Bout of Ileus

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RavenousDragon

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Hey guys! I need some help. So Brandy, my female rabbit, had a bout of ileus last night (I'm watching her play and eat all the hay she can find right now, so we made it mostly clear- poops are still a little small). But she's never had ileus before and I'm wondering the cause. Whiskey, my male, had it in November (similar, lasted about 12 hours and then was over with treatment). I just don't know what could have caused it- it seems unlikely that two rabbits in the same household get both get ileus in a 4 month span without it being the owner (my) fault in some way.

Her diet: unlimited Timothy hay (2nd or 3rd cut, Oxbow), 6 Oxbow Natural Science pellets in the morning and up to 5 additionally as treats (she's a 3.5 lb rabbit), fresh veggies every night (varies, but all are listed as rabbit safe of course). And periodically she gets PIECES of Oxbow brand baked treats or dried fruits for training purposes (I'm a HUGE proponent of a bored rabbit is an unhealthy and destructive rabbit, so we do lots of training of stupid tricks in our house). She also periodically gets Flax seed (used to be every day, but she kept getting soft cecotrophs, so that mostly stopped) as an antinflammatory supplement. Further treats include Oat Grass Hay and Orchard grass hay. For her teeth (as per the vet) she gets one timothy hay cube from Kaytee every other day (does have some alfalfa, but not a lot, mostly timothy to help keep those teeth filed down).

Medical history: She has to have her molars trimmed monthly (she's going in Thursday for this, so we are going to talk to the vet about her ileus too), but she's never actually had ileus from bad teeth in the past (we caught it before she had GI issues!). She has had (and periodically still does have) cecal dysbioses where her cecotrophs are too numerous and so we simply cut out all treats and sometimes even pellets until it clears up. Recently we found elevated liver enzymes (AST in particular- a hepatocelllar enzyme, indicative of hepatocellular damage) and so we treated with albon and milk thistle/lactulose in the hopes it was simply an ascending coccidial infection. She got some blood work that came back as even worse (this could be an artifact from sitting too long- it was free from my school and it sat a while, so we may retest on Thursday when we go to the vet).

Exercise- she has a total of about 20 square foot cage (but over a total of three floors with ramps to climb) and gets free run of the entire apartment (when we are home to supervise) about 4-8 hours per day depending on work schedules. She's a generally lazy bun, but she does periodically run around (she mostly comes out for the snuggles).

Stressors: my boyfriend recently left for a work trip on Sunday morning (she had obvious ileus signs Monday night about 7-8pm to put it on a timeline). He's been gone before with no issues. I've been struggling with depression issues (animals are great at reading body language, so she may be stressed because I'm different form normal ). It's been VERY windy here (75 mph gusts) and even though she's an indoor bunny, she doesn't seem to like the wind (however, this has never caused ileus before). Otherwise, it's a fairly quiet apartment and she's not an easy to stress bunny.

Whiskey, who had ileus 4 months ago is under the same conditions. Can you guys think of anything I'm doing wrong with my bunnies to cause them to have ileus? Thank you guys!
 
Here's a good article that might help. http://www.bio.miami.edu/hare/ileus.html

I'm no expert, but we have dealt with ileus/GI stasis a few times. I'm a bit surprised that your rabbit has to have her molars trimmed monthly! Also, does your bunny get ileus after the tooth trimming? But, if the teeth are causing her pain or discomfort, that could be a cause. I'm not sure what you mean when you say you only give 6 pellets - are these the tiny pellets, as in food pellets? What kind of veggies? Some veggies can cause gas. I would start with diet, any potential pain issues, and then consider the other issues. If they are both eating the same things, and they have both had ileus, then my guess would be something they are eating. Our vet gave us metoclopromide to keep on hand because we have one bunny who has dealt with some bladder sludge, and every now and then, he has a flare up, and he will start peeing on his cage floor, and if we leave him too long without treatment, he starts going into ileus, but if we give him a dose of metoclopromide at the first sign of it, he stops peeing outside his box, and within 6 hours, he is typically resolved. I hope you get it figured out.
 
As rabbit age they get stasis more easily, as their guts are generally not as performant as they were before (Aki never had anything until one year ago, she's almost 8 and she now has bouts of 'small poops' without any real reason from time to time - it generally gets resolved with fresh grass and some very pricey hay during a few days). Sometimes it's just a small stress combined with a bit of moulting.
It's very windy where I am too, and the rabbits seemed a bit on alert, even though they are inside bunnies too. Aki's small poops often occur when I'm gone - last time was during the Christmas holiday, when I had them stay at my house with someone coming twice a day to save them the train trip and the rambuctuous family festivities.
The diet you give sounds good, even if flax seeds, dried fruits and baked treats are probably not the best of idea if you suspect your rabbits are getting slow guts sometimes. It might be a good idea to replace those with fresh pieces of fruits which hydrate the guts and are less likely to aggravate any problem (dried apple is probably the less worse of dried goods).

