Treating Stasis

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BMCBun

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My 9 year old Dutch died of stasis this week sadly. He’s survived it many times before and have been stasis free for several years as we finally figured out most of the things that did upset his stomach.

Why it reoccurred recently will remain a mystery. My question is around the treatment for stasis. I have now lost two rabbits to this, both times we took them to an emergency Vet at night, they were both given gut mobility injections anmetacam so the standard. The only difference from our previous successful stasis treatment was that neither received a fluid drip in hospital.

Both died the next morning.

For the recent incident we eventually got to a rabbit specialist the next morning and he tried to empty his stomach with a tube but failed as his stomach content was almost a solid mass. He died from the emergency anaesthetic in the end.

During the night. We kept syringing him with critical care as per the Vet’s advice. But the situation didn’t improve. Unfortunately.

We’re thinking to maybe get another pair of rabbits but I won’t until I am confident in dealing with stasis at night as somehow we always have this late at night and don’t have a specialist vet open 24/7 anymore as we’ve recently moved from the UK to NL.

Would love to hear any advice for treating a stasis bun at home after an initial emergency vet visit. Or completely at home if that is possible, keeping them well enough until the specialists open. Will giving fluids help? If so where can you get the fluid from and how much do you use? At this point I am just fed up with emergency vets that don’t understand rabbits or do a half baked job. It just seems that they don’t understand the urgency of the situation and don’t know how to deal with it properly.
 

JBun

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I'm very sorry for your loss. It's always hard, but especially when you feel like your vet care wasn't what you thought it should have been, and they didn't give your rabbit the help you felt was needed.

For a rabbit to die the next day, tells me there was something critical causing the stasis and not just a 'standard' upset stomach from something they ate, or from a gut slowdown due to the more common causes. Usually stasis recovery lasts days to weeks. A sudden death so soon after the onset of having a lack of appetite, will mean there was a life threatening underlying cause. Things like bloat, internal bleeding, heart failure, respiratory failure, ingesting a toxin, etc. It wouldn't simply just be due to the fact that they weren't given fluids. To me that seems more coincidental.

Dealing with stasis at night is going to depend on the cause of the stasis. Some causes are immediate medical emergencies(eg. bloat, respiratory distress, rabbit is flaccid and non responsive), and some causes of stasis are less immediately life threatening, though still can be serious. If the rabbit is stable and not showing signs that things are critical, then waiting until morning is sometimes possible, but you really have to have a good undertanding of rabbit health and the warning signs of critical issues, to be able to make this determination. But that doesn't necessarily mean that things like syringe feeding can be started before seeing the vet. The problem with doing this is if the cause is due to something where syringe feeding is contraindicated, like with bloat or a complete gastric obstruction. But there are a few things that I will do at home in cases of stasis when the rabbit isn't showing signs of it being immediately critical.

I don't have access to a knowledgeable overnight vet, so if I've had a rabbit showing signs of stasis, I'll check the stomach to make sure there is no indication of bloat(feels like an inflated balloon just under the ribs), they are still responsive and reactive to me and not flaccid, and are showing no signs of mouth breathing or respiratory distress. If they don't show any of these critical signs and it seems more like an upset stomach to me, I will first make sure their body temp is normal and if not(which cooler body temp often happens with stasis), warm them up with a rabbit safe warm pack(not too hot). I will then try baby gas drrops and electrolytes(provided they are still swallowing, and if not it could mean it's critical), encouraging movement, and maybe some gentle belly massage. In cases of minor digestive upset, this usually gets them back to eating and behaving normally again within 3 hours, after the third baby gas drops dose. But if they still aren't feeling better by morning, then I'll take them in.


The only reason I can see to rush a rabbit to an inexperienced(with rabbits) overnight vet and not wait for an experienced rabbit vet in the morning, is if the rabbit is showing signs of it being an immediate emergency and the vet can provide critical life saving assistance like an IV, oxygen, or decompress a bloated stomach. Or in the very least, administer the appropriate pain medication. But I can also see a problem in taking a rabbit to an inexperienced overnight vet. If the vet doesn't understand how to properly rule out bloat or a complete obstruction, they may prescribe a course of action that could be detrimental to the sick rabbit, due to their lack of experience. Something llike not knowing how to properly check the rabbits stomach for bloat and not taking xrays that would show a case of bloat, then sending home the owner with instructions to syringe feed supposing it's a simple case of GI stasis. Which syringe feeding could lead to the death of the rabbit due to increased pressure on the stomach, lungs, and heart. So it is a decision that should be weighed if the overnight vet isn't at least semi experienced with rabbits.

If you have a vet that will work with you and teach you to give sub q fluids at home, that may be something you could do overnight to assist a rabbit that has stopped eating, until you can get to the vet the next day. Sub q fluids in many countries, will require a prescription and instructions by a vet. Otherwise, I just do the steps I talked about above. If the stasis is from gas pain, baby gas drops(simethicone) has gotten my rabbits feeling better soon after being given them. Or sometimes a rabbit with a little stomach upset, this will kind of 'kick start' them into eating and feeling better again.

There are a lot of rabbit owners that don't have access to a good overnight rabbit vet, so having to wait until morning can sometimes be necessary, as there aren't any other options.
 

cwebster

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Am very sorry for the loss of your precious bunnies. OvernightGI stasis is such a problem. Any time Dutchess will not eat her tiny apple, i call the vet but sadly there are no overnight knowledgeable vets here either.
 

BMCBun

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I'm very sorry for your loss. It's always hard, but especially when you feel like your vet care wasn't what you thought it should have been, and they didn't give your rabbit the help you felt was needed.

