sick rabbit wont eat

Question
QUESTION: My Rabbit has not been eating for about a week now. I have taken him to a vet and she gave me a few medications to feed him through a syringe. He fights me the whole time i'm trying to feed him. but i can usual get the medication down, but he wont let me give him the oxbow which is what actually has nutritional value. He stayed at the vet yesterday so they could try to get him to eat it but found that he fights too much for even them. How to i get him to eat? He wont touch his normal food or water in his cage. I've tried treats and things that i know he normally loves and he still wont eat anything. do you have any suggestions for things i can try?

Thank you for you time

ANSWER: Hi Helen,

Your question has me extremely concerned. If a rabbit doesn't eat for that long....there is something seriously wrong and bad things are about to start happening in huge numbers.

First, what medications were you given?  And what is the diagnosis for not eating?  The root cause of the concern has to be found and dealt with quickly.  Not eating can be a sign of many things.  One of the first things that comes to mind is a dental problem.  Certain breeds are more prone to dental issues than others but it is something that can affect any rabbit.  Usually, but not always, if it is a dental issue, they will eagerly approach food and then back away or some drop pellets from the mouth as they try to eat.  While it is easy to see the six incisors...it usually requires sedation to see the molars.  And dental issues are not limited to the part of the tooth that can be seen.  All rabbits are prone to mandibular (jaw) abscesses that may not present themselves externally.  An x-ray or MRI of the skull may be needed to look for any soft tissue concerns.

A condition known as GI stasis is also a concern.  The gut action slows dramatically.  Many times the rabbit will "hunker down" as it will be in pain.  Usually the eyes will be partially shut and the ears held back and close to the body.  The ears will usually feel cold to the touch.  The poops will be very small or may not be produced at all.  This can quickly lead to a potentially fatal condition known as ileus.  There could be a blockage in the GI tract.  I know of several rabbits that developed large fatty masses that restricted their digestive tract.  Again, an x-ray or MRI would be needed.  In some blockage conditions, surgery might be the only option and the success rate on GI surgery in rabbits is terribly low.

I am not a vet but I do treat these conditions often.  Here are my suggestions.

First, we need to find out what the root cause of the problem is.  If it is a true blockage, forcing food will result in excessive GI pressure and will result in a catastrophic event.  If it is a blockage and it is body material such as a tumor, surgery is the only option.  If the blockage is ingesta (undigested food, hair or inedible fibers such as carpet), an aggressive hydration protocol using sub-q or IV fluids would be the first step.  My major concern here is that nothing you mentioned in your post leads me to believe the root cause of this issue has been properly investigated.

Many rabbits get very stressed when being force fed and this can lead to additional issues.  And many rabbits do not like the Critical Care.  Most vets carry the original Anise flavor.  Oxbow now offers and apple-banana flavor that seems to be better accepted.  I would suggest offering some canned pumpkin...not the pie filling (too much sugar).  Look for the canned stuff.  Most rabbits will at least nibble at it.  Pumpkin is very nutritious and is high in fiber.  You can also mix the Critical Care in the pumpkin.  We have also used baby food in an emergency.  Banana-strawberry and apricots are a fav around here.

This is one case that I feel strongly should be under the direct care of a rabbit savvy vet.  Time is everything in a GI event. As the event progresses, the beneficial bacteria in the digestive system that helps digest the food will start to die.  Harmful bacteria will be allowed to start growing.  This is usually clostridium but we also see E Coli too.  This type event causes toxins to build in the body.  The pH in the gut will also start to radically change and that kills additional beneficial bacteria and can also lead to gastric ulcers.  The walls of the GI tract are quite thin.  The ulcers make it thinner.  Bad things will happen if they rupture.  For that reason, I do not allow any of my rabbits to receive gut motility drugs.  I would suggest finding a supplement called Bene-Bac.  It can be purchased at many pet stores...usually in the cat section.  It is a paste that contains huge amounts of colony forming bacteria including L Acidophilus and L Casei.  Those bacteria will help stabilize the pH in the gut.  

Let me know what medications this rabbit is on.  Some of them do have a negative effect on the GI.  And if the vet made some type of a diagnosis as to the cause of this issue.  If not, finding out the root cause should be a priority.

