Evie's been spayed today. Need some help

[ra7751]

Umm....I would be calling the vet tonight and demanding pain meds. The "long acting" pain meds they receive pre-op are good for no more than 12 hours....and that is if it's Buprenorphine (there isa "rest of thestory" behind the "long acting" injection). Many vets use Butorphenol which burns out in about 1.5 hours in a rabbit. Your vet's comment about not using pain meds to "protect the kidneys" makes me question his knowledge about rabbits. I am assuming he wants to protect thekidneys (the liver is much more affected by excessive NSAIDs than the kidneys)from NSAIDs (Metacam, ibuprofen, Motrin, etc.). They will damage the kidneys if they are used in a dehydrated animal (should have received fluids during surgery) or used for long term. There is more risk with the pain. And this class of drug is totally inappropriate for post-op pain management. We always insist on narcotics (and we have done many spays/neuters) such as Buprenorphine or Tramadol. There is no appropriate drug you can purchase without a prescription (in the US anyway). Did the vet tell you to use peroxide? I hope not. If we need to cleanan incision, we use sterile saline. And as far as antibiotics....we do not use antibiotics post-op unless there was a current infection (only once in all of our surgeries). And if you have Baytril in the fridge since May.....TOSS IT! If it is a compound (and if it is a suspension it is compounded)...it is only stable for about 14 days after mixing. I agree with Pipp with the heat...sounds a little shocky. Be careful using a heating pad as they can burn even on lowest setting. Don't force the food issue especially if she isn't on appropriate pain meds. Offer her a buffet of her favorite foods....dandelion greens are usually the fav here after surgery. To give you an idea about how effective pain meds are....we pick up our spays/neuters before they clear recovery....and they are eating usually within hours. But we use narcotics....and have for up to 5 days. Never had a problem.

This is another example of some comments I have made previously. Discuss the surgery with the vet...not the tech and not the front desk...prior to surgery. Get a detailed quote...you might be surprised at some of the charges. If you are told to remove food and water the night before....find a real vet. We do remove pellets early in the morning but they still have access to hay and water....and some have been eating hay on their way into surgery. Discuss follow-up treatment including pain meds to go home. This should not be an option....pain meds to go home without question. And I mean appropriate pain meds. Ask these questions to your vet...don't be intimidated. If they are worth their salt, it will prove to them that you are a well educated bunny slave and you know what it takes to care for your rabbit. I do....and my vets know where I stand and respect that.....and I always have appropriat pain meds on hand.

Healing vibes headed Evie's way.

Randy

 

[NorthernAutumn]

OK guys, It's been the full 12 hours since spay; all painmeds should be gone. She's taken about 4 cranberries from me. WhenI stroke her, the whole body is quivering and shuddering.

Will go grab the motrin and do her up right. I've got pumpkin.

Will have to move her out of the lower level of the condo to a more accessible area. She's huddled way in a back corner, w Stuart.

My poor girl...

I told that stupid vet that she needed pain meds! I was very specific that she needed them ,and he refused me, even after I had a full conversation with him

:grumpy::grumpy::grumpy:

I wish I had known all the drug names better... Maybe he would've believed me...

 

[Maureen Las]

I'm sure that she will come out of this just fine; you've got a lot of good advice...I've had a lot of shelter spays at my home from the vets ..most of them had laser surgery which is easier on them.

I have syringed pedialyte the first couple days and just when I am really upset that they are not eating or pooping enough they start..usually by the 3rd day.

if she still seems really uncomfortable tomorrow I would try the vet again and if he refuses I would look for a new vet
actually I would look for a new vet anyway..but for now just take care of her as you have been

 

[NorthernAutumn]

Two options here:

PROBABLY NOT> Junior Motrin (ages 2-11) Tablet form, 100 mg each. 1 tablet for 24-35 lbs.

Infant Motrin (2 and under), ibuprofen oral suspension, 40mg/mL

Under 12 lbs, says talk to adoctor.

12-17 lbs, give 1.25 mL

http://homepage.mac.com/mattocks/morfz/rx/drugcalc.htmlgives it as 5.78 mg as mean recommended dose, for a 1.7 pound rabbit

At 40mg/mL, that would be 1/8mL

Am I right?

 

[Maureen Las]

At 1.7 lbs..it would be 0.125cc or 1/8 ml.

be careful with the 1 ml syringe as that amount is small

 

[NorthernAutumn]

The lowest denomination on the syringe was 0.625 ml. I split it in half to get 0.3 mL (using sharpie), then divided the half into 3.

Tested the dose into my hands a few times, really slow. 0.125 is one drop, to my best measurements. I think that one drop is a bit low, but I'm not willing to risk it at this pt.I putthe dropon my finger (can't syringe it.. too small, inaccurate), and wiped it over her mouth.

Thank God that stuff tastes pretty good (I tried it first-berry flavour). She licked it off her lips, and is currently chowing down on an apple (Lots of water there, and she likes it too.)

How long can I keep her on the Infant Motrin for?

