QuestionQUESTION: My 3 year old rabbit Whiskers developed an obstruction in his stomach as confirmed on x-ray. For a week the vet and I agreed to treat him conservatively at home with sq fluid and timothy hay lettuce, pineapple ect as tolerated and to force feed baby food, which he fought. He did not improve and lost weight. I decided it was time for surgery. A blockage was removed from his stomach (hairball?) and his liver had signs of fattiness. Post op the vet gave me buprenex sq 0.1cc twice a day for 2 days and baytril sq 0.2cc twice a day for 10 days plus sq normal saline 100 cc twice a day until he would tolerate oral intake. Two days after surgery he started eating well and became more alert and active. He remained this way until the 5th postop day. At this time he refused to eat. He had good urinary output and a small amount of pellets normal in size and shape. I brought him back to the vet and he gave me lactated ringers for sq and reglan 0.2cc twice daily. He advised me to force feed with baby food. He is still relatively alert and active eats very little and still has urine output but no pellets, only some small amount of mucous occassionally. The vet feels we have exhausted all options. Any ideas I might try would be appreciated.
ANSWER: Dear Don,
Your bunny is lucky to have survived a gastrotomy, which is fatal to most rabbits. Is the vet you are seeing a rabbit expert? Very few rabbit expert vets will perform a gastrotomy on a rabbit without first exhausting all medical options and unless there is a complete obstruction, which your rabbit did not have (a complete obstruction results in acute bloat, which is nearly always fatal).
A rabbit stomach *always* has matter in it, usually a bolus of food and hair. This is normal, and rarely is an obstruction. A rabbit's stomach is never empty, and should not be. If the vet who did the surgery believes otherwise, then it may be that s/he is more experienced with dogs and cats than with rabbits, and an alternative practitioner's help should be sought.
If your vet truly thinks you have exhausted all options, I wonder how experienced he is with rabbits. The whole pineapple thing makes me suspect, too, that this vet may not be as up-to-date on treatment of GI problems in rabbits as one might wish. You might consider using the list linked here:
www.rabbit.org/vets
to find an expert rabbit vet for a second opinion, and possible alternative treatments.
The refusal to eat and the mucus in the stool is indicative of enteritis (inflammation of the intestinal lining), and requires treatment for both pain and the condition itself. Sulfasalazine can be very helpful for this, as it acts topically to reduce inflammation and pain. I've seen a bunny show signs of tremendous relief as quickly as a half hour after administration.
Additional treatments can be found here:
www.bio.miami.edu/hare/ileus.html
(www.bio.miami.edu/hare/ileus.pdf for a veterinary version)
and you should be monitoring bun's body temperature closely to be sure he doesn't become hypothermic from stress/pain, or spike a fever due to complications from the surgery (peritonitis?):
www.bio.miami.edu/hare/sickbun.html
I would at least give him some pediatric simethicone and gentle tummy massage, which can work wonders. A very *cautious and gentle* shallow enema can also really get things moving, but this should NOT be done by anyone inexperienced with rabbit enemas, and NEVER NEVER with a French catheter or anything that will go deeper than about 1/2" into the rectum.
But try the massage and simethicone and other treatments in the ileus article first. Your bunny should be able to recover from this if he's survived 5 days post op after a gastrotomy, but he will need your help and tender care.
I hope this helps.
Dana
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QUESTION: Thank you so much for your rapid response to this critical problem. I am implementing your recommendations and I am optimistic. Whiskers is tolerating the force feeding of baby food and as I write this has just started to eat some timothy hay. Thanks again.
respectfully,
Don
ANSWER: Dear Don,
I'm glad he's starting to eat again. Whew! Dodged a bullet there!
If you can get him some Critical Care from Oxbow Hay Company, that would be better "emergency food" than the baby food, which is designed for humans. Critical Care is designed specifically for recovering herbivores, and will really help your bunny get his GI back in order, as it contains fiber *and* beneficial bacteria to restore his natural flora.
You can get Critical Care from Oxbow at:
www.oxbowhay.com
I hope your bunny continues to improve, and never has any more "obstruction" problems. But if he does, please be sure to find a vet who is *very experienced* with rabbits so that nothing more aggressive than necessary is undertaken to help him.
Good luck!
Dana
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QUESTION: Dana,
Thank you so much. Whiskers is afebrile (for a rabbit), has good urine output, is putting out pellets although sometimes a little loose. I have stopped baby food per you direction and found a vet who had Critical Care from Oxbow and he is eating it freely. His activity and alertness is very good. bowel sounds are normal and he no longer appears in any gastric distress. Massages seemed to relieve gas and discomfort. I honestly believe he has turned the corner and will recover. We both thank you for saving him.
Respectfully,
Don and Whiskers
AnswerDear Don,
It wasn't I who saved him. It was you and your constant nursing and attentive, excellent care. Whiskers is very lucky to have such a caring "dad."
I'm sending lots of wishes for good health from this point on! :)
Take care,
Dana