Rabbit Hepatic Coccidiosis: Liver Signs and Weight Loss

Hepatic coccidiosis in rabbits is caused by Eimeria stiedae, a protozoan parasite that infects bile ducts and the liver — distinct from intestinal coccidiosis species. It causes weight loss, jaundice, and a distended abdomen, particularly in young or immunocompromised rabbits. Treatment with trimethoprim-sulfa or sulfa drugs is effective when started early.

Last reviewed: June 2026

What Is Hepatic Coccidiosis in Rabbits?

Coccidiosis in rabbits is caused by Eimeria species — single-celled protozoan parasites that complete their life cycle within rabbit intestinal or bile-duct epithelium. Eimeria stiedae specifically targets the bile duct epithelium, causing hepatic (liver) coccidiosis. It is the most pathogenic Eimeria species in rabbits and is distinct from the intestinal Eimeria species that cause diarrhea.

Transmission occurs through ingestion of sporulated oocysts from contaminated food, water, or bedding. Young rabbits under 3 months old are most susceptible, though adult rabbits can develop disease if immune function is compromised. Overcrowded, unhygienic housing is the primary risk factor.

As described in Quesenberry & Carpenter's Ferrets, Rabbits & Rodents, E. stiedae causes progressive bile duct hyperplasia, cholestasis, and pericholangitis, ultimately impairing liver function in severe infestations.

Signs of Hepatic Coccidiosis in Rabbits

Early signs:

• Reduced appetite and decreased energy
• Weight loss despite appearing to eat
• Pot-bellied appearance (hepatomegaly — enlarged liver)

Progressive signs:

• Jaundice — yellow tinge to gums, skin of ears, or conjunctiva
• Distended abdomen
• Pale or chalky-white feces (from reduced bile excretion)
• Diarrhea (intestinal coccidiosis may co-occur)
• Lethargy and hunched posture

Severe/terminal:

• Severe lethargy and collapse
• Complete anorexia
• Death in untreated young rabbits

Diagnosis is confirmed by fecal oocyst count (identifying E. stiedae oocysts, which are larger and have a distinctive morphology) combined with ultrasound or necropsy findings of a markedly enlarged, mottled liver with white nodules along bile ducts.

Treatment

Sulfonamides are the drugs of choice: trimethoprim-sulfamethoxazole (30 mg/kg twice daily for 10–14 days) or sulfadimethoxine. These drugs interrupt the coccidian life cycle. As described in Quesenberry & Carpenter's Ferrets, Rabbits & Rodents, treatment must be started early in the course of disease — established bile duct scarring is irreversible.

Supportive care:

• Ensure the rabbit is eating — hepatic coccidiosis rabbits are at high GI stasis risk
• Syringe-feed Critical Care or other high-fiber recovery food if anorexic
• Fluid therapy if dehydrated (subcutaneous or IV)
• Liver support (SAMe, milk thistle) may be used empirically by some exotic vets

Hygiene and prevention:

• Remove all feces from the enclosure daily — oocysts take 1–2 days to sporulate and become infectious
• Disinfect housing with ammonia solution or steam-clean (common disinfectants do not kill coccidia oocysts)
• Avoid overcrowding, which is the primary transmission driver
• Quarantine new rabbits before introducing them to an existing group

According to the AEMV Pet Care Guides, 2024, rabbits kept in clean, low-density housing with good nutrition rarely develop severe coccidiosis even if low-level oocyst exposure occurs.

When to See a Vet

Call your vet today if:

• Your rabbit has a noticeably distended or enlarged abdomen
• Your rabbit has been losing weight over 2–4 weeks, especially if young
• You notice yellowing of the gums or inner ear skin
• Feces have become pale, chalky, or very small

Go to the ER immediately if:

• Your rabbit has not eaten for more than 8–12 hours (GI stasis risk)
• Your rabbit is collapsed, lying flat, and unresponsive to handling
• Severe jaundice with complete loss of appetite in a rabbit under 6 months old
• Labored breathing alongside a distended belly

Frequently Asked Questions

How much does treating hepatic coccidiosis in rabbits cost? An exotic vet visit costs $75–150. Fecal testing adds $40–80, and abdominal ultrasound adds $200–400. A course of trimethoprim-sulfamethoxazole is low cost ($20–50 for 2 weeks). If the rabbit requires hospitalization and supportive care, expect $400–1,200 for a 2–4 day stay.

Can hepatic coccidiosis in rabbits be prevented with vaccines? No vaccines exist for rabbit coccidiosis. Prevention relies entirely on husbandry: daily feces removal, low population density, clean water and food, and quarantine of new animals. Good nutrition (unlimited timothy hay, limited pellets) supports immune function.

Can my other rabbits catch coccidiosis from an infected rabbit? Yes — oocysts are shed in feces and can spread to other rabbits if hygiene is poor. Treat the affected rabbit, deep-clean the entire enclosure with ammonia or steam, and monitor cage-mates for early signs. All rabbits in a group with confirmed coccidiosis should typically be treated.

Is hepatic coccidiosis in rabbits the same as intestinal coccidiosis? No — they are caused by different Eimeria species. Intestinal coccidiosis (from E. intestinalis, E. irresidua, and others) causes diarrhea; hepatic coccidiosis (E. stiedae) causes liver disease, jaundice, and abdominal distension. Both can occur simultaneously.

What is the prognosis for a rabbit with hepatic coccidiosis? Prognosis is good when treatment is started early and the rabbit continues to eat. Young rabbits with heavy infestations and established liver scarring carry a guarded prognosis. Adults with mild to moderate infection treated promptly usually recover fully.

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