Diarrhea after Surgery

[DazyDaizee]

Walter had surgery to remove the abscess on his back yesterday. He did well and ate that night. This morning he wasn't eating. I called the vet and asked if I should do anything at home to get him to eat. Following her instructions, I gave him 100mL SQ fluids and tried to force feed some Oxbow Critical Care, which he wouldn't take. I offered baby food, Critical Care, veggies, pellets, and hay. Luckily he started eating the veggies and his appetite got better throughout the day.

Now, tonight, he has diarrhea. His is on Metacam, but the diarrhea doesn't look bloody/tarry. He is eating much better and he's being relatively active. Should I be worried? I don't think the vet is open tomorrow for me to call, so I'm just wondering what everyone else thought. Of course I'll worry more if it doesn't go away...

He did get a metocloprimide injection the day of surgery, other than that he's just on Metacam.

 

[tonyshuman]

Does he have lots of hay to eat? When they have diahrrea the best thing to do is offer hay, lots of water, and almost no veggies.

 

[tonyshuman]

Wanted to add that you probably don't need to give him any more sub-q unless you think he's dehydrated. 100mL sounds like a lot.

Did you give him any new veggies?

 

[ra7751]

Is your vet rabbit savvy? First, I don't agree with surgery on an abscess....but that isn't really directly relatedto your question. I have treated some very nasty abscess and not one time have I ever had to open one. How much does your rabbit weigh? That amount of fluid is a lot of fluid unless he was terribly dehydrated prior to the surgery. Metacam is totally insufficient pain meds following surgery....it is better than nothing but should be used in combination with a narcotic aspect post-op. And why in the world would a vet give Metaclopramide pre-op? For that matter, why would it ever be given? I never allow GI motility drugs to be used for any reason. There is very little, if any, benefit to giving these drugs....but there is a huge downside. I have never seen anything good come from these drugs when used in a rabbit.

I personally would really like to know why this vet gave a gut motility drug. That is just nothing short of shocking.

I would suspect this bun is in pain....both from the surgery and from the violent contractions in the GI induced by the motility drugs (I am having a very difficult time with this line of treatment...and I use the term "treatment"quite loosely). The large amount of fluids is probably adding to the upset GI. And the stress of being force fed isn't doing any good either.

My suggestion is to let him "chill out" for a while. I have had rabbits not eat for about a week. Hydration is much more important and you are certainly hydrating with the amount of fluids he is getting. I would get more aggressive pain meds. I would not allow any future injections of gut motility drugs (and would get an explanation of why they were given to begin with....and there is no way any vet could convince me of the value of using motility drugs in a rabbit). Allow him to rest and relax....he has been stressed enough. And as he starts to eat again on his own....lots of hay and add a probiotic such as Bene-Bac to support the pH in the gut.

I hope I don't come across as being too blunt in my response but I am just nothing short of shocked with the motility drugs.

Randy

 

[DazyDaizee]

The metacloprimide was given to prevent the gut from having problems with the lack of food he'd eaten after surgery. I've had 3 different vets total prescribe metacoloprimide between two different rabbits for GI issues. From the research I've done, discussions with the vet, and reading vet books, I've learned that if the rabbit doesn't eat for an extended period, the gut shuts down. When the gut shuts down it doesn't really get going again on its own.
My bunny Toot was in GI stasis a while back and given metaclopramide, syringe fed critical care, and given fluids.. which helped immediately. So I feel that motility drugs do have some use in rabbits and have only seen positive results after they've been given.

With the abscess being removed, I don't know what an alternative treatment plan would have been since he likely got the abscess from PenG injections for another issue. It was in loose skin, very mobile and easy to remove. Also, the vet couldn't rule out it being a tumor that had abscessed.

With the fluids, he weighs almost 7lbs.. about 6.75lbs last time I checked his weight, but he's been gaining since I've had him. The vet didn't see him the day I gave fluids, but she knew he wasn't eating anything, so I'm not sure if she calculated on worst case scenario, but he seemed to absorb them quickly enough, which tells me that it wasn't overloading him. And perhaps she wanted to be cautious given the metacam.

As far as the veggies go, I will try to offer more hay and no veggies and see if he still eats, but the veggies were the only thing that really got him eating. It doesn't seem like he's had any more diarrhea since last night, and has some semi-normal stools in his pen this morning. He's much more active and seems happy, wanting to be pet, standing up in the pet looking for attention.

 

[ra7751]

Glad your bunny came thru the motility drugs. None of my vets, and all of them are vet school professors or teaching hospital instructors, will use motility drugs in rabbits. I will not even discuss using them with a doctor. Too much risk. The general thinking is that if there is not a total blockage they are OK. I think, and experience has shown me, that "total blockage" is certainly a term that is open to discussion. What exactly is a total blockage. Additionally, in the case of serious GI issues, there is a high probability of gastric ulcers forming. These lesions will cause additional thinning of an already thin GI wall. The contractions caused by the stimulation of these drugs are not only very painful but are strong enough in some cases to perforate any lesion in the GI. There is only one resolution to this problem. Again, and my opinion is non-professional but based on decades of experience with rabbits....is that no motility drugs will ever be used on my rabbits. I cringe when I hear a rabbit has been given these drugs....but I am elated things worked out well for you and your rabbit.

If you were getting a skin abscess after injecting Penicillin....those generally don't require much intervention other than topicals....not saying something could happen to make things worse. Were you buffering the Pen injections? Your vet should know that certain drugs should be buffered with fluids....Penicillin and Baytril are just a couple..... as theycan cause tissue necrosis if injected undiluted. I have a rabbit here...JoJo....that one of the forum members helped transport up the east coast from FL to NC. He had a jaw abscess. I had to shoot so much Pen in him that he had skin abscesses all the way down his back. Generally, if you inject necrosis causing drugs, they should be buffered and the injection points moved around.....I don't inject in the same area every time. I start at the shoulders....work on each side of the spine...then after those two injections, I move halfway down the spine and inject again on each side....and continue moving downward and then start over.

Randy

 

[DazyDaizee]

I didn't give the PenG injections, so I don't know. I started out fostering this rabbit and we've decided to adopt him. The lump was noticed by a volunteer at the rescue but was not seen by a vet until I got him. The abscess was not open, but under the top layer of skin. Luckily it didn't seem to be attached to any muscle or anything else, but rather it was in a deeper layer of skin, easily movable. He had it for at least 2 weeks, but likely closer to a month. It is unclear last time he got PenG injections, but it seemed that it was a few weeks before I got him.
I'm familiar with certain drugs causing necrosis when injected, and I dealt with this in a similar way as you describe with my rat when he needed it. I didn't know PenG was one of these drugs, so I'll keep that in mind if my vet every prescribes it. The problem is that I don't know what vet, if any, prescribed the PenG injections originally, and I don't know how they were given.

Wally is doing great now. He's eating like a champ, no more diarrhea, and he was hopping around quite a bit earlier in the day. So it's looking promising, I'm hoping for no complications.