When is next dose? Box says6 to 8hours...

 

[NorthernAutumn]

BTW, thank you so much everyone for your help so far!!!!

arty:RO members are the BEST!!!!!

I really appreciate all of your advice. I recognize that all of you have a heckuv a lot more rabbit experience than I probably ever will. Thank you so much for sharing your wisdom with me.

I just remembered: the vet told me that if I really thought the rabbit was in pain, I could come back tomorrow... but "she won't be" (insert self-satisfied smirk here). "She is so happy and feeling good already!"

BS! I will be brave and call them tomorrow to dole out some major reproval, and get me some narcotics (hopefully!). Otherwise, could Motrin get us all the way through this, as long as she keeps hydrated?

(On a side note, I have gotten into a major argument tonight with my BF, over your advice vs. common sense/logic vs. vet. Whether or not he actually believes that she's in pain, he drove me to get the drugs anyway. I wish that he had as much faith in you guys as I do...)

 

[Maureen Las]

I would call the vet tomorrow and get pain meds from him. Tramadol is a good drug if you can get it. Even if you can get Metacam probably better than ibuprofen.

I 'm not sure about the timing of dosages of ibuprofen..I never gave it myself and it is really being used because you don't have anything better. Make sure that you get as much fluids in hr as you can when giving this drug.

Rabbit dose calculator say 'as needed" which doesn't say anything. I would not give it any more frequently than q12 hrs and I would call the vet and insist on pain meds tomorrow

and then dump him after you get them...

keep us up-dated

 

[tonyshuman]

I do want to chime in that it's probably ok to dose like you did, but (as a student in pharmacy) you can't just go by weight to give the correct dose. Smaller animals in general will clear a drug more quickly from their systems because they have such higher blood flow rates. I have to look at my notes but I'll get back to you on what the proper dose should be...

Edit: that site is good. I'm sorry I assumed you didn't use a scaling calculation. Yay for that resource! Faster than a speeding pharmaceutical scientist!! Also, next time you could dilute the children's motrin down with water or pedialyte to give a more accurate amount.

I hope it makes her feel better and you can get some pain meds and advice from a vet soon (even if it's not the same one as before). Finally, and I don't know if anyone has mentioned this, but you'd be surprised what veterinary medicine you can buy at the local farm supply store.

 

[NorthernAutumn]

OK, just got back from vet.

Told him that I used Infant motrin with the correct dose on her last night. He felt that it was similar enough to metacam, so keep going with the motrin.

He stated that the Motrin should be one drop a day, same as if he had proscribed Metacam. He said that he didn't want her to be overmedicated.... Any thoughts on that?

Asked me how she was eating. Considering I've seen her have a drink and a tiny bit of apple,her eating sucks. He prescribed Metoclopramide, in oral form (.02 mL).

I specifically asked for Tramadol. Apparently, he only has large pills, which she would require 1/50th of. To get the correct dose would need the pharmacist to do it, and would likely take 3 to 4 days...

So, now what?

Second opinion?

 

[NorthernAutumn]

Just called the pharmacy to double check on the timeline. They've got tramadol available in 100mg forms, but as a controlled-release design, the pill cannot be split

They can run the prescription through, but the quantity can't be adjusted to her size...

Just gave another dose of Motrin.

 

[Maureen Las]

I feel like I'm in somewhat over my head here....
I would do as he say re. the motrin as I don't know.


Like I said yesterday the spays that I take home from my shelter will eat very little until about the 3rd day..I wouldn't want to give my rabbit metoclopromide after a spay because at this point I don't see any reason...

just give fluids..,continue to give wet veggies and small pieces of fruit..no one is giving her a chance to recover on her own.

if it was me ( and this is just me) I would get the tramadol tablets and break them down myself into minute increments but i shouldn't really recommend that because it's not precise. I would get them just to have them if needed
I think that tonyshuman is a pharmacy student so let's hope that she comes back in this AM
i wouldn't give metoclopromide yet after a spay .

I'm not coming through well for you on this so wait for another member's opinion:?

 

[Maureen Las]

forget what I said about the time released tramadol.. it cannot be split so no way to do it
I just thought of something..
There are pharmacies here that are called compounding pharmacies...they are not the big chain drug stores. When beau needed to have his medscompounded the vet called it into a pharmacist who does a lot of that.
maybe you could get out the phone book call some small pharmacies ,ask to talk to the pharmacist, explain all this and possibly they would have tramadol in another form that could be broken down and mixed

then your vet could call the prescription in to them ..in other words just change pharmacies

 

[tonyshuman]

I'm not in pharmacy school per se, as in I'm not training to be a pharmacist. I'm in school to get a phd and be a research scientist in the area of pharmaceutical sciences, which means I can do research into new drugs to make and how to give them to people. However, I am taking courses on how drugs are metabolized in the body. That's how I know about scaling drugs to different species.

