The caregiver can assist in the process by providing astute and accurate observations about the problem. However, extreme caution is necessary so as not to damage or rupture the cecum. In hand-raised babies, it is essential to provide adult cecotropes to the babies after their eyes are open. In addition you may wish to read the handout Hairballs in Rabbits for a more complete description of gastrointestinal tract function in the rabbit. In a healthy rabbit, the organisms live in the intestinal tract without causing problems. Some rabbits will have a gradual decline in appetite and develop smaller and smaller waste droppings, ending eventually with a complete cessation of food intake and a shutdown (ileus) of the intestinal tract and cecum. I would also have concern about the long-term prognosis for the rabbit. Because cecal impaction is a serious threat, I want to see the rabbit respond to treatment within twenty-four hours. Start mixing the lower energy pellets with the pellets you are currently feeding about ½ and ½ for about one to two weeks to see if the rabbit cleans up the food. Since the condition can also result from other stress factors, a careful review of known stressors will aid the caregiver in making necessary changes to the rabbit’s environment. Cecal contents have to be softened up, and then fiber helps get things moving again. She currently lives near Indianapolis with her husband of more than 20 years and four daughters. Cause of Intermittent Soft Cecotropes (ISC) A common complaint of rabbit owners is having their pet produce normal dry stools along with soft, semi-liquid droppings that stick to the rabbit and to the surroundings. The importance of fiber cannot be emphasized enough: it’s what is moved into the cecum for fermentation and further digestion, forming into the nutrient food called cecotropes. A non-profit rabbit rescue and education organization. Try different types of hay. Pineapple Receiving a neurological signal that the cecotropes are coming, the rabbit turns his attention to the anal area and eats the cecotropes directly (a process called cecotrophy); they are swallowed whole. In addition, cecal motility disorders may be gradual and progressive. Dr. Brown shares additional information: Anytime the pH of the cecum is altered, a rabbit is at risk for enterotoxemia. However, if quality grass hay is unavailable or if a rabbit only nibbles hay or doesn’t seem to like it at all, the rabbit has to be treated differently, as Dr. Brown indicates: Rabbits who do not freely graze on hay can be maintained on grass-hay-based pellets and leafy greens. Dr. Guerrera says that he’s had success emptying the cecum: Fluids are critical to the working of the cecum, so hydration is the key. Like many small animals, rabbits have a finicky digestive system. However, problems are most often caused by previous damage from chronic inappropriate diet and lack of exercise. Radicchio Dr. Bill Guerrera, who treats many rabbits from the Colorado House Rabbit Society, shares his experience: At first, the rabbit may act very normal and is eating and drinking. That means that subcutaneous fluids are not absorbed quickly enough to do much good. (Meloxicam works well in well-hydrated rabbits.). Collard greens Dock Hunched, reluctant to move, perhaps teeth grinding/chattering, Hunched, reluctant to move, perhaps teeth grinding/chattering, Initially may be normal but likely to drop as condition worsens, Lumps in cecum may be felt with gentle palpation (caution: cecum easily bruised/ruptured; rabbit-savvy veterinarian should make this determination), Enlarged, distended (can be very large) due to gas from GI shutdown. This dumping usually results in relatively formless, “pudding like” cecotropes, often with foul smell. For additional information, reference “Liver (Hepatic) Disease in Rabbits,” posted on this website. The Benefit of Cecotropes. Nuts Home care of rabbits with cecal motility disorder. However, the most common cause of cecal motility disorders is food, especially a diet too rich in carbohydrates – including starchy vegetables, fruits, and grains – and lacking in fiber. In addition, many clients neglect to mention that they feed treat foods, such as crackers and cookies or commercial rabbit treats, because they are fed in small amounts and owners don’t feel that these items are significant. Another presented with what is commonly referred to as “cow pile syndrome.” In both cases, the right diet returned them to a level of health that allowed them to live the remainder of their lives as normal rabbits. Compounding the problem is the lack of fiber; the rabbit is not eating enough grass hay, which means that the cecum does not empty as it should. Part 1: Improving the Diet with Dietary Restrictions. Pellets, carrots and fruit are the usual culprits. In any case, they usually do this when you're not watching (quite polite of them). If this is not possible, any of the hays mentioned may be used. severe arthritis or obesity). Few caregivers ever see the cecotropes, as it looks like the rabbit is simply grooming his anal area. This is when Clostridium spp. Mustard greens A rabbit usually produces cecotropes at a characteristic time