Diarrhea or Bacterial Enteritis
So what's going on? Most of us have heard the term "enteritis"; few of us have been lucky enough to never experience it in our rabbitries. But what is enteritis? Too often it is used by vets the way our own doctors use the term "upper respiratory infection" - as a catchall phrase to describe a condition of a certain system, caused by some unnamed bacteria. The signs and symptoms are familiar but too often the underlying cause is not.
Probing a Gut Wrenching Problem
After a long cold spell, you finally get a few days of unbelievably warm and beautiful weather and you finally have a prospective buyer or your newly weaned bunnies. You and your buyer enter the rabbi try, exchanging pleasantries and - WHAT'S THIS? Those -perfectly healthy-bunnies you just checked on yesterday are all huddled in the corner, eyes dull, coats ragged, nasty diarrhea, and accompanied by a family reunion of green bottle flies. You've gone through your routine Sulfa-Nox preventative program so it can't be coccidiosis. You haven't switched feeds and your current feed is fresh and free of mold. All you did was move these kids to a new cage away from mom and BAN! You've got a problem!
So enteritis is a general term for any nonspecific diarrheal condition in rabbits. Why general terms and nonspecific conditions? Usually because diarrheal and digestive problems in rabbits are not completely understood and the symptoms of one infection are easily confused with the symptoms of another. One way to eliminate some of dozens of possible causes is to take a stool sample to your vet for culturing. Be sure they look for more than coccidia! Many vets only look for this protozoa - if there is no evidence of this parasite in the feces, they may just write it off to "nonspecific enteritis". If your vet is thorough and "digs a little deeper", he/she may find quite a few different things lurking in that little pile of bunny poop.
In the healthy rabbit, there is a delicate balance of microbes in the digestive tract that live in harmony together either aiding in the digestive process or existing innocuously, with no known beneficial or detrimental purpose. Normally the action of these intestinal microbes is of little concern to us everything just hums along and a number of normal, semi-firm, dark, egg-shaped fecal pellets is produced throughout the day. In the morning, a pinecone-like cluster of feces, a product of the caecum, is often found below the cage. The rabbit is eating well, with bright eyes, gleaming coat of hair, and is active and happy. But, things are not always so dreamy in Bunnyland! Occasionally, something will go awry in the "microbial community" and one or more of the normally harmless bacteria will run amok causing trouble throughout the system.
The catalyst may be something as obvious as ingestion of too many greens or starchy or gas-producing foods such as cabbage, potatoes, or lettuce. These foods stimulate the growth of certain types of bacteria in the gut which quickly multiply out of control, throwing off the delicate balance and causing a diarrheal condition. Remember that diarrhea is the body's way of diluting and expelling a harmful substance.- Other times the cause is something as esoteric as changes in the pH, salinity, motility, or osmotic pressure in the intestinal environment. The rabbit's immune defenses also play a role; animals that are stressed or ill with some other condition are at an increased risk of developing an enteritis complex.
If you are lucky enough to have a lab or vet that can detect a specific bacteria in your stool sample, you will be better able to treat and/or prevent the reoccurrence of the condition. Some bacteria which may be
active in a diarrheal condition include Campylobacter spp., Salmonella, Clostridium spp., and Escherichia coli (E. coli). These may act in combination with each other or with some other unidentified bacteria or
virus and are discussed in greater detail below.
Mucoid Enteritis, like all enteritis complexes a short time back, is not well understood and has no known cause but is believed to stem from a bacterial toxin, as well as various metabolic, nutritional, and
pathogenic factors. Mucoid enteritis is most common in weanling rabbits 7-10 weeks old but also affects adult animals. Although transmission though infective feces is possible, mucoid enteritis does not appear to be contagious - suggesting the involvement of some physiological factors (improper functioning of the cecum has been suggested). Some predisposing factors include: dietary changes, dietary fiber under 6% or over 20%, extensive antibiotic use, stress, certain hereditary predispositions, high feed intake, and . . springtime! Now we have a disease for every season, don't we? The disease is also more common in
young does and does with large litters.
