GI Stasis

[Barley N. Hopps]

Hi, I guess I'm just looking for reassurance here as Barley's recovery from this seems slow to me, but then, I've read it can take weeks.

On Sunday, Barley wasn't as social as usual and I put it off to him snubbing me for spending more time painting a bathroom than paying attention to him! (The bathroom is around the corner from him, no paint fumes with this paint but I kept doors and windows open anyway) Monday morning he did not come to greet me as usual but was hiding behind a small grass hut in his condo. He had not eaten or used his litter box overnight so I got him a vet appointment right away.

The vet examined him carefully and noted some weight loss since his annual check-up in February, and no sounds at all from his insides. She did blood and urine work, and took x-rays and found some stomach contents but it didn't appear to be moving beyond there. She prescribed Cisapride and Metacam, and Critical Care for syringe feeding. She kept him there for most of the day, in fact, giving him fluids and keeping an eye on him. I was to give him the cisapride for 5 days but somehow it only lasted 4. (I may have overdosed him a bit by including the amount in the nozzle part of the syringe instead of measuring only 1 cc in the syringe. Just thought of that now.) He is still getting metacam today and tomorrow, once a day. Later that same day, he left some sticky specimens in his litter box, and he has been passing hard, hairy little stools since, thankfully, and peeing.

The vet wanted to do another blood test on him on Thursday to double-check something, and in the meantime, I spied some bare, red patches on his hocks so had her check them out. She had no idea why his feet were like that but she'd seen it before on a Flemish Giant who was an indoor house bunny. I'm to keep an eye on his feet, and am being extra vigilant to keep his litter box clean. (I was only cleaning it once a week, just putting a handful more of kiln-dried pine shavings on the wet part in the meantime. Now I'll clean it properly twice a week.)

It's now Saturday and he's still pretty lethargic, barely eating on his own, and I haven't seen him drink anything at all - but he's not a big drinker normally. He's eating romaine lettuce, pea shoots, flat pea pods and the odd commercial treat (Veggie Puffs and Healthy Bits) and occasionally noodles down a strand of timothy hay, but is really lacking enthusiasm.

The vet suggested I syringe-feed him a little less to make him hungry. I was getting 40 ml into him morning and evening the first day, then 40 and 20, 30 and 20, and 30 again this morning. He's really getting fed up with the syringe feeding too and often just holds the stuff in his mouth or lets it ooze out.

Can you tell me if this is all going sort of typically? Is he being slow to recover? Could sore feet have caused all this? He's on carpet, and his levels in his condo are covered in carpet which is covered with old sheets. Is all this syringe-feeding making him depressed? Is there any way I can entice him to eat more hay? It's Oxbow brand and seems to have a decent green colour so I'm hoping it's fresh.

Sorry to go on and on. He's always been such a happy, healthy boy, it's awful to see him so quiet and miserable. Any help at all is gratefully accepted!
Thanks!
Liz

 

[JBun]

If he still doesn't want to eat much on his own, it's possible there is some other medical problem causing the lack of appetite. A lot of times dental problems can cause a lack of appetite, which in turn can lead to stasis. Did the vet check his molars and take a radiograph of your rabbits head to check for dental problems?

I wouldn't be feeding him less of the critical care. It doesn't sound like he cares much for it, so he will naturally want to eat his regular food on his own if he is feeling well enough. If this is dental related, you may have better luck getting him to take the critical care if it is warm and not cold, as the cold food and water can sometimes be uncomfortable on a mouth or tooth that is hurting.

If his hocks are sore, you can put neosporin(not the pain relief kind) on there, and/or A & D ointment, and cover the feet with baby socks secured with vetwrap, to protect the feet. Just make sure not to do the vetwrap too tight.

 

[Barley N. Hopps]

Thanks for your reply, Jenny! Yes, the vet did check his teeth but I'm not sure if she took x-rays of his head or not. I am making up the Critical Care with warm water, and I asked the vet about putting anything on his feet and she said not to at this point but to keep checking them. I clipped his nails when I got home.

