Recovery from a blockage

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keyofeflat

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Hello. My female lionhead Dahlia (she's between 2-3 years old) ended up with a blockage this past Thursday. After a procedure and a two night vet stay, we brought her home. She's been eating a pretty good amount of greens but no pellets or hay so far. We've been managing with her pepcid and cisapride just fine, but the critical care we only started to be more successful with just last night (Monday). We are just now getting into a solid groove with bunny burrito-ing her, as she fights us every step of the way and it took some getting used to and trial and error to get it down for the several syringes worth of meds and critical care. We haven't been too successful with her laxatone as she tends to spit it out. She's pooping, while still small irregular, and her behavior is fine so she seems to be on a good road to recovery.

My question is - how long can this recovery time typically last and what should I be expecting throughout the process? Dahlia not eating hay worries me as she LOVES her hay, but I get it's only been a few days and as I said she's eating greens and we're getting some critical care in her. I think she's also distressed with the bunny burrito and syringe dance we have to do 5 times a day for her meds. She has a bonded mate, Marley, who has been a little aggressive with her since she got home - just chasing her and punching her when she doesn't groom him, no nipping that I have seen. They're separated now to ease the stress on her with recovery, but I think that is also distressing her since they were attached at each other's hip before.
 
When syringing anything, be sure to put it between her cheek and her side teeth (not on her tongue or the main part of her mouth where there is a risk of forcing it down her throat). When it is placed in the cheek area, they cannot spit it out but have no choice but to lap it up. Just put small amounts at a time.
 
My rabbit Dimi has been through GI stasis several times, unfortunately. I think it's very good that you're getting her to eat greens. Make sure they are nice and wet when you feed them as she will get more water that way. My Dimi does not drink much water, so when she is having a problem, I sometimes will syringe her some water as well. And the critical care is good too.

She may have the smaller, lesser poops for a week or two- that's been my experience. As long as she is still eating and pooping, it usually means things are working. But it can be frustrating to see the smaller, infrequent poops. Last time Dimi had a problem, she had the smaller poops for two weeks even tho she was on all her meds. We feed Dimi a small amount of plain canned pumpkin to help move hair along, on a regular basis. Sometimes when she is having the smaller poops, we give her some of the pumpkin mixed with water as she is more apt to drink it. The vet thinks Dimi's problem is hair- not a true hairball, but rather too much in the digestive system such that it slows down. She sheds a LOT. We try to brush her everyday, which is so important with her shedding issue. At the holidays, we slacked off a few days, and that's when things started to slow down. In addition to the motility med metoclopramide (similar to your cisapride), she also is to take Metacam, which is an anti-inflammatory. My rabbit vet says that they think inflammation of the cecum is involved in GI stasis or hair blockage, and the Metacam can help. I always thought it was just for pain. But I was to start her on it as soon as i saw small or infrequent poops. And I was surprised that it worked.

Keep offering fresh hay... she'll eventually take it. The most important thing is to keep her eating, even if just greens. My rabbit is not bonded, but based on what I know, it can be stressful to be separated- although I understand you need to keep her from the other rabbit's aggression now. If they can see each other at least when penned, and maybe have some time together in a neutral area vs a cage/pen, that can restore some normalcy.

The advice above about syringing is spot on. Rabbits can aspirate if it's forced straight back. I've never tried the rabbit "burrito". For Dimi's meds, my husband holds her while standing (or she'll try to get away) lengthwise across his chest, and I give her the meds from the side into her cheek area, just a little at a time, giving her time to lap it up and swallow. This works great for us, but Dimi is very used to it and just kinda relaxes there while I dose her. I hope your Dahlia is back to her old self in no time!
PS- my rabbit will not eat that petromalt (laxatone) either. She hates it. The vet said no big deal, many rabbits will not take it.
 
DON'T give her the laxatone. It's from an old school way of curing stasis and it really causes more problems than anything. Most vets don't prescribe it anymore and activelly advocate against it. It can actually cause blockage again as it coats what's inside the guts. It's supposedly to make the mess slide out, but it can make the content of the stomach cluster in something to big to be expulsed. If she is pooping and taking the critical care, it's fine. Cisaprid is fine too. If she's eating veggies but not hay, the best thing would be to get grass. If you can't, try other types of hay (some of them have flowers or mint in it which makes it more enticing). Second crop is often a hit. I have an older rabbit who has had slow guts / stasis problems a few times since she hit the 7 year old mark and she's always eating that a lot better than normal hay. Give leafy greens mostly, wet, so the guts are kept well hydrated.
I never 'burrito' my rabbits. I just get on the floor with the rabbit on my knees, his side pressed against my belly and I put the syringe behind the teeth. After a few time, it's easy. I think it's less stressful that way and, honestly, I always thought doing the burrito thing was too complicated. But if it works for you, it's fine.
Her mate reacting badly is to be expected. I think you were right to separate them. You'll have to rebond from the start when she's all better (neutral space, put them together back in their previously vinegar / vaccum cleaned area). It happened to my previous pair after a surgery. They fought like crazy and suddenly seem to remember they were friends when put in a neutral space with carrots. It honestly took 5 mn and everything went fine afterwards. There are two factors here : the vet and the meds put a weird smell on your bunny and, in her absence, rabbit n°2 became king of the realm and feels compelled to defend it against 'intruders'. When healed, your female will smell like herself again (you can put some perfume on the second rabbit's nose just in case). And by putting them together in a territory that is once again neutral the previous hierarchy should be restored.
 
I am a fan of the burrito method. My lionhead was too feisty to syringe feed. I've never had to deal with a blockage, just GI stasis after my spay.
As far as how long... every rabbit is different. My vet gave me an arbitrary number of days to continue my meds and treatment but I decreased my regimen from 3x a day to 2x a day to see if she was eating and drinking and pooping on her own. Then once a day and I eventually stopped earlier than the vet told me.
My thought process was she isn't going to eat on her own if I kept syringe feeding her food. But I was home at that time so I could watch her all the time.
 
I just want to comment on the Laxatone issue. I also was under the impression that Laxatone or any other form of hairball medicine was BAD for rabbits, and not helpful with GI stasis. I had read an article by Dana Krempels basically stating this. She says since it's mineral oil based, it can coat an impaction and not allow water to penetrate the stool (which is believed to help resolve that). At any rate, since Dimi's shedding is so prolific, my rabbit dr (who is a pretty famous rabbit expert) recently told me to try Petromalt (which I think is the same as Laxatone??) I was like, NO WAY and told her about what I had read. She said that for the most part, it true. It is definitely not a first line treatment. But since we are pretty sure Dimi's problem relates to ingestion of large amount of fur, she wanted me to try it. She said it would not hurt her. I totally trust her, so I tried it. But it was a moot point since she would not eat it. So I guess my point is that there are specific cases where this may be helpful as an adjunct treatment (not a replacement for motility, pain, gas meds). If in doubt, you could mention the Dana Krempels reference and ask your vet. And that vet should really be familiar with the most up to date rabbit health items, as they are changing and updating quickly.
 
Laxatone and other hairball remedy can infact work.
This is such a hugely argued topic. Most who advocate against it can make as good of an argument as those who argue for it. Its up to you who you believe.

Not all blockages or semi blockages can absorb water and fall apart. Hair is not like hay or food. It does not absorb water and fall apart like hay.

"Lubing up" the items intaken so they pass through unobstructed can be fantastic in many cases.

My guys LOVED their petromalt. Would just put a chunk on the edge of their bowl and they would lap it right up.
 
Keep in mind there are so many brands and so many flavours.
It may not hurt to visit the cat section at petsmart and try a few different ones and return them if she wont eat them.
My guys went for the malt flavour petromalt. Not sure what Petcos return policy is like but it should be similar.

You could try mixing it with Banana or something else too.
 
Thanks everyone. Our vet is the one that gave us the laxatone, but she fought SO hard with it we just gave up anyway. She's doing good - finally eating hay and her poops are normal so we are going to weaning her off of the cisapride. Bunny burrito is the only method we could use to successfully give her the meds. She's a diva, lol.
 
Watermelons said:
Laxatone and other hairball remedy can infact work.
This is such a hugely argued topic. Most who advocate against it can make as good of an argument as those who argue for it. Its up to you who you believe.

Not all blockages or semi blockages can absorb water and fall apart. Hair is not like hay or food. It does not absorb water and fall apart like hay.

"Lubing up" the items intaken so they pass through unobstructed can be fantastic in many cases.

My guys LOVED their petromalt. Would just put a chunk on the edge of their bowl and they would lap it right up.
Click to expand...



Dana Krempels advises against it in her article:
"It may be inadvisable to use petroleum-based laxatives* such as Laxatone®, as these hydrophobic products may coat an intestinal mass,
making it more difficult to hydrate."

I think hydratation is the main point to get rid of stasis, so to me it's counterproductive. My first rabbit died taking this and I'll never give it again. I'm not saying it can't help in some cases, but I think it's not worth the risk when the rabbit is passing poos with Reglan / Cisaprid which are a lot safer. Of course, it's only my opinion ^^.

Anyway, I'm glad she's recovered! Stasis and blockage are always scary.
For future reference (hope it doesn't happen again, but you never know), if you haven't read it, there's a good article about recognizing and treating stasis:
http://www.bio.miami.edu/hare/ileus.pdf
 
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