If you feel like they eat their hay the same as before, you can continue with the same brand. Aki is becoming more finicky, so I'm now buying Crau Hay (about the best and the priciest you can find in France, but the only one she will eat every piece of) and giving some when I feel she is not eating as much as she should - I also give it when I have to leave on business trip to make sure there is no major problem in my absence.
 
I'm a bit surprised that your rabbit has to have her molars trimmed monthly! Also, does your bunny get ileus after the tooth trimming? But, if the teeth are causing her pain or discomfort, that could be a cause. I'm not sure what you mean when you say you only give 6 pellets - are these the tiny pellets, as in food pellets? What kind of veggies? Some veggies can cause gas. I would start with diet, any potential pain issues, and then consider the other issues. If they are both eating the same things, and they have both had ileus, then my guess would be something they are eating.

She's a netherland dwarf mix, so her jaws are not shaped quite right and her teeth don't come into contact like they should, unfortunately. So it's molar trims for us! The 6 pellets are the little tiny food pellets. Veggies include- parsley (common), cilantro (common), kale, romaine lettuce, collard greens, spinach (rare), and many others. We vary it, but most commonly it is parsley or cilantro

Aki, since I can't figure out how to quote two people in one message :p, with her cecal issues, she actually seems to to better with the dried stuff- do you think I should switch over anyways?
 
She's scheduled for a liver ultrasound tomorrow. Wish her luck in finding something treatable going on with her liver!
 
Well, generally dried stuffs are not recommended in that situation as it doesn't bring moisture and they are high in sugar (sugar has a bad effect on ileus), but I guess it depends on what the problem is. I hope with the ultrasound, you can find the source of the issue - it's really hard to try to treat something without knowing exactly what it is...
 
She's a netherland dwarf mix, so her jaws are not shaped quite right and her teeth don't come into contact like they should, unfortunately. So it's molar trims for us! The 6 pellets are the little tiny food pellets. Veggies include- parsley (common), cilantro (common), kale, romaine lettuce, collard greens, spinach (rare), and many others. We vary it, but most commonly it is parsley or cilantro

If the pellets are timothy based, you can give the recommended amount for the age and size of your rabbit (usually the packaging will show it), unless the pellets are causing problems with the teeth/digestion or your vet says not to give the pellets. Do you give daily veggies? I would stick with romaine lettuce, parsley, and cilantro. I did read somewhere that some rabbits have a bit of a sensitive stomach and the cilantro, kale, and spinach can cause problems. We only feed romaine because it's easy for us to get and our rabbits will always eat it. As for the molar trims/dental problems....I'm not sure of the age of your bun, but you might check with your vet to see if it is possible your rabbit has chronic pain, either from something else, or from the dental issues. We have a mini lop who just turned 6 this year, and he has a bad hip that causes him pain. When he is in pain, he doesn't want to eat, can't get comfortable, etc. He wouldn't move a lot, so he started having trouble with his bladder (and sludge), which caused more pain. So, we put him on a low dose of Metacam twice a day and it has made a world of difference!! We haven't had stasis issues in over a year. I'm assuming you are seeing a rabbit savvy vet? I hope they figure out what is going on with your bunnies!!!
 
Forgot to add....I personally would not use the dried treats. We were buying Oxbow treats for one of our rabbits, and it turns out that it was causing his chronic teeth issues to be worse. We only give tiny pieces of banana as a treat when we are giving medications.
 
Yeah. The treats we break into 8ths and just give one of those per day max (most days we just use pellets as treats). So the treats are not exactly a lot of their diet. We do give veggies daily- a small handful. We vary it so they can get all the nutrition they need with as few pellets as possible (e.g. kale and spinach for vitamin K, even though they are very high in the oxaloacetates and calcium). The vet we see is VERY rabbit savvy (I work there, and we see at least 1 rabbit per day, usually quite a bit more, as well as birds, mice, dogs, cats, lizards, etc. It's a lot of fun!). Brandy is almost 4, and she did get a basic muscloskeletal exam at her last annual (about 3 months ago).

Thank you guys!!
 
We are back from the vet! The ultrasound showed no abnormalities except for a mild gastritis (particularly a mild thickening of the mucosal layer of the stomach), but that could be the cause or the result of the ileus. The radiologist spent quite a bit of time on her liver and it was completely normal, along with her small and large intestines from what he could see (there's a lot of intestine in a rabbit). Kidneys were normal as well. So we still don't know what's going on with her liver, but there isn't anything visibly wrong with it, her gall bladder, or bile ducts.
 
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