| Summary Information |
| Diseases / List of Miscellaneous /
Metabolic / Multifactorial Diseases / Disease summary |
| Alternative Names |
- Constipative mucoid enteropathy (CME)
- Mucoid enteritis
- Note: this term is also used for a variety of conditions
with known causes in young, particularly weanling, rabbits. (B600.10.w10)
See also:
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| Disease Agents |
- Unclear. Stress, diet (low fibre, high carbohydrate), pathogens,
enzyme deficiency, enterotoxins and dysautonomia may be involved. (B600.10.w10,
B601.8.w8)
- Experimentally, similar disease, with production of excess mucus in
the colon, can be produced by ligation of the caecum, although
pathological findings are not exactly the same as in natural disease. (B600.10.w10,
B601.8.w8, J4.181.w5,
J13.44.w2, J495.46.w4)
- Mucus production was ample in rabbits in which the distal branch
of the ileocaecocolic blood vessels and nerve were incorporated
into the ligature, but necrosis of the colon also developed
(unlike in natural disease); when the vessels and nerve were not
included in the ligature, gross mucus secretion was evident in one
of eight individuals. (J495.46.w4)
- Microbial dysbiosis and excessive acidity in the caecum. (B602.16.w16,
J495.37.w4)
- In rabbits with mucoid enteropathy, the caecal contents showed
"dramatic" dysbiosis, including loss of protozoa, large
metachromic bacilli and other Gram-positives,
and increased Gram-negative
organisms. (J495.37.w4)
- Caecal pH
was lower than normal; this could cause the microbial dysbiosis. (J495.37.w4)
- Hypersecretion of mucus, and impaction, may be due to specific
microbial factors associated with the changed flora. (J495.37.w4)
- Stimulation of mucus secretion, and increase in number of
visible goblet cells was produced in rabbit colonic explants when
filtrates from the caecal contents of rabbits with experimental
mucoid enteropathy were added to the culture medium. (J495.36.w3,
J495.46.w3)
- The presence of abnormal fermentation and caecal maldigestion has
been shown in rabbits with experimentally-produced disease: the colon
contained reduced quantities of acetate and butyrate (usually the most
abundant short-chain fatty acids) and increased amounts of proprionate,
isobutyrate, valerate and isovalerate. (J13.47.w3)
- Note: May be concurrent with gastrointestinal tract
infections (e.g. Colibacillosis,
Tyzzer's Disease in Lagomorphs,
Clostridial Enteritis and Enterotoxicosis in Rabbits,
Intestinal Coccidiosis. (B600.10.w10)
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| Infectious
Agent(s) |
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| Non-infectious
Agent(s) |
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| Physical
Agent(s) |
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| General Description |
Clinical signs
- Anorexia. (B602.16.w16,
J4.181.w5)
- Lethargy/weakness. (B602.16.w16,
J4.181.w5)
- Crouched posture. (B614.15.w15,
J4.181.w5)
- Coat appears rough. (B614.15.w15,
J4.181.w5)
- Abdominal distention. (B600.10.w10,
B614.15.w15, J4.181.w5)
- Failure to produce normal hard faeces. (B600.10.w10)
- Sometimes diarrhoea. (B602.16.w16,
J4.181.w5)
- Production of large amounts of mucus, (B600.10.w10,
B602.16.w16)
sometimes mixed with faecal material. (B600.10.w10,
B614.15.w15)
- Total failure to produce faeces. (B600.10.w10)
- Polydipsia (B600.10.w10,
B614.15.w15)
or reduction in water intake. (B600.10.w10,
J4.181.w5)
- Tooth grinding, probably due to abdominal pain. (B600.10.w10,
B614.15.w15)
- Dehydration. (J4.181.w5)
- Caecal impaction palpable. (B600.10.w10)
- Sometimes gastric dilatation palpable. (B600.10.w10)
- Sometimes respiratory signs. (B600.10.w10)
- Hypothermia
(99 - 102 °F). (B614.15.w15)
- Sometimes cold extremities. (B614.15.w15)
- Sometimes squinting. (B614.15.w15)
- Loss of weight (B614.15.w15)
- 20 - 25% weight loss may occur in one or two days. (J4.181.w5)
- Note: signs are progressive. (B600.10.w10)
- Usually a fatal condition. (B600.10.w10,
J4.181.w5)
- Acute: One to three days of illness before death. (J4.181.w5)
- Chronic: four to 10 days before death. (J4.181.w5)
- Occasional survivors. (J4.181.w5)
- Clinical pathology: Increased PCV,
haemoglobin and RBC-count,
due to dehydration. Increased erythrocyte sedimentation rate. (B614.15.w15)
Pathological findings
Gross pathology:
- Stomach: may be distended, containing fluid and gas. (B600.10.w10)
- Small intestine: may be distended, containing fluid and gas.