I am concerned that your vet didn't give you Metacam because it's specifically meant for rabbits and giving Motrin is ok, but not optimal. It's best to give anyone a drug that was designed for them to take. There are lots of factors that go into how a drug acts in the body, so it really is best to give veterinary drugs to animals and people drugs to people. In some cases, like emergencies when you don't have the veterinary drug available, it's ok to give an animal human drugs IF you're very careful about the dose, which it seems you are. In addition, the species scaling equations are very dependent on where the drug is metabolized, which is often in the liver but not always for all drugs, so they are not perfect. Even within the pharmaceutical industry, species scaling of drugs to go from animal testing to human testing is only right about 80% of the time. Thus, it's best to give an animal a drug that is designed for that animal, and your vet should know that.:?

Often pharmacies, drug stores, and farm supply stores will sell smaller syringes, so you could use one of those and be more accurate as well. Insulin syringes are usually 1mL, and are marked in "units." 10 units = 0.1mL, if I remember correctly.

It is probably ture that the tramadol cannot be compounded to give to your rabbit. Extended release means that a large amount of the drug is put into filler in the tablet, and just cutting the tablet up won't get an even amount of it. Grinding up the tablet and giving it dissolved in liquid won't work either. It may sound like it would work, but if a rabbit needs 2mg/day or so, and you grind the tablet up and split it into 50 equal portions, dissolve one in liquid and give orally, you'd be giving the rabbit all 2mg at once (because it's already dissolved), when they're supposed to have 2mg over an entire day, and that dose could be too high. I hope that made sense.

They don't want to overmedicate her because it can stress the liver and kidneys. I think you need to get your vet to give you Metacam or go to another vet to get it or Tramadol. Preferably, go to another vet. I don't like how this one acts. Motrin is ok in a hurry when there is nothing better available, but I don't think it would be good to do for a long time.

Again, I do not have a Pharm D, MD, DVM, whatever. I'm just a student interested in how drugs work. I'm not even qualified to be a pharmacy technician! The best person to talk to is another vet who can and will give you a real veterinary analgesic. Best of luck to you both. I hope this cleared things up, and if not please tell me, I can try to explain better.

 

[NorthernAutumn]

No Tramadol to be found in a bunny format...

I've got Metacam now.. They're suggesting one drop per day (every 24 hours).

At 1.7 pounds, do you think that will be effective?
She last had Motrin at 12 noon today... It's 5:20pm where I am. How long do I wait?

 

[Maureen Las]

How is she behaving; what does she look like right now..is she eating and pooping ..is she hunched over and grinding her teeth.??////

Does she look like she is in pain?

 

[NorthernAutumn]

I've never heard her grind her teeth... but her body is vibrating like crazy. She ate two tiny morsels of romaine lettuce, and has refused all else, including banana, raspberry, raddichio, banana chips, cranberries, snow peas...

I still think she's in pain. Haven't seen her sitting yet. Currently lying in litterpan, with back legs slightly extended.

Stu is with her, but I think the poops in the house are his. NO signs of urination in litter pan :?. Saw her take a drink of water last night.

I just gave her a drop of metacam before I got to read your post. It's been 9 hours since the Motrin. I really hope this is OK. If she needs more food, I can keep trying...

Seriously, is one drop per 24 hours supposed to do anything????

Mad Evie! Bad Autumn! I've never used metacam before: smells horrific, and probably tastes wretched too. The motrin went down a lot easier.

She's camped out under her warm towel right now, looking furious and sad.

 

[RexyRex]

I had to pull this info from another forum, but when I had Alaska spayed she was gived .01ml of Metacam every morning for pain for 7 days. She was also given 1ml of Trimeth/Sulfa twice a day for her antibiotic. At the time of her surgery she weighed 2.8lbs. I hope she starts to feel better soon :hearts

 

[NorthernAutumn]

Thanks for the info RexyRex: that means that my 1.7 lb Evie is receiving a similar dose to your 2.8 lb. Alaska, as one drop is approx. 0.1mL.

My vet said not to go over 4 days with the metacam. I think I'll go with your 7 days; seems more reasonable, considering recovery is 14 days.

Evie thanks you so much for confirming the info. It feels wrong to be questioning this vet so much, but considering that pain management was way down on their priority scale, I don't know what parts of their info to trust.

Will go give Evie a hug from all of you (even tho she's mad at me )

Hopefully she'll start chowing down soon

THANK YOU AGAIN!!!!!!!!

 

[RexyRex]

I don't blame you for questioning them, I remember that my vet was very adamant about pain management. When Gixxer was neutered through the Humane Society he wasn't sent home with any pain meds and Dr. Forward let me stop by right after picking him up to pick up Metacam for him as well. He was only on it for 3 days and that was really for a precaution, he didn't act like his surgery bothered him at all. I think that I stopped Alaska's pain meds after 5 days because she started to fight me so hard to take I was afraid that I would hurt her trying to restrain her to take it. I called the vet and she said "if she's fighting you that hard then I doubt she's in a lot of pain, stop the Metacam".

The only warning that I was given with the Metacam was to stop immediately should she develop diarrhea.