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RABBIT POO     

The mystery of rabbit poo unlike most mammals lagomorphs [including domestic rabbits] produce two types of pellets, fecal and pellets (the round ones you find in the litter tray) and cecotropes. The latter are produced in a region of the rabbits digestive tract called the cecum. This contains a natural community of bacteria and fungi that provide essential nutrients.                                                                                       

How does the rabbit get those essential nutrients? He eats the cecotropes as they exit the anus. The rabbits' blissful expression when he's engaging in cecotrophy (the ingestion of cecotropes) will tell you that he finds this anything but disgusting. In fact, rabbits deprived of their cecotropes will eventually succumb to malnutrition. Cecotropes are not feces. They are nutrient-packed dietary items essential to your companion rabbit's good health.

Each individual rabbit usually produces cecotropes at a characteristic time of the day, which may vary from rabbit to rabbit. Some produce cecotropes in the late morning, some in the late afternoon, and some at night. In any case, they usually do this when you're not watching, which might be why some people refer to cecotropes as "night droppings."

Normal Intestinal Products

Anyone who lives with a bunny has seen a fecal pellet . These are the small, brown "cocoa puffs" that we all hope end up mostly in the litterbox. They are round, relatively dry and friable, and composed mostly of undigested fiber. Rabbits do not ordinarily re-ingest fecal pellets, though a few bunnies seem to enjoy an occasional fecal pellet hors d'ouevre.

A normal cecotrope  resembles a dark brown mulberry, or tightly bunched grapes. It is composed of small, soft, shiny pellets, each coated with a layer of rubbery mucus, and pressed into an elongate mass. The cecotrope has a rather  strong odor, as it contains a large mass of beneficial cecal bacteria. When the bunny ingests the cecotrope, the mucus coat protects the bacteria as they pass through the stomach, then re-establish in the cecum.

DIARRHEA        

True diarrhea (unformed, watery feces) is relatively rare in adult rabbits. It can be caused by intestinal parasites, such as coccidia (Eimeria spp.), roundworms, tapeworms, or anything that inflames the intestinal lining. Your vet will be able to examine a fecal sample (you should probably provide the vet with a bit both fecal and cecal pellets) to examine them for signs of parasitic infection.

True diarrhea is more common in baby rabbits. One of the most common causes is coccidia, and if you see runny stool in your baby rabbit, you must get him to the vet as soon as possible for treatment. In a baby rabbit, dehydration caused by diarrhea can rapidly result in death. It is wise to consider runny stool in a baby rabbit a true emergency.

The cecum is a delicately balanced ecosystem. If the intestine is moving too slowly, or if the rabbit is getting a diet too rich in digestible carbohydrates and too low in crude fiber, the complex population of bacteria in the cecum can become "unbalanced." This condition, known as cecal dysbiosis . Simply put, cecal dysbiosis means that the beneficial bacteria (e.g., Bacteroides spp. and a variety of others) are outcompeted and outnumbered by less desirable inhabitants such as yeast (a fungus, usually Saccharomycopsis sp.) or even very harmful bacteria such as Clostridium spp., related to the ones that cause tetanus and botulism.

A rabbit suffering from cecal dysbiosis will produce cecotropes that are mushy, pasty or even liquid. They are usually quite foul-smelling, and often stick to the bunny's back end in great, nasty clumps. These unformed cecotropes are not a primary disease, however. They are a symptom of a disorder somewhere in the bunny's system. In order to cure the runny stool problem, the underlying cause must be addressed.

The Causes of Runny Poo in Baby Rabbits

Weaning Too Young

If the bunny suffering from runny stool is a baby, how old is he? If younger than eight weeks, and not nursing, his runny stool problem may be due to his being weaned too young. Many pet stores will (illegally) sell rabbits younger than eight weeks of age (and some as young as four weeks!), because that is when they are still "cute" and more apt to be purchased on a whim. Sadly, many of these babies will succumb to intestinal disorders.

Unlike most mammals, baby rabbits have a sterile lower intestine until they begin to eat solid food at the age of 3-4 weeks. It is during this time that their intestines are at their most critical phase, and the babies need their mother's milk, which changes pH and provides vital antibodies that help the baby gradually adjust to his changing intestinal environment. Without mother's milk, a baby starting to eat solid food is highly susceptible to enteritis (inflammation of the intestinal lining), which can cause fatal diarrhea.

At the first sign of runny stool in a baby rabbit, off to the vet! Treatment for diarrhea in baby rabbits will probably include subcutaneous fluid thereapy, and administration of oral probiotics. Lactobacillus acidophilus powder (NOT yogurt, which can make the problem worse) suspended in clean drinking water and carefully administered via syringe seems to help foster a healthy intestinal environment and may even soothe intestinal inflammation. A very small amount of a clay-based product such as Kaopectate can help solidify the stool and stop the cycle.  

