disabled bun need some advice

[nuttymeg]

I went through quite a rollercoaster ride in the past week. Took my elder bun who is 7.5 with paresis from EC to the vet for what i suspected was a possible bladder rupture. So vet does the ultrasound and agrees says nothing can be done etc to put him down. I was so afraid i called my husband crying my eyes out saying i cant do it alone,so my husband suggested we will go together later that day so i booked the appt. During the day at home i felt so sick.i felt i was doing the wrong thing and got him to a different vet for a second opinion, and thankfully that second opinion saved his life. He was bloated from gas,he weighed a pound heavier than normal from all the gas. Hes doing fine now,but one thing i have noticed that if hes not given any cisapride he isnt pooping,i get nothing. I give the meds,a couple hours later a bunch of poop will come out. Hes eating a ton,drinking very well.

I called the vet tonight to see if he needs the meds for the rest of his life and hes not in favor of doing that but was willing to offer another prescription for him. Is this something that is common in disabled buns? He cant hop,he can wiggle himself around his pen. When he was bloated he was pooping but in the smaller side and he had very loud gas sounds i could hear from about 5 ft away. Hes no longer as gassy like he was before,i hear it once in a while. I want to make sure i am doing the right thing for him. Has anyone had a bun on motility drugs for an extended period of time?

 

[JBun]

I'm so glad you followed your instinct and got a second opinion. Bladder rupture would be extremely rare, whereas bloat is one of the more common medical emergencies with rabbits and would be one of the first things a rabbit vet should investigate when there's severe abdominal distention.

I'm wondering if your rabbits gut just needs more time to settle and return to normal. That's not unexpected after something so serious. Though with something so serious, there may be a slight possibility of ongoing issues if permanent damage to the gut occurred, or if there's still an underlying medical issue going on. So just something to be on the watch for.

There's also the issue with cisapride needing to be gradually reduced over several days to weeks. If you were stopping the med abruptly, this might be the reason you aren't seeing the normal return of gut motility. Rabbits need to be gradually weaned off of it.

www.medirabbit.com/Safe_medication/GI_stimulation/cisapride.htm

One thing to do with GI disruption and clearing up gut imbalance and slow motility, is making sure your rabbit is eating plenty of fiber with good quality medium coarse grass hay. The hay should help quiet down those loud gut sounds by rebalancing the microflora. I would even go so far as to exclude all high carb/sugary foods, and possibly reduce pellet amounts as well. This is to limit the sugars promoting harmful bacteria growth. Plus fiber in hay is usually the best food for sorting out rabbit GI issues.

Though do watch closely as loud gut sounds can be a signal of more serious issues like pathogenic bacteria. So watch carefully for there being normal fecal balls. If fecal balls start going mushy or you're seeing a lethargic or depressed state, or anything concerning, contact your vet immediately.

 

[TreasuredFriend]

Thanks for your advice to @nuttymeg here, @JBun.

We also have a disabled/special needs' gal with paresis who makes loud gut sounds. She is termed hospice care with her compressed spine discs and originally diagnosed degenerative neurological. She's on meloxicam and tramadol. Comin' up on her 7 year b-date.

She has a hx of UTI's (urinary tract infections) so sugary fruit treats are extremely limited. Our DVM agrees that give her what she enjoys as a hospice bun, yet I immediately know when her pee stream changes and I suspect she has another UTI. Azithromycin is scripted. Plenty of medium coarse hay and occasional orchard grass and farmer-baled hay with sparse clover stalks are routine.

She makes loud gut sounds. I provide butt baths and hand feed her cecotropes. I have not had to give her cisapride. Hubby holds her, supports her, under her chest, to readily drink water from her large water bowl, 4x daily.

Second opinions are a good plan. I hope you have many years ahead with your senior boy, nuttymeg.

X-rays and labs for our hospice gal are done as needed.

 

[nuttymeg]

He is eating hay,i have reduced the pellets as well. Even gave some fennel to help with the digestion.He was super uncomfortable last week,even just picking him up he wasn"t a fan. I was told to give him critical care, i did that once and he was in so much pain he was grinding his teeth. So i never did it again,he was eating though,but the vet wanted him to get it. I just find it so odd that if hes not getting the meds i literally see no poop from him. Thankfully we caught his bloat quickly,husband noticed it monday night and tuesday morning he was at the vets.

 

[nuttymeg]

I'm so glad you followed your instinct and got a second opinion. Bladder rupture would be extremely rare, whereas bloat is one of the more common medical emergencies with rabbits and would be one of the first things a rabbit vet should investigate when there's severe abdominal distention.

I'm wondering if your rabbits gut just needs more time to settle and return to normal. That's not unexpected after something so serious. Though with something so serious, there may be a slight possibility of ongoing issues if permanent damage to the gut occurred, or if there's still an underlying medical issue going on. So just something to be on the watch for.

There's also the issue with cisapride needing to be gradually reduced over several days to weeks. If you were stopping the med abruptly, this might be the reason you aren't seeing the normal return of gut motility. Rabbits need to be gradually weaned off of it.

www.medirabbit.com/Safe_medication/GI_stimulation/cisapride.htm

One thing to do with GI disruption and clearing up gut imbalance and slow motility, is making sure your rabbit is eating plenty of fiber with good quality medium coarse grass hay. The hay should help quiet down those loud gut sounds by rebalancing the microflora. I would even go so far as to exclude all high carb/sugary foods, and possibly reduce pellet amounts as well. This is to limit the sugars promoting harmful bacteria growth. Plus fiber in hay is usually the best food for sorting out rabbit GI issues.

