Fighting GI stasis

[tanya_v]

My Holland lop Wasabi is a sick baby and I need some help in between vet visits. He got sick last Sunday, was checked by a vet on Monday, and he is going to the vet's again on Monday next week. He is not eating or drinking by himself. He wanted to eat baby food (pumpkin, carrot, apple) but the vet told me not to give it to him. He does poop but very little. He pees a lot. He is on a Critical Care diet, subcutaneous fluids, simethicone, metoclopramide, bene-bac, and bromelain.

The bunny is about 5 lbs. I was told to give him critical care 24cc 3 times a day and this is what I am doing. But I am not sure how much bromelain to give.

Any advise would be greatly appreciated.

 

[JBun]

I'm sorry you're bun has been sick. I'm afraid I can't give you any info on how much bromelain to give as it's not a normal GI stasis treatment and so I can't point you to a reliable rabbit medical site that might have that info. You could try a google search and that might bring up the info you're looking for.

I did however notice one usual GI stasis med missing from your list, and that's pain meds. Rabbits are normally given(and in most cases should be given) pain meds when they have stasis. Reason being is that a rabbit in pain will be less likely to want to eat on it's own, so good pain management is essential. Usual pain meds are meloxicam/metacam for mild to moderate pain control, and buprenorphine or tramadol for more severe pain. If your vet didn't prescribe pain meds for your bun, I would highly suggest requesting some.

Did your vet find the cause for the stasis? If not, were the teeth checked? I ask as dental problems are a common cause for stasis and the fact that your bun would willingly eat soft baby food might be an indication that there are dental issues(molar spurs, elongated tooth roots, infection, etc) as rabbits can become selective in what foods they will eat when their mouth is hurting, and sometimes will have a preference for soft foods as it's less painful for them to chew. With your bun still having a lack of appetite and stasis for almost a week, that can also point to there being an underlying health problem at the root of the stasis. So if your vet hasn't found a cause as of yet and further diagnostics such as a thorough dental exam, blood tests, and/or xrays haven't yet been done, then having those done might help you(and your vet) discover what is causing the continued stasis.

Best of wishes and I hope your bun is soon feeling well.

 

[Aki]

I agree, normally vets give you Metacam (meloxicam) to go with the mobility drug. Rabbits are very sensitive to pain and just having a bit of a stomach ache can prevent the rabbit from eating normally again (or moving around, which is really important to stimulate the guts) - my Aki had stasis twice last year and she perked up almost immediately after the pain went away.
Benebac, Bromelain and Simethicone don't sound very useful to me and that's a lot of meds to take which is probably stressful for the rabbit (and for you). I would discuss with your vet the possibility of dropping those and taking Metacam instead while continuing with the Reglan (Emeprid or whatever mobility drug you're giving) and the CC.
I also agree about what JBun said concerning the cause. GI stasis is an effect, not a cause. Sometimes it's caused just by a stress or a big moult, but it's better to check there is no underlaying condition which could prevent recovery or cause a new bout of stasis (for Aki, it took me weeks and a relapse to understand that her eyesight was worsening and that it was stressing her out and making it harder for her to eat hay from the hayrack...).
Is he eating at all on his own?
But if he is pooping and that there is no pus, that's a good sign. At least, there is no blockage and as long as the guts are still working, you don't risk a build up of bacteries - those being the most dangerous things caused by stasis.
I hope Wasabi feels better soon!

 

[tanya_v]

I took my bunny to another vet today. He was showing some improvement and I hoped he will be better. I found out he has an ear infection the other vet didn't find. Also the lower molars are to pointy and they are cutting into his tongue. And he has kidney problem now. He has poor chances but the vet will try to file his teeth without general anesthesia and treat his ear infection and then we'll see. I don't know at this time if I should keep trying. The vet is not very optimistic.

For the pain medication I was given a different drug and only 2 doses. And it's very expensive. The new vet will give us meloxicam.

He started eating a little bit of greens but he is not drinking so I have to administer liquids sub-c.

 

[JBun]

I'm glad you found a vet that could help figure out what was going on with your bun. Your bun does have some difficult health issues, but there is always some chance that they can be improved enough that your bun can continue to have a good quality of life for some time yet. At least now you have a knowledgeable vet helping you and your bun. If you go ahead with treatment, I hope it goes well and that your bun is soon feeling better.

