Resolved: Erik is beginning stasis

[Ivory]

Thanks for the encouragement, guys. I really appreciate it.

Apparently he woke my mom up at 3 in the morning by digging in his box. I think this is good. It means he's moving around a little bit and getting some exercise. He's mostly lying down. Like I said earlier, he's in obvious discomfort without being in complete and total excruciating pain. He isn't grinding his teeth but he isn't completely great either. He was also urinating well.

He also got a shot of Baytril to help prevent any overgrowth of bacteria, and I'm pretty sure a steroid shot to stop his intestines from inflaming. I'm encouraged by the fact that he still has some appetite. He also received a warm-water enema as he was constipated.

I know it can take 2-3 days for the results of treatment to show up. I'm just so worried about him. I need to just trust that he'll be okay. We got him through this once before and we'll get him through it again.

Mom sent me a picture of him resting after the day. It's the position he was staying in for a while. I'll post it in a minute.

 

[Ivory]

Here's his pic. To many it looks like he's feeling okay, but if you really look, you can tell that its largely not.

 

[Ivory]

Erik has a 2.5 inches by three inches long accumulation in his stomach. I suspect it has large amounts of carpet in it. It takes up the majority of his stomach. He has had bowel movements since his enema, however. I don't know where the accumulation is located but the spot that it's opened on must be letting some things through.

I don't know if he will have to be opened or not. I will keep everyone updated.

It isn't good but we're not on the verge of dying quite yet.

 

[dquesnel]

Hi Ivory, that doesn;t seem like too great of news but it is not dire either.

I saved this message from Dana Krempels in event of foreign ingestion. I think it may really help you. Here it is:

1. Hydrate bunny *well* with subQ Lactated Ringer Solution and continue hydration support throughout treatment.

2. Administer proteolytic enzyme (this must be done with caution, as it can burn the oral and esophageal mucosa; we give a little bit of simethicone suspension first, to coat the surface of the mouth and esophagus a bit. But even a little bit of mouth/esophagus soreness will go away in a day or two.)

3. Administer lactulose at a dose of 0.5cc per kg of body mass every 8 hours. This is an osmotic laxative, and will draw liquid into the gut. As the proteolytic enzyme dissolves mucus (and possibly some fur, depending on which supplement you use--pancreatic enzymes will blast fur, too.) holding the mass together, the hydration drawn in by the lactulose will help hydrate it, making it easier to pass through the gut.

(NOTE: I do NOT recommend using mineral oil *at all* in a case like this. It can coat the mass, making it nearly impossible to re-hydrate, and can make matters worse if the mass is too big to pass, even with lubricant. The best way to do this is to break up the mass as much as possible, and then it will pass more easily, with or without lubricant.)

If the rabbit is eating anything at all, keep up with *wet* fresh greens. Fragrant ones sometimes will entice an inappetent bunny to eat, but it's important to get even a *little* bit into her now and then.

If the mass has moved into her intestines, it may be possible to gently massage it, once it's hydrated, and knead it into a smaller, more passable mass. This must be done carefully, to avoid injuring the intestine, but I've done this myself with good success.

Hydration of the *intestinal contents* is paramount for a problem like this: subQ hydration is not sufficient, as a lot of that will simply pass out via the kidneys without entering the intestine. Lactulose (or super-saturated epsom salts, which tastes nasty) is great for ensuring hydration of intestinal contents.

If this situation is not improving, then a careful enema of saturated epsom salts and warm water will help hydrate the lower GI tract, sort of "lubing" things up and helping them come down the chute. The enema also seems to stimulate lower GI muscle contractions, which can only help in a situation like this.

In short, this *can* be treated, depending on how much synthetic fiber there is inside the mass she's created in her intestines. It's always best to try medical treatment (such as those described above) before resorting to surgery.

Gastrotomy (stomach surgery) seems to be tolerated far less well in rabbits than enterotomy (intestinal surgery). We've had good survival in bunnies who've had to undergo an intestinal resection, but not so great with stomach surgery.

If you *do* resort to stomach surgery, one vet up in NJ who has an incredibly high survival rate ascribes his success to his filling the surgically emptied stomach with well-hydrated Critical Care (http://www.oxbowhay.com) before closing it up. This seems to "jump start" the system. A rabbit is an herbivore whose stomach and intestine is normally *always* containing some food, and it does seem that a completely empty stomach somehow contributes to the shutdown of the entire intestine. If you can stimulate it to move with a bit of food inside, the survival rate is better, at least from the few data points we have!

I would take the massage advice especially and have your parents do some massage on his stomach and intestines. It has worked for me in loosening up masses in rabbit tummies and will stimulate their GI system in ways no medication can.

I hope this is what he needs first though, Dr Krempels advice makes sense. I think this is something that will take a while to pass though, hair takes a while to pass in rabbits so carpet fibre may take longer in such a large quantity. But as you said before, you have pulled him through before and I bet anything he can be pulled though this time as well. Keep us as updated as you can, I want Erik to feel better soon... Sending good vibes

 

[LuvaBun]

Oh Ivory, I am so sorry you and Erik are going through this.

