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Old 12-17-2017, 05:11 PM   #1
Bucktooth
 
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Default Gut stasis

Bucktooth has problems with gut stasis. It's happened 2 x and we've given her pain meds, syringe fed critical care and done chiropractic as well. Both times were fairly mild and she recovered in 1-2 days. This is over the course of her 3 years of life. I can't remember how long ago maybe last year?

Since those episodes she has had a few more incidences where her appetite went down, her behaviour off not finishing her pellets etc and when this happens I would immediately give her critical care in a syringe and one or two feedings of that and she's back to herself.

Bucktooth is 3.5 years old spayed female mini rex. She's indoor, she has a large 2 story hutch, and is out running around 12 hours a day at least. She eats free choice Timothy hay or mixed grass hay that is high quality horse hay, and gets two tables spoons of oxbow adult rabbit pellets twice a day and one oxbow digestive support biscuit twice a day. For greens she gets parsley, cilantro, mixed green lettuces and mint etc. She just gets a small amount of those twice a day. She drinks a lot of water out of a bowl. She's 5lbs and not overweight, her teeth are ok.

Last Saturday her appetite went down, I was away but my boyfriend told me right away, so Sunday we gave some critical care, she started eating, but was off and on all week, not eating as much as normal, poops smaller etc, on Friday we took her to the vet, she was eating at the vets of course and looked ok. We she was pooping and peeing there. We gave her metacam x 3 days, and did chiro. She came home and won't eat. Starting Friday night I've been doing the critical care around the clock. She is pooping small poops not nearly as often as she should and not peeing very much (she isn't drinking that I can tell)she will occasionally nibble food. She ate a lettuce leaf, a tiny bit of hay, a tablespoon of pellets from last evening til this morning and this morning all she ate was a digestive biscuit.

What the heck else can I be doing for this rabbit? What is good to do for gut stasis? I want to give her sq fluids I think, and I can do that at home, I don't really want to take her to the vets again because that will further stress her but I think I should so she can be fed the critical care during the day when everyone is at work. Should we do an x-ray? Gah! This bunny belongs to my 5 year old daughter and sleeps on her bed with her. It's like her dog, she has to get better.

What would you do? Any advice?

Jessica


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Old 12-17-2017, 07:20 PM   #2
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I know struggling with GI stasis is frustrating, one of my rabbits is prone to stasis bouts (but she's old so slow guts are kinda normal). I'm not a vet but here is what I think from my own experience. About her normal diet, she might need some more vegetables - normally it's about 8% of the body's weight in vegetables everyday. I found that giving a lot of wet leafy greens helps with my rabbits' guts, as does keeping three different hay bags open at all times and giving small handfuls of hay 7 - 8 times a day rather than one big pile (new things are interesting, a pile of hay from 2 hours ago is like old news... ^^').

About the current treatment, I think metacam 3 times a day is a LOT. Normally, it's given once a day, about 0.2ml for a kilo of rabbit, except for really accute pains. Is she even in pain? (staying hunched, grinding her teeth, trembling) If she isn't, I would stop giving that as metacam causes slow guts and is counterproductive when treating stasis - it's good to give it if the rabbit is really in pain as pain prevents recovery but I generally stops it after one or two days (as soon as the rabbit is pooping a bit, they generally aren't in pain anymore).
Two, what your rabbit really needs is a gut stimulant (a laxative if you will). It's actually the only thing that works for a real stasis as it keeps the guts moving. If I didn't miss it in your post, your vet didn't prescribe one which is quite surprising. You need metoclopramide (Reglan or Emeprid). Your vet should have some. I keep it at all times at home and a single dose often does the trick (with a case that has lasted for days like yours, you might need to give it 3 times a day for a few days - it's a perfectly safe medecine, rabbits tolerate it really well). Water is also absolutely critical. Dry guts can't evacuate what they should. I give water with a 1ml syringe, about 5 syringes every four hours during the day (it's tedious but with a bigger syringe you risk to drown your bunny) and give wet grass / leaves a lot hoping the rabbit will accept to eat them. Massages are good also. Keeping the rabbit on your knees on the floor, you have to gently lift the bunny's hindquarter by putting your hand under her belly to help the guts to move. I never give critical care as the rabbit generally starts to eat on their own about 12 hours after the first metoclopramide dose. Of course, if your rabbit won't eat much, continue to give it.
Keeping the rabbit warm is important too. Stasis makes the rabbit's temperature drop. So providing a cushion or a blanket on which the rabbit can snuggle (if she doesn't eat them!) can help.
Then, even if it's hard not to check on her every five minutes, it's best to leave the rabbit alone and in a quiet environment as much as possible when you are not treating her.
I hope it helps!


