RIP - Clover is at Vet on a drip...

[p1rat3]

Clover is at the Vet now and has not properly eaten since Sunday, we think. The story goes like this:

Monday I notice she has not eaten much. Fine she gets in a mood and does not eat for a day sometimes. Tuesday Mikayla comes to me and says that Clover has not eaten. Now I am worried. She has a little bit of a runny but. I clean her box to see if she is pooing. I can the out-of-hours vet number and he says to give her more fibre. Okay, I am with that, but how when she is not eating? So I suggest wetting some pellets and giving them to her in a syringe. He agrees and this is what we do Tuesday night. I also tried to give her some Timothy hay and she is usually crazy for it. She would not touch it.

Wednesday morning she is sulking even worse hiding in places she does not even normally go. She has properly pooed, and only weed in her hutch. She always goes in her box! I take her in to the vet (I was going to anyway even if she seemed better). He says she probably ate something bad. We have let her have her runs in our back garden for nearly three years now and she has never eaten anything bad. Anyway, I go with this possibility. He gives us some Bio-Lapis (* I looked this up see links below) and sends us home, with no fibre treatment.

I give her 4 of the 5 a day I am supposed to give her (figured we missed the morning treatment). On the last one of the day she did not even want to swallow and was actually spitting out the soggy pellets. Even more lethargic. Worried again.

This morning she would only lift her head if I touched her and was not moving around. I took her right to the vet where they admitted her. They have her on a drip for hydration. And kept her on her Bio-Lapis.

I just called and they said he is still on the drip. She has not eaten and she is still being given her motin. I am a little worried about her not getting any food by any means. Shouldn't they be giving her a fibre treatment by syringe? I am thinking about bring some of her food down, she can be picky, but how is her digestive system going to get moving again if she is not getting any fibre?

I am worried.

Jay

*
http://www.vetscriptions.co.uk/PROTEXINBIO5.html

http://www.animalmedicines.co.uk/product.php?productid=735&cat=462&page=1

 

[Michaela]

Oh I hope she's ok. ray:

When bunnies don't eat it can get so serious so quickly. Here is the RO Library article on Stasis (it's very good imo). I'm hoping someone who knows more will see this soon, is your vet experienced with rabbits? If so then she's in the best place. :hug:

 

[p1rat3]

Yes, they are registered small animal vets. and , Up until recently I have been confident with them. Some of the vets seem to know more than others though and I am not 100% sure about this guy she has been seeing.

I know she is better there than at home. I just hope she is getting the best and right treatments.

I don't know, it could be a hair blockage? :-(

J

 

[Michaela]

If they are registered then hopefully this vet is confident and experienced in small animals too. :hug:

Hmm, yeah it could be a hair blockage, Stasis can be brought on by a number of things, it's hard to know.

 

[p1rat3]

OK, I have just read that article (again) and I am sure he is giving Clover a Molility drug. He felt her gut and did not feel anything. But, he did not do an x-ray. She had runny poos the first couple of days, and they smelled, but I don't think she is pooing at all now. I will have to check where she slept last night again when I get home.

J

 

[Marietta]

The article that Michaela pointed out is THE bible for GI stasis. Take special note on the article called "GI stasis-the silent killer by Dana Krempels. In case your vet is not rabbit savvy, or in case you have doubts, you could print this out and give it to him. Still, in case you're not happy with the specific vet, you can always ask the clinic for a second opinion.

When it gets to syringe feeding, fibre itself cannot be fed via a syringe, only Critical Care, mushed pellets mixed with water, mushed pumpkin (which is high in fibre), baby food. When a bun reaches this point, the important thing is to eat ANYTHING, to keep her GI tract mooving. Since they put your rabbit in SQ hydration, they're doing the most important thing: hydrating her GI system.

Molting could result in GI stasis or, even, creat a blockage in the intestines. the difference is that stasis (=slow-down or complete halt of the intestinal contractions) can be treated medically, whereas a true blockage needs surgery. To find out which is the case, an X-ray is needed. Also a vet experienced in rabbits, because remains of undigested food or gas in the intestines or the stomach can be easily misinterpreted as a blockage by a vet who has not seen a lot of X-rays, especially for GI stasis purposes.