 

[tanya_v]

I'm glad you found a vet that could help figure out what was going on with your bun. Your bun does have some difficult health issues, but there is always some chance that they can be improved enough that your bun can continue to have a good quality of life for some time yet. At least now you have a knowledgeable vet helping you and your bun. If you go ahead with treatment, I hope it goes well and that your bun is soon feeling better.

Thank you. I am giving him a chance. This new vet is amazing. She managed to trim his molars a little for now without sedating him so it's easier for him to eat.

 

[tanya_v]

Now he stopped peeing.:cry2 How often do bunnies pee?

 

[Watermelons]

How much has he actually been drinking? When did you last do SubQ fluids vs him last peeing?
Fluid has to go in for it to come out.

 

[tanya_v]

How much has he actually been drinking? When did you last do SubQ fluids vs him last peeing?
Fluid has to go in for it to come out.

The vet told me to give him 50cc sub-q once a day and that plus his Critical Care food would be enough. He peed three times in the morning but nothing after 2 pm. I called the vet and was told to give 50cc more. Still nothing. I was told not to give him fluids orally. The previous vet told to give 100 cc and the bunny was peeing a lot.

 

[tanya_v]

And now diarrhea. :bigtears::bigtears: Can I give Pepto Bismol to a bunny?

 

[stevesmum]

I don't think so. Is this true watery stool or just soft poops? I'm so sorry you're going through this and it sounds like you need to reconsult the vet. And spend lots of time and love with him.

 

[tanya_v]

His poop is very loose. He is taking TMS and the vet suggested giving him 1cc of non-fat yogurt twice a day. The diarrhea started yesterday.

 

[stevesmum]

Yeah hopefully jbun or ravenousdragon will hop on with some advice. This doesn't sound good though

 

[RavenousDragon]

Is he eating any veggies at the moment? Or just the critical care and yogurt? I would talk to the vet and maybe even cut the yogurt back out (they oven have a lot of sugar and protein!). That might be the issue, unless you added yogurt after the diarrhea started.

 

[tanya_v]

He is eating Critical Care and pellets. Greens just very little. And he is not eating hay at all. I give him non-fat plain greek yogurt. I started giving him yorurt along with TMS so I am not sure with one to blame.

 

[stevesmum]

I had two rabbits on that last year and no diarrhea. I know there are some vets that still recommend yogurt but I don't think it's good for rabbits. I don't think they can digest milk proteins.

 

[tanya_v]

I had two rabbits on that last year and no diarrhea. I know there are some vets that still recommend yogurt but I don't think it's good for rabbits. I don't think they can digest milk proteins.

Well, this vet is probably the best bunny doctor within 1 hour drive around me. I have bene-bac but I am not sure how much to give him. The vet was supposed to call 2 hours ago and I am still waiting.

 

[tanya_v]

Got a hold of the vet and she insists that yogurt is fine. She doesn't know how much of powdered benebac to give. The instruction on the package says 1 tea spoon for 1-5 lbs of weight. It sounds like too much.

 

[JBun]

I would be extremely concerned about the diarrhea. If it is true watery or pudding like diarrhea and not just soft mushy cecotropes, that is considered a true emergency with rabbits.
http://www.bio.miami.edu/hare/poop.html

And if it is true diarrhea, I personally would stop the yogurt and possibly the antibiotics as they could be the cause of the diarrhea. With antibiotics, if your rabbit is getting sulfatrim, though this is usually well tolerated, some rabbits can have an adverse reaction to it(I had a rabbit die from it). Diarrhea can be one result, and this usually means that pathogenic bacteria is taking over, and this can be extremely harmful very quickly, so needs to be addressed immediately. I would request a change of antibiotics with my vet, and I would want that change to include metronidazole to cover the possible cause of the diarrhea being enterotoxaemia caused by the bacteria clostridium sp. Questran is also recommended to absorb the toxins created by the bacteria.
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm

Rabbits can't properly metabolize dairy products, and though yogurt might be recommended by some, it's clear your rabbit is having an adverse reaction to either the yogurt or antibiotics, and since you can't determine which, I would stop both and consult with my vet. I would personally go with the bene bac as it is a much safer option to provide probiotics to a rabbit. With the amount of bene bac to give, I would just guesstimate what is going to be the right amount. If a tsp seems too much, give a little less. Better to start out with a little less to make sure there are no adverse digestive reactions, then increase if there are none and you feel more is needed. And it's not like a medication that has to be given in exact amounts. Though do keep in mind that there are sugars in it, so that has to be taken into consideration.
http://www.bio.miami.edu/hare/ileus.html

Because sugars and starches will 'feed' the bacteria, it's also usually recommended removing pellets and any other starchy/sugary foods, and free feeding some sort of grass hay only. This helps with restoring the normal gut bacteria. If your rabbit isn't eating well on it's own, I would syringe feed a slurry made from hay or hay pellets.

Though your vet does seem knowledgeable about rabbits in some respects, one thing I have learned about getting the right treatment for my rabbits when they are sick, is that I have to be their advocate and become self educated on what is usually considered the correct treatment for their various illnesses, and that I can't just leave it to my vet and trust they know what they are doing. I've experienced and read of too many instances of misinformed or under educated vets prescribing the wrong treatment for a rabbit, sometimes with fatal results. I really hope your vet will listen to your concerns and work with you to help your rabbit get well again.

 

[tanya_v]

I would be extremely concerned about the diarrhea. If it is true watery or pudding like diarrhea and not just soft mushy cecotropes, that is considered a true emergency with rabbits.
http://www.bio.miami.edu/hare/poop.html

And if it is true diarrhea, I personally would stop the yogurt and possibly the antibiotics as they could be the cause of the diarrhea. With antibiotics, if your rabbit is getting sulfatrim, though this is usually well tolerated, some rabbits can have an adverse reaction to it(I had a rabbit die from it). Diarrhea can be one result, and this usually means that pathogenic bacteria is taking over, and this can be extremely harmful very quickly, so needs to be addressed immediately. I would request a change of antibiotics with my vet, and I would want that change to include metronidazole to cover the possible cause of the diarrhea being enterotoxaemia caused by the bacteria clostridium sp. Questran is also recommended to absorb the toxins created by the bacteria.
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Clostridial_enteritis_rabbits.htm

Rabbits can't properly metabolize dairy products, and though yogurt might be recommended by some, it's clear your rabbit is having an adverse reaction to either the yogurt or antibiotics, and since you can't determine which, I would stop both and consult with my vet. I would personally go with the bene bac as it is a much safer option to provide probiotics to a rabbit. With the amount of bene bac to give, I would just guesstimate what is going to be the right amount. If a tsp seems too much, give a little less. Better to start out with a little less to make sure there are no adverse digestive reactions, then increase if there are none and you feel more is needed. And it's not like a medication that has to be given in exact amounts. Though do keep in mind that there are sugars in it, so that has to be taken into consideration.
http://www.bio.miami.edu/hare/ileus.html

Because sugars and starches will 'feed' the bacteria, it's also usually recommended removing pellets and any other starchy/sugary foods, and free feeding some sort of grass hay only. This helps with restoring the normal gut bacteria. If your rabbit isn't eating well on it's own, I would syringe feed a slurry made from hay or hay pellets.

Though your vet does seem knowledgeable about rabbits in some respects, one thing I have learned about getting the right treatment for my rabbits when they are sick, is that I have to be their advocate and become self educated on what is usually considered the correct treatment for their various illnesses, and that I can't just leave it to my vet and trust they know what they are doing. I've experienced and read of too many instances of misinformed or under educated vets prescribing the wrong treatment for a rabbit, sometimes with fatal results. I really hope your vet will listen to your concerns and work with you to help your rabbit get well again.

Thank you. I stopped giving him yogurt and I am giving him metronidazol later today. I was told it has to be 72 hours between injections. I gave him 1/4 teaspoon of benebac yesterday and I should have it in gel form today.
The vet told me to stop motility medication and it seems to stop the progress. She said you don't do motility drugs eith diarrhea. The bunny is in pain and his stomach is in knots. I give him pain meds once a day per vet's recommendations. And I massage his tummy 4-5 times per day. I am afraid he is not doing well. If I take him to the vet the only option would be to put him down.