Re: Jack still not doing well

Question
QUESTION: First, I would like to again thank you for all of your excellent advice.  I wrote last week about my 9 year old bunny Jack who has GI stasis.  He's still hanging in there.  I have a couple of additional questions.  We went back to the vet last Saturday 8-21, and they seemed to feel he was a little better (not sure I agreed with the assessment at the time)- I had them give him more sub-q fluids, but that was about it.  I also requested the fluids (they used a 1000 ml IV bag for him) to take home and give him some there.  They obliged and gave me the rest of his IV bag and extra needles.  I initially planned to give to him only every 2-3 days, but the last two days, I feel it is necessary to do every day.  They said he should get about 50 ml at a time.  He is not urinating with any regularity and has not voluntarily pooped.  (He peed twice last night after getting the fluids and an enema).  I have also been giving him the enemas essentially every day.  Twice I have gotten a respectable amount of gel-like mucus mixed with about 10 to 15 coated small stools.  A couple of times, he has not passed anything with the enema - which I contribute to my lack of experience and likely not doing it quite right.  He's taking all of this with a fairly good disposition, but I know it isn't his favorite activity.  Go figure.  Anyway, I would say on a positive note, that the last few days, he seems to pick at the greens I've been keeping in his pen - twice a day, I am putting some fresh greens - dandelion, kale, parsley - the stuff I've seen him show interest in.  I'm not sure if he's actually eating it though.  I have not seen him drinking either. (hence the sub-q everyday).  I suppose my questions are: Can you over-do the enemas? - I'm being careful to not irritate the anal region.  Also, are the sub-q's too much?  I feel like I've got him on life support, and the only reason he's doing as well as he is is because I'm forcing both ends.  If the middle isn't doing it's part, then what?  Also, he's still getting the Cisapride and Mylicon.  He is really fighting me about the Critical care and oral fluids - I'm only getting him to take about 2-5 teaspoons/ day.  We are both working hard to maintain our desperately needed patience.  Any other suggestions or info about what I could expect down the line would be very helpful.  Thanks again for your time, you are such a great help!

ANSWER: Hi, Stacy

I'm sorry Jack is still ailing.  It's been a while, so please forgive me if I ask questions I've already asked:

1.  Have the vets checked his mouth for *buccal* spurs?  These usually arise on the upper arcade, point into the cheek, and are *very* hard to see and file without anesthesia.  But they do occur, and they can cause this kind of chronic misery.

2.  Bloodwork?

I don't think you can really overdo the enemas if you're doing them just 1-2 times a day. But is he also getting gentle abdominal massage?

I'm not sure I asked before...but has he ever shown signs of large, misshapen poops, or has he generally produced normal-looking "cocoa puff" fecal pellets?  If the former, and he is white with dark pigment, I wonder if he has "Cowpoop Syndrome."

But his picky, picky eating makes me think molar spurs or other painful mouth problem again and again....

Dana

---------- FOLLOW-UP ----------

QUESTION: I believe the reason this all started is that he may have eaten something that uspet him outside - he and my female were on the patio grazing some weeds - he may have gotten something that didn't agree since this all started slowly after that.  I also noticed around that time he was pulling the carpet apart in his pen and may have eaten some of that although he's never acutally eaten that in the past.  
Before going to the vets, I felt him all over - including pressure on his mouth, in his mouth with my finger, cheeks, and jawbone.  He did not flinch or seem to feel any discomfort.  I know that isn't the same as a vet dental exam, but the danger of the anesthetic at his age and in his current condition doesn't seem wise to me.
As far as his stools go, they have always been normal - he's never had a digestive problem before - always very healthy and active.  I am doing the enema in the evening (when I have more time) and giving him the massage - which he seems to love.
I feel that if I had begun this regimen sooner, a lot of this could be avoided.  My fault.  He is still very alert and active.  Last nights enema was rather successful - we managed to pass a lot of mucus (starting to look more yellowish and greenish - not sure that is good though).  I also wised up and am making the critical care a bit thicker and he seems more willing to accept that.  I would say I got a respectable amount in him today.  As a side note, he is a brown bunny with a white belly.  But, like I said, he's never had the abnormal poops.  Perhaps if I can get enough in the top end it will work it's way through - I think he did eat a little bit of greens last night, and my husband saw him drinking yesterday...  Still hopeful.  Thanks again for your time.


Answer
Dear Stacy,

If he ate something toxic, he may be slowly recovering from a severe insult to his liver, and that can take time and lots of nursing.  I've had to go through this, too (for different reason), and while I'm not a big fan of herbal remedies, I would almost swear that when I started giving the liver-challenged bunny doses of glycerin-suspended extract of milk-thistle seed.  (It most often comes in an alcohol (ethanol) solution, but I figure a compromised liver needs ethanol like it needs magic mushrooms...)  Can't hurt, might help.  

We gave our sick baby jackrabbit the contents of two glycerine capsules mixed in a bit of water (the stuff has the consistency of peanut butter inside the capsules) twice a day at first, and then once a day.  I saw improvement after the first two doses, though I know each patient is a sample size of one, and there could be any number of other factors involved.  But I have used it several times since, and have always seen improvement after the first couple of doses.  Not scientific, but something to try, maybe?

I hope Jack continues to improve!  He's lucky to have such a caring mom.

Dana