I forgot some info in my initial post. Barley is just over 4 years old, an ordinary European black rabbit that my daughter picked up from the university grounds as a baby. Since adulthood, he hasn't been much of a drinker, is fairly picky about what greens and veggies/fruit he gets, but eats about 2 cups of greens/day (when well). He has access to hay at all times but has never been big on eating that either. I was startled when the vet told me last year that he should be eating a pile of hay as big as himself on a daily basis! He's never eaten that much! He weighs just over 5 lbs when healthy. I don't know what his weight came in as on Monday but she said it was down a bit.

Thanks again for your input! If his feet get worse, I'll tell the vet about your suggestions!
Liz

 

[molly]

If you can do sub q fluids at home, that would go a long way to help break up any dehydrated matter in his stomach.

Are you giving probiotics? They may help also.

I had a rabbit in stasis for the better part of two months and I found adding pumpkin puree (NOT pumpkin pie filling) to her force feed helped a lot. She even started eating it on her own after the first time she tasted it and that made her a lot happier because she hated me force feeding her.

For increasing hay consumption, how much are you feeding rabbit pellet wise? I don't feed pellets to any of my rabbits and I have found their hay consumption increased a lot when I weaned them off pellets. Same goes whenever I have foster rabbits, when I give them a limited quantity of pellets, they start eating more hay.

Try different types of hay also. If you can get quality mixed grass hay (the type sold for horses) some rabbits prefer that to the store bought varieties. Bourne Free farms sells a mixed grass hay that my finicky bunny really likes, it can be hard to get though so you may have to contact them and order it directly and I don't know how much shipping from ON to BC would cost. There are probably local alternatives for you though.

Putting hay in the litter box also encourages hay consumption and litter box use. (At the shelter I volunteer at, we recommend spot cleaning the litter box daily to spot issues right away.) You can try stuffing cardboard (toilet paper) rolls with hay and putting them in his play area so he'll be encouraged to play with them and maybe eat them. Sprinkling hay with fruit juice or pellet dust or lightly steaming it can also make it more palatable. Make sure you discard any moist hay after a few hours so it doesn't grow mould.

I would cut out commercial treats completely at this point, they're of no benefit.

For his feet, I'm not a big fan of Neosporin/Polysporin - if he grooms it, he will be ingesting a broad spectrum antibiotic that may cause further GI issues. I've had success with Soother Plus by Heal x, it's a non-medicated ointment that provides pain relief and encourages healing. Make sure you're providing plenty of padding in the bottom of his cage (i.e. several layers of towels) to help him heal. Is it just missing skin or are there sores?

Is he producing stools? How many? Are they small/dry? Is he active at all?

 

[Barley N. Hopps]

Thanks for your reply, Molly! I am unable to do sub-q fluids at home, but he did take a drink from his water bowl just a little while ago. I am not giving him any probiotics either, but I've read about adding some pumpkin to the Critical Care so will pick up a can of puree and see how he likes that. He loves his medicam, by the way, the little addict, and takes that like a trooper. He really perks up after that too so I'm afraid he must be in pain otherwise. I only have one more dose of that now (for Sunday) so I'll see how he is on Monday.

He's never been a big pellet eater. He would eat 2 or 3 tablespoons a day. He also enjoys rolled oats and gets about 2 tablespoons/day. I see he's eating those again after not wanting them for a couple of days. He also ate a small piece of banana this morning after rejecting that earlier.

I will try to find some different hay to try too, along with the timothy. There are hay sources around here but the first cutting isn't in yet, and then I'm expected to buy an entire bale! I have nowhere to store a 50 lb bale of hay and no one to share it with, so I'm kind of stuck with the store offerings, I think. I've read to steer clear of alfalfa but will hunt out some other kinds. I like your idea of stuffing toilet paper rolls with hay too! I think he'd enjoy something like that.