Randy

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

QUESTION: The meds the vet put him on are:

- Critical Care Oxbow
- Baytril oral solution
- Metronidazole Oral
- Cisapride

The vet took an x-ray the first time i took my rabbit in, she said nothing really looked out of place but she thinks there is some kind of a blockage in his stomach. She checked his teeth and said that he looks great.

The vet also suggested at first that i give my rabbit Nutrical and papaya pills but he started to have really bad diarrhea so she said to give him the others.

The vet gave me a number of a specialist to call if by Monday my rabbit still isn't better. So i guess i can call tomorrow morning.

He is starting to eat a little, like a few bites but he still wont drink. Oh, and i guess my rabbit is really smart cuz he figured out that if he wont swallow the medicine will just run out the other side of his mouth, so he doesn't  fight me anymore, he just wont swallow

I'm really worried about him! I can tell he's loosing weight and thats not good, i just can't afford to keep taking him to the doctors and having them run tests.. the first appointment he had cost me over $300... is there anyway for the doctor to figure out whats wrong without all the expensive tests and MRIs and stuff?

Again, thank you for your time and knowledge

Answer
Hi Helen,

Has your rabbit been administered sub-q fluids?  If not, I would highly suggest it.  The most likely cause of an impaction is a dehydrated mass of ingesta...that is stuff the is naturally in the GI tract that binds together when the rabbit becomes dehydrated.  It basically blocks the digestive tract.  While this the most likely cause, it could be a tumor that is restricting the gut.  I would suggest getting in to see the "specialist" first thing in the morning if at all possible.

I am not a vet but I will give you my personal non-professional opinion on the treatment being offered at this time.

The Critical Care is good if you can get her to eat it.  Have you tried some of the other suggestions I made in the earlier e-mail?  Instead of Nutrical (which we call "fat in a tube") I would suggest a probiotic to help with the bacterial status is the gut.  Many have the idea that yogurt will help.  Do not use yogurt if anyone suggests it.  While there is some benefit in the bacteria cultures....most yogurts contains high levels of sugar and diary products and that is the last thing you need in a bad GI.  The CC does contain some cultures like L Acidophilus.  That does some good by helping to stabilze the pH in the gut to allow a better climate for good flora growth.  I use a product called Bene-Bac...it is available at most pet stores.  It contains huge amount of colony forming bacteria including L Casei which is very beneficial.

The antibiotics are controversial in the vet community.  Some say there is no proof they are needed.  However, if you culture what is coming out of the gut, I suspect you will have a primary growth of clostridium (which is toxic) with possibly a secondary growth of E Coli.  Both of these are toxic.  I do use the metronidazole (flagyl) with great success.  I hope it's flavored....it tastes horrible.  Put a drop on your tongue and see for yourself.  If it is not flavored, ask the vet to flavor it, ask your personal pharmacist for "FlavorX" (banana usually works well) or some pharmacies carry an "at home" flavoring kit called FlavorIt.  The flavoring should make it taste a little better.  I am not a huge fan of Baytril for much of anything but it might be of help against possible E Coli.  The cisapride is a scary drug.  All I will say about that one is that there is no way on earth that drug will ever be administered to one of my bunnies for any reason at any time.

My non-professional opinion is to get this rabbit hydrated with sub-q or IV fluids.  You can do a basic check for dehydration by scruffing the skin above the shoulders.  The skin should snap back into place immediately.  If there is any delay, fluids are needed.  

I am wondering about the x-ray....do you know if it is a digital rad?  If it is, they can e-mail you a copy and you could forward it to me..maybe I can see something.   Just a thought...but remember that I am not a vet.  

I really have a feeling this bun needs fluids as soon as possible.  I would keep offering greens as they are mostly water.  But do try to get her in to the other vet as soon as possible.  At this point, anything I could suggest would require a veterinary professional to perform.  Work on the hydrations.  Something you might try....get a fresh pineapple (the real fruit) and squeeze as much juice as you can.  Mix some of the Critical Care into the juice and see if she will take it.  Most really like the pineapple juice.  There might even be some benefits from the fresh juice.  Use only the real fresh fruit as other forms of the juice contains lot of sugars.  Wish I could do more to help...but I think we are beyond the point that we need a very experienced rabbit vet.

Randy