Loose stool, incontinence, intermittently for the last year

[Adam]

I have a rex (I think) of about 6 pounds and 6 years old, and for a while now she has had incontinence where she pees or a combo of pee and poop, with the poop ranging from mostly normal but wet, and mushy.  The amount of mess she makes can range from a few small spots to several large ones. Usually overnight, then sometimes in the morning to continue.

I’ve tried various diet restrictions and changes, benebac, some bloodwork from the vet to check for infections and liver, and various consults with that vet.

I’d like some more suggestions. I’ve avoided a medicine that is supposed to help because the vet said it might have side effects and she doesn’t quite understand how this would be intermittent herself. I’ve avoided antibiotics, as there’s no other symptoms of any sort of infection.

The only 2 notable things about her health, is that she seems sort of chonky (but could be fluff), and she does make weezy sounds sometimes when sleepy, along with sneezing (perhaps mild snuffles?). Maybe that’s 3 things.

Thanks for any input.

[Wick & Fable]

Can you give some details on what diet changes you have tried, in addition to what current diet is?

When I hear of rabbits with chronic GI/poop issues, megacolon is my first thought: https://wabbitwiki.com/wiki/Megacolon#Symptoms
— There is a genetic component in many cases, so if your rabbit is an English spot with not that many spots, that can actually be supporting evidence, though not conclusive one way or another. Some rabbits simply have mega-colon-like symptoms but ‘confirmation’ on diagnosis isn’t necessarily obtained (nor possible with how varied presentations may be).

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[DanaNM]

I agree that megacolon came to my mind as well. Often megacolon goes along with weight loss though, so if her muscle tone and weight are good, then it may not fit the megacolon symptoms. It would be good to weigh her regularly to know for sure if she is very fluffy.

The combo of urinary incontinence could indicate something else as well. Could you give the names of the specific medicines that were suggested (but that you didn’t want to try)?

Urinary incontinence can also be a symptom of a Urinary tract infection, has the vet done a urine screen?

Is she spayed? Wondering if she could have a cancer that is affecting her.

How long has this been going on?

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Bam]

If you’ve had bloodwork done, the vet would have seen signs of an active infection. Difficulty breathing can be related to the heart, but your vet has problably checked that already.

Rex rabbits are prone to chunkiness, which is probably due to their genetics. A chonky rabbit can have difficulty moving about and cleaning itself downstairs, which can contribute to a messy poop situation.

What med did you opt not to try?

Incontinence in a rabbit that doesnt have a UTI makes me think of e cuniculi. Its a microscopic parasite that nowadays is classed as a fungus. The rabbit can be infected with it in its mother’s womb or get it from other rabbits. It can lie dormant all the bun’s life, or it can be many years before it starts to cause trouble. It can affect any organ in the body, although its mostly known to cause head tilt and kidney problems. It can affect the gut and the heart as well as the eyes, the nervous system and the kidneys.

What dietary restrictions have you tried? Both excess protein and excess simple sugars can stimulate the growth of unfavorable gut microorganisms, resulting in sticky poop. A bun needs 12% protein and really as little simple sugars as possible (and by that I don’t mean all carbs, buns need quite a bit of complex carbs).

How are your bun’s living conditions (indoors, outdoors, free roam, part time free roam etc)? How is her appetite? Is she spayed?

[DanaNM]

Also (fresh on my mind since this just happened to another member’s bun), is liver torsion, which can cause: ” anorexia (n = 15, 94%), lethargy (n = 9, 56%), decreased fecal production (n = 6, 38%), inappropriate urination or defecation (n = 4, 25%), crouched or hunched body position (n = 4, 25%), hiding behavior (n = 2, 13%), and soft stools (n = 2, 13%). ”

Source: https://www.sciencedirect.com/science/article/pii/S1557506314001049#:~:text=The%20most%20common%20clinical%20signs,particularly%20mini%20lops%2C%20were%20overrepresented.

But if your vet checked for liver function maybe this was ruled out? I think it’s normally diagnosed by ultrasound.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Adam]

Thank you all for taking an interest, I will give what info I can here.

First off, I don’t know the name of the medication I opted not to try.

Second, while she may be fluffy too, she def is of healthy weight, appetite, and attitude.

Third, The vet believed she had mega-colon from the start. Very large poops, but until the last year, no urinating randomly or loose stools.

Spayed, yes, when very young.

Here is the room they have during the work day. In the evening and most weekends they get to run around the house: https://photos.google.com/u/1/share/AF1QipOO8MBHyHmFlytH1rxfeyfJFHkHjuZEHJZDRZ_DezfGWkYs0hspgpDL0kiNgNGzZA?key=R3Y1b05YT1JfZVczdVlnLTJOeFllNWF1Wk1wUEN3

The white one is snuggles, the one with the issue.

Diet Restrictions: My strategy was to cut out certain or multiple types of vegetables based on a few criteria:

sugar content

high calcium such as kale, broc, collards

rabbit food pellets that have much more than just timothy grass

I did less restrictive where I gave these things on occasion and I stopped feeding these things entirely  where their diet was distilled or filtered tap (when distilled became hard to find for a while), timothy hay, and occasional timothy pellets, and lettuce such as romaine and green leaf.

I could find no single culprit, and this took a long time and dedication due to the intermittent nature of the problem.

Currently, she gets (spread throughout the day) a cup of kale, one baby carrot, one dried apple slice, a cup of lettuce, a cup of either spring mix or collards or a couple pieces of broc, some occasional pellets, the rest is timothy hay freely given.

[DanaNM]

She does fit the color pattern for the “charlie” gene that’s associated with megacolon. It can tend to start really causing issues around 3-4 years in severe cases.

