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GI Stasis in 2 year old bunny

22 10:47:33

Question
Dana...PLEASE HELP!! I have a 2 year old Eastern European Siamese rabbit named Snowbell. It is an intact male. We noticed a "clean cage" and bloating on the Fouth of July. The very next day we made an emergency visit to an exotic vet in our area that diagnosed Snow with GI Stasis. She prescribed Metacloprimide (4 times daily) and also sent us home with Morphine injections (twice daily). He was also given a bolus of IV subcut fluids. She said to massage him, feed hay & fresh greens only and continue therapy. She checks in with us everyday. Still, it has been about a week now and no sign of poop. The rabbit has gurgling noises in the gut and the vet says she doesn't think he's blocked. He's very bloated still. I added Simethicone to the therapy as well. He saw the vet agin this past weekend for another large bolus of subcut fluid and she changed the pain meds to oral Metacam. She wanted Cisapride for him but cannot find a pharmacy to give it to me. He remains on Metacloprimide. How much longer can my bunny survive this? He is not drinking as much as he should but he is eating bits of Timothy hay and the fresh greens little by little. We are also force feeding Critical Care as needed. He doesn't seem to be in horrendous pain...no grinding of teeth really. He does rest in a hunched position but that is not anything new for him. Yesterday, we hopped him quite a bit to stimulate him. He actually hopped our staircase in the house five times up and down. He is able to do that again today. How is this possible? When he does this, we hear loud, almost watery flushing & gurgling from him but he does not appear to be in any pain. HELP!!! How much longer do you think it will take for him to recover and does this seem like something he can survive? Thank You for answering me!!

Trisha

Answer
Dear Trisha,

I've seen a bunny go for 10 days without pooping, but it's no fun!  :(

I think one of the most effective ways to get the intestines stimluated is twofold:

1.  Gentle, careful enema with warm water, using a pediatric ear syringe.  They look like this:

http://www.medshopexpress.com/518882.html

but get the pediatric version at any local pharmacy.

We do this by holding the bunny cupped in a forearm/elbow in a "C" and gently inserting the lubricated syringe tip into the opening that "winks back" when you touch it. (This is how you avoid the prepuce!)

Do not insert the tip of the syringe (lubricated with KY jelly or similar lubricant) farther than about 1/2" into the anus, and express the warm liquid *very* carefully, never forcing anything.

Rock the bunny back gently, allowing the liquid to travel up the rectum before letting bunny back down.  You will be amazed.  In most cases, this will bring a sticky batch of mucous poops out within a few minutes.  In some cases, it takes a few trials (maybe an hour apart) to get things moving.  But the enema stimulus really does work.


2.  HYDRATION, HYDRATION, HYDRATION!
If things are very slow, you could add some epsom salts to the enema water, which will act as an osmotic laxative to bring liquid into the gut.  But be sure the bunny is well hydrated via subcutaneous Lactated Ringers Solution beforehand.  One great contributor to ileus/GI stasis is dehydration!

Oral or rectal administration of lactulose (an indigestible sugar that also acts as an osmotic laxative) also can help.

For a complete protocol on how to deal with this problem, please see:

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

and for the vet:

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

...if s/he is interested.

Pediatric simethicone suspension will help alleviate the gas and bloating, but gentle, vibrating tummy massage is also very imporant for both moving gas out and stimulating intestinal movement.

Here is a possible source for cisapride:

http://store.galladechem.com/shared/StoreFront/default.asp?CS=gallade&BusType=Bt...

Thought it's a pretty darned big quantity.

Hope this helps!

Dana