Woolblock, need an expert!

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I have been seeing poo bracelets (poo strung together by fur) in my rabbit, Digg's litter box during his most recent moult. And I believe my rabbit had a bad bout of wool block last night. He refused food, He kept arching and laying with his stomach puffed out looking horribly uncomfortable. Throughout the night I kept messaging his abdomen, which he's seemed to like, and giving him fluids for hydration with a syringe. At 5:00 in the morning his condition had not improved, he still looked extremely uncomfortable. At 7:00 in the morning I went in to check on him, expecting the worst, but miraculously, he was up and eating and seemed all perky.

But I didn't feel like he was out of the woods, I felt he might have a blockage floating around that is only partially cleared, because all though he is eating and has pooed there's not enough poo, and some of the poo has fur. I also think I feel some lumps the size of a grape in two places in his gut that might be blockages.

So today I took him to the rabbit specialist an hour out of town. I really don't feel she helped enough though. I told her I felt blockages and she didn't really try to feel for the blockages. She did feel the rabbit wasn't in eminent danger based on how the stomach felt. In the end she only said keep hydrating and offered Cat Laxative and I bought it. I don't feel that is enough. I think he's got lots of fur in his gut and possibly blockages forming and it could happen again. He's not pooling enough I think his gut is not moving enough.

So here comes the question based on the following....
Rabbit experts like Dana Krempels, say never use cat laxatives. Dana Krempel's advice to another rabbit owner with a blockage was:

*1. oral hydration
2. subQ fluids
3. orally administered osmotic laxatives such as lactulose and/or epsom salts
(avoid any petroleum-based or other oily lubricants or laxatives for now, as they could
prevent proper hydration of the mass.)
* http://en.allexperts.com/q/Rabbits-703/2009/10/Urgent-hard-lump-rabbit.htm

So should I
1. Ditch the cat laxative, its petroleum?
2. Should I get some Lactulose (it at the pharmacy) Like what Dana Krempel says and give that until the moult is over? If so what is the dosage?
3. Or should I just keep hydrating, giving him lots of fluids and forget about motility drugs? (because a lot of rabbit experts are against any kind of motility drugs)
4. Is there anything else anyone knows of, besides papaya pills and pineapple, I should be doing?

( In case anyone thinking this wouldn't have happened if she groomed him better... I Would like to say in advance, I know!, but I've been grooming my rabbit, but he's a Jersey Wooly with the angora like fur and fur just keeps coming and coming and coming. I've groomed him to the point now where he has bald spots in some places, but he still has fur in his poos, I'm starting to wonder if I should just shave him ).

 

[Blue eyes]

How's bunny doing?

Is your bunny eating hay? Hay is the best thing to get his gut moving again.

JBun is a great resource and wealth of information. If she doesn't see this post, I suggest you PM her and I'm sure she will be able to help.

 

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Thanks blue eyes. I try really hard to get him to eat as much hay as possible. I limit his pellets etc... and put lots of fresh hay in. He gets lots of fresh grass too. But he doesn't eat the hay and grass as much as my other rabbits do. For the last two days I've really cut his pellets way back to nothing, hoping to get him to eat the hay but I still don't see him eating it and when he sees me he looks desperate for me to give hims some pellets, even stomps his foot at me. I'm thinking about dipping hay in some fresh made pineapple juice to get him to eat more. I think him not eating his hay might be his real problem. His front teeth look ok but I wonder about the back. He did poo yesterday and I was happy to see the size of the poos looked normal, not small like they do if a rabbit is in stasis. But there where a few poos strung together with a bit of fur .
Besides giving Hay all I have been doing is giving him electrolyte solution/with fruit to get him to drink plenty of fluids.
I also think I feel a lump in his side which could be a blockage, or is it a kidney? I don't know

 

[Blue eyes]

I'm glad he seems to be doing a bit better. I understand some bunnies are just picky about hay. (I've been lucky that all of mine are/have been good hay eaters.)

Have you tried some alternate types of hay? Maybe he'll like a different kind moreso.

 

[Channahs]

I am scared to respond as we just lost our beloved Jovi to the very same issue, but she wasn't eating or pooping. Are you noticing varied sizes in the poos? Are you finding any tiny ones? Did your vet do an x-ray to rule out that there wasn't a blockage in the side of the gut (I can't recall the word) where it's less likely to move? We were told to give pineapple juice from a fresh pineapple, don't even think of using canned or processed juice is what we were told. We too were given cat laxative, but it was a gel base. Also we were told to give Metamucil. Is that the same as Lactulose? The good thing here I think is that he is pooping. Even as pearls, things are moving. I've always wanted a long haired rabbit, but for this reason I can't bring myself go there. I WOULD probably end up shaving bun lol but that's just me. Will Digg eat herbs and greens? Maybe he would be happy with lots of cilantro and parsley and dill since you've cut his pellets back so much. He might also like some Critical Care and would take it from a spoon.