Intestial Parasites

As mentioned before, coccidial infection is very common in some areas, and some vets will simply treat a baby rabbit's diarrhea as coccidia, even without a fecal test. Common antibiotics used to treat coccidia include Albon and the potentiated sulfas, such as Trimethoprim Sulfa (TMZ) or Bactrim.

The Causes of Runny Stool in Adult Rabbits                                                                       

Obesity
Is the bunny with mushy stool stuck to his bottom obese? If so, the cecotropes could be normal, but he can't reach them as they are produced, and so smears them all over his bum in trying to reach them. Calorie reduction (first step: remove commercial pellet food and any starchy treats, replacing them with fresh, fragrant herbs) and exercise are in order.

Arthritis
Similarly, a rabbit who is suffering from degenerative joint problems in the spine, hips, or other areas, may not be able to reach his cecotropes easily. He ends up sitting on some of them, and squashing them into his fur. Arthritis can be treated by your veterinarian, who may prescribe a non-steroidal anti-inflammatory drug (NSAID) such as Rimadyl (carprofen) or Meloxicam, though all the usual cautions for use of NSAIDS apply.

Starch-rich Diet
Rabbits, like horses and cattle, are strict herbivores. The rabbit intestine--and its normal bacterial flora--has evolved to feed almost exclusively on grass and herbs.   Does your rabbit get starchy treats such as oatmeal, crackers, bread or sweets? Some rabbits with very sensitive intestines can suffer from runny cecotropes even from being fed commercial pellets. Fruit, as healthy as it is for humans, can be too much of a good thing for rabbits. The high level of sugar and starch in table fruit makes them too rich for a bunny except as a very small, occasional treat. A diet too rich in digestible starch is one of the most common causes of runny cecotropes in companion rabbits.

Fiber-poor Diet
A rabbit should be fed unlimited grass hay, such as timothy, brome, wheat or oat. DO NOT use alfalfa, as this is far too rich in calories and protein for good rabbit health. If a rabbit does not get unlimited grass hay to nibble on throughout the day, the muscles of the intestine may become flabby, and the normal peristalsis (muscular movements that push food through the gut) will become sluggish. This causes the passage of food through the cecum to be too slow to properly "flush" the bacterial populations, and cecal dysbiosis can result. The high fiber content of grass hay also helps to "dilute" the starch of other dietary items, and helps to provide a healthy intestinal environment. In preventing and curing a runny stool problem, it is very important to provide a heathy diet.

PARALYSIS

Paralysis is defined as loss of the ability to move a body part.   Unfortunately, companion rabbits sometimes suffer paresis of the hind limbs that makes them unable to stand with those legs, and to locomote normally.

There are several reasons a bunny can lose the use of the back legs, including

• trauma to the spine, pelvis, or limbs
• arthritis of the spine or pelvis
• degenerated, damaged, or ruptured vertebral disc
• the sporozoan parasite, Encephalitozoon cuniculi, the pathogenicity of which is controversial.

If the problem is chronic, rather than acute (as from trauma, which may necessitate immediate palliative care and cage rest, as prescribed by your veterinarian), physical therapy may be very helpful. Some rabbit "parents" report success at restoring a bunny's movement by enlisting the services of a qualified,  vet  who is also a skilled acupuncturist. Massage, acupuncture and skeletal manipulation can sometimes make a very great difference in the bunny's mobility and quality of life.

Encephalitozoon cuniculi is a protozoan parasite that infects the renal and nervous system of rabbits. 

EAR INFECTIONS

Of the causes listed, we have found that by far the most common is a middle or inner-ear infection. The Vestibular Apparatus, largely responsible for the sense of balance, is located in the bulla of the skull, a large, hollow space near the base of each ear. An ear infection can cause the tissues of the ear and inside the bulla to become inflamed, and this can interfere with proper function of the Vestibular Apparatus. A very severe inner ear infection can actually cause the bulla to fill with hard, caseous (i.e., of a tough, cheeselike texture) pus. This presses on the Vestibular Apparatus, and prevents its proper function. Any inflammation of the VA can cause head tilt.

Under the best circumstances, pus is visible inside the ear, and the vet can take a sample for  culture This will reveal (1) the species of bacteria most likely responsible for the infection and (2) the types of antibiotics most likely to kill that species/strain of bacteria. Although the most common pathogens we have seen associated with head tilt are Pseudomonas aeruginosa and Pasteurella multocida, but there are many others which also can cause this problem. Each species/strain of bacteria has its own specific sensitivity and resistance to various antibiotics. Before you throw good money after bad in a "guess" at an effective antibiotic (some vets will automatically prescribe Baytril, since it's safe--but it may not be effective against the bacteria causing the problem!), it's really best to invest in For a culture and sensitivity test if there is pus inside the ear to culture.

