That bunny ain't dropping Easter eggs

Years ago, pregnant with my first child and having no veterinary training yet, I acquired a young Nubian goat kid with diarrhea. Fecal testing revealed a protozoan parasite referred to generically as coccidia. A cautious expectant mother, I asked my physician if exposure to goat coccidia was harmful to my unborn baby. When he reported back that goat coccidia (Eimeria spp.) are "host specific" -- meaning goat Eimeria are contagious only to other goats -- I was very relieved.


Flash forward a decade and I find myself, now an animal doctor, doling out this same information to dog owners on a regular basis. Finding microscopic coccidia eggs on an annual fecal float test is not uncommon. Dogs may pass Isospora or Eimeria eggs in their stool, but as with goats these coccidia parasites are "host specific." As I explain this to horrified pet owners, they are relieved to hear it is not contagious to them or their children.

A small sampling of the oodles of eggs
-- coccidia, not Easter -- being passed by two
sick bunnies I saw this month. 

Identifying the presence of coccidia is easy. Now here's where it gets tricky. Remember that coccidia are "host specific." If a dog tests positive for an Isospora-type coccidia it may require treatment because Isospora is a dog coccidia. But if an Eimeria-type coccidia is seen, the dog is simply pooping out the coccidia that a rabbit once pooped out. Quickly differentiating between Isospora from Eimeria based on subtle differences in size or ornamentation takes practice and experience. Nevertheless, seeing as nibbling rabbit poop is a pretty common canine past time, chances are pretty good that many dogs are pooping out a non-canine coccidia.*

Many animals host coccidia without any outward signs of illness. In fact, sickness generally occurs only in very young animals during times of stress. As in my goat kid, coccidiosis may cause severe diarrhea. My yellow Labrador developed screaming diarrhea a few days after we brought him home as a puppy thanks not only to Isospora spp. but also to the stress of leaving his litter. Some of my canine patients--puppy or adult--that test positive for coccidia have unexplained scooting or butt licking without abnormal stools. A short course of treatment for coccidia often relieves all these symptoms.

I recently examined two very young bunnies with diarrhea and lack of appetite. These baby bunnies had been turning up their twitching little noses at hay and pellets for several days, eating nothing but carrots (a treat, not a balanced meal). The day I examined them they had been passing liquid orange stool for several hours. Not having had an occasion to test a pet rabbit's stool before, I was unsure of what I would find. Imagine my surprise when I focused my microscope on the fecal float slide to find hundreds of oval eggs. Coccidia! Eimeria-type no doubt. Treatment with anti-coccidia medication--a teeny tiny portion of the average dog dose--was started immediately, and the owner decided to provide additional nursing care at home.

What fascinates me about this case is not so much identifying rabbit coccidia -- as I explained, we veterinarians see it all the time as an incidental finding on canine fecal floats. It's just that I had never seen so much of it in one place. And never had I paused to think about what the rabbit coccidia might do to the rabbit! The story of these two very sick baby bunnies overwhelmed by coccidia has given this parasite a face and personal meaning to me.


* Cats can be infected with or shed coccidia in their stool as well including various species of Isospora or Eimeria which are not contagious to people. 

The "Cone of Shame": A Necessary Evil

The figure of speech "going off to lick your wounds" is okay in the metaphorical sense, but not when we're talking about dogs and cats after surgery.

Veterinarians cringe when well-meaning owners proudly announce that Fido has been licking a surgical wound in order to heal it.  Dog saliva may indeed contain compounds that numb the wound and neutralize some microorganisms. However, doggie drool and kitty spit also has potentially harmful bacteria in it, and the act of licking itself can ruin a good surgical closure.

Dogs and cats routinely create serious infection in their skin from over-licking an area due to allergies, injury or post-surgical discomfort. That's why veterinarians regularly dispense an Elizabethan collar (e.g., e-collar) following spays, neuters and other surgeries. The "cone of shame" prevents the dog or cat from licking the incision, allowing the wound to heal faster and without complication.

Sometimes, however, the e-collar is an inadequate deterrent.  I have met Houdini-like dogs who escape from their e-collars no matter how they are fastened. Some dogs figure out a way to chew through the plastic rendering the cone useless, while others ram it into things until it cracks, bends or (especially in Wisconsin winters) shatters. Many dogs act so demoralized initially that sympathetic owners can't bear to keep the cone on them at all. Most recently, I had a canine patient whose long nose poked over the edge of her cone just far enough that she managed to lick her spay wound to the point of infection and dehiscence.

Dehiscence is a fancy medical word for the splitting open of a wound. A dehiscence may be minor, involving a tiny part of the skin incision and requiring no special treatment. Or maybe a few skin staples will be placed to hold the wound edges closer together for faster healing. The worst kind of dehiscence, the kind that keeps veterinary students up all night and biting their nails following their first spay, is an opening completely down through the abdominal wall so that the animal's abdominal fat or even intestines protrude through the wound. Dogs have been known to chew on their own insides when this happens! Yikes! Thankfully, this is exceedingly uncommon.

Maddie's abdominal skin dehiscence looked a lot like this

Even Maddie, the long-snouted Springer Spaniel who managed to ferociously lick outside the cone, presented with just a partial dehiscence. While I could peer down through her subcutaneous tissue and fat to the sutures holding her abdominal wall together, thankfully the abdominal closure remained intact and her guts stayed in. Maddie's dehiscence was so severe, however, that she required general anesthesia so the dead, infected wound edges could be trimmed away, or debrided. I resutured the wound, placed Maddie on a course of oral antibiotics and gave her a larger e-collar. I expect the wound to heal normally after this, but I won't be surprised if she develops a seroma, or pocket of fluid under the skin, from bouncing around too much before the area completely heals.

Don't assume if your pet isn't licking their incision immediately after surgery that they won't. Some animals leave their surgery site alone during the early phase of healing, but attack it just as the skin finally starts to mend. If you have ever experienced insanely itchy skin as a surgical incision or even a minor cut begins healing you'll understand why dogs and cats suddenly notice their surgical wound a week after the fact!

The "cone of shame" is obnoxious, humiliating and completely necessary in most cases. Even with the cone on, however, pets can develop complications in their surgical wounds that require follow-up care by their veterinarian. Please follow your veterinarian's post-op instructions closely regarding exercise restrictions, wound care and medications. And most of all, don't let Fido lick!