Any updates? I'll be keeping good thoughts coming your way.

Jan

 

[Maureen Las]

I didn't know that it had progressed to this;;



let's hope that he doesn't need surgery

 

[Ivory]

We've followed that regamine almost exactly :?. But in all honesty, most blockages don't take up over 3/4s of a rabbit's stomach. How in the name of all things holy he has managed to accumulate such a mass, I haven't much idea. I mean I know, but I'm willing to bet its from chewing carpet. And it isn't in his intestines. At all. They're clear. If it were we could massage...:?

Also to mention- the reason it wasn't felt on original palpation was because the intestines were palpated...and like I said... they're quite clear. He doesn't have any gas in them, either. He isn't bloated yet...that's been under control...

Gastrotomy is only performed when all other options have been exhausted, namely, management with fluids (and possible motility drugs) after 3-4 days isn't successful. The surgery itself isn't so bad; it's the post-operative care that tends to have problems...

As of now, there is no change. He pooped after an enema today, but that's just stuff already in his instines. Maybe the mass shifted, and that's why he went from pooping and eating fine to his current state. I don't know. I will talk in person with Dad tomorrow. And I will keep everyone up to date.

Again..right now, I just don't know what's going to happen. He isn't worse, he's being maintained...but not getting better may as well be getting worse.]

I'll also mention that I'm very acutely aware of how this can end badly. :?

Thank you for the advice from Dr. Krempels. She has some valuable input there that I appreciate.

 

[AngelnSnuffy]

How's Erik doing? How are you?

 

[Ivory]

Erik is about the same. We've called up the exotic specialist in the state- and are following his course of action. He gives Erik about a 65% chance- which is what I wanted to hear. He has a majority chance- we don't have to put him down.

I'm okay, worried sick. But we're going through this! And I hope we make it.

 

[Maureen Las]

ray:ray:

 

[Ivory]

I'm about to head down to see him...I will take some pictures of him.

thank you guys for being so helpful and kind. I didn't realize how much I'd rely on the forum during this time. Thanks for ya'll's prayers.
:sickbunny:

Hoping for these:

:litterhealthy:

 

[Ivory]

More news: I'm taking him to New Orleans tomorrow to the exotic specialist. We're going to get in as early as we can. Dad had called him and he seemed to be a nice guy. Erik is eating some craisins.

I saw the X-ray. The entire opening at the bottom of the stomach is completely and totally blocked- but he's trying to pass it. It's where the stomach narrows down. Basically, there's just too much stuff to pass through, and it isn't.He isn't in excruciating pain- but he's very, very uncomfortable. He chances are good right now- but we still can't be sure until its over. I'm cautiously optimistic. I have a camera and will take some pictures.

We are going to administer some lactulose. Dr. Rich has a concoction that he feeds bunnies in Erik's case. He will likely be housed there for a few days.

 

[Maureen Las]

Good Luck to both of you

you're in the best hands..
Ihope that Erik can pass i:hug:t
let us know..

 

[Ivory]

He's passing some. There was a some hairy/carpety poo.

 

[LuvaBun]

Passing something - anything- is good.

I hope everything goes well tomorrow. Will be keeping everything crossed!

Jan

 

[AngelnSnuffy]

That's great to hear, I hope he continues to pass. Best of luck!

 

[Flashy]

Thinking of you and he, hope that he is doing ok today.

 

[Jenk]

Ivory wrote:

He's passing some. There was a some hairy/carpety poo.

I'm glad that he's passed some carpeting. (Now you know that some of it's moving through/leaving his system.)

I'm thinking positive thoughts for him (and you). ray:

Jenk

 

[Maureen Las]

What's going on Ivory?

I hope more poops :?

 

[BethM]

How's Erik doing? I really hope he's feeling a little better.

My Nick had stasis earlier this year. He was obviously sick for a week, seemed to perk up for almost a week, then seemed sick again. Nick also had a large mass in his stomach he couldn't pass, it was mostly ingested hair that had dried out a bit. Luckily, we were able to hydrate him and get everything moving again. It seemed like once he got hydrated, the mass was able to break up and be passed, bit by bit. (When he finally started pooping, the poops were almost solid, hard, masses of nothing but hair. Ick.)

While Nick refused food most of the time he was sick, when I was able to get some greens in him, I switched him to red leaf lettuce, it seemed to have more water in it than romaine. I also made sure to wet all the greens I offered right before, a sneaky way of getting a little extra fluids in him. (While he was sick, he never ate more than a few mouthfuls each day.) Nick was very resistant to being forced fluids, so he had to get SubQ fluids. I also found that he would readily eat fresh mint leaves (moistened), which he never liked before then. Peppermint is supposed to be good for tummy aches, so maybe that's why he was eating it.

Anyway, I hope to hear an update on your guy, he's in my thoughts.