Vet has been seen; 6 year old Dutch has ileus, wont eat

Question
Hello,
I am hoping you can help me.  I have a 6 year old taupe Dutch rabbit, Booja, that I rescued when he was six months old.  He has always been incredibly healthy until recently when I noticed he was eating less and his litter box remained clean throughout the day.  I took him to an emergency clinic last Sunday evening (today is Wednesday); however the veterinarian on duty didn't have much expertise in rabbits.  He felt his abdomen and said that he felt something hard and round.  (His temperature was normal that night and I have taken it everyday since and it's remained within the normal range.)  I immediately had x-rays taken and a nearly round mass was seen outside the stomach.  The radiograph wasn't completely clear but it is assumed that the mass is outside the stomach, near the cecum.  He gave Booja an injection of Banamine and Metoclopramide as well as sub-cutaneous fluids.  I took Critical Care home and have been force feeding him since Sunday night.  I followed up by taking him to a specialist on Monday who didn't feel that it was GI statis, but rather a tumor or abscess.  Booja was extremely gassy and was given one injection of Gas-X.  He also was given another dose of Reglan as well as some acidophilus and then sent home with Metacam, Reglan and acidophilus.  I am administering the Reglan and acidophilus twice a day and the Metacam for pain, once a day.  The loud sounds from Booja's stomach have lessened quite a bit, but are still audible from time to time.  I have read many of your other articles, and am trying to do the abdomen massages and have been syringe feeding him the Critical Care.  He takes all his medicines willingly and even will drink his water from a syringe, but he is completely against eating the Critical Care food.  I realize this is incredibly important and I do force him to take at least a few syringe-fuls, but it worries me that he is not eating yet.  His stools had completely stopped, but began again late Monday evening, small and mucus covered, but at least he is going again.  I was just wondering what the typical time frame is for him to go back on his food.  He is only getting about a 1/3 of the amount recommended by the veterinarian and it's concerning me about weight loss.  I also have tried different leafy greens and timothy hay, but he will only eat them occasionally.  He is still lethargic and not himself; I feel that I am at a loss as to what else I can try.  I just don't want to lose him and I have decided that surgery isn't an option.  Could it be that I am expecting too much too soon with ileus?  Is there any other treatments that you could recommend?  I certainly don't mind continuing with the treatments for as long as it will take, but I find myself getting downhearted thinking that he's not getting better quickly and then I begin wondering if he does have a tumor or abscess.  I am trying to stay positive, but any help you can give me would be appreciated more than I could say.  Thank you for your time and please take care.

Kimberly

Answer
Dear Kimberly,

Has anyone looked at his molars?  This is a very common trigger for chronic, unrelenting ileus.  Please see:

www.bio.miami.edu/hare/dental.html

I have found that an enema will jump start a static gut when all else fails.  Instructions for this can be found here:

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

Please be sure the vet who is helping you is *very* rabbit savvy, as you will need an expert who knows what to look for in terms of the trigger for this ileus.  It is a *symptom* of his main problem, not the problem itself.  Until the source of pain/stress causing the ileus is found and dealt with, the problem is likely to continue.

I hope this helps.

Dana