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Highly sensitive rabbit - GI Stasis earlier in the week - steadily eating currently, but still bloated/uncomfortable

22 9:41:36

Question
Hello Dana,

We have a 2 year old Dutch bunny who was adopted from a shelter in December 2011.  Prior to her adoption, her ears were injured (they're ok now)~ it is unclear if it was due to human mishandling or an animal attack, but the result is that she becomes very distressed when picked up or held.  

On her annual vet check up in the spring, she screamed when our local House Rabbit Society recommended vet picked her up and he felt that it was not worth stressing her out to proceed with the exam.
We have been working with her to get her more comfortable with handling - but she isn't quite there yet.

Earlier this week, she started showing signs of GI Stasis - suddenly stopped eating/pooping - and we promptly took her to our vet's office.  
Our usual vet was unavailable and we were seen by another vet in the office.  
Our bunny is very affectionate and playful, but, as mentioned above, she doesn't tolerate being handled/picked up and will scream if she is forcibly held (which has only happened at the vet's office).  
Again, our regular vet is keenly aware of how sensitive she is and makes a great effort to avoid over-stressing her.

Unfortunately, in spite of alerting the vet on call and the vet techs to her sensitive nature, she was handled forcefully and we heard her scream at least twice while she was out of the room having her vitals checked.  I also heard one of the techs complaining about what a crazy rabbit she was.  She scratched one of the techs, who was less than gracious about it and made some snide comment about how we must not handle her often.
 
She was given Simethicone, Meloxicam, and Metaclopramide and we were directed to take her to an animal ER overnight for monitoring because her temperature was low.  They suggested she might need some x-rays if the meds didn't produce any results.

We were very apprehensive about being separated from her overnight and concerned that being monitored in the ER would only stress her more.

The amazing doctor at the ER recognized that being handled only increased her stress level and forcing her cooperation was only going to lead to negative consequences for her.  He let me try to coax her to eat some Critical Care and even though she refused, I was able to coax her into eating some parsley and hay while we were there.  
This vet felt that she would be better off at home, even if her temp was low.  He gave me some Critical Care and said that if I could get her to eat it without being force feeding, it might speed the process along.  She has snubbed the Critical Care at home, too (although I occasionally manage to get a little in her by way of dipping parsley in it).  
He also felt that the medication was unnecessary if getting it in her stressed her out.

At home, she continued eating parsley and hay and drinking water from a dish (she seems uncomfortable reaching for her water bottle) and I began to see droppings in her litter box again.

When the ER vet called to follow up in the morning, he seemed to think it was OK that I couldn't get her to eat the Critical Care, as long as she continued eating and pooping.

Her droppings have continued to be normal - the usual coco-puff type - and she has continued to eat hay, parsley, and cilantro.
However, in spite of continuing eat and poop, she continues to appear uncomfortable and her belly has been hanging low.  When she stretches forward, she quickly pulls back into a hunched position.  I have started giving her 1cc of Simethicone (which she initially licked off my finger until she realized she liked it and will now take it from the syringe)every 3-6 hours today and gently massaging her belly.

In the last few days when I give her free range outside of her cage, she walks around our playroom a little and then finds a corner to lie down in or sit in, but she doesn't display her usual vigor and twitchy joyfulness.
When she is out, I notice that she seems to be favoring her left leg as though is pulls on her abdomen when she steps off it.

Tonight I went ahead and gave her .5 mls of Meloxicam (which she happily took from the syringe), hoping it would ease her discomfort.
I plan to contact our regular vet if she continues to appear uncomfortable, but I was hoping you might have some additional insight and suggestions.

Is it possible for GI Stasis to continue in spite of normal eating and elimination? Or is there something else we should be looking at?  What other suggestions do you have for a rabbit who seems uncomfortably bloated?  Is there a way to lightly sedate a rabbit so that she can have an x-ray taken without becoming a danger to herself?  Or would sedation also just be one step back?  Is it advisable to give her a dose of the Metoclopromide?

Thank for whatever thoughts and suggestions you might have.
~ Ann

Answer
Dear Ann,

If she's producing poops, she's not suffering from ileus.  The GI tract is moving.  The bloating could be due to gas, and the simethicone should help.  But also gentle tummy massage including moving her body in different positions to help her pass the gass can help.  Electric, vibrating massage can really help break up those gas bubbles.

There is the possibility, though, that this is not gas.  I would ask your regular vet about getting a dose of Ativan or Diazepam for her before you go to the vet so she will be mildly sedated and not act so wild when handled for a radiograph.  That is really the only way to see what's going on, and whether it's her GI tract or something else in her abdomen that's causing the swelling.

In the meantime, I think the meloxicam can't hurt (unless her kidneys are in trouble).  Hope you can get her to your good rabbit vet soon, but call ahead to get that sedative and give it to her about an hour in advance.  

Hope that helps.

Dana