of the day, which may vary from rabbit to rabbit. These toxins are absorbed into the bloodstream and affect many organs in the rabbit’s body, often resulting in death in a very short time. Each individual rabbit usually produces cecotropes at a characteristic time of the day, which may vary from rabbit to rabbit. Go ahead and put grass hay in the cage and particularly the litter box area (no, they will not eat soiled hay so don’t worry, but many rabbits like to eat while they use the bathroom and this can help get them to eat hay). In addition, the drug can destroy the stomach lining and damage the kidneys, especially in a dehydrated rabbit. This may be due to a starch or protein content in the pellet that is still too high for that individual rabbit. Remember that from here on out, your rabbit should ALWAYS have grass hay available as the basis of a good diet. These foods provide a variety of nutrients as well as moisture. When researching complementary treatments, be aware of training and qualification requirements and give careful consideration to the health, nature, and needs of your rabbit. Prevention of cecal disorders. As noted early in this article, grass hay plays a pivotal role in moving food through a rabbit’s digestive system, and so an unlimited amount of fresh grass-hay is recommended on a daily basis. Angela Lennox, DVM, Dipl ABVP (Avian) is a 1989 graduate of Purdue University, has practiced exotic animal medicine exclusively since 1991, and is the owner of Avian & Exotic Animal Clinic of Indianapolis (Indiana). Iota toxins are absorbed into the bloodstream and produce a toxic condition commonly known as enterotoxemia. One of them, elderly and very ill, presented with a large soft mass that looked as though it had been dispensed from a soft-serve machine, complete with swirl on the top. Rabbit poops are in the form of small balls that are uniform in appearance, dry, and hard to touch. Severe metabolic disease (such as kidney or liver disease). When your rabbit returns to normal stool production and after the introduction of green foods you can try feeding small amounts of fruits and other vegetables as treats. For most veterinarians, surgery into the cecum is the last resort; thus, it is carried out primarily on critically ill patients. He has worked at the Denver Zoo, has presented various veterinary topics to local groups, and is a published author of several animal field studies. The return to normal stools may take two weeks to three months, depending on the severity of the disease in your pet. Affected rabbits are often still bright, alert and eating well. Signs of sick rabbit Digestive Issues. In mucoid enteropathy there is production of clear mucous stools followed by gradual wasting, which if left untreated will lead to death.Clostridium spp. Dr. Stahl mentioned that high-starch or refined carbohydrate foods (e.g., crackers, cereals, bananas) are highly fermentable. Other causes of cecal disorders (e.g., ingestion of foreign material, antibiotics) are also mentioned, the knowledge about which will help caregivers take proactive steps to protect their rabbits. Generally the babies will eat cecotropes directly from the mother in some cases harvesting cecotropes from a healthy bunny and including them in feedings is the only route (or syringe/force feeding). Maintaining the balance of flora in the cecum is critically important to a rabbit’s health. Proper nutrition is a must for these rabbits to decrease the probability of recurrence. The cecum then “dumps” contents randomly instead of producing nicely formed cecotropes. This diet is much too high in carbohydrates and often low in indigestible fiber. The mucous covering of the cecotropes makes them sticky and hard to remove. Dandelion greens (and flower) and E. coli bacteria are normally found in small amounts in the cecum and do not cause a problem. (Please read our handout Care of Rabbits for details on this diet.) NOTE: How do you know your rabbit is eating enough hay? Enterotoxemia, a life-threatening disease, results from toxins produced by specific bacteria that overgrow in a rabbit’s GI tract. Refined sugar Raspberries During a physical examination, many rabbits with ISS are significantly overweight with obvious fecal staining of the hindquarters or feet. There is no specific test to diagnose the cause of ISC. Acute dehydration may lead to additional problems. This condition can be fatal in 24 to 48 hours, particularly in recently weaned rabbits. Vitamin C should also be discontinued once the cecotropes return to normal. Cause of Intermittent Soft Cecotropes (ISC) A common complaint of rabbit owners is having their pet produce normal dry stools along with soft, semi-liquid droppings that stick to the rabbit and to the surroundings. I give a small handful of SS to my buns everyday along with the greens and hay. Administration by IV (intravenous, by vein) or IO (intraosseous, into the bone marrow, e.g., of the femur) gets fluids into a severely dehydrated or otherwise critically ill rabbit. Antibiotics can also put a rabbit at high risk, especially oral administration of those contraindicated for them, such as clindamycin, erythromycin, penicillins, or