Bunny has been having soft stools for 5 days now. When it first happened, I thought it was the usual thing where I’d have to adjust the Lactulose dosage, which I did. Normally, his soft stool problem is self-limiting and it will resolve itself after a few days. But it has not.
Also, about a week ago, Bunny’s appetite decreased significantly. I gave him Mirtazapine followed by deworming him and that seem to have solved the inappetence. However, he is really choosy nowadays so it’s not easy feeding Bunny. These few days, he wants renal kibble. And because of his recent significant weight loss, I have resorted to free-flowing snack (kibble) for him (that means for Cow Mau and Indy too – these two are really happy about it, though!).
Bunny only weighed 3.6kg this morning and this weight loss is alarming. So I took him to the vet today and I was prepared that it would be bad news on his kidneys. After all, Bunny has been a CKD patient for 3 years now. We know he is deteriorating.
At one time, his urine was totally colourless, but somehow, miraculously, he was able to concentrate his urine again after that. We don’t know what happened. Even the vet was surprised.
I was so sure this time that it’s Bunny’s kidney deteriorating. The loss of muscle mass and weight loss must be due to protein loss, I thought. So I had actually wanted to spare Bunny from another trip and just go to the vet’s to get the medicine for proteinurea. But the vet wanted to do a urinalysis again and also check Bunny’s heart, so I said I would try and collect Bunny’s urine before the appointment.
I waited with Bunny until he got up from his nap, then I took him to the grass where I know he will be likely to urinate. He did, and I was ready with the container. The yellow colour of the urine gave me hope.
So off we went to the vet’s, Bunny and me.
The urinalysis showed that there is NO protein loss (no proteinurea). Bunny’s SG is 1.026 which is even a slight improvement from the last time. So that’s fine. His kidneys are still able to concentrate his urine. That’s a relief.
I told the vet about the soft stools and she said that it is likely the diarrhoea can cause weight loss as well. Now, this was something that had no occurred to me at all. I thought the diarrhoea was self-limiting and would go away on its own after I adjusted the Lactulose. I was wrong.
I’m so glad I took Bunny to the vet’s for a proper diagnosis!
Reminder to self: Never EVER self-diagnose or make assumptions.
So, an ultrasound was done to check Bunny’s entire digestive system. The scan showed that Bunny has a gut problem. From the stomach to the duodenum, the wall is inflamed. Bunny is also very gassy (has severe flatulence). There is a bit of gall bladder sludge as well. The bile ducts are also swollen.
From the digestive system, the vet checked Bunny’s heart. He has a gallop rhythm and thickened heart muscles which is probably due to wear and tear. Bunny wasn’t exactly very happy with the scan that took quite long so I requested that the vet spared him from an echo. The ultrasound of the heart would be good enough.
Bunny also has halitosis (smelly breath) and is 5% dehydrated despite the thrice-weekly subcut.
So the main problem today is GI intolerance and not the kidney’s. But Bunny is still a CKD patient. The vet says we should also KIV pancreatitis but there is no cure for pancreatitis, only supportive care.
So for today, Bunny would need quite a bit of medication: He was given a B-12 injection at the clinic and this is to be followed with B-12 supplement, folic acid, Ursofalk for the gall bladder sludge (I know this medication was so effective on Ginger), Metrogyl (antibiotic for the gut infection) and Fortekor (1/4 tablet – low dose) for his heart. Fortekor is an ACE inhibitor that dilates blood vessels, lowers systemic blood pressure and reduces high pressure load in the heart.
The vet also advised to increase his subcut to 150ml five times a week since Bunny is always dehydrated. That would come up to a total of 750ml per week instead of the 225ml thrice a week (total is 675ml). This is also because Bunny becomes fidgety every time we hit 200ml. I worry it’s because he cannot take so much fluids at one go. So 150ml is definitely more manageable. Doing it five times a week is also not a problem for me.
Bunny’s recent weight loss could be due to water loss through the intestines or the diarrhoea as well as malabsorption due to the inflamed intestines. The dehydration is also due to the intestines being inflamed – it cannot absorb the water so what goes in comes out again. So we really have to resolve the gut problem first.
Back home for a quick snack. Cow Mau and Indy wanted the snack too.
The vet also said it’s better to stick to 1-2 types of food for now until Bunny’s diarrhoea clears up. So it can be one type of canned food and one type of kibble (since Bunny loves the kibble so much now). Also, just one type of protein would be good too. That would have to be chicken.
The Ursofalk powder was in a big capsule, so I stuffed in the Metrogyl, folic aid, B-12 and Fortekor. Semua sekaligus, satu kali. The vet said I could do this. She actually suggested it.
The vet said Bunny might be a bit slower in recovery because of his FIV+ status. We will just have to give it some time. But I’m glad it is a treatable condition.