His cage floor is very cushioned with some carpeting and old sheets. One hock has a white area like it's calloused and about an inch of redness. The other hock is just quite red. You have to push the fur out of the way to actually see it. When you first turn him over onto his back and his feet are up, all you see is furry feet, but I caught a glimpse of red on one occasion and started investigating. The skin just looks red but isn't broken. The vet says she doesn't think it's urine scalding because it would be elsewhere and he's good and furry everywhere else.

His droppings are beginning to look more normal. There was a fair amount of hair in them earlier, not so much now, but they're small-ish. I think he's passing about as many as is usual for him now, and they're not as sticky as when he first started the treatment.

He was very inactive this morning until he got his metacam and then he started moving around a bit more. He usually has wonderful "spazz attacks" when he races from the tv room to my office (the two areas he's allowed to roam in) back and forth several times, doing binkies and being generally crazy, but he hasn't done any of that since some time last week.

 

[molly]

Stop giving him the rolled oats immediately, they could be contributing to his issues. Grains are too high in starch and calories and lack necessary fibre. He needs fibre to maintain a healthy balance of gut bacteria and the oats encourage the wrong type of bacteria plus they are probably filling him up so that he's less likely to eat hay. Your vet was correct about the amount of hay he should be eating, you should try to not give him any treats or other foods that carry little nutritional value if he's not eating enough hay.

There are a few good articles on stasis out there, this is one of them: http://rabbit.org/gastrointestinal-stasis-the-silent-killer-2/

Can you take his temperature? It sounds like he's deteriorating because he's been in stasis for so long now, his temperature would give a better idea.

Subcutaneous fluids are much more effective at rehydrating stomach contents than oral fluids and it really sounds like he needs them. It sounds like you have to go to the vet Monday, I recommend you ask them how to do them at home. It's really not that hard and it helps a lot. In the meantime, you can try to rehydrate him by making his force feed a little watery and/or giving fluids by mouth. If you can pick up some unflavoured Pedialyte, that would be even better.

It sounds like he has mild ulcerative pododermatitis/sore hocks/bumblefoot. It's not his primary issue but you should read up on it to try to prevent it from worsening.

 

[Zeroshero]

Glad to hear he is improving, my bun is experiencing a similar problem it has been seven days and he still is not able to go off cisapride. I caught his stasis really soon (he didn't entirely stop deficating). I read Dana Krempel's article and it states that it can take two weeks to fully resolve. I will keep you and your bunny in my thoughts. It is so stinking stressful having a sick bun.

 

[Barley N. Hopps]

Molly, I will stop with the oats right away then, and the treats. The vet wanted me to give him just whatever he would eat to get him eating again on his own and then I guess I would wean him off these treats after that. I have read that article before - it IS very good! The vet took his temperature on Monday and said it was normal. I'll ask her about the sub q fluids next time I talk to her but I have been mixing his Critical Care with more water than they recommend, mostly because it seems to get thicker and thicker just while I'm feeding him! I will look up the bumblefoot issue and see what I can find out about it.

I just got back from picking up some meadow hay and orchard grass hay. He was trying to get into a bag before I could even open it and tucked into a small handful immediately! I tossed most of his pellets, just left a few in his bowl to wean him off them, or at least restrict them more.

Thanks again Molly!

And thank you for your comments, Zeroshero! I will keep you and YOUR bunny in MY thoughts too. It is very stressful having a sick bun, and I'm also caregiver to my ailing mom who worries me as well. Sometimes I wish I was a silly little kid again with no worries!

 

[molly]

I'm not saying you should stop feeding pellets all together (I really don't like them but it's a personal choice and it also depends on the situation/individual rabbit) but it is important to feed limited quantities.

I'm glad to hear he likes the hay, that will help him a lot. I hope he continues improving. It's a good idea to learn how to take his temperature yourself because it's helpful to monitor temperature once or twice a day when they're having GI issues. Your vet should be able to show you how if you ask them.

