Gut Stasis AND Kidney Infection

oscarMeet Oscar
Oscar was a patient of mine who came in because he had some mild abnormalities – soft droppings, decreased interest in hay and some possible weight loss.  His owner had started Critical Care before bringing him in.  On exam he was definitely thin and his abdomen felt soft and doughy.

Diagnostics/Treatment
We took an xray of Oscar and found a ton of gas in the intestines!  Definitely gut stasis.  His blood work was normal and we started Oscar on various medications.  When he returned for his followup appointment, he wasn’t back to normal – more weight loss, still not eating well…Xrays showed improvements but not what we wanted to see so back onto treatments he went.

But Wait, There’s More
We saw Oscar for other issues 2 months later – but the xray still showed gas!  Since Oscar’s blood work was even better than previously we moved on to the next step.

PyelonephritisUltrasound
We found Oscar’s problem – both kidneys showed changes consistent with pyelonephritis (kidney infection).  We put Oscar on 6 weeks of heavy duty antibiotics and his kidneys improved.  There were no further episodes of weight loss or appetite changes.

How Can That Be?
Most of the time we aren’t able to identify the cause of gut stasis in rabbits and rodents like Oscar.  Pain, fear and stress are common causes that may be already gone by the time we see our patients.  Trying to figure out why the gut is slowing down is why we want to run tests like xrays and blood work.  Basically – what is going on inside and is there anything else we need to worry about…

Some diseases, like pyelonephritis, are hidden.  They don’t show up on xrays and they don’t make changes in the blood work until they’ve caused serious damage to organs.  That’s where advanced imaging such as ultrasounds, CT scans and even MRIs can make all the difference.

But, just like with Oscar, we don’t start there!  Oscar didn’t get better as fast as he should have and he had the gut stasis return.  At that point we could tell something wasn’t right – we were able to investigate further and find his hidden problem.

Rabbit and Rodent – Gut Stasis

Huh?  Gut Stasis?Guinea Pig
If you’re new to rabbits, guinea pigs and chinchillas you may not be familiar with a common problem – gut stasis.  This is a condition, from mild to severe, where normal gut movements start to slow down or stop entirely.  Without intervention your pet can die from this problem.

Let’s Back Up to Some Anatomy
rabbit giRabbits and some rodents (like guinea pigs and chinchillas) are hind gut fermenters.  Anyone familiar with horses knows what this means – they have a ton of large intestines and do most of their food processing there.  They do this through a large number of bacteria, hence fermentation.

Since it’s really difficult to digest grass or hay, these guys have a cecum and colon that actually separates large indigestible fibers from small fermentable particles and fluids.  The gut actually has two phases and switches from production of normal “hard feces” to cecotrophs of “soft feces” periodically throughout the day.  The cecotrophs are small, dark, soft feces that are packaged in a protective mucus coating.  You shouldn’t really see these as they get eaten as they are produced.  The mucus helps protect the cecotroph as it passes through the stomach in order to be re-digested.

What Causes the Gut to Slow Down?
Oh boy…here you go:

  • Pain
  • Diet (changes, not enough fiber, too many carbohydrates or proteins)
  • Stress (fright, fear, pain, poor home care, thunderstorms, the construction down the street…)
  • Husbandry Errors (overcrowding, lack of cleanliness…)
  • Other Illness (causing pain or stress)
  • Dental Disease
  • Diseases that Interfere with Eating
  • Medications that Disrupt the Gut
  • Certain Antibiotics (that disrupt the normal gut bacteria)

The Downward Spiral
So, once it starts it gets worse.  Slowed gut motility can lead to the build up of material in the stomach (trichobeozars), gas build up in the GI tract (resulting in pain), stomach ulcers, disruption of normal gut bacteria resulting in overgrowth, fatty liver disease … all things that contribute to making the problem worse.  As the food stays within the intestines, the body continues to remove fluids from the digesta.  Sometimes this can create a wad that is hard to get moving again or actually results in a fecal impaction.

What About Obstructions?
We used to think the trichobeozar in the stomach was the cause of their problems and needed to be removed – not anymore!  Experiments in the early ’80s proved the trichobeozar was the result of gut stasis and not the cause.  We don’t need to remove it unless there is a true foreign body present.  But they can get true obstructions – these are emergencies.  Your rabbit will be very sick and getting more sick very quickly.  Low body temperature is serious for both obstructions and more standard gut stasis.