cephalosporins. This negative effect on prostaglandins, a group of hormone-like substances, is an important consideration. Dr. Tomáš Chlebeček, a companion animal veterinarian who also has a special interest in rabbits, adds this: In a well-functioning digestive system, simple sugars and starches are removed by the small intestine before the food reaches the cecum. A rabbit with enterotoxemia may exhibit signs of: Signs such as diarrhea, hypothermia, and shock are very serious. Three general stages of cecal motility disorders are discussed in this section: abnormally soft cecotropes, cecal hypomotility (slowdown), and cecal impaction (stasis). You will see the normal round, dry waste droppings and only the occasional formed cecotrope in the litter box or cage floor. They are nutrient-packed dietary items essential to your rabbit's good health. Too many treats or too little hay (fiber) will result in an excess of cecotrope. Mucoid enteropathy: excessive mucus. I also provide guidelines for a diet that is high in fiber and water content (Oxbow Critical Care™ is a popular choice). Home Care: The Rabbit with Abnormally Soft Cecotropes. We will refer to this condition as intermittent soft cecotropes (ISC) in this article. Decreased appetite; may exhibit pickiness (e.g., may eat leafy greens but not pellets). ISC is most often caused by an inappropriate diet and in these cases it is not difficult to treat. In addition, having a furred companion aids rabbits when they are ill and helps reduce boredom in healthy rabbits, reducing the desire to chew (and potentially reducing ingestion of harmful substances). An analgesic for pain will also be required. The maximum amount of a treat food is one tablespoon per two pounds body weight of any combination of the following: Apples Many brands of rabbit feed contain seeds, corn and other foods that are too high in calories to be the basis for a healthy rabbit’s diet. Some owners observe that the soft droppings occur only at certain times of the day or night. Other, more uncommon causes of ISS include: partial intestinal obstruction particularly in the area of the junction of the cecum with the small and large intestine, internal abscesses, neoplasia (cancer) and other systemic disease that causes changes in the cecum, such as kidney or liver disease. Signs to watch for include those listed above for obviously soft cecotropes as well as: Another sign may be lumps in the cecum; however, a rabbit-knowledgeable veterinarian should make this determination. The soft stools are actually malformed cecotropes that should have been eaten directly from the anus by the rabbit. The rabbit is unable to eat them, and they may end up on the floor or pasted to the rabbit’s rear end. The treatment of ISC is based first on a serious diet restriction to grass hay, which acts to return the GI tract to normal, and secondly a gradual reintroduction of additional foods after normal cecotropes are produced for at least a week. Additional writings have covered topics such as aging and the environment. The primary author has a special interest in cecal function because of her rescued rabbits. Bill Guerrera, DVM has always been interested in avian/exotic animal care and received his degree from Colorado State University. In a nutshell, the problem is not the production of soft stool (the waste material that makes up the round, dry droppings) but that the cecotropes, the nutrient-rich droppings produced by the cecum, are abnormally liquid and cannot be eaten. In addition, toxins such as heavy metal or inappropriate antibiotics can cause cecal flora changes. Vitamin supplementation should be short term and need not continue once the pet is on a healthy diet and is producing normal cecotropes. It must feel good to shed the excess weight and to have normal GI function again! HOME CARE OF A RABBIT WITH CECAL MOTILITY DISORDER. Seeds and nuts add a lot of extra calories and starches and can be part of the problem. Treatment for the early stage of cecal hypomotility (slowdown) leading to impaction is much the same as for ileus, the cessation of GI tract movement. Rabbits should be eating their cecotropes, but if they are unformed or there are too many, they will not eat them. Dr. Lennox offers additional explanation: A rabbit who doesn’t seem to do well with green leafy vegetables may have a genetic intolerance. During this pellet conversion it is important to STOP ALL TREAT FOODS! Utilizing the principles of behavior and training, she is teaching ways for people to live in harmony with their companion animals. Used with permission. Many of our clients comment that after the treatment for ISS their rabbit experienced a new “lease on life” and was as active as a young bunny again! This may happen if the rabbit is fed too many pellets, treats or rich greens in his diet or if the rabbit is unable to reach down and consume them (ex. After all, when you remove the pellets and treats from the diet, it is like taking chocolate away from a chocoholic! – Marie Mead. The most important part of the treatment of uncomplicated ISC is to feed grass hay to your pet. If a rabbit is not treated early, the caregiver will suddenly notice changes in the