Good luck

 

[Barley N. Hopps]

Well I like to say "everything in moderation" so I'll just cut back on the pellets. He's not crazy about them anyway, and if it makes him eat more hay, then it seems the sensible thing to do! I will talk to the vet about taking his temperature too. I just sent her a detailed email on his progress, and about the Pododermatitis. I would like to take care of that right away in case it's the cause of all this trouble, or even partly the cause. Many thanks, Molly!

 

[Azerane]

Glad that he's picked up a bit. Sometimes it is something as simple as trying a different type of hay.

 

[Barley N. Hopps]

Thanks, Azerane! I guess his initial interest got me all excited because now he's eased off on the new hay too. Sigh. He's eating kale though, and ate almost his normal 2 cups of greens yesterday so I'm optimistic. I can feel his hip bones and his spine so I'll continue syringe feeding as a supplement until he's eating better. Gosh this is worrying!
- Liz

 

[molly]

If it's causing him pain it could be the cause of his stasis but the fact he doesn't eat a lot of hay doesn't help either. How's he doing today?

 

[Azerane]

I believe you've had his teeth checked thoroughly right?

 

[Barley N. Hopps]

Thanks for asking after Barley, Molly! Sorry I didn't reply earlier. I don't seem to be receiving notification in my email, although I'm pretty sure I ticked that box. Will check that again.

Well my boy seems to be getting back to his old silly self! He is eating up his veggies and starting to move around more. I opened the door to a Forbidden Room today to see if he'd try to get in, as usual, and sure enough - the ears went up and he came dashing over and slipped in when he thought I wasn't watching. ) I supervised him in there carefully while he explored and then ushered him gently out when he made his way near the door again. He's displaying his old curiosity and nosiness, which is such a delight! He's making nice deposits in the litter box, and nibbling a bit more hay. I've limited his pellets to about a tablespoonful, no more oats, no store-bought treats. From now on, it's hay, veggies, a few pellets, and a small piece of fruit once a day for his treat. I didn't syringe-feed him this morning, which helped his appetite, but I think I'll syringe feed him tonight because his weight is still down a bit. He was 2.56 kg in February at his annual check-up, and 2.4 last week and today. Do you think this is a good idea?

Azerane, the vet checked his teeth but only did x-rays of his body, not his head.

 

[Pet_Bunny]

I am seeing this now.
Do you feed any vegetables?
Again, everything in moderation, but when it comes to parsley, I have success giving bunnies bunches of parsley when they would not eat anything else. You could even dip them in water before feeding to give them extra hydration.

 

[Barley N. Hopps]

Thanks for posting, Pet_Bunny. Yes, he's eating kale, romaine lettuce, spinach, flat pea pods, and pea shoots. I offered some carrot, cilantro, and red and green pepper, but he declined.

 

[tonyshuman]

Sounds good. I like your "forbidden room" test--my Tony is like that with places he's "not allowed" to go in. Good to know he's not the only mischievous bunny out there! It sounds like he's eating well, but if it takes much longer than a 2 weeks or so to get him back to eating normally again it might be a good idea to have his teeth checked.

 

[Zeroshero]

Glad to see he is becoming more like his old self again

 

[Barley N. Hopps]

Thanks Tonyshuman and Zeroshero! He's up and down, some days I syringe-feed him once (about 30-35 ml) and sometimes twice, depending on the evidence in the litter box and how much he's eating. He's pretty keen on his greens, has 2 tablespoons of pellets/day, but he's still gracefully nibbling only a strand or two of hay at a time. He never was big on hay. He's getting very suspicious of me now too, that I'm going to haul him off and weigh and syringe-feed him!

It's such a catch-22 situation. I don't want to leave him without enough food in his system, but I don't want to over-syringe-feed him so he's not hungry to eat on his own. If he would eat more hay, I'd probably stop the syringe-feeding. Any ideas?