* the most distinguishing signs of mucoid enteritis are the clear,
mucousy diarrhea, below normal temperature, and its presence in adult
* impaction of the cecum or terminal part of the intestine may be
palpated in young animals.
* another characteristic sign is the animal's desire to keep its front
legs and head in its water bowl.
* abdominal bloating & sloshing sound in th
* hunched posture
* tooth grinding
* rapid weight loss
(all common signs in other forms of enteritis).
Signs at necropsy:
-* little inflammation or discoloration of the intestinal wall
(distinguishing from other enteritis complexes)
* Gas and watery fluid in stomach and small intestine
* Thick, almost transparent, gelatinous plug of mucous in the large
* Mucous or fluid in the cecum
* a mass of dried ingesta may be found blocking the ileum, cecum, or colon
* May require a fecal culture to differentiate from colibacillosis,coccidiosis, or salmonellosis.
Treatment: Bactrim, Reglan, and Chloramphenicol have all been used with some success. Electrolyte solutions, Vit. B complex injections, and rehydration with Lactated Ringer's Solution have also been useful. A simplified, bland diet of pellets, oats, and hay with a fiber content between 16-20%, and plenty of fresh, clean water is also recommended. Breeders that have successfully treated rabbits with mucoid enteritis state that there appears to be little sign of reoccurrence.
[Note from AngoraRabbit.com: Berberine
as a treatment for mucoid enteritis. - Feb. 19, 2016.]
BACILLUS PILIFORMIS: Tyzzer's Disease
Bacillus piliformis infection (Tyzzer's Disease) is common in a number of species including dogs, cats, horses, rats, mice, rabbits, cavies, and several species of wildlife. It probably exists innocuously in the intestinal tract of most species and is said to "persist in spore form for years outside its host." (Harkffess & Wagner, p. 199). Tyzzer's disease may be spread by the ingestion of infected feces and the spore form may remain infectious in soil, bedding, or contaminated feed for a year or more. The breeder should suspect the presence of carriers if there are persistant sporadic outbreaks of the disease. Most common in bunnies 3-8 weeks old.
* Rough hair coat
* watery diarrhea (not always present)
* weight loss
* death within 48-72 hours (unless subclinical "carrier" form)
Signs at Necropsy:
* enlarged liver with any number of white,- gray, or yellow nodules,
1 to 2 mm in diameter (more pronounced in carriers)
* edema, congestion, hemorrhage, and ulceration of the intestine
* yellowish fluid in gut
* pale lesions (necrosis) in the middle layer of the heart
Treatment: Oxytetracycline (water soluble powder) for 30 days has been used successfully to suppress an outbreak. Penicillin, chloramphenicol, cephaloridine, and erythromycin has also been proven effective.
Campylobacter: Proliferative Ileitis, "Wet Tail"
The role of Campylobacter in enteritic diseases of rabbits is not fully understood at this time. However, this bacteria has been associated with histiocytic enteritis (inflammation of the tissues of the small intestine) in rabbits in a 1982 study (Umemura et al.) and has been isolated in a number of cases of proliferative ileitis (or "wet tail", also an inflammation of the small intestine) in hamsters.
Campylobacter is responsible for many epizootic (epidemic) outbreaks in rodent colonies, being spread through infected feces, and occurs in a large number of species. While this bacteria has not been fully explored or understood as a cause of diarrheal conditions in rabbits, there have been recent studies suggesting~ its involvement. Campylobacter is highly pathogenic (disease causing) in man as well as many other species which may be responsible for its spread to rabbits.
* rough hair coat
* hunched stance
* lack of appetite
* watery diarrhea -
* death within 48 hours in acute cases
Signs at Necropsy:
* thickened ileum (the lower third of the small intestine)
* increased blood (or inflammation) and ulceration in the intestinal wall
* yellowish fluid containing mucous or blood inside the intestine
* perforation of the gut wall
Treatment: Enteritic conditions caused by Campylobacter spp. have been successfully treated with Erytromycin (20mg/kg body weight) but a disturbance of the gut flora may result, cause~ing further intestinal problems. Tetracycline hydrochloride (water-soluble powder) is also effective and less disruptive to intestinal flora. Neomycin sulfate at 50mg/rabbit (water soluble powder) for 5 days is also effective.