What Can I Do?
Hind gut fermenters should never have an empty stomach – if there is any change in appetite or droppings start giving Critical Care until you can get to a vet.  The more abnormal your pet, the quicker you should get help.

What Does the Vet Do?
We may want to run some tests to better Guinea pig critical care feedingidentify your pet’s disease – radiographs and blood work can tell us a lot.  High blood glucose levels are actually more common in cases of obstruction.  The good news is that most of these animals can be managed with medical treatment such as Critical Care and fluids.  We will also consider if anti-gas medications, antibiotics or even medicines that promote motility should be used.

Can I Prevent Gut Stasis?
Yes…and no.  You can reduce the risks by feeding your pet a good quality grass hay with some leafy greens and a small amount of pellets.  Alfalfa hay has too much protein for regular bunnies, guinea pigs or chinchillas.  Lots of pellets means fewer long fibers that are so important to maintain normal gut movements.  A good healthy home environment can reduce stress as well.  Annual checkups with your vet are the best way to detect problems early and make sure problems you might not see (like dental disease) are identified as soon as possible.  Always brush your pet when they are shedding – if you have a long haired variety you’ll already be brushing very, very frequently just to keep the hair clean and prevent matts from forming.

The Itchy Piggy

Ectoparasites (external parasites)

There are several types of mites and lice that can infest a guinea pig.  The three most common are Trixacaus caviae (a scabies mite), Chirodiscoides caviae (the guinea pig fur mite), Gliricola porcelli (slender guinea pig louse) and the oval guinea pig louse (Gyropus ovalis).

Less Common Parasites

Both lice and the fur mite are less common in Guinea Pigs.  Lice feed on the hair shaft of the guinea pig and cause alopecia (fur loss), a rough hair coat and mild puritis (itchiness).  These symptoms are usually only seen in cases with heavy infestations or some type of underlying immunosuppression.

Lice and their eggs (nits) can been seen in the fur of the guinea pig.  Here is a video (rather shakey I’m sorry to say) of lice moving about in the fur of a guinea pig.

Scabies – The Mite of Itchiness

Scabies is a term that most commonly refers to Sarcoptes scabei.  Guinea pigs can get that mite, but do so rarely.  The most common problem-causing mite for guinea pigs is Trixacaus caviae.  This mite looks very similar to the other members of the scabies family.  It is a burrowing mite that causes alopecia, crusting and an intense puritis.  The itching can be so bad that a guinea pig may scratch herself so much she causes trauma and secondary bacterial infections.  Anorexia with severe weight loss and increased vocalizations may occur.  In some cases just touching an infected pig will induce a seizure.

The areas most commonly affected are between the shoulders, along the back and the rump area.  But any part of the body may be affected.  Here is a severely alopecic guinea pig and some images of the mites.

Mites in a Guinea Pig

This Guinea Pig has fur loss and thickening of the skin due to mites

Guinea Pig Mite

This mite is most likely Trixacaus caviae

Treatment for all these parasites involves injectable ivermectin or topical selamectin. The life cycle of the mites/lice involves several stages and the medication can only kill one of the stages so treatment is usually repeated 2 or 3 times.

But My Guinea Pig Has Been Fine for Years…

Guinea pigs can carry mites in their skin – and not show any signs.  Sometimes, when stressed such as with old age or with disease, dermatitis (skin infection) may develop.  Vitamin C deficiency is a common cause of stress since (like humans) guinea pigs must get Vit C from their food.  It’s also possible they’ve had one of the less noticeable parasites (like the fur mite) that becomes a problem once other disease is present.

My Guinea Pig Keeps Getting Mites…

Do you have another guinea pig? -as you should!

Guinea pigs are very social and should live in groups.  Often the unaffected buddy is acting as a little Typhoid Mary and re-infecting the sensitive guinea pig.

Make sure to treat all “in contact” pigs!

Life Gets Better with the Right Meds

Here is an image of that itchy pig from before.  This is only 2 weeks into treatment – look how much better he looks.

Guinea Pig, mid mite-treatment

This Guinea Pig is only 2 weeks into treatment – look at the improvement!

What About Me?

Can you get mites and lice from your guinea pig?  Yes and no…most of the little critters prefer the piggies so we don’t have to worry. The various mites in the sarcoptes family can be hard to ID.  It appears that the guinea pig version (Trixacaus caviae) doesn’t like humans but some of the others do.

In general, these mites may bite people and cause itching but they don’t seem to infest people.  Still, if you have skin issues it would be a good idea to take it up with your dermatologist.  Maybe you have an immune suppression issue to be concerned about…