Rabbit Medicine and Surgery Q&A 19

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A colleague has been treating an eight-month-old rabbit with a respiratory tract infection with a long-acting s/c injection of amoxycillin-clavulanate. Two days later the rabbit has developed acute diarrhoea and is presented in a collapsed state.

Question	Answer		Article
What is the most likely diagnosis?	Antibiotic-associated diarrhoea and enterotoxaemia. In rabbits, antibiotics, especially ampicillin, amoxycillin and amoxycillin-clavulanate, can alter the intestinal flora, leading to bacterial overgrowth of pathogenic species such as Clostridia spp. Amoxycillin-clavulanate is a high-risk antibiotic when given via any route and is contraindicated in rabbits.		Link to Article
What is the prognosis?	The prognosis in this case is extremely poor. Clostridia spp. multiply, resulting in enterotoxaemia, dehydration, electrolyte loss and acute death. Aggressive treatment is necessary if this rabbit is to survive.		Link to Article
What are the treatment options?	Treatment is often unsuccessful. Intravenous fluid therapy should be commenced with supportive care. The rabbit should be kept warm and the body temperature monitored. Cholestyramine is an ion exchange resin that absorbs enterotoxins and may be useful if given early on. Probiotics are of questionable use; however, they are unlikely to cause any harm and may be of some benefit. Metronidazole may be administered to act against anaerobic Clostridia spp. Analgesics may be indicated. If GI stasis has occurred, motility modifiers such as metoclopramide should be administered.		Link to Article