't lead to soft stools at all. I would continue on the antiparasitics of course, and also consider adding a probiotic. It's possible the mushy stools are coming from the cecum, although they don't seem like cecals, because she might not have the correct bacterial content in her GI. I hope that makes sense. Try something like Probios or Bene-Bac.

I don't know what the crusty nipples could be. It sounds like it could be mastitis, a skin infection, a skin parasite, or what about vent disease? When I think of crusty, I think of syphillis, and I assume that could affect nipples as well.

Strange... Did the vet see the crusty nipples?
 
I contacted the rescue to inform about the crusty nipples. She wonders if it may be a sign of cancer. She also questioned whether the soft stools may be persistent because some recent forms of coccidia are resistant to the Albon, so we may try something else for that.
I have Marshall Probiotic. It says 100% safe for ferrets and other small animals. I assume most probiotics are the same? Can I use this for her?
I have no experience with rabbit syphillis, but from what I've read I have doubts that that's what is causing the crustiness in this case. It's not severe and it's localized to just the four upper nipples. The skin isn't irritated or inflamed. I don't know if she has something else challenging her immune system if syphillis could come about? Is it something they carry for life and become symptomatic at times of stress, or do they just have it and remain symptomatic.. or recover completely? I just don't know enough about it.

I don't think it's a parasite or infection because she's not itchy and the skin looks health underneath. The crustiness easily flakes off. It's yellowish in color and loosely caked around the entire nipple. There's not a huge amount of it, but it's definitely noticeable. I actually felt it when I picked her up and my hand hit the right spot.

This is such a frustrating case because vet care/funds are limited and it's a strange mixture of symptoms without an obvious impact on her overall wellbeing.
 
The probiotic should contain 2 different kinds of lactobacillus, enterococcus, and a bifidus bacterium. I worry that the Marshall one may just be saccharomycetes cerivasiae, which is brewer's yeast. It probably won't hurt, though.

I am pretty sure that syphillis does not stay in the system if it is treated. It's possible she's carrying it with only a few symptoms, but if there's nothing in the vent area or mouth, and since the skin isn't red, it is probably not syphillis but is instead a discharge coming from her nipples, which could be a sign of mammary cancer. It's pretty unusual for a rabbit to lactate without a litter. There are other causes for lactation without needing to lactate, but mammary cancer I would think is the most common.

I don't remember what the best antiparasitic for coccida is off the top of my head...
 
The probiotic does have those 3 things, plus: streptococcus faecium fermentation product, aspergillus oryzae fermentation product, yeast, torula, yucca product, dried milk, and dextrose.
I know that Albon is most commonly used for cats and dogs for coccidia, at least at the animal hospitals I worked at.. but if there are resistant strains, I guess that complicates things.

Could she have mammary cancer without an external tumor? She doesn't have any mammary enlargement, either, which is what makes this more strange to me.
 
DazyDaizee wrote:
Yeah.. I'd like to have some bloodwork done.. I'll have to talk to the rescue and see what more we could do diagnostically. Can renal insufficientsy cause the soft stools as well?
Click to expand...

My bun , Gabriel who died last July from renal failure had shown a plethora of symptoms including loose stools. he was drinking huge amounts of water and having messy stools. All were attrubuted to the renal failure although it is not a common side effect because it involves another system of the body.
Women are told to go to their doctors if there is any change in the nipples; I also thought of cancer as this would be something that would be a symptom in a woman althoughi have not seen it written as a symptom in a a rabbit.

Since your rabbit has had coccidiathis is more complicated as if it is still active then the stools could be attributed to that. despite all of the treatment for it.
I wanted to ask more about the hind end positioning as this could indicate either pain on elimination, straining or some other issue.. . seems like a clue to me ?

I believe that Ponazuril/Marquis is the treatment that Randy would use for a rabbit with coccidia.

Not sure how available this is as it is expensive and a horse dewormer.

I think that this bun has multiple problems with overlapping symptoms which is causing all the confusion with diagnoses.

I assume the rabbit is not spayed


 
She is spayed, though I think it was done within the past few months. The positioning is constant. At first I thought she was uncomfortable.. but now I'm not sure...
 
Positioning the front of her body higher seems like it could be a method that she has developed to get more oxygen /air...stretching herself out to get better airflow.
Does she have any respiratory symptoms at all? or does what I just posted sound feasible since you are with her and I'm trying to figure it out by your desscription

For ex if one of my buns has gas he will sit very erect ..almost as if it is uncomfortable to "slouch"and there is more room (due to gas) if he sits tall

 
She doesn't have any respiratory symptoms, but I could see her having gas considering the large belly. I guess I would expect her to be more uncomfortable if it was gas. There's no obvious mass that the doctor felt, but when I feel her belly I can feel some solid areas.. perhaps stool in the cecum? I really don't know what it is..
I think I may have a biased view, also, because I recently lost my Patagonian cavy who the vet believed had ileus and may have had a motility issue his whole life. He had a very large belly while the rest of him was skinny. Xrays showed an extremely large mass that appeared to be a gas filled cecum. His attitude was good and he ate well and showed no obvious discomfort until two days before he died when these emergency visits took place. Because they told me this was something rabbits get, I immediately thought about it when I first felt this rabbit's belly and was informed of the history of problems with her stool.
 