For a rabbit to die the next day, tells me there was something critical causing the stasis and not just a 'standard' upset stomach from something they ate, or from a gut slowdown due to the more common causes. Usually stasis recovery lasts days to weeks. A sudden death so soon after the onset of having a lack of appetite, will mean there was a life threatening underlying cause. Things like bloat, internal bleeding, heart failure, respiratory failure, ingesting a toxin, etc. It wouldn't simply just be due to the fact that they weren't given fluids. To me that seems more coincidental.

Dealing with stasis at night is going to depend on the cause of the stasis. Some causes are immediate medical emergencies(eg. bloat, respiratory distress, rabbit is flaccid and non responsive), and some causes of stasis are less immediately life threatening, though still can be serious. If the rabbit is stable and not showing signs that things are critical, then waiting until morning is sometimes possible, but you really have to have a good undertanding of rabbit health and the warning signs of critical issues, to be able to make this determination. But that doesn't necessarily mean that things like syringe feeding can be started before seeing the vet. The problem with doing this is if the cause is due to something where syringe feeding is contraindicated, like with bloat or a complete gastric obstruction. But there are a few things that I will do at home in cases of stasis when the rabbit isn't showing signs of it being immediately critical.

I don't have access to a knowledgeable overnight vet, so if I've had a rabbit showing signs of stasis, I'll check the stomach to make sure there is no indication of bloat(feels like an inflated balloon just under the ribs), they are still responsive and reactive to me and not flaccid, and are showing no signs of mouth breathing or respiratory distress. If they don't show any of these critical signs and it seems more like an upset stomach to me, I will first make sure their body temp is normal and if not(which cooler body temp often happens with stasis), warm them up with a rabbit safe warm pack(not too hot). I will then try baby gas drrops and electrolytes(provided they are still swallowing, and if not it could mean it's critical), encouraging movement, and maybe some gentle belly massage. In cases of minor digestive upset, this usually gets them back to eating and behaving normally again within 3 hours, after the third baby gas drops dose. But if they still aren't feeling better by morning, then I'll take them in.


The only reason I can see to rush a rabbit to an inexperienced(with rabbits) overnight vet and not wait for an experienced rabbit vet in the morning, is if the rabbit is showing signs of it being an immediate emergency and the vet can provide critical life saving assistance like an IV, oxygen, or decompress a bloated stomach. Or in the very least, administer the appropriate pain medication. But I can also see a problem in taking a rabbit to an inexperienced overnight vet. If the vet doesn't understand how to properly rule out bloat or a complete obstruction, they may prescribe a course of action that could be detrimental to the sick rabbit, due to their lack of experience. Something llike not knowing how to properly check the rabbits stomach for bloat and not taking xrays that would show a case of bloat, then sending home the owner with instructions to syringe feed supposing it's a simple case of GI stasis. Which syringe feeding could lead to the death of the rabbit due to increased pressure on the stomach, lungs, and heart. So it is a decision that should be weighed if the overnight vet isn't at least semi experienced with rabbits.

If you have a vet that will work with you and teach you to give sub q fluids at home, that may be something you could do overnight to assist a rabbit that has stopped eating, until you can get to the vet the next day. Sub q fluids in many countries, will require a prescription and instructions by a vet. Otherwise, I just do the steps I talked about above. If the stasis is from gas pain, baby gas drops(simethicone) has gotten my rabbits feeling better soon after being given them. Or sometimes a rabbit with a little stomach upset, this will kind of 'kick start' them into eating and feeling better again.

There are a lot of rabbit owners that don't have access to a good overnight rabbit vet, so having to wait until morning can sometimes be necessary, as there aren't any other options.

Thanks. I have not tried baby gas drops so will keep that in mind. The vet’s advice was to keep feeding which I wish now I didn’t do as that just caused him more pain.

Just wish I knew what caused this/if it could have been avoided! But at his age I guess it was inevitable eventually. It’s so frustrating to do everything you can as an owner and still be let down/get it wrong. Keep re-playing it in your head thinking you should’ve seen the signs etc… These little ones become part of the family and seeing them suffer is super hard.

The house is just so empty without his little feet running to say hello 😔
 
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So very sorry for your loss. It seems most of the episodes of GI stasis seem to happen after vet hours so I try to make sure I have on hand what I will need to get my bun through the night. This includes Mylicon infant drops for gas (you can also use Gas X tablet and dissolve in water/crush and syringe feed, syringes, gut stimulating med (usually Metoclopramide), pain med (Metacam or Bupenorphine), critical care, tummy rubs, and SQ fluids if taught how (easy to do). Usually the expression is if you have it on hand, you won't need it but so far, that hasn't worked that way with my bun. You sound knowledgeable about GI stasis so the above may not be new news to you but maybe to someone else reading this.
 

BMCBun

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So very sorry for your loss. It seems most of the episodes of GI stasis seem to happen after vet hours so I try to make sure I have on hand what I will need to get my bun through the night. This includes Mylicon infant drops for gas (you can also use Gas X tablet and dissolve in water/crush and syringe feed, syringes, gut stimulating med (usually Metoclopramide), pain med (Metacam or Bupenorphine), critical care, tummy rubs, and SQ fluids if taught how (easy to do). Usually the expression is if you have it on hand, you won't need it but so far, that hasn't worked that way with my bun. You sound knowledgeable about GI stasis so the above may not be new news to you but maybe to someone else reading this.

Seems that way yes! That’s the plan I follow but will try to get fluids and gas drops. He had a gut mobility injection and Metacam injection so I thought he’d be ok 😔
 
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