CLOSThIDIUM: Clostridial Enterotoxemia, "Young Doe Syndrome"
As in Campylobacter, Clostridium spp. are only now being explored as causes for diarrheal conditions in rabbits and its role at this time is not fully understood. Only recently has Clostridium-caused enteritis beeri distinguished from the all-encompassing term "nonspecific enteropathy". -
Cavies and hamsters are susceptible to overgrowth of Clostridium following antibiotic treatment. The use of lincomycin or clindamycin has been associated with the development of this condition in rabbits.
Clostridia are normally found in a benign state at variable levels in the large intestine of the rabbit. Thus, although transmission from one animal to another (via infected feces) is possible, it is more likely that disease occurs through overgrowth of the bacteria from the affected animal's own gut flora.
A condition called "Young Doe Syndrome" occurs in breeding does who have had a restricted diet during pregnancy and are then returned to full feed immediately after kindling. Affected does die suddenly 1-4 weeks postpartum. A few days prior to death, the rabbit will go of f its feed and may salivate profusely. Another condition called "Milk Enterotoxemia" has been associated with Clostridium overgrowth in the neonatal rabbit. A low level toxin passed in the milk has also been blamed. The young kit thus affected will die suddenly within 3 days of birth.
* profuse green or brown watery diarrhea w/bad odor
* mucous in feces
* lack of appetite
* gurgling intestinal sounds
* death within 6-72 hours from first sign of diarrhea.
Signs At Necropsy:
* hemorrhages of the brain
* edema (swelling caused by excess fluid) of the cecum, ileum, and colon
* thickening of the intestinal wall
* green, brown, or yellow fluid (w/or w/out mucous) or gas in the intestine.
Treatment: Colimycin, tetracycline (water soluble powder added to water), nitrofurantoin. Also oxytetracycline plus neomycin and chloratetracycline plus vit.B12 have been used successfully.
ESCHERICHIA COLI: (E.Coli) Colibacillosis
Colibacillosis is a common disease caused by the bacteria Escherichia coli (E.coli) and has received a great deal of press recently due to the deaths of a number of people by its presence in undercooked hamburger.
While many rodents and pther species normally carry E. coli benignly in low numbers in their intestinal tracts, the rabbit and cavy generally does not. As in Clostridium infections, E. coli overgrowth can occur
after antibiotic injections which kill off healthy bacteria that normally keeps Clostridium and E. coli in check. Clostridium overgrowth is very similar to E. coli-produced enteritis and positive diagnosis, though not always necess~ry, may be acquired only through laboratory culture.
* slight diarrhea and recovery or
* watery diarrhea or massive expulsion of a fecal puddle
* death in acute cases within 6-72 hours
Signs at Necropsy:
* hemorrhage and edema of the cecum
* brownish watery or mucousy bad smelling fluid in intestine
* congested kidneys
Treatment: Add roughage to the diet with hay or oats. Sulfaquinoxaline in the feed and lactobacilli in the water from 3 - 8 weeks of age has been successfully used. Also used: tetracycline alternated with nitrofurantoin over several weeks; oxytetracycline plus neomycin; chloratetracycline
plus Vitamin B; neomycin sulfate.
Salmonellosis, caused by Salmonella typhimurium and 5. enteritidis, is A uncommon disease of rabbits but cavies are highly susceptible and rats ~nd mice may carry the disease for long periods of time without showing any symptoms. The bacteria is spread by the ingestion of infected feces or fecal-contaminated feeds. Because salmonellae can remain in the intestinal tract of a carrier animal and be continually shed through the feces into the environment, salmonellosis can quickly become an epidemic, especially if carrier rodents are present in the rabbitry or caviary.