rabbit’s behavior and responsiveness. Fiber is second in importance. Essentially, the disease is a poisoning of a rabbit’s system, and it is caused by the overgrowth of pathogenic bacteria, notably Clostridium spiroforme and E. coli. Rabbits do not become underweight on this diet so you do not need to monitor the weight. Unlike many other species, in which liquid is removed from the contents of the large intestine, the rabbit actually secretes fluid into the upper part of the large intestine to allow sorting of the two fibers. Mango If the condition of ISC cannot be resolved with dietary treatment then your veterinarian will need to perform further diagnostic investigation to determine if there is additional disease. Once the pet starts eating the hay gradually reduce the amount of pellets to zero over the next week and continue with feeding only grass hay as described in the section above until the soft stools are gone for a week. It is only when their populations grow abnormally that enterotoxemia occurs. Also, make sure to purchase Timothy-based pellets. HOW THE CECUM FUNCTIONS IN A HEALTHY RABBIT. Determining whether a rabbit is suffering from a condition that affects the cecum or colon requires the skill of an experienced rabbit veterinarian. Therefore, the cause of death may not be obvious. In addition, our domestic rabbits retain the prey flight-response of their forebears and the stress of real or perceived danger can adversely affect digestion, cecotrope production, and gut motility. A rabbit’s diet is ideally composed of high-fiber, low-energy foods. Prokinetics (motility drugs) may be considered, though scientific trials are lacking; opinions on which drugs are most effective vary. by Marie Mead with Drs. However, under certain conditions the microorganisms proliferate, producing rapid onset of severe illness. my rabbit is not eating his cecotropes We have taken our lop eared castrated male rabbit, mischief, to the vet for a check up, as he doesn't eat his cecotropes. Caregivers can become knowledgeable about drugs considered safe for rabbits by perusing articles on this website, including where to find additional medical information. Caregivers may want to consider supplementing their rabbit’s care with alternative therapies, some of which are addressed in separate articles posted on this website. The benefits of a healthy diet are not only getting rid of the ISC, but also improving your rabbit’s dental, GI and mental health. These high-starch foods – which are also highly fermentable – are quickly broken down by the cecal bacteria, resulting in cecal gas, possible overgrowth of dangerous bacteria, and an imbalance in the delicate cecal flora. For Rabbits not Currently Eating Grass Hay. TREATMENT AND PROGNOSIS FOR RECOVERY FROM CECAL MOTILITY DISORDER, Treatment and Prognosis for Recovery: Abnormally Soft Cecotropes. Pea pods (flat, NO peas) The indigestible fiber stimulates the movement and mixing of the intestinal contents; therefore, fiber must be ingested regularly to keep the digestive system working as it should. Peas Despite these soft droppings, however, there is evidence of normal, dry, round stools being produced daily as well. This is how rabbits get all the nutrients they can from their diets. The condition can last for months or even years. Some folk believe in an egg cup of pellets but Im afraid i dont.. http://www.youtube.com/watch?v=NRUtPKhCg8s It does, however, require a commitment by you, the caregiver, to provide a healthy diet for your pet for the rest of the pet’s life. Now that your rabbit is eating healthy pellets reduce the amount of pellets to 1/4 cup per day for each 5 pounds of body weight. Several hours after eating, contractions of the cecum and colon move the cecotropes out toward the anus. May exhibit mild to moderate pain (e.g., less active), Severe abdominal pain due to gas accumulation. Image Source Similar to humans, rabbits may be checked for any medical condition or rule out any illness by evaluating their poop. She has made a home with special-needs rabbits and other animals, all of them rescues. This article covers the following topics: How the cecum functions in a healthy rabbit, including indigestible fiber, digestible fiber, and cecotropes. If the rabbit won’t eat large amounts of hay and holds out instead for the greens, Dr. Lennox advises caregivers to reduce the quantity of greens. Before starting the discussion of cecal disorders, it should be noted that caregivers can help protect their rabbits against the diseases, which can be life-threatening. Not only is the condition messy, but there is a concern that the rabbit may be missing vital nutrition if he cannot eat the cecotropes. Current research indicates that return to health hinges on fluids and fiber. Affected rabbits are often still bright, alert and eating well. In addition, rabbits are used to eating a wide variety of textures and tastes and it is much healthier mentally to have a variety of foods in their daily lives. Cecotropes are produced in the cecum which is a part of the rabbits digestive system. That’s right, ALL treat foods. Monitor the waste droppings as described above to make sure your pet is eating sufficient