Once the results of the culture and sensitivity test are back, don't be surprised if your vet tries a combination of two different antibiotics to kill the bacteria. Many experienced rabbit veterinarians are now finding that combining two antibiotics is more effective at killing some of the more resistant bacteria found in rabbit ear infections. It is especially important that your veterinarian be familiar with the specific needs of rabbits in terms of antibiotics, since some of these drugs (e.g., any oral penicillins such as amoxycillin or ampicillin, and any lincosamine antibiotics) can be deadly to rabbits, even if they are commonly used on other species.

Whatever the prescription, it is vitally important that you continue to give the rabbit the full dose for the full time span your vet has indicated. Stopping the antibiotic therapy before the infection is fully gone can simply promote the selection of a resistant strain of bacteria, since those are the last ones to die off when exposed to antibiotics. If you stop the antibiotics too soon, only the most resistant ones will be left to reproduce and repopulate your poor bunny's ear!

In some cases, an ear infection appears highly resistant to the most commonly used antibiotics. A relatively recently "rediscovered" therapy that has proven highly effective in cases of head tilt, jaw abscesses and other infections of the head is treatment with bicillin  a rabbit-safe combination of injectible Penicillin-G Procaine and Benzathine. This has been used on rabbits who were deemed terminal and untreatable, and produced miraculous cures. It is something to consider if conventional antibiotic therapies are not effective.

While the antibiotics are doing their work, your vet might also prescribe other drugs to help restore balance and control the discomfort associated with vertigo. Meclizine (commercially known as Anti-Vert) is excellent for controlling dizziness, though it will not work for every rabbit. If meclizine does not control the nystagmus, your vet might prescribe a course of short-acting corticosteroids to reduce the inflammation interfering with the vestibular apparatus. We have found that these drugs can sometimes help restore normal posture even before the infection is fully cured.

It can sometimes take weeks or even months to completely cure an inner/middle ear infection. This may sound like a long time, but if supportive care is offered, and the rabbit continues to eat and drink normally and is still interested in life, it means she's not ready to give up. The condition is disorienting, but does not seem to be painful. The illness is temporary, if hard to watch, but it's worth a course of supportive care to see your bunny happy and running around again.

For mild cases (slight swelling and redness), simply changing the environment and diet of the animal may be all that is needed. This may include providing:

• A smoother floor
• Softer and thicker bedding
• Dry surfaces
• Increased cleanliness
• Increased vitamin C for guinea pigs
• Fewer calories to overweight animals

HEAD TILT

The condition medically known as torticollis (which is Latin for "twisted neck") and sometimes as "wryneck" causes a rabbit's head to twist over sideways. Often, torticollis is accompanied by a rapid side-to-side movement of the eyeballs (nystagmus), an indication that the bunny is suffering from dizziness/vertigo that should be treated along with the problem causing the head tilt.

Symptoms may appear very suddenly or exhibit a gradual onset, but the result is the same: a bunny is walking around with his head on "sideways." In some very severe cases, the bunny may be so disoriented that he simply cannot walk, and spends much of the time rolling sideways in a wild attempt to regain his footing. This is most distressing to the human caregiver, and far too many a bunny with head tilt has become the victim of his caregivers' well-meaning desire to "not let him suffer."

In truth, head tilt is usually quite treatable, though recovery may be slow. Euthanasia should be considered only as a last resort, when all attempts to cure the infection have failed, leaving the bunny in misery, unwilling to eat, drink or act normally at all. Note, however, that a permanently tilted head is not a symptom requiring euthanasia! Many rabbits with their heads tilted at a jaunty angle are living completely happy lives, running and playing with all the vigor of their straight-headed bunny pals. The most important thing is to cure the source of the head-tilt symptom. Once this is accomplished, improvement of the rabbit's posture will follow more gradually, with physical therapy and exercise.

It is not at all uncommon for symptoms of torticollis to appear very suddenly. As with almost any illness, the more rapidly the disorder is diagnosed and treated, the greater the chance for full recovery. 

Causes of Torticollis
Torticollis is not a single disease. It is a symptom of a problem with the rabbits' balance system, components of which include the central nervous system (brain and spinal cord, collectively called the "CNS"), the visual system, the vestibular apparatus in the inner ear, and even the pads of the feet, which tell the bunny he's standing on solid ground, the way gravity "intends" him to. Hence, a rabbit exhibiting torticollis may have a problem with one or more of the balance components, and causes of this include (but are not limited to)

• middle- or inner-ear infection
• parasitic infection of Encephalitozoon cuniculi in the CNS
• parasitic infestation of a nematode worm, Baylisascaris procyoni
• stroke
• abscess or tumor in the brain (intracranial abscess)
• head trauma