Salmonella is easily spread from one species to another (including man). Because of this health hazard, any animal suspected of having salmonellosis should be handled as little as possible and screened for
the presence of Salmonella spp. Any rabbit or cavy with a confirmed case of salmonellosis should be destroyed, incinerated if possible (along with any animals coming in contact with the infected one), and the entire premises sanitized.
* lack of appetite & weight loss
* rough hair coat
* light colored soft feces
* discharge from the eyes (conjunctivitis)
* small litters & abortions
* shortness of breath, difficulty breathing
* high temperature
°* sporadic deaths
Signs at Necropsy:
* enlargement, congestion, and focal necrosis (spotting) of the liver, spleen, and intestine
* gas and fluid filled gut
* enlarged spleen, red & congested gut & liver, and yellow spotting in internal organs of carriers
Treatment: Because of the relative ease with which salmonella is spread, the difficulty involved in identifying carriers, and its hazards to humans, treatment is rarely attempted. However, oxytetracycline in the drinking water for 10 days has used with some success.
some general notes:
More often than not, all forms of enteritis are lumped together as "enteritic complex" regardless of their many possible causes. That's because the signs and symptoms, treatments, predisposing factors and
preventative measures are very similar. They all originate in the intestinal tract and most (but not all) have diarrhea as their most obvious sign of trouble. Thus, there are some treatments that are common to all of them. Here are a few general remarks to help you decide what problems you may have and how to treat them all.
Predisposing Factors & Preventative Measures:
Likely targets for trouble have positive gut reaction to some simple solutions
1. stressful conditions.
The risk of developing any form of enteritis is greatly increased by the presence of any stress factor such as a dramatic change in weather, changes in diet, weaning, pregnancy or lactation. In summer & spring, E. Coli infections are more common. In winter, salmonellosis is more prevalent, especially in weanling cavies and postpartum sows. All forms are more common during weather changes and severe weather. What to do: Reduce stress! Don't make sudden changes in diet, housing, etc. Wean bunnies at 8 weeks of age or later if possible. Remove the mother to a new cage, leaving the litter in the cage they are accustomed to. When purchasing a young animal, don't handle it too often for the first day or two. Allow it to become accustomed to its new surroundings in a quiet, stress-free manner. If you must change feeds, do it slowly by mixing the new feed with the old at gradually greater proportions. Protect rabbits from extremes in weather. Keep drafts out of rabbitry in cold weather and provide extra ventilation in hot weather. Feed plenty of hay during long spells of wet weather or bad storms, when travelling, at shows, during any stressful event to counteract the effects (diarrhea).
2. Weanling rabbits and cavies.
Their gut is relatively uncolonized and therefore lacks the healthy bacteria to balance any incoming unhealthy bacteria. Because of its lack of ''digestive maturity'', it is also more prone to the overgrowth of any bacteria already present in the intestinal tract. These youngsters undergo a great deal of stress as they are weaned and removed to new cages or new homes. They are also still becoming accustomed to eating solid foods. What to do: Introduce solid foods slowly. Rolled oats is an excellent first food. Don't separate the litter from their mother or each other before 8 weeks if possible. Supplement bunnies with Lactobacillus acidophilus (in drinking water with 1 tbsp. of Tang to improve taste) to aid in development of healthy intestinal flora. Be very sparing with greens until animals are 12 wks.old at least.
3. Poor or unbalanced diets.
A diet too high in protein, starch (grains like corn, potatoes, etc.) or gas-producing (cabbage, legumes such as soybeans, etc.) can cause rapid proliferation of certain types of bacteria in the gut, throwing the flora levels off balance. Certain bacteria such as Clostridium spp. and E. coli, which may already be
present benignly (inactive) in the intestinal tract may overgrow in the presence of certain substances (like starch) and cause disease. A diet too low in fiber (6% minimum) can be problematic also. High fiber diets
are necessary for proper movement of materials through the digestive system. What to do: Any change in diet may lead to even a temporary diarrheal condition so changes are best made very slowly. Provide plenty of good quality grass hay. Add rolled oats-to your usual ration, they provide good amounts of fiber and are mild to the digestive system. Introduce greens slowly. Do not feed "empty treats" that do not provide any useful nutrient and the animal would not normally eat in the wild. Keep other treats like carrots, lettuce, sunflower seeds, bananas, etc. to a minimum. A rabbit or cavy that has filled up on treats has no room left for the important nutrients it can only get from a complete,pelleted ration. Never feed beans, potatoes, cabbage, other high-starch foods to rabbits!
