Lapis ISSN 2398-2969

Diarrhea: overview

Synonym(s): clagging, scour, enteritis

Contributor(s): Lesa Thompson, Jenna Richardson, Sarah Pellett

Introduction

  • Cause: numerous, eg diet-related (sudden diet change, inappropriate diet, low fiber-high carbohydrate), drug induced, bacterial dysbiosis/enterotoxemia, viral infection, parasitic infection, systemic illness, neoplasia and metabolic disorders.
  • Signs: unformed feces varying in consistency from 'cowpat' to mucoid to liquid. True diarrhea occurs when no hard fecal pellets are produced. Large volumes of soft or liquid feces are passed with little or no voluntary control.
  • Diagnosis: clinical signs, history of drug therapy/diet change/stressor, fecal parasitology, fecal culture, fecal microscopy, blood biochemistry, electrolytes, hematology and abdominal radiography.
  • Treatment: specific to the cause, supportive therapy including fluid therapy to correct dehydration and electrolyte imbalances, supportive feeding and analgesia. In some cases, gut protectants/stimulants, toxin-binders and antibiotics are also indicated.
  • Prognosis: good in mild cases, guarded to poor in severe cases.

Print off the Owner factsheet on Diarrhoea to give to your clients.

Presenting signs

  • Dependent on severity of diarrhea:
    • Presence of diarrhea in enclosure or accumulated around anus (important to differentiate from uneaten cecotrophs).
    • Anorexia.
    • Weight loss.
    • Lethargy.
    • Abdominal distension/discomfort.
    • Hunched posture.
    • Dehydration.
    • Hypothermia.
    • Collapse or acute death.

Acute presentation

  • Dehydration.
  • Depression.
  • Tachypnea.
  • Signs of hypovolemic shock (weak pulses, pale mucous membranes, hypothermia).
  • Death.

Geographic incidence

  • Worldwide.

Age predisposition

  • Diarrhea is more common in young rabbits, especially around the time of weaning. It is less common in adults.
  • Viral-related diarrhea, coccidia, E. coli and Clostridia spp are more severe in young rabbits.
  • Prognosis is poorer in kits and younger animals.
  • Young rabbits are susceptible to enteritis because;
    • Weaning is a stressful period and after weaning rabbits are likely to be transported and mixed with other rabbits.
    • Exposure to pathogens when the caecal microflora is not established.
    • Suckling rabbits have a high stomach pH (5-6.5) and have protection against infection from an antimicrobial fatty-acid product, referred to as ‘milk oil’, and also passive maternal antibody. Hand reared rabbit kits fed on milk substitutes do not have this protection and severe enteritis is a common.
    • As rabbits age from 10 days onwards, healthy bacteria from ingested maternal cecotrophs pass through the gastrointestinal tract and establish the commensal hindgut flora. By day 15 onwards solid food is ingested and by day 30 milk ingestion is minimal. The production of milk oil during this weaning process diminishes, increasing the risk of the young rabbit succumbing to disease during this period of time.
    • The stomach pH at this time reduces to that of an adult rabbit of pH 1-2.

Sex predisposition

  • No specific gender predilection.

Breed predisposition

  • No information found on breed predispositions.

Public health considerations

  • The bacterial condition salmonella Salmonellosis is a zoonotic risk.
  • Strict hygiene should be observed when handling infected individuals or those suspected of carrying the disease.

Cost considerations

  • Potentially high losses in a commercial environment.
  • Hospitalization and supportive therapy costs can be significant in individual pet animals.

Special risks, eg anesthetic

  • Anesthesia should not be considered until the patient is stabilized and fluid losses and electrolyte imbalances have been corrected.
  • Affected patients are at a greater anesthetic risk.

Rabbits with fecal staining around the perineum are at greater risk of myiasis Fly strike developing. The area should be cleaned and checked twice daily. A topical fly repellent could be used as an added precaution, but care is advised (cannot apply cyromazine (Rearguard, Elanco UK AH Limited) to broken skin).

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Sequelae

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Summa N M & Brandao J (2017) Evidence based advances in rabbit medicine. Vet Clin Exot Anim 20 (3), 749-771 PubMed.
  • Benato L, Hastie P, O'Shaughnessy P et al (2014) Effects of probiotic Enterococcus faecium and Saccharomyces cerevisiae on the faecal microflora of pet rabbits. J Small Anim Pract 55 (9), 442-446 PubMed.
  • Nicodemus N, Carabano R, Garcia J & De Blas J C (2004) Performance response of doe rabbits to toyocerin (Bacillus cereus var. Toyoi) supplementation. World Rabbit Science 12, 109-118.
  • Linaje R, Coloma MD, Perez-Martinez G & Zuniga M (2004) Characterisation of faecal enterococci from rabbits for the selection of probiotic strains. J Appl Microbiol 96 (4), 761-771 PubMed.
  • Davies R R & Davies J A (2003) Rabbit gastrointestinal physiology. Vet Clin Exot Anim 6 (1), 139-153 PubMed.
  • Bellier R & Gidenne T (1996) Consequences of reduced fibre intake on digestion, rate of passage and caecal microbial activity in the young rabbit. Br Vet J 75 (3), 353-363 PubMed.
  • Maertens L, Van Renterghem R & De Groote G (1994) Effects of dietary inclusion of paciflor (Bacillus cip 5832) on the milk composition and performances of does and onncaecal and growth parameters of their weanlings. World Rabbit Sci 2, 67-73.
  • Percy D H, Muckle A, Hampson R J & Brash M L (1993) The enteritis complex in domestic rabbits: a field study. Can Vet J 34 (2), 95-102 PubMed.
  • Cheeke P R & Patton N M (1980) Carbohydrate overload of the hindgut; a probable cause of enteritis. J Appl Rabbit Res 3, 20-23.

Other sources of information

  • Delaney M A, Treutling P M & Rothenburger J L (2018) Lagomorpha. In: Pathology of Wildlife and Zoo Animals. Eds: Terio K A, McAloose D & St. Leger J. Elsevier, UK. pp 481-497.
  • Prebble J (2014) Nutrition and Feeding. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 27-35.
  • Harcourt-Brown F (2014) Digestive System Disease. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 168-190.
  • Carpenter J W (2012) Exotic Animal Formulary. 4th edn. Elsevier, Saunders, USA.
  • Benato L, Hastie P, Shaw D, Murray J & Meredith A (2012) The Semi-Quantitative Effect of Probiotic Enterococcus faecium NCIMB 30183 and Saccharomyces cerevisiae NCYC Sc47 on the Faecal Microflora of Healthy Adult Rabbits (Oryctolagus cuniculus) using Real Time PCR. In: Proc BSAVA Congress. pp 460. 
  • Oglesbee (2011) Diarrhea, Chronic. In: Blackwell’s Five-Minute Veterinary Consult: Small Mammal. 2nd edn. Wiley-Blackwell, UK. pp 391-393.
  • Oglesbee (2011) Diarrhea, Acute. In: Blackwell’s Five-Minute Veterinary Consult: Small Mammal. 2nd edn. Wiley-Blackwell, UK. pp 388-390.
  • Meredith A & Flecknell P (2006) BSAVA Manual of Rabbit Medicine and Surgery. 2nd edn. BSAVA, UK.
  • Harcourt-Brown F M (2002) Textbook of Rabbit Medicine. Butterworth Heinemann, UK.


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