If you haven’t found this page already, this page has a lot of good info on megacolon, including special diets that seem to help (although a bit unorganized): https://www.vgr1.com/megacolon/

If it is megacolon, it’s very encouraging that she’s at a good weight and is generally doing pretty well, as many megacolon buns don’t live past 5. There seems to be a lot of variation in how it presents. Often megacolon buns are put on a maintenance dose of cisapride, a motility med. It’s also really encouraging that your vet even thought of megacolon, many vets haven’t heard of it.

The amount of greens seems on the high side (3 cups of greens total, if I read that correctly?), and I would probably cut out the carrot and apple completely, even if you didn’t notice a huge improvement without them. Sugars and starches can lead to imbalances of the bacteria in the gut and cause problems and soft poops, so I think it would be wise to remove them to be on the safe side.

Broccoli, kale, and collards (broccoli especially) can cause gas, which could also contribute to pain and GI slowdown.

Anecdotally, one of the leads at the rescue I volunteer yet has seen improvements in buns with cecal dysbiosis and soft stools with feeding a bit of alfalfa hay. But those are usually acute cases, rather than a chronic issue.

I agree with Bam that ruling out EC and other parasites is a good step.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Adam]

Thanks a lot for the info, for some reason I didn’t notice this reply until now when I was about to bump this.

I’ve tried long periods without any gassy, oxalate, calcium, or sugary vegs/fruits, and gave up on that strategy just recently. I can try it again as I do other diet adjustments like maybe some alfalfa you mentioned, and will review that link you posted.

When her first partner died, she went into stasis pretty bad, this was back in late 2017. I was close to giving her a motility med I still have, but I don’t know if it’s that same one, as well as performing an enema, but luckily I did not have to. She has had something like that happen 3-4 times, if my recollection is good. So not much more than once every other year.

But anyway, I read here I believe that such meds should not be given unless absolutely necessary. Maybe some are better than others?

[Bam]

My bun Vilde stood on metoclopramide (Reglan)  for a couple of months back in 2019, after that he had it as needed. My vet explained it isn’t considered a strong drug. It is the same med humans get for migraine-related nausea. It must however not be given if theres suspicion of an intestinal blockage (risk of intestinal rupture) and it is best given together with a painkiller (when the gut starts up, it can be somewhat painful).

Is your bun keeping weight on? Megacolon buns tend to have difficulty absorbing nutrients from their food and might for this reason need rather rich food, contrary to what is generally recommended for buns that have a “poopy butt”-problem. Flare-ups are as a rule caused by “stress” – but pretty much anything can be stressful for a rabbit, so that doesnt really give much of a lead.

ETA: Here is a video on rabbit nutrition from the HRS in 2014, that moderator Dana NM posted about in another thread recently. Its a very good video. The topic of hereditary (genetic) megacolon and its dietary implications is discussed starts at around 52 minutes.

 

[longhairmike]

my applejack (10yrs, maybe more) had been leaving piddles all around the place, but i discovered it was because he was having trouble emptying himself and was just leaking whenever he was full,, so now i pre-pee him a couple times a day. i hold him a few inches off the ground over a litterbox and put a little pressure on his abdomen just in front of his rear legs,, after a few seconds,, tail goes up, shakes, and out shoots a stream,, and its weird because you can feel him sort of ‘deflating’ as he empties.  just be aware that this is a mostly horizontal stream, so make sure you have a good 12′ of litterbox behind him or one with a wall that is higher..

[DanaNM]

Also just to circle back to something that was said earlier in the thread, you might talk to your vet about treating for E Cuniculi as a precaution given the urinary incontinence issues. The medicine for it is very well tolerated, and the tests for it are really unreliable, so many vets will opt to treat for it if there is any suspicion.

Giving an enema to a rabbit can be really risky, so I would never attempt to do that at home. Rabbit medicines can run the range of “very safe”, to definitely only use as needed. And some meds that are not safe orally are safe to be given sub-cutaneously (like penicillin, for example). It is definitely correct though that you should give prescription meds at home unless your vet has told you specifically to (for example, my vet has given me the pain med metacam to use as needed for my senior bun that has arthritis, and my other bun that has gas pain occasionally).

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Adam]

We started the cuniculi treatment Monday.

I’ve noticed that since this started her poops just mostly seem malformed. Maybe because they come out wet, but just not like they used to be. They used to be really big, which is why the vet said megacolon, but otherwise like bunny poop. Now they just aren’t. Not finding good ways to describe it. They are looser, like don’t hold shape as well, wet, and sometimes it’s really like loose stool for humans, but I can’t tell if it’s even poop at that point or some sort of other discharge accompanying poop (this is fairly rare).

Anyway, the vet said that if the cuniculi course doesn’t help we can try estrogen treatment. Anyone know anything about that?

[jerseygirl]

What are her grooming habits like? Is she able to keep her butt clean? Do you occasionally see her bend to get cecatrophs?

She is a senior rabbit now so another possibility (along with the others mentioned) is arthritis or another condition affecting her spine. It might be more difficult for a rabbit to empty bladder efficiently, expell sediment, keep clean & avoid UTI’s, produce & eat cecatrophs to keep gut health at optimum. Along with that, just pain itself (or even stress) could cause some loose poos and urination out of litterbox.

[Adam]

She does eat her cecas, not always, but I see it often. She had been keeping very clean considering the messes. Used to be much worse when she had a lot more fur down there. The vet helped trim that and it has made a huge difference, so that’s probably something we’ll need to do once in a while.

[DanaNM]

It sounds like she could be having cecal dysbiosis, which can accompany megacolon, or may be it’s own thing.  Sometimes buns will alternate between a “wet” and “dry” phase. Have you tried any probiotics with her?

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

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