What medicines is she on? Analgetics are usually needed, since GI stasis is most all of the times accompanied by gas. Gas distents the stomach and intestines and causes pain. When the rabbit is in pain, the immediate reaction is to stop eating. And then you get into a vicious circle. Simethicone (brand name: infa-col), a syrop for infant colic helps break up the gas bubbles, which makes them pass more easily.

Also, if they're planning to use any gut-motility drugs (or if "motin" that you mention is this kind of a drug), they should do it with extra caution and only after having evaluated the X-rays and ruled out a blockage case, because if there's a blockage then the intestine may erupt with the sudden, violent contractions that these drugs cause. There is, in general, a lot of controvercy on these drugs, although my experience (once only, thank God) with gut motility drugs was positive. But this is only my own experience.

A lethargic bunny is a very seriously sick bunny, so, a rabbit expert clinic is the best place to be.

Please note that GI stasis is a secondary symptom of a pre-existing problem, so when, hopefully, this is over, you should think of verious causes that may be the culpit. Nutrition? An undetected illness? Stress? Maybe some material ingestion (such as plastic, carpet or rug pieces, too much paper)?

Let us know how she goes. I wish that she recovers soon.

Marietta

Eddited to add that I just read your above post which crossed mine. If she had runny, smelly poos, you should ask for a poo culture, she may have parasites, clostridium etc. in her intestines, which needs to be treated.

 

[p1rat3]

I am worried that the molility drug that she is being given might kill her. Like I said there was no x-ray.

She had diarrhea. I mean really runny but that basically stopped lastnight. Probably becuaes of her dehyration though. I see you say I should ask for a test of her stool. I hope they can get enough to test. I will ask for this when I phone this afternoon (about an hour from now).

She has not eaten, or been forced to eat ANYTHING since Tuesday night. I can't imagine not feeding her is a good thing, unless they did think there was a blockage, and then the motility might not be the best treatment...

 

[p1rat3]

Ok, have done even more research. The medicine she is being given "Bio-Lapis" is "A concentrated soluble powder containing Protexin (probiotic), Profeed (prebiotic), enzymes, electrolytes and vitamins to help quickly restore the gut microflora in rabbits..."

http://www.animalmedicines.co.uk/product.php?productid=735&cat=462&page=1

http://www.vetscriptions.co.uk/PROTEXINBIO5.html

I figured I had beter look for the people across the pond.

The doctor actually said "We need to improve her molility" or something like that.

J

 

[Marietta]

Having read what you attach, this is a probiotic for, indeed, restoring gut flora, but in case of GI stasis, this is not treatment...Better print out D. Krempels' article and hand it over to the vet a.s.a.p. I hope he/she is willing to read and follow the protocol.

Marietta

 

[p1rat3]

EDIT: i found the article that has him as the author.

re; "...Better print out D. Krempels...' article"

I am sorry but none of the articles are listed with this author on that thread. I will print it out once I know which woud be best for my vet to read.

Do you guys think I should try and get her home (once hydrated) so I can do belly massages and other treatments that he is not doing? Or am I being crazy?

J

 

[Marietta]

Here is the article of D. Krempels:

http://www.bio.miami.edu/hare/ileus.html

You should get her home if she shows a sign of improvement, i.e. not being lethargic, eating a bit, etc.

If you trust that they're doing a good job, you let her stay till she feels better. If you're on serious doubt, try to get them to follow the protocol and find out what her medication and treatment is up to now, before deciding on your further steps.

Marietta

Edited to add: When will you see her?

 

[p1rat3]

I can try and see her tonight. I want to get there before they close so I can make him angry by ahnding him a copy of this article.

Why? Do you think I should look for signs of recovery and then ask to check her out and take her home?

J

 

[p1rat3]

OK. I am going to see her. If they have given her nothing else I am going to ask for vitamin B and some pain meds and take her home. At least she can make her recovery (or not) at home.

J

 

[Pipp]

Marietta wrote:

Eddited to add that I just read your above post which crossed mine. If she had runny, smelly poos, you should ask for a poo culture, she may have parasites, clostridium etc. in her intestines, which needs to be treated.

