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Emergency protocol for diarrhea in infant and juvenile
rabbits, cottontails and hares
copyright Dana Krempels, Ph.D. July 2007
An infant lagomorph presenting with runny stool will often be close to death within hours of onset if the condition is not treated immediately and aggressively. Such animals succumb primarily to dehydration, but inflammation and shock are often contributing factors.
We have used the treatments below to successfully save infant and juvenile lagomorphs who were close
to death from diarrhea. All treatments below should be undertaken only under the advice and supervision
of a licensed veterinarian. Find an experienced rabbit veterinarian at
www.rabbit.org/vets
While the author recognizes that it is best to prescribe medications for known pathogens, she has seen
enough young lagomorphs quickly die from dehydration and other complications of diarrhea to realize
that it is not always possible to identify the causative agent in time. A very sick baby rabbit may have no time to wait for a culture and sensitivity test, or even a fecal exam. For this reason, I recommend that the following emergency treatments be provided as a lifesaving measure. (If a baby rabbit is dying anyway, then these things may give the only chance of survival).
Among the most common causes of diarrhea in young rabbits are Escherichia coli and Eimeria spp.
The treatments below are meant to combat primarily these two agents, and are shown in the order
that we administer them to effect the greatest preventive and palliative care possible.
KEEP THE BABY WARM AND QUIET. A dehydrated baby rabbit can easily become
hypothermic, which is not only life-threatening, but can interfere with the efficacy of the treatments
below. Towel-wrapped warm water bottles or bags are a safe source of heat.
1. To arrest diarrhea quickly (of critical importance):
Imodium (loperamide) at 1 mg/kg Q 4-8 hours (depending on severity). This is available
over the counter at most pharmacies.
2. Hydration:
Subcutaneous Lactated Ringers Solution (10ml/kg total in 2-3 boli over 24 hours.
This can be increased if the diarrhea is severe, to prevent dehydration and keep
electrolytes at normal levels. Consult your veterinarian about the proper dosage.
3. Antibiotics:
a. ciprofloxacin at 20 mg/kg Q 12 hours – PO (oral administration) only. Oral
administration provides immediate contact with intestinal pathogens that injections will
not handle as quickly or directly. Although there may be some concern about potential
fluoroquinolones’ potential interference with normal cartilage development in juvenile
mammals, (1) we have seen no evidence of this in the many lagomorphs we have treated
with these antibiotics and (2) if the choice is a possible cartilage problem or death, the
choice seems clear.
b. metronidazole at 20mg/kg Q 12 hours – PO only; see above.
4. Anticoccidial medication:
1. Ponazuril/toltrazuril (20mg/kg Q 24 hours)
OR
2. Trimethoprim sulfa or Albon (sulfadimethoxine)
(Note: We have found that ponazuril (Marquis by Bayer) is far superior to the sulfa or potentiated sulfa antibiotics for killing coccidia. My own (unpublished) data show
complete parasite eradication (as determined from sequential fecal exams showingprogressively
more shrunken and vacuolated sporocysts) in three days of treatment.
5. Helminthicidal medication:
Panacur (fenbendazole) at 20mg/kg Q 24 hours (Note: albendazole has a higher
radiomimetic toxicity than fenbendazole or oxibendazole, has been associated with acute,
fatal toxicity in rabbits. It is NOT recommended for this species.)
6. Recommended analgesia (pain relief):
1. pediatric simethicone suspension (0.5 – 1.0 cc Q 6-8 hours) for gas relief
2. sulfasalazine (30 - 50 mg suspended in clean water Q 12 hours)
3. barium suspension (0.5-1.0 ml Q 12 hours) (also helps arrest diarrhea)
4. meloxicam (0.1 – 0.3 mg/kg Q 24 hours)
OR
5. Banamine (flunixin meglumine) (not both! Use only one NSAID!)
6. Tramadol (2-6mg/kg Q 12 hours)
(Note: If Banamine is used, famotidine (antacid) is also recommended, but should not be
administered for an hour after other medications have been given.)
7. General immune support and bacteriocidal action:
colostrum (contents of 2 capsules dissolved in about 10cc pasteurized goat milk).
Administer small amounts over several hours, about 1-2 cc at a time, or as much as the
baby will accept.
8. Absorption/adsorption of intestinal toxins:
Questran (cholestyramine resin) - by prescription at most major pharmacies DO NOT
ADMINISTER THIS AGENT FOR AT LEAST ONE HOUR AFTER ALL OTHER ORAL
MEDICATIONS HAVE BEEN GIVEN, AS IT MAY INTERFERE WITH OR INACTIVATE
THE OTHER DRUGS.
Suspend about ¼ teaspoon in 10 ml of water, and allow to hydrate for approximately 10 minutes.
Give 1-2 cc of this suspension every 12 hours, but DO NOT give it within an hour of other
medications, as it may absorb them. DO NOT give any other medications for 4-6 hours after
Questran dose, as Questran will continue to absorb/adsorb substances from the gut lumen,
reducing or eliminating their efficacy.
Updated on 17 October 2009
For more information, please contact:
Dana Krempels, Ph.D.
Department of Biology
University of Miami
Coral Gables, FL 33124
[email protected]
http://www.bio.miami.edu/hare/squirts.pdf