Though do watch closely as loud gut sounds can be a signal of more serious issues like pathogenic bacteria. So watch carefully for there being normal fecal balls. If fecal balls start going mushy or you're seeing a lethargic or depressed state, or anything concerning, contact your vet immediately.

So i have found that if no motility drugs are given he gets gassy, starts grunting etc. I give him one nightly dose of the gut meds and he's perfectly fine for the day and poops plentifully. He is eating mounds of hay without issue. When i spoke to the clinic about him needing the meds daily they said it wasnt advisable,I dont understand why that would be the case, Its just one dose a day he needs and all is good.

 

[New2RabbitsDonna63]

Wow. Thanks for sharing your story. What a lucky bunny to have you guys.

 

[JBun]

So i have found that if no motility drugs are given he gets gassy, starts grunting etc. I give him one nightly dose of the gut meds and he's perfectly fine for the day and poops plentifully. He is eating mounds of hay without issue. When i spoke to the clinic about him needing the meds daily they said it wasnt advisable,I dont understand why that would be the case, Its just one dose a day he needs and all is good.

I think probably because the body stops being able to stimulate the GI tract while on the gut motility med. And I think maybe, the longer a rabbit is on it, the longer it takes to wean them off it.

Have you tried completely eliminating pellets and all high carb/sugary foods (including Critical Care), and only feeding free fed good quality grass hay (not a coarse cutting) and maybe some select leafy greens if well tolerated? Though to remove pellets, hay eating has to be really good, a good quality hay, and not too coarse; select greens if tolerated, a salt lick, and monitor weight closely as well, to make sure no unhealthy weight loss occurs.

Monitoring your rabbits weight

I had a rabbit that even the smallest amount of pellets or sugary foods, would cause him to feel sick/get gassy, and stop eating and develop GI stasis. Then the Critical Care I was trying to syringe feed him while he wouldn't eat, was making him sick too. I had to get him on a free fed hay only and select greens/forage diet, to get him better. And he wouldn't touch loose hay, so it was pretty tricky to get this worked out quickly. But I did, and once off pellets/sugars, he never had a bout with stasis again.

So changing the diet is something I would try. But in addition, maybe see what your vet thinks about very gradually reducing the once daily dose, after the diet has been changed, so that after a few weeks of gradual reduction, hopefully your buns own body takes back over with gut motility back to normal without the use of meds, and hopefully the diet elimination solves the reoccurring gasiness.

Of course if the elimination diet doesn't work, and your bun doesn't do well with even a very gradual reduction of cisapride, then it could mean there's damage to the GI systems ability to function correctly. And that would seem to mean that daily gut stimulants would be essential.

I do remember a past RO member had a rabbit that was on cisapride long term, despite trying to remove any offending foods from the rabbits diet, and trying to gradually wean the rabbit off the med. I don't remember exactly what happened with that, just that they couldn't successfully get the rabbit off the med without encountering problems.

 

[nuttymeg]

I think probably because the body stops being able to stimulate the GI tract while on the gut motility med. And I think maybe, the longer a rabbit is on it, the longer it takes to wean them off it.

Have you tried completely eliminating pellets and all high carb/sugary foods (including Critical Care), and only feeding free fed good quality grass hay (not a coarse cutting) and maybe some select leafy greens if well tolerated? Though to remove pellets, hay eating has to be really good, a good quality hay, and not too coarse; select greens if tolerated, a salt lick, and monitor weight closely as well, to make sure no unhealthy weight loss occurs.

Monitoring your rabbits weight

I had a rabbit that even the smallest amount of pellets or sugary foods, would cause him to feel sick/get gassy, and stop eating and develop GI stasis. Then the Critical Care I was trying to syringe feed him while he wouldn't eat, was making him sick too. I had to get him on a free fed hay only and select greens/forage diet, to get him better. And he wouldn't touch loose hay, so it was pretty tricky to get this worked out quickly. But I did, and once off pellets/sugars, he never had a bout with stasis again.

So changing the diet is something I would try. But in addition, maybe see what your vet thinks about very gradually reducing the once daily dose, after the diet has been changed, so that after a few weeks of gradual reduction, hopefully your buns own body takes back over with gut motility back to normal without the use of meds, and hopefully the diet elimination solves the reoccurring gasiness.

Of course if the elimination diet doesn't work, and your bun doesn't do well with even a very gradual reduction of cisapride, then it could mean there's damage to the GI systems ability to function correctly. And that would seem to mean that daily gut stimulants would be essential.

I do remember a past RO member had a rabbit that was on cisapride long term, despite trying to remove any offending foods from the rabbits diet, and trying to gradually wean the rabbit off the med. I don't remember exactly what happened with that, just that they couldn't successfully get the rabbit off the med without encountering problems.

I am suspecting another bout of EC. I have read that its very possible that EC affects the contractability of the stomach due to the high blood flow going to that organ. Its really the only reasonable cause. I will treat him for the EC and see how it goes from there.