Some Fecal Mucous...(again)...

[Jenk]

Zoe was on Baytril a few weeks' ago due a light growth of a few bacteria types. A follow-up culture revealed a lightgrowth of Entercoccus, so a 14-day course of Baytril was started again.

She's been back on Baytril for three days';tonight, I noticed that her fecals are wildly ranging in size/shape again. Also, I found a string of mucous severalfecals. (Some fecalswere slick-feeling and, so,may have absorbedsome mucous.)

Can such fecal changes occur with antibiotic treatment? Par for the course, so to speak?

I will likely call the vet tomorrow to pick her brain(especially since Hubby and I leave for vacation this Friday). I'm still concerned about leaving my crew with a non-bun-savvy pet sitter; buteven the bun-savvy person who could board them hasn't any experience with a megacolon bun.

Thanks,

Jenk

 

[tonyshuman]

Is she on probiotics with the antibiotics? That's something I would recommend.

 

[Pipp]

This is pretty confusing... Enterococcus is a 'good' bacteria. but you're saying the balance is off. According to Randy, that's one of the main ingredients in Bebe-bac. So yes, killing it off with Baytril means a pro-biotic is a good idea.

But I don't know that it can be micro-managed like this, although I'm by far not an expert.

It just seems that trying to artificially balance the gut is a teeter-totter and it isn't addressing the problem of why the balance is off to begin with. This time it's probably the antibiotics, yes, but that means its just a viscous circle.

What's her diet history? Have you experimented a lot? I suspect you have, I know you're very knowledgeable and provide the utmost care, but it would be nice to get her back to a natural state.

sas :bunnydance:

 

[Pipp]

PS: I think the mucus is just a 'gut' reaction to internal stress, a lining or a 'cushion'.

The imbalance and the antibiotics I think traditionally cause mushy cecals, but given the disruption, a GI slowdown and affected fecal output doesn't seem to be a big surprise.

I'd start treating for pre-stasis if they're off in terms of size and shape and the mucus is signaling internal stress of some kind. Best to nip it in the bud before Friday.

But with natural treatments -- canned pumpkin, hay, water-soaked veggies if they agree with her, etc.


sas :bunnydance:

 

[Jenk]

tonyshuman wrote:

Is she on probiotics with the antibiotics? That's something I would recommend.

At various times in the past, we've tried "balancing" things out with probiotics (at the onset of odd issues). I never noticed a positive change from them, really. In fact, her gut seemed to go more "off" when on them (i.e., got louder, more "poppy" in sound).

There's more...See my reply to Pipp....

 

[Jenk]

Pipp wrote:

Enterococcus is a 'good' bacteria. but you're saying the balance is off. According to Randy, that's one of the main ingredients in Bebe-bac. So yes, killing it off with Baytril means a pro-biotic is a good idea.

I was told that it's a "light growth" of Entercoccus. Perhaps that is normal. I don't know "normal" anymore, though. Regardless, I think I need to stop the Baytril. The remainder of my reply will explain why....

But I don't know that it can be micro-managed like this, although I'm by far not an expert.

Zoe's gut was majorly micro-managed by herfirst vet, which made me believe twothat a bun'sgut can/should be micro-managed whenever there's an imbalance. I've learned over time that that's not the case. And now I'm feeling disappointed...that the current vet may have made a boo-boo in trying to bring down a "good" bacteria count. (I do know that the previous vet once gave Baytril to bring down a high growth count of Enterococcus.)

Have I mentioned that I'm starting to despise vet medicine in general? :twitch:

It just seems that trying to artificially balance the gut is a teeter-totter and it isn't addressing the problem of why the balance is off to begin with. This time it's probably the antibiotics, yes, but that means its just a viscous circle.

She's a megacolon bun with a malfunctioning digestive system.We can't possibly learn throughtests what exactly causes the malfunction (especially since it's believed that megacolon buns have malfunctioning and/or missing nerves that line the intestinal tract).

The other tricky thing with megacolon buns is like the chicken-and-the-egg story (as in, which came first? kind of thing): Does a megacolon bun have gut slowdown because of a bacterial imbalance, or does a bacterial imbalance cause the gut slowdown? My belief is that it can go either way at any time.

What's her diet history? Have you experimented a lot? I suspect you have, I know you're very knowledgeable and provide the utmost care, but it would be nice to get her back to a natural state.

Yes, and no.She started with these problems after the first month that we had her. Is that becauseI was advised to feed her greens so young? Or would she have developed such problems regardless of the greens? No one can say.

