Diarrhea in Rabbits
Dr. Lani Steinohrt
Veterinary care is aimed toward determining the cause of the diarrhea so appropriate treatment recommendations may be offered. Diagnostic testing includes a very thorough history and physical examination by an experienced veterinarian. The veterinarian will recommend specific tests depending on the severity of the diarrhea and the condition of the rabbit. A careful physical examination to evaluate the motility of the intestines or the presence of gas in the intestinal tract, to look for sources of pain, and an oral exam to evaluate the teeth will be performed.
Radiographs (X-rays) give an overall look at the rabbit's internal organs and skeleton. Abnormal gas patterns in the stomach, cecum or the intestines are extremely valuable in determining the cause of diarrhea. Radiographs may also help to find painful conditions that may cause your rabbit to stop eating cecotrophs, such as arthritis. Occasionally, other conditions, such as tumors, or changes in the size and shape of the liver and kidneys may be found.
Examination of the pet's feces (flotation, direct smear and grams staining). The fecal flotation and direct smear may identify parasitic or bacterial causes of diarrhea. The gram stain will determine if the rabbit has abnormal types of bacteria, such as clostridia in the intestinal tract.
A complete blood count (CBC), the number of circulating red and white blood cells, may help differentiate between infectious and non-infectious causes of diarrhea. Some rabbits with serious alterations in cecal bacteria flora may develop septicemia, where dangerous bacteria gains access to the general circulation. The CBC is very helpful in diagnosing this.
Serum chemistry panel will detect any electrolyte abnormalities, and give evidence of other systemic involvement such as malfunctioning kidneys or liver.
Barium studies/contrast studies. The rabbit swallows a special dye and X-rays are taken over a period of time. This study will look for tumors or foreign bodies, and may identify ulcerations or thickenings of the intestinal tract. This study also helps determine if the ingesta is passed through the intestinal tract at the appropriate rate.
Pasteurella test. Determining the pasteurella status of the rabbit may be helpful in gaining an overall picture of the health status of the rabbit. A positive test means the bacteria is directly or indirectly contributing to the diarrhea.
Abdominal ultrasound allows visualization of the abdominal organs for evidence of masses, abnormal organ densities, intestinal wall thickening, and foreign bodies within the intestinal tract.
Diarrhea is a symptom that can be caused by many different diseases or problems. Cecal diarrhea can be mild, with the rabbit otherwise appearing healthy, or can lead to painful bloating or occasionally, life threatening bacterial septicemia. Constant, true diarrhea causes life-threatening changes in hydration and electrolytes, and warrants aggressive treatment. The diagnostic tests described above should elucidate the cause of diarrhea so that proper therapy can be instituted. Pending the results of the diagnostic test the therapy is directed toward preventing further consequences such as dehydration, cecal bacterial changes, and spread of disease to other parts of the body.
Dietary modification is necessary for diarrhea that is the result of inadequate amounts of fiber. All greens, fruits and other vegetables are withheld. The ration of pellets is reduced and the amount of timothy or grass hay is increased. Unlike the treatment of acute diarrhea in cats or dogs, withholding food from rabbits for a period of 12 or 24 hours should NOT be instituted. Unless directed by your veterinarian, rabbits should never go without food. If a rabbit is not eating, food is given in the form of a specific high-fiber gruel (available from your veterinarian), and assist-fed via syringe. If food is not accepted by assist feeding, a tube may be passed through the nasal cavity into the stomach for forced feeding of gruel.
Fluid therapy. Many rabbits that have diarrhea become dehydrated and require fluid therapy. The route the fluid is given (under the skin, through the vein or orally) is dependent on the severity of the diarrhea and the health status of the rabbit. Fluid therapy is an important part of supportive therapy that is used until a definitive diagnosis can be found.
Pain medication is often a very important part of treatment. Many rabbits with diarrhea develop painful gas bloat or intestinal cramping. Painful rabbits refuse to eat, worsening the disruption of bacterial flora. Pain medications can be given by injection or an oral route.
Motility drugs that change the rate the ingesta (food) are passed through the intestinal tract are sometimes given.
Antibiotics aimed at the infectious cause of diarrhea may be used based on the grams stain and/or culture or observation of large amounts of gas in the cecum. In critically ill animals, these are usually administered via an intravenous route.
Deworming will be performed based on the positive identification of diarrhea-causing parasites. This is usually only a problem in young or recently weaned rabbits.
Administration of a commercial product that absorbs bacterial toxins is often administered.