(B600.10.w10)
- Caecum: contains dry contents and gas. (B600.10.w10)
- Colon: distended with gelatinous mucus, often with a plug of
mucus obstructing the colon. (B600.10.w10,
J4.181.w5)
- Note: not GIT inflammation. (B600.10.w10)
Histopathology:
- Jejunum and ileum: goblet cell hyperplasia, minor infiltration of
inflammatory cells. (J4.181.w5)
- Caecum and colon: goblet cell hyperplasia. J4.181.w5
- Occasionally also goblet cell hyperplasia in other organs - bile
duct and gall bladder, pancreatic dusts, tracheal mucosa. (J4.181.w5)
- Intestinal mucosa and submucosa oedematous and containing
inflammatory cells. (J4.181.w5)
- In rabbits with mucoid enteropaty induced by caecal ligation: (J4.181.w5)
- Crypt hyperplasia (small and large intestines), increased goblet
cells, increased luminal mucus. (J4.181.w5)
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| Further Information |
Susceptibility
- This is a disease of domestic rabbits, particularly
intensively-reared rabbits, not of wild rabbits. (B600.10.w10)
- Stress appears to be important. (B600.10.w10)
- Mainly a disease of weanlings/growing rabbits, but with occasional
cases in adult pet rabbits. (B600.10.w10)
- Usually in rabbits 7 - 14 weeks old. (B602.16.w16)
- In adults, may occur following transportation, parturition or
another stressful event. (B600.10.w10)
Diagnosis:
- Clinical signs and findings of examination. (B614.15.w15)
- Abdominal palpation: impacted caecum, sometimes gastric dilatation.
(B600.10.w10)
- Radiography: caecum containing solid impacted material,
sometimes also containing gas. Gas distending the small intestine.
Stomach may be dilated with fluid. (B600.10.w10)
- Necropsy: Colon containing large amounts of mucus. (B600.10.w10)
- Histopathology: Goblet cell hyperplasia (ileum, caecum,
and/or colon), depletion of acidic mucus in the glands of the colon,
and plugging and dilatation of the lumen of the glands with mucus. (B614.15.w15)
Differential diagnosis:
- Enteritis (various causes). (B600.10.w10)
- Hepatic Coccidiosis in
Lagomorphs. (B600.10.w10)
- Note: Mucoid enteropathy may occur concurrently with
gastrointestinal tract infections (e.g. colibacillosis, Tyzzer's
disease, cocicdiosis, clostridia). (B600.10.w10)
Treatment
- Aggressive non-specific treatment: (B600.10.w10,
B602.16.w16, B614.15.w15)
- Fluids therapy - oral or subcutaneous if the rabbit is not
dehydrated; intravenous or intraosseous if it is dehydrated. (B600.10.w10,
B602.16.w16)
- Analgesia to treat pain associated with gastric or colonic
distention. (B600.10.w10)
- Anti-ulcer treatment if the rabbit is anorexic. (B600.10.w10)
- Motility stimulants. (B600.10.w10)
- Repeated enemas. (B600.10.w10)
- Antibiotics may or may not be useful. (B600.10.w10)
- This is a supportive treatment only. (B602.16.w16)
- Give antibiotics which are not common causes of gut flora
disturbance, e.g. enrofloxacin, trimethoprim or metronidazole.
(B600.10.w10)
- Probiotics may be given, or caecotrophs from a health rabbit
(which will contain normal rabbit bacterial flora). (B600.10.w10)
- Cholestyramine (Questran) may be given to absorb enterotoxins in
case these are produced. (B600.10.w10)
- 2 g in 20 mL water daily by gavage. (B602.16.w16)
- Offer tempting and high-fibre foods such as fresh grass, good
quality hay, green cabbage, kale, carrots, dandelions etc. (B600.10.w10)
- Euthanasia of rabbits with advanced disease. (B600.10.w10)
Prevention
- Diet high in indigestible fibre and low in simple carbohydrates for
recently-weaned rabbits. (B600.10.w10,
B602.16.w16, B614.15.w15)
- Minimising environmental stressors. (B614.15.w15)
- Ensure plentiful available water, particularly for
recently-transported rabbits. (B614.15.w15)
- Possibly restricted food for weanlings. (B614.15.w15)
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| Associated Techniques |
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| Host taxa groups /species |
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| Disease Author |
Debra Bourne MA
VetMB PhD MRCVS (V.w5) |
| Referees |
William Lewis BVSc CertZooMed MRCVS (V.w129) |