Anything that I've ever added into her diet, I've done soridiculously slowly. So she's never had any major additions just thrown into the mix. I have, at times, removed thingsat the onset of digestive problems; but I've not done so in the last six months'. Rather, I've slowly decreasedwhatever may have seemed to upset her gut (e.g., parsley), "phasing it out."

She's been on a primarily hay diet, bolstered by a small amount of pellets (between 1-2 tsp./day). That hasn't changed in the last six months'.

 

[Jenk]

Pipp wrote:

PS: I think the mucus is just a 'gut' reaction to internal stress, a lining or a 'cushion'.

Yes, it's a sign of gut irritation (enteritis), which has me worried. I can tell that she's having major discomfort now, too. Zoe loves things that she views as "treats," especially pellets. I gave her 1 tsp. of them this morning, and she hasn't touched them. She did sniff them, but then returned to her hidey spot.

The imbalance and the antibiotics I think traditionally cause mushy cecals, but given the disruption, a GI slowdown and affected fecal output doesn't seem to be a big surprise.

True, the slimy fecals could be from the drug. But I get nervous when mucous and badly misshapenfecals appear. Her fecal range is so vast, that her small ones and dry crumbles; her largest ones are nearly 10 times the size of our Californian's fecals!

I'd start treating for pre-stasis if they're off in terms of size and shape and the mucus is signaling internal stress of some kind. Best to nip it in the bud before Friday.

But with natural treatments -- canned pumpkin, hay, water-soaked veggies if they agree with her, etc.

Here's the thing: Zoe's gut does horribly with anything new, it seems. I don't trust canned pumpkin; and she definitely can't handle greens--especially when showing obvious signs of enteritis.

She does get tons of 1st-cut timothy hay and some other types as a treat (e.g., oat and orchard grass).I only have orchard grass on hand now, though.

She only drank a fraction of the normal amount of water that she usually drinks overnight, which was my first tip-off that she's feeling worse. Of course, that also means that her gut--which becomes dehydrated easily--is at more risk of a slowdown, back-up. I will try to syringe her extra water today and see if I can make any improvement.

I've already left a message for the vet regarding Zoe's symptoms. If I need to leave her at the vet's to begin with (since our sitter isn't bun-savvy), I'll do so. I keep telling myself: No matter what, we still need this vacation. But I want to ensure that Zoe's in the best possible place for care. I hate feeling this torn/stressed right before an event that's supposed to be fun. :twitch:

 

[Pipp]

Just to make it clear, the 'good' bacteria is only good when it's balanced. I always thought it was the yeasts they were trying to balance it with, but on overgrowth of either, good or bad, is bad. So I'm not saying 'hey, you're killing off the good stuff.' But there's a lot of back and forth.

Is Zoe a white spotted bunny with dark rings around her eyes? My foster sisters and their brother were megacolon buns (or two of them were), but it didn't really affect them too badly, they had large poops and the odd runny cecal, but they didn't get sick. They were on a diet of mostly veggies.

I do hope they come up with a better treatment for this. Out of curiosity, are they using or suggesting gut motility drugs? Any other meds?

sas :expressionless:

 

[Pipp]

I'd try the pumpkin. I have yet to have a bun react badly to it.

How does she do with grass?

And try to give everything a little time to work. Even a lot of drugs will cause upsets for the first 24 or 48 hours and then they're great. Although that's a scary proposition.


sas :expressionless:

 

[Jenk]

Pipp wrote:

Just to make it clear, the 'good' bacteria is only good when it's balanced. I always thought it was the yeasts they were trying to balance it with, but on overgrowth of either, good or bad, is bad. So I'm not saying 'hey, you're killing off the good stuff.' But there's a lot of back and forth.

Quite right about the balance issue. All I know, though, is that the vet said that Zoe has a light growth of Enterococcus. Nothing else was mentioned (as either showing up on the test and/or being a concern).

I'm leaning toward the Baytril being the problem. What's tearing me is that I know antibiotic treatment shouldn't be stopped suddenly; it should run the full course. But I've skipped her AM dose out of concern for her lackluster behavior. (After giving her some Metacam for the discomfort, she has perked up a bit more and even left her pen for brief morning exercise.)

Is Zoe a white spotted bunny with dark rings around her eyes? My foster sisters and their brother were megacolon buns (or two of them were), but it didn't really affect them too badly, they had large poops and the odd runny cecal, but they didn't get sick. They were on a diet of mostly veggies.

Yes, she's thestereotypical "charlie-marked"bun. Ironically, though,it's thought thatbunshaving few (and especially faint) spots down the back have more digestive complications. Zoe hasmany, distinctly-defined spots.Go figure.

I'm shocked that your foster buns were able to tolerate greens; I've read that most megacolon buns quickly develop gas/stasis issues from greens. But they're all different, so...

I do hope they come up with a better treatment for this. Out of curiosity, are they using or suggesting gut motility drugs? Any other meds?

She's been on motility drugs at various times. Currently, she's not because, when she began Baytril three days' ago, her gut was in a betterplace. But I'm awaiting thevet's call to see what I should do. (I especially want to know if I can stop the Baytril now withoutdetrimental effects.)

 

[Jenk]

Pipp wrote:

I'd try the pumpkin. I have yet to have a bun react badly to it.

I'd be slightly more willing to try it if we weren't about to leave the country in less than 48 hours'.

How does she do with grass?

I've not tried her on grass (assuming that you mean freshly-grown stuff, likeoat grass, wheat grass, etc.). Someone did mention it recently, but I've been so busy that I forgot to checkwith RO members for their experience withfeedinggrass to a megacolon bun.

And try to give everything a little time to work. Even a lot of drugs will cause upsets for the first 24 or 48 hours and then they're great. Although that's a scary proposition.

If the vet tells me to resume the drug, I likely will; I don't know what else to possibly do at this point. Again, things would be different if I intended to be home for a long spell. But being gone and having a non-bun person sitting for our crew 1.5 hours' per day is worrisome to me.

 

[tonyshuman]

A slight growth of enterococcus doesn't sound like a bad thing to me at all. It is present normally, as Pipp said. I think it would call for some probiotic to get the GI flora back in balance.

The probiotic contains enterococcus, but Randy says it doesn't get into the GI itself--the effect of most probiotics is to acidify the gut, which helps the correct bacterial populations re-establish themselves.

Part of the problem here may be that we don't understand how GI microbial communities work very well. It's really an emerging field of research in science and medicine, as until recently it was thought that the inside of the body is sterile and free of microorganisms. Of course, now we know that's not the case, but knowing exactly what microorganisms live in a given gut, what should be there, how to get the "right" ones there, and how these things correlate with disease is really unknown. There is even a lot of evidence to support that a large component of obesity in humans (and mouse models of human obesity) is the gut flora. People who are overweight tend to have different microbial content in their gut, even if they're on the same diet. It is possible in mice to "recondition" the gut of an obese mouse to have the same microbes as a mouse of healthy weight, and then they will lose weight. Pretty revolutionary stuff, but we really don't know how it works. A lot of chronic human GI diseases (like IBS and Chron's) have been linked to GI flora imbalance as well. It's just very hard to study because not every healthy person will have the exact same gut flora, so there's a range of what's healthy that is unique to the individual.

What I'm trying to say, is that maybe a hands-off approach, with lots of water and hay, few veggies, pellets, or treats, and daily probiotic may get her gut back in order, after the micromanagement that your vet did. It's possible the vet was trying to make Zoe's gut flora confirm to some list in a vet textbook that doesn't accurately represent what Zoe's individual gut needs. Getting her diet back to the most basic things a rabbit typically eats in the wild, along with probiotics to promote the growth of the correct bacteria, may get her gut to settle down. It could take a while, and it may be a bit scary to do (you mentioned the noises their guts make when you give them probiotics), but I think maybe if you stick with it for 2-3 weeks it will stabilize. This is totally a postulation, though.

The most common diet I hear of (and have seen with one shelter bun) for megacolon bunnies is high-hay, low anything else. The poos may be funny shaped and have mucus once in a while, but they don't stop up completely.

So frustrating for you. I'd stop the baytril right now, and just have the sitter keep an eye on them while you're gone. Maybe a more hands-off approach by the sitter will do some good?

 

[Jenk]

tonyshuman wrote:

What I'm trying to say, is that maybe a hands-off approach, with lots of water and hay, few veggies, pellets, or treats, and daily probiotic may get her gut back in order, after the micromanagement that your vet did. It's possible the vet was trying to make Zoe's gut flora confirm to some list in a vet textbook that doesn't accurately represent what Zoe's individual gut needs.

We actually managed a hands-off approach for five whole months'--until Zoe ingested so much plastic off of her litter box. Her gut's been in-flux ever since then (April).

My current vet doesn't micromanage nearly as much as my previous one. He had Zoe boomeranging around with every drug/supplement possible. It was tiresome for me to give so many meds (sometimes a total of nine med.dosesper day!).

I spoke with the vet this morning. She said that she put Zoe back on Baytril because she suspected that, with Zoe's sluggish gut, the "low" bacterial growth might increase to more troublesome amounts. (You know how it is: Too much of a good thing is still not a good thing.) She also figured that it would be best to nip a possible growing issue in the bud, since we're leaving on vacation.

Getting her diet back to the most basic things a rabbit typically eats in the wild, along with probiotics to promote the growth of the correct bacteria, may get her gut to settle down. It could take a while, and it may be a bit scary to do (you mentioned the noises their guts make when you give them probiotics), but I think maybe if you stick with it for 2-3 weeks it will stabilize. This is totally a postulation, though.

Now if only I were going to be home for a long stretch of time to even start this program.

I've looked into Zoe's litter box; she's passed a seriously low amount of fecals (most of them dry) overnight. I'm not sure what to do at this point. I'll call the vet again tomorrow for some advice.

The most common diet I hear of (and have seen with one shelter bun) for megacolon bunnies is high-hay, low anything else. The poos may be funny shaped and have mucus once in a while, but they don't stop up completely.

Zoe's diet has always been high-hay and low everything else. (She's only getting 1-1.5 tsp. of pellets, for cryin' out loud--and no greens.) And her gut still manages to slowdown regardless. And whenever I've played the wait-and-see game, her gut function would continue to slow until medical intervention was necessary.

So frustrating for you. I'd stop the baytril right now, and just have the sitter keep an eye on them while you're gone. Maybe a more hands-off approach by the sitter will do some good?

Beyond frustrating and stressful for me, especially the with vacation timeclock ticking.

The vet agreed about stopping the Baytril, since Zoe's already had seven doses (which could/should be enough to take care of a "low"--and possibly growing--bacterial growth).

I'm not sure yet if I should leave Zoe with the sitter to start with, or if I should have her stay at the vet's. There are definite pros and cons to both options. I'd prefer Zoe stay in her familiar environment. But the sitter can't handle rabbits (syringe-feed, etc.), and she'd only be spending 1.5 hours'/day in our home. So many things could get overlooked....But they could be overlooked at the vet's office, too.

UGH...

 

[Pipp]

It's not good to stop and re-start antibiotics soon after, but its okay to just stop them. That's why they need to be taken until the end of the prescription, if its not quite eliminated, a reoccurrence can render the drug useless.

Is the slowdown small dry poops or megacolon poops and/or mushy cecals? Small dry poops cry out for hydration, not just fiber, thus the wet fiber (pumpkin and grass) I would think is better.

And btw, my foster bunnies with Megacolon also had light spots down their back. I wish I could remember which one didn't have much of a problem. If it was Peaches (and I think it was), she had dark spots along her back.

Very odd!

sas

 

[Jenk]

tonyshuman wrote:

It could take a while, and it may be a bit scary to do (you mentioned the noises their guts make when you give them probiotics), but I think maybe if you stick with it for 2-3 weeks it will stabilize. This is totally a postulation, though.

Are you suggesting that I try giving her probiotics for 2-3 weeks'? I ask because a bun expert on another forum said that giving probiotics past seven days' is ineffective.

Ahhh...Yet another discrepancy in the world of bun ownership....

 

[Jenk]

Pipp wrote:

It's not good to stop and re-start antibiotics soon after, but its okay to just stop them. That's why they need to be taken until the end of the prescription, if its not quite eliminated, a reoccurrence can render the drug useless.

I don't disagree with your statement, but I've been told (by more than one vet) that simply stopping antibiotic treatment too early can make certain bacteria more resistant.

Also, Zoe's last course of treatment was several weeks' ago, so I think that this latest (but more brief) treatment doesn't count as a stop/re-start situation.

Is the slowdown small dry poops or megacolon poops and/or mushy cecals? Small dry poops cry out for hydration, not just fiber, thus the wet fiber (pumpkin and grass) I would think is better.

The slowdown signs are dry, misshapen, even broken-looking (small) fecals. It makes so little sense, though; she drinks about 200+ mL of waterevery 24 hours'. It just seems that her gut somehow misappropriates the fluid. Where it goes, I've no idea....

I still don't like the idea of addingsugar (no matter how natural)to her ultra-touchy digestive system. She doesn't even seem to handle Critical-Care well, so make if it what you will. I'm thisclose to putting her back on a hay-only diet and calling it a day....

 

[tonyshuman]

I've never heard anything about probiotics being ineffective past 7 days. That said, I haven't looked into it at all. That protocol I wrote was just what I would do in this situation.

I think she'll be fine at your house, just make sure the sitter knows what the mucus looks like. Another option is to go on a hay-only diet while you're gone. It really might be the best thing for Ms. Sensitive Belly Zoe.

 

[Maureen Las]

tonyshuman wrote:

A slight growth of enterococcus doesn't sound like a bad thing to me at all. It is present normally, as Pipp said. I think it would call for some probiotic to get the GI flora back in balance.

The probiotic contains enterococcus, but Randy says it doesn't get into the GI itself--the effect of most probiotics is to acidify the gut, which helps the correct bacterial populations re-establish themselves.

Part of the problem here may be that we don't understand how GI microbial communities work very well. It's really an emerging field of research in science and medicine, as until recently it was thought that the inside of the body is sterile and free of microorganisms. Of course, now we know that's not the case, but knowing exactly what microorganisms live in a given gut, what should be there, how to get the "right" ones there, and how these things correlate with disease is really unknown. There is even a lot of evidence to support that a large component of obesity in humans (and mouse models of human obesity) is the gut flora. People who are overweight tend to have different microbial content in their gut, even if they're on the same diet. It is possible in mice to "recondition" the gut of an obese mouse to have the same microbes as a mouse of healthy weight, and then they will lose weight. Pretty revolutionary stuff, but we really don't know how it works. A lot of chronic human GI diseases (like IBS and Chron's) have been linked to GI flora imbalance as well. It's just very hard to study because not every healthy person will have the exact same gut flora, so there's a range of what's healthy that is unique to the individual.

What I'm trying to say, is that maybe a hands-off approach, with lots of water and hay, few veggies, pellets, or treats, and daily probiotic may get her gut back in order, after the micromanagement that your vet did. It's possible the vet was trying to make Zoe's gut flora confirm to some list in a vet textbook that doesn't accurately represent what Zoe's individual gut needs. Getting her diet back to the most basic things a rabbit typically eats in the wild, along with probiotics to promote the growth of the correct bacteria, may get her gut to settle down. It could take a while, and it may be a bit scary to do (you mentioned the noises their guts make when you give them probiotics), but I think maybe if you stick with it for 2-3 weeks it will stabilize. This is totally a postulation, though.

The most common diet I hear of (and have seen with one shelter bun) for megacolon bunnies is high-hay, low anything else. The poos may be funny shaped and have mucus once in a while, but they don't stop up completely.

So frustrating for you. I'd stop the baytril right now, and just have the sitter keep an eye on them while you're gone. Maybe a more hands-off approach by the sitter will do some good?

Wow interesting stuff....

 

[Maureen Las]

Gabriel (RIP) had megacolon and no matter what I did nothing had any pattern to it ; so it was sort of like I really did not have any control over his problem. he most often had his slimey big and small gross poops and then would periodically go into stasis. I did use motility drugs on him because he was impossible to handle and nothing else I did worked.
I think that Zoe is similar in that it seems as if there is just no way to get control over this condition and she is more prone to stasis than Gabriel was.

ithink that she would do better at home than at the vets and if she did have problems the sitter would catch them at some point and take her to the vet and then if the vet thought she needed to stay there you could do that.

We are supposed to be here for the rabbits butI hate to see a person suffers as much as you from this Jen .

you really need to take the vacation.

"Hugs"

Maureen

 

[Jenk]

I think she'll be fine at your house, just make sure the sitter knows what the mucus looks like. Another option is to go on a hay-only diet while you're gone. It really might be the best thing for Ms. Sensitive Belly Zoe.

This idea is attractive, though it raises two questions:

1) Is it bad that I just remove pellets from her suddenly? (Granted, she only receives a tiny amount as it is, but...)

2) Zoe's not passing a normal amount of fecals right now, and what she has passed overnight is mostly dry. That's what truly worries me now. Without drug intervention, her gut always seemed toget worse whenever I tried the wait-and-see (or leave-it-alone) method.

I'll likely still call the vet tomorrow to see what she recommends. Yeah, I'm not feeling too secure about the situation, seeing as we leave in about 32 hours'....