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Old 12-17-2017, 10:26 PM   #3
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Default Gut stasis

Thank you for your reply.

She isn't getting metacam 3 x a day it's once a day for 3 days and it's a fairly conservative dose imo she's only getting 0.25ml once per day and she weighs 5lbs. it's the 1.5mg/ml. I'm pretty sure we don't have metaclopramide at that vet, but we might at the emergency hospital I will try to track some down. We have cisapride, not the same thing at all but I've read some people have luck with that.

She does get multiple hay feedings every day, we never let it run out, I would say 3-4 times we change the hay. It's fresh cut, not from a bag. But I can definitely give her more greens, I just didn't want to upset her stomach further. I don't give her as many as I should.

She just ate several stalks of cilantro but no poop yet since this morning.

Should I take her to work tomorrow to feed her and give her sq fluids and more pain meds? I'm out of metacam and I don't think I have any laying around so she won't get any until I come home from work. I will leave at 7 am and not be able to return til 7pm. I work an hour away one way. I can take her with me, but that will further stress her. What's worse, no food or stress? I'm thinking no food will be worse but I'm really waffling with this decision because it's my own pet and I can't think clearly.

Jessica
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Old 12-17-2017, 10:36 PM   #4
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I actually might pass on the motility drugs, they don't sound so great when I'm reading about them here. I will see what the Dr says about them.

Jessica
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Old 12-17-2017, 10:37 PM   #5
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Try feeding a piece of apple or pineapple. Feed lots of fresh greens. Apple I find helps in most cases to relieve gas but there's a possibility it could make the problem worse if a blockage is present. Simethicone for babies/children is also good to have on hand and can be purchased without prescription at any drug store. Feeding some ginger may benefit. Gentle massages of the abdomen should also help your rabbit. Encourage lots of drinking. Sometimes adding 100% natural juice to water will help. I've experienced this once or twice in the past as well.
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Old 12-18-2017, 05:01 AM   #6
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I tend to avoid the motility drugs as well. I usually just start with Critical Care, and that works well for my buns. I would say bring her to work with you and feed her throughout the day. I know it stresses buns out to be in a hospital setting, but I've personally had the best luck with regular, multiple feedings, even in stressful situations.
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Old 12-18-2017, 05:58 AM   #7
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What did the vet do to investigate the cause of the stasis(conscious or sedated dental exam, thorough physical exam, blood tests, xrays, rule out bloat)? GI stasis is just a symptom of another health issue. It is often from stomach upset or digestive slowdown, but it can have another primary cause such as dental problems, bladder problems, kidney or liver disease, heart problems, bowel obstruction, parasites, arthritis, spinal problems, sore hocks, cancer, etc. Basically anything that causes pain and/or discomfort. So it could be your rabbit has something else as the primary cause that is leading to your rabbit being in pain and not wanting to eat. If this is what's going on, then you need to have your vet investigate the primary cause if they didn't already, and it may take additional diagnostics to get to the bottom of what's causing this.
http://www.bio.miami.edu/hare/ileus.html

If it isn't another health problem causing the stasis, but is a dietary problem causing it, then you need to try and determine what might be the trigger food. It could be an ingested foreign food, veggies that have started to spoil, hay that may have gone bad, or a sensitivity to the pellets. I had a rabbit that started having problems with stasis right after I got him. Just as he was starting to get better he would start to get sick again. I finally realized that he was starting to get sick again right after he started eating pellets again, and I realized it was the pellets causing the reoccurring stasis. He had a sensitivity to pellets for some reason. Once I stopped the pellets, he never had stasis again. It can be other things too. I've read of accounts of rabbits being sensitive to a particular veggie or a particular type of hay, some rabbits can even have problems with critical care food mix. So if it is a food issue, it's going to take careful observation and trying to see if you can tie it to a particular food.

