Sufalcrate Dosage for rabbits

Question
Hi Dana,

My rabbit is 1.5kg and has mouth ulcers (on the insides of both cheeks) that the vet says was not caused by molar spurs. She's prescribed sufalcrate although she admits she is unsure of the dosage in rabbits. I'm giving him .1cc of a 1gm/5ml suspension twice daily.

My rabbit stopped eating on Friday morning and had no fecal output on Friday. On Friday night I began giving him Critical Care. On Saturday morning there were a few cecals and several very very tiny and extremely hard fecal pellets as well as some urine. At this point we took him to the vet who gave us the sufalcrate for the mouth ulcers she found.

Since then (Saturday at lunch and it is now Sunday at lunch), we have continued with the Critical Care and there has been no more solid feces. The bunny is producing cecals (I see him eating them every now and then), but there is nothing else in his litter box.

He's drinking a lot of water and every now and then eats a piece of hay or two.

He also seems a little unbalanced - he tried to jump onto his shelf this morning and missed. Also when he's eating the cecals, he has fallen over a time or two. He's shedding badly and blowing his coat in great waves of fur.

The vet did not think he had a blockage (seeing that he's producing cecals), but I'm concerned that his gut has not come back up to speed in the last 2.5 days of Critical Care (and he's still not interested in food).

Are there any tests I should ask my vet to perform? Any ideas? She's stumped as to what could be going on - she was thinking a food allergy as my bunny has also had scabbing around his mouth that comes and goes. But there is nothing different that we have been giving him or using to clean his area with.

I was going to ask her about Mycotoxins...

Any thoughts would be very appreciated.

Thanks.
N  

Answer
Dear Nadia,

Has the vet drawn blood to check his kidney and liver values?  Oral ulcerations (associated with uremia) can be a sign of renal disease, as can excessive drinking.  As the kidneys fail, a high level of nitrogenous waste in the bloodstream can also cause neurological signs, such as the lack of balance you describe.  If the bunny is drinking excessively and also urinating copious, dilute urine, then renal disease is a likely culprit.

I know sucralfate can help for intestinal ulcers, but haven't heard of it being used for oral ulcers.  Can't hurt to try, I guess.  We use 0.5cc/kg of body weight for rabbits.

But this sounds as if it could be quite serious.  If the bunny is in renal failure, subcutaneous fluid therapy can help flush the toxins from the system, though this should be used judiciously: a bunny with failing kidneys will not have the normal ability to balance electrolytes, and too much fluids--even containing a balance of electrolytes--can cause different problems.

My recommendation is to find a vet who is more familiar with rabbits:

www.rabbit.org/vets

for a second opinion.  And definitely ask about blood chemistry coupled with urine specific gravity test to see if the kidneys are concentrating urine normally.  If your bunny has renal disease, it will depend on whether this is due to a sudden insult (toxic substance) or has been chronic, as far as treatablility is concerned, with the latter being not a very hopeful diagnosis.  In some cases of acute renal insult, fluid therapy and supportive care can get the bunny through the crisis with enough renal function remaining to live a normal life.

I hope this helps.

Dana