amounts of hay. A rabbit who suffers from cecal impaction generally will not be returned home until he is no longer in critical condition. Caregivers may wish to read “Liver (Hepatic) Disease in Rabbits,” which discusses the importance of cecotropes and a healthy liver. Behaviors signaling pain (see below), Critically ill: depressed, lethargic. Date Reviewed/Revised: 12/07/2009, Copyright 2009 – 2012 by Susan Brown, DVM. You may also find cecotropes caked to your rabbit’s bottom. To help move contents out of the cecum, very gentle massage to the belly may be beneficial, depending on the condition. “Doughy” contents in cecum felt with gentle palpation (caution: cecum easily bruised/ruptured; rabbit-savvy veterinarian should make this determination), Distended abdomen (cecum full of fluid and gas), Inflammation around anal area due to accumulation of cecotropes, In early stages behavior may be deceivingly normal, “Water sloshing” sounds from liquid-filled cecum; soiled hindquarters, Irregular cecotrope production (in number and timing), Occasional mucus from the anus (without the usual accompanying cecotropes), Inflammation around anal area (due to accumulation of cecotropes), Decline of normal appetite and water intake, Pain (e.g., hunched appearance, inability to stretch out; unmoving; teeth grinding). Borage Pear This can lead to a bacterial imbalance in their gut, though the rabbit may appear healthy. Dr. Brown offers this: My experience with several hundred rabbits who have had pudding-like cecotropes – but were otherwise active, alert, and medically normal – is that feeding a diet of only grass (not alfalfa) hay usually turns them around in a week. If not given enough fresh hay, may chew on paper, wallboard, etc. True diarrhea in a rabbit is a sign of a serious and often fatal condition. It is estimated that B12is synthesized 100x the daily requirement. He has authored numerous book chapters and articles on avian and exotic animal medicine and surgery. Dr. Angela Lennox, who has practiced exotic animal medicine exclusively for more than twenty years and is past president of the Association of Exotic Mammal Veterinarians, concurs: Hay drives the gastrointestinal tract. However, if the rabbit is not eating hay or not eating it in the quantity needed, then a gradual reduction in the quantity of processed pellets is necessary to prevent hepatic lipidosis. A healthy diet for a house rabbit consists of unlimited grass hay as its primary component with additional green foods and limited high fiber/low energy pellets. Baby greens Papaya As already noted, diet plays a critical role in the proper functioning of the cecum, and veterinary guidelines can help return a rabbit to health. Below we will take a closer look at each one of them. Corn Once the rabbit stops producing the obvious soft cecotropes for a full week – meaning his body is now producing cecotropes normally – I gradually add in one leafy green food every three days until the rabbit is eating a nice variety. Cecotropes are an important part of a healthy rabbit diet and are usually eaten directly from the anus as they are produced. She is coauthor of Self-Assessment Color Review of Small Mammals and author of numerous lay and professional writings on rabbit medicine and care; she has also lectured extensively in the United States and Europe. A rabbit may produce cecotropes at various times during the day, and this periodicity may vary from rabbit to rabbit. They are nutrient-packed dietary items important to your buddy rabbit’s good health. She is involved in exotic animal care at rescue organizations and shelters. Excess amount of cecotrope-Too many cecotropes are a sign of an unhealthy diet. The dose is 100 mg per 5 pounds of body weight one to two times daily. In ISC the production of waste droppings is unaffected and they are formed normally and appear in the toilet area mixed with the soft stools. He monitors the rabbit very closely and asks the client to regularly weigh the bunny. Carrots Rapid fermentation in the cecum upsets the pH, creating an environment more hospitable to dangerous bacteria. It may be that a rabbit reacts with loss of appetite and subsequent slowdown of gut motility, which leads to the life-threatening shutdown of both the intestinal tract and the cecum. Young rabbits, especially those newly weaned, are especially susceptible to the disease when they are fed a high-starch diet because their digestive system does not yet have the normal amounts of microbial flora, as does that of a healthy adult rabbit. The rabbit is producing too many cecotropes Most of the time when you notice a lot of cecotropes in your rabbit’s litter box or around the room, it’s because your rabbit is producing too many cecotropes so they don’t want to eat them all. We need to add these foods back in carefully though, because your bunny has a history of GI unbalance and we don’t want to return to that state. Brussels sprouts A rabbit may produce cecotropes at different times during the day, and this periodicity might differ from bunny to rabbit. At the end of the article is a chart that sums up the various disorders and signs. 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