g i stasis

Question
QUESTION: Dear Dana my rabbit stopped eating and pooing last Sunday i took her to the vets who gave her Metoclopramide Baytril and Rimadyl i have been giving recovery and fluids. She has also been having Metoclopramide 0.2mls twice daily. Itook her back because there was no improvement and the vet said give her subcutaneous fluid twice daily 20mls each time and also try liquid paraffin 0.1mls little and often . She still hasnt improved at all and i am desperate is there anything you can suggest that may help?Also she is very difficult to give orals to because she wont swallow so there is only so much that i can give her and do you think she is having enough subcutaneous fluids?Thank you for any help you can give in this matter .

ANSWER: Dear Katherine,

Sometimes when the stimulus that elicits GI stasis is very strong and painful, it can be very difficult to get the bunny's GI tract moving again.  If you have not yet read this article, please do so immediately:

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

and here's a version for veterinarians, from Exotic DVM Magazine:

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

Perhaps the most important thing you can do is give your bunny gentle abdominal massage.  This seems to help get things moving even better than the gut motility drugs, and along with them, it can really kick start things.  Instructions are in the article above.  

Pediatric simethicone suspension to help her pass the accumulated gas is important, as are pain medications.  The pain medication may also help the underlying condition *causing* the ileus, so this is very important.  

The amount of fluids she needs depends on her weight, and since you have not told me her weight, I can't tell if 20cc's twice a day is a reasonable quantity.  But I doubt your vet would steer you wrong on that.  It's also possible to overdo the fluids with disastrous results.

If things really are not improving, ask your vet about the enema described in the article, and to show you how to do it, if you are not sure how.  DO NOT UNDER ANY CIRCUMSTANCES allow anyone to give an enema via French catheter!!  Any fluid delivery syringe should never be inserted more than about 1/2 beyond the anal opening, to prevent damaging the rectum.  An enema can *really* help things get going when all else has failed.

I hope this helps.  Please write back if you have more questions.

Dana



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

QUESTION: Dear Dana thank you so much for the reply my rabbit is pooing and eating now . The only problem now is the poos are very soft and some are watery I realize they are not going to be normal yet but is this what you'd expect?Also for future reference my rabbit is about 2kgs is there an average dosage for subcutaneous fluids per kgm? Thank you for your help Katherine

Answer
Dear Katherine,

I'm glad your bunny is starting to improve.  Goopy poops are to be expected at first, but if this continues for more than a few days, then ask the vet about Questran, as described in the article I sent.  It might be good to ask the vet about giving her some *now* to help speed her recovery and prevent intestinal irritation from any bacterial toxins left over from the stasis.

Fluid need will vary depending on the state of the patient, and your vet will be best able to tell you how much (or if) fluids are needed.  In general, normal intake for a mammal (including what's in the food) is about 90-100ml/kg per day, but it should never be given all in one bolus.  Usually fluids are given over the course of the day in 2-3 doses, so as to avoid causing potentially fatal overdose problems.

Hope this helps.

Dana