Yes, this is the issue, the stasis is a byproduct. It's likely they did a fecal smear.IDing if a parasite is the cause is usually the first thing done. Ask for a diagnosis.

There's no blockage, so motilty drugs won't kil her, not much of an issue there.

They could be following protocol for cecal dysbiosis (gut imbalance, liquid cecals), which I think is hydration and heavy probiotics treatment,buta highfiber diet to rebalance the system is also essential.

EDITED TO ADD: X-rays would ID gas pockets, although it's a good bet she's gassy and in pain so they'd probably treat her for that anyway. The x-ray could tell if it'sbloat, although that's usually comes on faster and is more immediately critical. (True bloat requires emptying the gas viaa tube through her mouth into her stomach). Did she eat a lot ofspring grass?


sas:clover:

 

[Marietta]

p1rat3 wrote:

I can try and see her tonight. I want to get there before they close so I can make him angry by ahnding him a copy of this article.

Why? Do you think I should look for signs of recovery and then ask to check her out and take her home?

J

P1rat3, I don't think that making him angry will be a constructive gesture. The point of giving him the article is to provide more specialised info for GI stasis treatment, in case the particular vet is not experienced.

In regard to your question on the timing of checking her out, there is a lot of info I don't have in order to judge that, such as if and how rabbit savvy this vet/clinic is, if you have the means and time to follow the protocol by yourself (when my bunny got sick with GI stasis I didn't bother to do anything else, I wasn't sleeping and didn't go to work at all for a week). Even then, a vet would be needed to prescribe the necessary meds, though.I also,cannot visually attest the actual state of health of your bunny right now, i.e. how critical her condition is, how is she responding to her treatment, if at all, etc. And I wouldn't qualify tomake a judgementeven then, because I'm not a vet and I have noprofessional knowledge on rabbit health.

I have to tell you that 9 months ago I faced the first (and up to now, the last, thank God) GI stasis and gas incident with my bun, a dwarf hotot. It was a very serious situation, a couple of times I really thought he'd die on me right there, in front of my eyes. It took him 13 days to poop, he wasn't eating at all, he was barely drinking out of a syringe, he wasn't moving and got lethargic too. Hewas syringe fed mushed pellets and liquidsfor a week, not really eating even that, he spit it out. During that horrible period I tried all I could (I wasn't a member of RO then, unfortunately), I printed out the protocol of Dana Krempels' article and followed the parts I could (i.e. the non-hospitalisation parts of the treatment). I took my bunny twice for X-rays to the only Animal Hospitalwe haveand the vets couldn't read them properly. The first time they told me there's a blockage, the second time they told me there wasn't. I must tell you alsothat some of the drugs were not available in my country (I live in Greece) and, the worst part is that we don't have rabbit savvy vets. So, in my case, I had no choice, I would either treat him myself or loose him. After 12 excruciating dayswithout improvement, in aboutthe same condition,I was so desparete, so lostand rather sure he'd die that I e-mailed Dana Krempels, explained the situation and asked for her opinion. I didn't think she'd reply to a total stranger living in the other part of the planet, but, God bless her, she replied immediately.To my heart and my reality,Danasaved my bun. She told me to use either one of the two (or the two combined) gut motility drugs mentioned in her article, since everything else had failed and since there was no vet to show me how to give him SQ fluids. In Greece only the one (for human use) was available, so I went for it. I gave him one dose and within 3-4 minutes, he produced a hugemass of hair, mushed pellets and poo(5cm X 2.5cm !!!!), which was what was blocking his intestine and which actually got off his but with my manual help, because it wouldn't fit out of there otherwise, it was way too big.Right after that, hewas pooping all over. He started eating within the next 10 minutes. This went on for half a day, I gave him only hay and some pellets initially, because his poos were extremely soft and his GI flora must have been an awfulmess. That was it, in no time he was back in life. He could have been dead that easily also.

But, as I told you, I had no choice and no professional help. I dread the time something like this or something else, equally life threatening, would happen to us again.

So, to conclude, if you are confident that your bun will be treated better with you than in the clinic you mentioned, or if there is no other rabbit savvy vet in your area, whom you can trust, then, you are the one to take the right decision for your rabbit...