Try belly massages around the area you think you feel the lump with a just barely firm pressure. Also run him around. Don't let him get lazy and sit in one place. Gotta keep everything moving around in there. One last thing. If he looks like he's in any pain whatsoever, please ask your vet for something to relieve it.

 

[JBun]

Personally I would question how rabbit knowledgeable a vet is if they are suggesting using a cat laxative in what seems to me, not the appropriate circumstances. Like you have read, petroleum based laxatives can coat a blockage and prevent fluids getting to it that help with breaking the blockage up, so really aren't something you want to be starting off with in a mild case of stasis, when none of the more common treatments have been tried and fluid therapy has not been given. And when petroleum laxatives are given, they should always be preceded by aggressive IV and/or sub q fluid therapy,. I'm guessing your vet didn't do this since you didn't mention it. Generally once a complete blockage is ruled out, a gut stimulant, meloxicam for pain, and sometimes rantidine, are the meds usually prescribed. Then Critical Care for syringe feeding if needed. I know some vets don't believe in using gut motility meds, but my belief is that they can be a very helpful med when used appropriately. In part I tend to go off of what rabbit vets in the UK are doing, since they seem to have some of the best rabbit specialists around, that have lots of experience due to rabbits being such a common pet there, and gut motility meds seem to be regularly used for GI stasis issues. Though if I were to have my pick of which one to use, it would be cisapride, as it doesn't have the neurological side effects that metoclopramide can have.

Lactulose is only appropriate in certain circumstances as well. But it also should be accompanied with aggressive fluid therapy. The one downfall of using lactulose that needs to be taken into consideration, is that it is sugary, which could possibly affect the rabbits microflora and further complicate the stasis problem. If it were a choice between using a petroleum laxative or lactulose, I would choose the lactulose, since it is an osmotic laxative and actually helps draw fluid into the digestive system.

Since you didn't mention the vet giving you meloxicam or a gut stimulant, I'm guessing you weren't given them, which in the least the meloxicam should really be an automatic thing any rabbit savvy vet should prescribe for a rabbit in pain? And it sounds like your buns teeth weren't checked either? Which should really be an automatic thing a vet does in a case of gut stasis, since so many times it occurs due to a rabbits teeth causing eating problems. If you can, I would try and find a better vet, and if your bun not eating hay continues to be an issue, it would probably be good to have your buns molars checked and possibly xrays done as well to check for possible tooth root elongation or infection being the possible cause of your rabbits stasis and not wanting to eat hay. Because hay really is one of the best things for motility problems. Especially a coarse hay if your bun will eat it.

Coarse stalky hay with lots of indigestible fiber, is what essentially 'drives' a rabbits gut motility. The more indigestible fiber that is consumed, the better the motility and the larger the fecal poop(to a point). But this also needs to be balanced with soft leafy hay that has most of the nutrition that is needed. So with your bun not eating hay well, I would suspect this to be at the core of his slow motility problems.

The problem with cutting back pellets when your bun doesn't make up for it with eating more hay, is that the reduced food intake will just further slow gut motility down. It's essential for the rabbit to be getting adequate nutrition to help keep that motility moving, even if you have to syringe feed. It really is essential to solve why your bun won't eat hay, and it's probably not a good idea to cut pellets back unless you are able to figure out why he won't eat hay, and/or find something fibrous that he will eat that can replace his pellet portion that you are reducing. Along with a thorough dental exam to rule it out as the cause for the lack of hay eating, there is also trying different types of hay. Something with a good mix of stalks and leaf is preferable, or if you tend to feed more pellets, you can feed a stalkier hay. You just need to balance the needed nutrition and maintaining a good weight, with the needed fiber for good digestion. You also don't want a grain type hay with lots of seed heads in it, as this will contain a lot of carbohydrates. You can still use a grain hay like oat, but it would be good to pick out any seed heads. Another option for hay, though not as good as loose hay, is a plain grass hay pellet, if you have them there. Here in the US we have timothy hay pellets that are commonly used for large livestock, but I also have used them for my rabbits. I had one bun that wouldn't touch hay when I first got him, because he had never had loose hay before. He would only eat pellets, but he had developed a digestive issue where pellets would cause him to go into stasis. So I got these hay pellets(they were a timothy/alfalfa mix), and he would actually eat them just fine. So I fed him those until I could gradually get him used to eating hay, which he did eventually. It was a good alternative in that particular situation.

Another possible option, depending on where you live and it's availability, is to feed forage. I know of one rabbit that just won't touch hay, but will eat forage, like tree leaves/branches, plantain, dandelion, etc. So the owner collects forage to feed her bun instead of hay. Especially good are tree leaves like apple, willow, hawthorn, as these have lots of indigestible fiber, as well as tannins which seem to help with some digestive troubles.

