Re: HELP! 9 yr old bunny with stasis

Question
My bunny Jack is nearly 9 years old.  He's never had stasis in the past but nearly 3 weeks ago, he slowly stopped eating and then stopped drinking.  My other rabbit frequently does this and she responds well to Petromalt and water via pipet.  She's fine within a couple of days.  This did not help Jack, so I added pineapple juice and belly rubs to help any digestive upsets/ blockages.  (He WAS drinking on his own)  Despite his lack of eating and eventual drinking he stayed remarkably alert and active; therefore, I didn't think it was a blockage - just old age and that perhaps his time had come.  I finally determined that a vet visit was in order (I know I should have done so sooner).  The x-ray determined that he does indeed have stasis and the vet prescribed several things.  He received sub-q fluids, antibiotics - I believe Baytril (which I'm worried about the effects of - seem to do more damage than good from what I've been reading), panacur for any parasite he may have picked up, Critical care, a painkiller (can't remember the name of it), and Cisapride which I'm really worried about.  From what I've been reading, Metoclopromide is much better to help gut motility as the Cisapride can cause a lot of pain and possible ruptures of the digestive tract.  The vet did not indicate if it was a total blockage or not.  Based on the time frame that he has not eaten, it seems like he doesn't have much time to get his gut moving.  He'd had some very minor (abnormal) poops the day before going to the vet (8/18) and ate a small amount of strawberry (not the best food, but I'm happy that he willingly eats ANYTHING)  I've cut down the dosing on the Cisapride that I've been giving.  These medications make me worry and I've read that the gas drops and pedialyte may help and I feel that they are a better alternative to the medicines.  I've been following the vet's orders except for the Cisapride.  Jack is becoming very uncooperative with taking the meds and I'm trying to spend time with him while not torturing him with pipets of medicine so he doesn't associate me with stress.  He's truly an amazing bunny and deserves the best chance I can give him.  Can you suggest anything better for him?  Or if you have any opions whether or not I should ask the vet to switch his gut motility drug from Cisapride?  I'm taking him back to the vet tomorrow for follow up and likely more fluids.  Thank you for your time and help.

Answer
Dear Stacy,

First, let me set your mind at ease about the cisapride and Baytril. Both are very safe for rabbits, and certainly do NOT do more harm than good.  Metoclopramide is also safe, and it's sort of a toss-up as to which GI motility med is "better" for rabbits; there have been no rigorous studies comparing them in rabbits, to my knowledge.  We've used both, and had no problems.

Next, Jack is not old at the age of nine.  He's on the upper end of "middle age" but should still be going strong.  We're having many of our rabbits live well into their teens these days, so don't let his age be a factor here unless you're considering anesthesia.  

For an organized overview of how to treat his GI stasis, please see:

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

I can tell you from experience that I have learned NOTHING works better to get a sluggish GI moving than an enema.  This must be done with extreme care in a bunny, since you don't want to tear or rupture anything, but the instructions in the article above should get you through this, or you can ask the vet to show you how.  Literally within a few minutes after an enema, a completely silent gut will be burbling away--most gratifying!  We hardly ever use gut motility drugs any more, since enema, gentle massage and simethicone seem to work much better unless there's a really severe problem.

Next, regarding blockage:  there probably isn't one.  If he had a complete stomach blockage, he would be dead within a few hours, and if he had a lower intestinal blockage, he would be so miserable that he would not be eating.  If he's eating *anything*, his gut is likely moving, even if very slowly.  (I've had personal experience with ileus, and I can tell you that even the *thought* of food makes you want to hurl. Which rabbits can't do, so it must be even worse for them...)

Once the protocols in the article and above have helped you get Jack's GI jump-started, it's time to figure out WHY his gut went static, since GI stasis is a symptom, not a disease.  And in an older bunny like Jack, my first suspect is always dental problems, such as molar spurs:

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

If your current vet isn't experienced with rabbit dentistry, then you might wish to use the list here:

www.rabbit.org/vets

for referral to a vet who can help.

I hope this helps, and Jack will be good as new soon.

Dana