Sucralfate Dosage

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HoneyPot

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Hi, does anyone know the rabbit dosage for Sucralfate? My vet doesn't have it, so she's 'winged it' for Oliver, but if Randy - or someone has any idea, can you let me know?

So far she's giving him .1 CC twice daily of a 1gr/5ml suspension.

I have to go back to see her first thing this week -Oliver has odd mouth ulcers and he's completely refusing food (since Friday morning) although he's drinking lots. He hasn't pooped properly since Thursday - he's producing cecals, but not regular poops (or else they're soft and he's eating those too).

He's a little uncoordinated - tried to jump onto his shelf this morning and missed. He's also shedding badly, his coat is horrendous right now.

When he was examined, the vet didn't think he had a blockage (especially since the cecals aren't a problem). I've been hand feeding critical care four times a day but there have been no solid poops since yesterday morning (cecals are pretty regular though - he's eating those).

When I go back to her on Monday, she intends to do a biopsy of the ulcers however, I've been doing a bunch of reading online and I'm wondering about Mycotoxins. She's given him the Sucralfate - which should be in the right track if it is, but since she isn't sure of the dosage...

Anyway, if anyone has any idea, please let me know.

Thanks!
Nadia
 

ra7751

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Hi Nadia,

Just a question here....is your vet an experienced rabbit vet or is she relying on a particularly well known printed manual? Sucralfate is not something I would use in a rabbit. It is a human drug used to treat duodental ulcers. The idea is to coat the ulcer to protect it from stomach acid. I don't know that it does all that well in rabbits and has some very undesirable side effects. I do know of some instances that it has worked....but in my opinion, it is much more like the gut motility drugs....the risks far exceed any possible benefit. This drugs can cause "bezoars"....like hairballs or ingesta in rabbits....since the drug can also bind to food and cause undesired collecting which will result in a GI slowdown.

I really doubt mycotoxins would cause this condition. Mycotoxins cause serious and life threatening GI disturbances that generally lead to "blow out" diarrhea. Mycotoxins poisoining can happen in contaminations as small as several parts per billion. Most labs can't even test for this (in the forage food). Mycotoxins do cause ulcers...but it's deep in the GI tract as far as we know.

I have only seen one other rabbit that had ulcers in it's mouth. I am not a huge believer of virus infections in rabbits (other than pappiloma) but it is likely this is some type of viral infection....like some of us humans get in our mouth. If this were my rabbit, I would be making sure it is properly hydrated and is eating a very basic diet. Not a bad idea to do a lab just to see but I bet that will be very uncomfortable. The only real treatment protocol for a virusis supportive care. I would also try to find some soft hay since an oral ulcer can occur from a puncture of a stiff stem and the puncture gets infected....and if that is the case, it would most likely be a bacterial infection. I would get your vet to administer fluids....at least 5% if not a little more. And some pain meds would certainly be in order. In this case, Tramadol would probably be most welcome. And I would take a very close look at the molars. If the molars have spurs, they can cause sores in the mouth also. And I would most likely offer a probiotic in an attempt to stabilize the pH in the gut. The pH (normally very acidic) will start to change in a GI slowdown and that can cause a series of cascading issues.

And going back to the Sucralfate.....if your vet has a specific clinical example of using this drug for this, that's good. If she is just reading off the VIN or from one particular manual....I am not so comfortable with that. Good luck.

Randy
 

HoneyPot

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Thanks Randy - your information is wonderful - as always. I took him to another vet that is more knowledgeable and he agreed the sucralfate is not the way he would have gone (he uses it as a last resort type medication he said).

Oliver is with the vet now - he's being put under so the vet can get a proper look around in his mouth at the ulcers etc. and see if there is any other bruising. Possibly then doing some blood work, but definitely getting some pain medication. Will know more later.

Thanks again.

N.
 

ra7751

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That sounds much better. No slamming of vets intended...but the VIN, Five Minute Vet Consultand the Merck Manual do not make a rabbit savvy vet. I knew exactly where the information on the use of this drug came from. I know the use of Sucralfate is very old school....and from that time that we didn't understand a rabbit as well as we do today. I certainly agree with your new vet that this drug should be used only as a "Hail Mary". Sounds like we are on a much more sensable line of treatment here. Keep me posted.

Randy
 

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