I don't what to say other than it seems as if something is going on without diagnosis.
I am not a vet but if you have the $$ I would get a blood panel and abdominal xrays to rule out tumors that are not visible

I think that I will also send this Randy's direction as he probably can put the puzzle together if anyone can...
 
If she was my rabbit I would come up with the money.. but she's a foster rabbit, so it's really up to the rescue. I'm just looking for something to think about in the meantime until they decide to do more diagnostically.
 
Hi,

I am going to study this thing for a day or so but I do have some suggestions. First, I would certainly do a blood panel especially with the increased thirst....and do a titer for EC while you are doing this just in case. Pay close attention to renal values including glucose....and liver values due to her possible past obesity issue. Hepatic Lipidosis is certainly a strong possibility. I would tryfor some rads of the abdomen if possible. Fecals are notoriously inaccurate. Coccidia is nearly always resistant to Sulfanomides. And Sulfanomides, especially used with other oral antibiotics, are devastating on the gram positive bacteria in the gut. Sulfanomides have been linked to Tyzzer's Disease....which is most likely at least part of the mythical "Megacolon" (which I don't believe exists in the form that is believed....just another excuse when something isn't truly known). If you combine parasites along with these antibiotics....there is no way that gut can work correctly. The only true treatment for coccidia is a strong immune system....and that might be a problem here. But, if your vet can get some Ponazuril (Marquis)....I think that might givethat a shot. It is not an easy drug to acquire and isa very expensive drug. It is also a bit of a challenge to compound into an appropriate dosing. And oddly enough, I would seriouslyconsider continuing with the Metronidazole. It has some very beneficial anti-inflammatory properties in the gut. I am not so sure something designed for ferrets (which are obligate carnivores) is appropriate for rabbits (which are obligate herbivores). Not something I would use in that form. Wondering how much dextrose is in that stuff. I do like Bene Bac powder and I am ordering something from American Pet Diner called "Critter Be Better" to use with weaning cottontails.

I will keep reading over this issue. I have seen this in rescues that have not been fed properly and it seems to result in some issues in the actions in the gut. It has sometimes taken us over a year to get a gut like this back in order. But I see some black clouds in-between the lines here. I suspect we have multiple issues resulting in some very unusual presentations. I think a blood panel and some rads will most likely shed some light on this rabbit's condition.

Randy
 
Thanks Randy!!



Here is the probiotic I use ; it is also available in powder form which is cheaper

this stuff can be bought at petsmart and/or petco or ordered on-line
http://www.revivalanimal.com/store/p/1401-BeneBac-Pet-Gel-Powder.aspx?feed=TheFind&gdftrk=gdfV2457_a_7c543_a_7c1842_a_7c622_d_231


Probios is made for horses but can be used for rabbits

http://www.petfooddirect.com/store/product_detail.asp?pf%5Fid=60551203&dept%5Fid=684&brand%5Fid=807&Page=

You can but probios at either a farm store like farm and Fleet or order on-line.

I think you need more diagnostics to really find out everything going on with her.
 
I have an older rabbit with a huge dewlap as well and she seems to have the same problem. No diarreah, but horribly dirty bottom nearly all the time. I have not had any vet analysis done, but I believe that in her old age it is just an inconvenience to reach behind and clean herself back there. I know she is capable, because she will after baths. But otherwise I do not see her cleaning herself. Otherwise she eats, drinks, and acts normally, so that's the conclusion I've come to for myself. This could be the case for your rabbit too.

On the subject of persistent diarreah, I wouldn't be giving ANY veggies at all to a rabbit with this condition. I'd give about 1/8-1/4 cup (per 5 lbs. body weight) alfalfa pellets daily with an unlimited variety of fresh grass hays. I can guarantee you'd see better results on this diet than one involving fresh veggies.
 
She was off veggies for some time with no change. It's not true diarrhea, because she does have normal stools as well. And currently the stool isn't very bad. Throughout the day she'll have normal stool, then mushy (still formed pellets), then normal, then sometimes even softer stool. It varies day to day without any change to the diet. I started giving the veggies (only 1/2 cup romaine lettuce daily) when the vet recommended it.
She gets about 1/4 cup Timothy pellets (1/2 cup split with her cagemate) and unlimited timothy and grass hays.

Randy, I look forward to see what you come up with. As for the probiotic.. the benebac says it's okay for dogs, cats & small animals also...
 
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