Your rabbit is getting a minuscule amount of meloxicam, and in my opinion is insufficient for any rabbit experiencing anything but the mildest of pain. Usual dose for rabbits is 0.3-0.6mg/kg per day for maintenance, 1.5mg/kg for short term pain control. Your rabbit is getting 0.37mg and she is 2.3kg, which puts her at 0.16mg/kg daily dosing. Research has found that rabbits need higher and more frequent dosing than other animals like dogs, because rabbits have a faster metabolism. In my opinion, 0.15mg/kg is not enough to have much, if any effect on a rabbit experiencing more than mild pain. As an example, I had an older rabbit with arthritis. She was getting 0.5ml twice a day of the 1.5mg/ml and she was 1.7kg. Anything less and I could tell she was feeling too much discomfort.

Your rabbit is larger than my rabbit and is getting far less. For a rabbit the size of yours and experiencing stasis for some unknown cause, I would want to be giving at least the highest maintenance dose(0.6mg/kg), which would be 1.4mg for a 2.3kg(5lb) rabbit, or about 1ml of the 1.5mg/ml suspension. It was also found that once daily dosing wasn't sufficient in providing 24 hour pain relief, and that twice daily dosing was better at providing 24 hour coverage, and what I prefer to do as well. So that would be 0.5ml twice a day for a 2.3kg rabbit, giving daily while the rabbit continues to have these stasis issues/pain, and only tapering down if the rabbit improves significantly. The only reason I wouldn't give meloxicam to a rabbit in pain, is if it produced an adverse reaction, it is suspected there might be a gastric ulcer, or if the rabbit needed even stronger opiate pain relief. You may find that once your rabbit is put on adequate pain relief, that her eating may improve significantly. A rabbit in pain is less likely to want to eat, therefore getting pain under control is essential. Don't take my word for it though, here are some links with references for the dosing and the importance of pain relief for rabbits.
http://www.vgr1.com/metacam/
http://wildpro.twycrosszoo.org/S/00C.../Meloxicam.htm
http://rabbit.org/the-importance-of-...r-pet-rabbits/

Which gut stimulant to use depends on what is causing the gut stasis and which part of the digestive tract needs to be stimulated. Though if given the choice, I would prefer cisapride.

The fact that your vet isn't prescribing adequate pain relief or gut motility meds, makes me wonder how experienced a rabbit vet they are. Any good rabbit vet understands how important pain control is with rabbits. If you aren't sure how experienced your vet is and would like to find a better vet, you may be able to find one on this list.
http://rabbit.org/vet-listings/

You're in the best position to know whether or not bringing your rabbit with you would be too stressful. I will say that if she would only be mildly or moderately stressed, I would probably bring her. If she would be severely stressed, I may opt to leave her home and feed right before I left. A rabbit experiencing severe stress can be very detrimental to their health and recovery. But you just have to make your best guess on what will be best for your rabbit.

You will also want to think about if there might be a reason she did well at the vet and isn't doing well now that she's back home. Is there maybe a triggering factor? A food that she gets at home that she wouldn't have had at the vet, or some type of stressor in her environment. Though it could also just be coincidence that she seemed to be ok at the vet.
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Old 12-18-2017, 09:11 AM   #8
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Quote:
Originally Posted by Bucktooth View Post
I actually might pass on the motility drugs, they don't sound so great when I'm reading about them here. I will see what the Dr says about them.

Jessica
What did you read against mobility drugs? Metoclopramide is considered to be really safe as long as there is no blockage. It is recommended in this case by all the rabbit specialists I know, it was always prescribed to my rabbits in stasis case by all the vets I've ever seen (including the most well-known rabbit specialist in France). I've used them several times during the last decade with no side-effects, they even saved my rabbits more than once, and they are recommended by the House rabbit society, the French rabbit society and Diana Krempels :
http://www.bio.miami.edu/hare/ileus.pdf
http://rabbit.org/gastrointestinal-s...lent-killer-2/


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