4. Excessive improper use of Antibiotics.
Certain antibiotics are potentially dangerous because they destroy healthy bacteria in the animal's intestinal tract, allowing the more harmful forms to multiply and cause damage. Penicillin should never be used in any form on cavies and only by injection on rabbits. Any oral form of penicillin such as Amoxi-drops (Amoxicillin liquid) will quickly cause a potentially deadly case of diarrhea in even an otherwise healthy rabbit. Lincomycin or clindamycin should not be used on rabbits for the same reason.
What to do: Use antibiotic for the minimum amount of time required for proper treatment. Any antibiotic use should be monitored carefully and followed with treatments with probiotics - substances which contain healthy bacteria. This includes Lactobacillus acidophilus (found in yogurt), Probiocin, and Bene-Bac. These are especially useful in young animals. During treatment, provide plenty of good quality hay.
5. Presence of other diseases or conditions. An infection such as Pasteurella or an infestation of parasites can seriously weaken the rabbit or cavy's immune defenses, opening the door to intestinal disease. Talk about adding insult to injury! What to do: Eliminate any other infections where possible. Often diarrheal conditions will occur during treatment of other conditions due to the use of antibiotics or anthelmintics (wormers). These will generally clear up once the treatment ided but make sure you have eliminated the condition you were Cing first before tackling the enteritis with another medication.rantine the sick animal and follow general recommendations for stress.
Unsanitary conditions. Allowing fecal material to build up in your cage floors where it can easily find its way into feed and water bowls is like sending out an open invitation to disease! Enteritic infections can be spread from one animal to another by fecal-oral transmission and a recovered animal can become reinfected through its own feces that were allowed to pile up while it was ill. Bacillus piliformis can remain active and infectious in fecal material for over a year. Salmonella is continually shed in the feces of a carrier where it can infect other rabbits, cavies, and you! What to do: Eliminat? feces from rabbitry & caviary on a regular basis. Dispose of them in an area that you will not be tracking potentially infective material from the manure pile to the barn. Bury or incinerate dead animals. Use a propane torch to burn hair off wire cages so that feces clinging to the floors falls through. Scrub cages, feed & water bowls, and nest boxes with a bleach and water solution (none of the above bacteria are resistant) and a wire brush on a regular basis. Don't forget to sanitize your show carriers after each use!
7. Introduction of Infection into Herd from Outside Source. A number of bacteria can be easily spread from one animal to another through a shared cage during breeding or through contact with infected feces in a dirty show coop. (Although mucoid enteritis does not appear to be contagious)
Each is also present in a number of other animal species -which may contribute to the infection of your herd. What to do: Eliminate all unnecessary contact of your rabbit or cavy with any other, even in the
same herd. It is very difficult to tell who's carrying what! Minimize the number of new animals you bring in to your barn. Establish a breeding herd that you can work with through several generations without bringing in new blood if possible. Constantly adding new animals from many different sources adds to the risk of introducing disease. But don't inbreed too strongly! This will lower your animal's vitality and make it more susceptible to disease. If you "pet sit" rabbits or have a group of animals come in regularly for dressing out or quick sale, keep their cages separate from your own herd and leave empty when not in use. If you are breeding someone else's doe or sow, arrange to keep it for a week or more so you have a chance to observe it for signs of illness. At the shows, don't let animals sit in coops that are dirty or that an ill animal came out of. Don't allow your rabbit or cavy to be carted all over the show room where it can become thoroughly stressed while being introduced to disease causing bacteria. Eliminate as many visitors, both human and animal, to your rabbitry as you can. Sounds a bit antisocial but if you're really interested in the health of your animals, you won't let all sorts of folks, esp. those with rabbits of their own, bring in all kinds of germies on their shoes, clothes, hands, etc. The big poultry houses allow absolutely no visitors! Don't forget the nonhuman kind either. Rats and mice should not be tolerated. Dogs and cats add to the stress factor and poultry that is allowed to roost on top of your cages create a potentially dangerous health risk as well as a nasty mess. If you allow your rabbits a bit of freedom (which they enjoy and seem to need) prevent them from running under its cage and the cages of others where it can come into contact with droppings (even its own).