When it comes to slow gut motility, hay(coarse hay particularly) and fluids really are the most important things to help improve it, but it only helps if the bun will eat the hay and drink the water well. You also need to be careful about giving things with sugars and carbs, as these tend to further slow down gut motility, as well as the potential risk of them upsetting the microflora balance and causing an overgrowth of harmful bacteria. These are two of the better articles on explaining digestive issues in rabbits, so if you haven't read them, it's worth taking a look.
http://rabbit.org/sluggish-motility-in-the-gastrointestinal-tract-2/
http://rabbit.org/disorders-of-the-cecum/

Honestly, if I had a long furred rabbit, and the fur was causing health issues, I would opt for keeping it clipped to help reduce the chances of these problems occurring.

 

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Thanks Jbun for the thorough reply, you are a legend.
I don't know what to do about vets, this one is supposed to be one of the best in NZ which is such a small country there only 2 other vets I know of who are rabbit savvy and they are 5 and 8 hours away. If I want those drugs you mentioned I will probably have to go back to her.

I went out and got some willow based on your suggestion and some nasturtiums and green curly lettuce and he ate quite a bit. I can get lots of things like plantain and willow of forage but getting different kinds of hay in this country is very difficult. All the hay I can find here is orchard grass and rye. There aren't pre bagged hays like timothy in pet stores - everyone here just buys bales of hay or slices form the bales.

I did clip some of his hair today, he has very little hair now so hope he can't get anymore in his system. His poos still are coming out in different sizes and shapes some small some normal. Some where linked with hair again but not as bad as before. Each day his poo seems to be a little better.

Thanks again for all the information and the articles to read Jbun you are a god send, thanks.

 

[JBun]

I think sometimes when you have limited options, you just have to pick the best vet possible, preferably one that is going to be open to your input and any research that you have. Then what you have to do is research good reliable rabbit medical sites, studies, and other good rabbit textbooks, on your own to find what the best options are and most common treatments, then hope your vet may also do a bit of research too. And also a vet that will consult with the experts if possible, is helpful as well. It's a pain, but sometimes the only way to ensure your bun gets the treatment that is needed.

It may even be worth it to you to invest in a veterinary book on rabbits. Molly Varga just put one out I believe, and she is considered a rabbit specialist in the UK. It is an updated version of the rabbit expert, Frances Harcourt Browns book. So both excellent rabbit vets that can be relied upon to have the best and most up to date knowledge on treatment for rabbits. Here it is if interested.
http://www.amazon.com/dp/B00EQH7D62/?tag=skimlinks_replacement-20

For the hay, actually orchard grass and rye are both good hays for rabbits. Orchard grass may have the added benefit of better wear on the teeth to help control overgrowth of molars, because of it's high silica content. And a mature stalky rye hay is excellent for it's indigestible fiber and roughage, if you can manage to get it where the seeds have already fallen from the heads or not too many mature seed heads(because of the carbs). I had a mature(though still green) rye hay for my rabbits one year. They LOVED it! I think it was probably their favorite hay. And their fecal poops were never better. Big, golden, and pretty perfect as fecal poop goes. The only issue that I had was my older bun loves stalky hay, so she wouldn't eat enough of her pellets and would primarily eat the rye hay. This was a problem because mature stalky rye hay doesn't have a lot of protein or other nutrients, just mostly roughage, so she started to loose weight. But my other rabbits that ate their pellets well, maintained their weight fine. So it's just a matter of balancing the food that contains most of the nutrients, with the roughage from the hay, if this is a type of hay you end up trying. It was certainly a hit here. I wish I could find a good reliable source for it again. Would sure make my buns happy. If it's a leafier rye hay that's available to you, then it is going to be mostly good for its nutrients and not so much the indigestible fiber that the stalky rye would have.

If you can get a mature stalky rye hay, and your bun will eat rye and orchard grass both, I think a mix of both hays might be a good combination. Farm hay is just fine if it's good quality, little to no weeds(and no dangerous ones), and has never been wet. And if his poops aren't looking as good as you'd like, up the amount of rye hay. Then just monitor his weight to make sure he stays at a healthy weight.

 

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Jbun, getting the Vet manual sounds like an excellent idea thanks for the suggestion. Its been a big problem for me going to local vets in emergency situations, with them having no experience with rabbits. Would be excellent to be able to point to something in a Vet manual.

I will be going on a hay finding mission soon. Right now it is the new hay cutting season here in NZ and ads for hay are coming up on the farm forums. There's first cut and second cut hay and I think the second cut hay is stalkier so I will get some of that and try to get a few different kinds of hay for variety. If I'm lucky I might be able to get some hay from some people who grow it specifically for their precious horses- the horse people always have excellent hays