URGENT - rabbit stop eating

Question
Dear Dana,
First of all I'd like to congratulate you for this wonderful job, helping people all around de world. Please, don't stop! We need you.
My little bun has 3 years old. She had an otitis 20 days ago. The vet prescribed baytril 15 mg for 15 days, and  neomycin ear drops, she was with fungus too, and was taking 5 drops twice a day of ketoconazole.
She was ok, and then in the last day of baytril, my other rabbit (5 years old) became sick, he was diagnosed with asthma ... He took enrofloxacin that caused diarrhea. Then I noticed that she (the first one) stopped eating, I decided to take two of them to other vet. The diarrhea was controlled and he start eating and pooping.... But my girl has stopped eating  since Monday... She is under vet care since then, in his clinic... (Four days until now) She was diagnosed with gas in the Gi tract and she is taking simethicone, intestinal motility agent, anti inflammatory, and sub cutaneous fluids, the vet said that she took so much baytril, and doesn't  want prescribe more antibiotics to her....  But she doesn't get well.... She is pooping very small, because she is not eating.. The two buns are side by side in the clinic. What could I do? I'm desperate.  We also found out a stone in her urinary bladder, but he thinks that the gas is causing the pain... And if I take her back home? It would be better? What should I do?  Leave her in the clinic? Please, I wait your answer. Thank you very much. Cintia

Answer
Dear Cintia,

First, I would get her home as soon as possible.  Being in the hospital is stressful, and that will only make her intestinal situation worse.

What you have going on here is multiple problems that are likely causing enough stress/pain in your bunny to cause ileus, a shutting down of the normal peristaltic movement of the intestine.  I don't know too many bunnies who will get ileus due to an upper respiratory infection (it is not likely she has asthma), but a urolith (bladder stone) can certainly cause enough pain to do this.

But you need to deal with one problem at a time.

1.  It is extremely unlikely that the enrofloxacin caused the runny stool.  More likely, the runny stool was a harbinger of the ileus:  an imbalance of the normal cecal flora can cause mushy cecotropes that are often mistaken for diarrhea by a vet who is more familiar with dog/cat medicine than with rabbits.  Please read:

http://www.bio.miami.edu/hare/poop.html

2.  Your bunny likely stopped eating because her GI tract was shutting down (peristalsis was stopping).  Please read:

http://www.bio.miami.edu/hare/ileus.html

Of all the treatments described therein, the most effective is the gentle, shallow enema.  DO NOT use a French catheter!  A simple pediatric ear syringe with slightly warm water will do the trick, and the procedure is described in the article.  I've found that within minutes of a carefully administered enema, the GI tract is burbling away and bunny feels 1000X better.

3. The gas is being caused by the ileus.  Simethicone and GI motility agents are a good idea, but the enema will often work faster.  Gas is definitely causing pain, but that does not mean that the bladder stone is NOT causing pain!  Both are!

4.  Pain management is a must.  Is she getting metacam or tramadol or both?  I would certainly ask the vet about that.

5.  Is your bunny with the otitis a lop?  If so, this may be a lifelong problem, as the abnormal position of the ears fosters ear infections due to lack of air flow and a constantly moist environment for opportunistic bacteria and yeast to grow.  Daily, gentle ear washes with a good ear flush solution can really help (use warm, not hot or cold), so have the vet show you how.

6.  Despite what many people will tell you, it is NOT a good idea to force feed a bunny whose GI tract is static.  Until the GI tract is moving again, do not force feed.  Offer fresh herbs, freshly pinched to expose the fragrant sap and juice.  But until you hear gut sounds (it's a good idea to invest in an inexpensive stethoscope for emergencies like this), don't force bunny to eat large amounts of food.  (I've suffered ileus myself, and the LAST thing you want around you when your gut is not moving is food or anything reminding you of food!)

I hope this will help.

Dana