Other general treatments: when your bunny's got the runs and you
don't have 24 Hour Lab available
Because of the commoness of the problem, there is a virtual plethora of diarrheal/enteritic treatments (& folk medicines) available to the rabbit & cavy breeder. Because we're basically focusing on the digestive tract (mostly from the cecum to the colon) there are a number of general aids that can soothe the grumbling guts, no matter what bacterial badboy's to blame. These are all perfectly helpful to any bunny who's ailing and perfectly harmless to any bunny who's not (so don't be afraid to try them out). Remember the main things we're treating: diarrhea, bacterial infection, inflamed bowel, pain, dehydration, low blood sugar and malnutrition.
Apple cider vinegar, add to drinking water
Blackberry leaves (don't be stingy with these, good general tonic)
Comfrey leaves - general tonic
Yogurt - contains Lactobacillus acidophilus, healthy bacteria
Plasterboard (also good for bunny's aching feet)
Orange Pekoe Tea (stuff an old Lipton's Tea Bag in your water bottles and treat your rabbits to Sun Tea. The tannic acid is the key to its helpful action.
Oak leaves - more tannic acid
Yarrow - digestive stimulant, anti-inflammatory
Agrimony - leaves are anti-diarrheal, antiviral & antiparasitic
Lady's Mantle - leaves are anti-diarrheal
Kaopectate (said to be less effective on mucoid enteritis) up to 3 ccs by mouth per day
Immodium AD - more effective where sluggishness of the intestinal
tract and gas buildup is a problem
Hyland's Colic Tabs - a homeopathic treatment for gas buildup and pain
Willow branches - salicylic acid found in willow is the main ingredient in aspirin. soothing & pain relieving.
Nutri-cal - a must for animals that aren't eating. High calorie,nutritive paste.
Karo Syrup - also for animals that aren't eating, to keep the blood sugar at proper levels.
Pedialyte - pediatric electrolyte fluid, a must to combat dehydration that comes with diarrhea.
Dri-Tail - liquid medication for hamsters with wet-tail.
Neomycin Sulfate is main ingredient, effective in treating bunnies with bacterial enteritis.
Vitamin B12 (or B-complex Vitamin injectable) - increases appetite
and boosts immune system. Good for all stress-related conditions.
Vitamin C - add to rabbits' feed, increase amount in cavy feed.
Boosts immune system.
Switch feeds - your current feed may be too high energy, low fiber
-(select a feed that doesn't contain corn)
Many Thanks to Kate Kiley and the "DRBA" for permission to reprint this information.
Sources for information:
Charmaine Rhodes, phone interview "Mucoid Enteritis"
Official Guidebook. American Rabbit Breeders Assoc. 1991
Merck Veterinary Manual. 7th edition. Rahway, NJ: Merck & Co. 1991
"A Guide to Infectious Diseases of Guinea Pigs, Gerbils, Hamsters,
and Rabbits." Committee on laboratory Animal Diseases, Institute of
Laboratory Animal Resources, mAR News: Volume XVII, No. 4 1974
Cheeke, Peter, Nephi Patton, & George Templeton. Rabbit Production.
5th ed. Danville, IL: Interstate Publishers, 1982.
Harkness, John & Joseph Wagner, The Biology and Medicine ~ Rabbits and
Rodents. 3rd ed. Philadelphia: Lea & Febiger, 1983.
Ody, Penelope, The Complete Medicinal Her~ London: Dorling Kindersley,
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