Marietta

 

[Michaela]

Did you go to see Clover Jay? How is she? ray:

 

[p1rat3]

I was on my way to get Clover when I called to check what time they closed. I thought I would ask what treatments they had given her and to have that information ready when I arrived. Because I had mentioned Clover she asked me to hold on. The Veterinary Surgeon got on the phone and told me:

That he went to check on her at 2 and she seemed about the same as in the morning. Then he went to check on her at about 4 and saw that she was a bit bloated. He was going to give her and scan to see what was going on and when he picked her up she started breathing very hard. he went straight to put her on Oxygen. But she stopped breathing and shortly after her heart stopped.

That is about how he said it.

I went down there and asked him a few things, like: Why she was not given any pain medication. Why she did not have a scan when she came in. Why she was not given any food or appetite stimulants. He gave the standard answers about this is how they all treat these symptoms. They did say that they had started the motility drugs on her today.

I did not yell at him and told him I hoped we both could learn from it. I did ask him to read the articles and if he thought that he could have treated her better that he could pay for her treatment otherwise I would pay. Maybe this was too harsh, but I do think that both him and I could have done better. I think she would have had a better chance if I had re-read the GI stasis article on Tuesday night. I relied on the Vet too much and I wish I had done more.

I miss her and will blame myself at some level for a while. This is part of my grieving.

Thank you everyone for your guidance and support.

Jay

 

[Michaela]

Oh gosh, Jay this is not what I wanted to hear - you must be devastated, I am so sorry. :tears2:

Binky free Clover.:rainbow:

I know you will want to blame yourself, but you really shouldn't. It's so wrong that vets today barely get trained in small animals at all, I have experienced their lack of knowledge more than once, (vets here are particularly awful because it's quite rural). We shouldn't have to depend on Internet research, vets should know how to treat our pets properly. Like you said though, at least you can take something out of it, you will always know for the future and perhaps the aritcles you gave the vet will help another bun or two.

Thinking of you. :hug:

 

[slavetoabunny]

I'm so sorry. RIP Clover.

 

[Pipp]

So sorry, Jay. :bigtears:

Re-reading the story, I think the initial treatment was good, my first guess would have been cecal dysbiosis, liquidy cecals caused by an imbalance, and treatment is really high fibre foods (the wet pellets or Critical Care if she wasn't eating hay), andhydration, the Bio-Lapis was a good call. (Trying to get fibre into a CD bunny is an age-old problem).

Butit's also possible you were faced witha case of bloat whichunfortunately it's fatal more often than not.

I hope the vet at least provides a free necropsy.

Bloat is different from a stasis or other gas attack. Thestomach fairly quicklyfills with excess gas, fluid,foam and/or hair, itswells and it canstart to twist (vovulus).

They often get diarrheafirst, and yousee a lethargic 'hunched' bunny (as opposed to a regular gas attack where they seem uncomfortable and press their tummies to ground). Their temperaturedrops, probably because of the pain. Itispainful, usually is accompanied byteeth-grinding, and calls for heavy duty pain meds.

The only treatment isdrainage through a gastric tube. They often re-bloat, so it may need to be done several times.

I've been trying to learn what causes it, but nobody seems to know.According to Rami at Medirabbt,it may be related to overeating and/or exercise immediately after eating, and he also mentions lack of fiber in the diet, change of diet, excessive drinking,stress, a pyloric blockage or other GIproblems. (Thatpretty much covers anything and everything). I've heard about it happening to bunnies who have eaten wet spring grass.

The condition isirreversible after a certain point -- the swelling interferes with blood circulation, the heart rhythm, etc.

I'm not sure if your vet is aware of this condition or if he thinksClover may have been suffering from it.

As noted before, stasis is a symptom of other problems. It's important to know how to treat it, but it's alsoimportant to determine the cause. In some cases, like bloat, some stasis treatments, like tummy massages and exercise (not sure about gut motility drugs) could make the situation worse.

I would thinkin Clover's case, my firststeps would have been to do a fecal test,take an xray and administer pain meds. But who knows if that would have worked, it may have already been too late if it was bloat. It's just not very cut and dried.

So sorry for your loss.

:rip: Clover.



sas :tears2: