Sass has Abdominal Discomfort/Gas

[dquesnel]

After a long summer of slowdown and coaxing Sass to have a good appetite (see thread here http://www.rabbitsonline.net/view_topic.php?id=37998&forum_id=16) Sass has finally regained his normal behavior and appetite, but not without a twist of course...

I have been spending the month weaning him off his Cisapride, and he responded to it well. If his poops looked like they were getting small again, I would increase it a touch, and then resume decreasing the doseages. His appetite is great, pooping just fine.

Saturday the 20th I gave the rabbits a heaping handful of hay, he slammed right into it with a great appetite. Not one hour later, he was giving signs of gas. I quickly got some simethicone (1.5mL) into him, followed by a full dose of Cisapride and left the house for a few hours. Upon return, he was back to his normal self, had eaten all his food, was begging for treats, and made some poops of various sizes/shapes in his litterbox (it looked like they had been in his gut for a while). The poops didn't look normal, but he was also making normal ones later that same evening.

I have continued decreasing his Cisapride, and today he was VERY hungry for his breakfast and inhaled it. Again, not more than an hour later he was showing gas symptoms. I gave him the simethicone and full Cisapride dose again. I am at work and am not sure yet what I will find when I return home, but I hope the same thing as last time!

It is strange this is happening considering he is otherwise healthy- as healthy as he has been in 4 months. I wonder if he lets his gut empty, then sleeps for hours without waking. When he wakes he is terribly hungry, scarfs his food down and this causes gas? Or I wonder if this has more to do with the Cisapride decrease, and that he might have a small impaction in his gut? If his poops are mishapen and small again in the litterbox when I get home (praying for ANY poop) that would make sense. Both times this happened I had noted there were not many poops in the box, as if he hadn't eaten overnight/during the day. His tummy also felt doughy. As I mentioned before though, he is otherwise healthy and I have seen him eat really well- he is showing no other signs of slowdown or pain except these two gas attacks. When it happens, he will go back and forth from the hiding spot to his litter tray in the hunched position, I wonder if he is straining to poop.

I have called the vet, they want me to update tomorrow morning and the vets will consult with each other today about it. She said that it is strange that he will let himself not eat for several hours, most buns will be continuously munching on food and as he is an otherwise healthy bunny it could just be a lazy personailty... I cannot be there to offer him fresh food every couple hour and wake him up.

I feel so sad that he feels badly, he has been through so much the past several months. It doesn't seem fair that when he is starting to get so healthy, that this is happening to him so frequently. He has done so well...

Prayers for my sweetie pie please. I want so badly to come home today and find him hungry and happy again! The first time it happened I did not worry, but now that is has happened again in less than two weeks, I do worry.

 

[tonyshuman]

I don't know, but it sounds like you are a very diligent and caring bunny mama. Sass is a total cutie and I hope things work out for you two!
:clover::adorable:arty0002:

 

[Maureen Las]

Based on rereading your previous thread I really don't think that this is question that we can answer.
Since Sass has had rather complex GI issues throughout the summer and been on cisparide such a lenghty time I would guess that it is either a result of the continued use of the drug, the attempts to wean him off it or a combination of thiswith his specific GI condition .
I looked up the drug because I had thought that using for lengthy periods sometimes caused it to become less effective..however I really cannot find that.
http://www.wedgewoodpharmacy.com/monographs/cisapride.asp

I hope that he has pooped when you get home and also that the vets can determine why he is eating all at once and then getting gas.
you could try giving the simethicone and cisapride at different times rather than together.

let us know.........

he's really cute..looks like my (RIP) Jacques

 

[dquesnel]

Thanks guys.

Almost 5 hours later, and still crouched/gassy.

Going to give some more simethicone and tummy massages now.

Usually he gets simethicone and cisapride at different times of day, it was just this once. Hopefully they don't counteract each other?

 

[Maureen Las]

I don't think they counteract each other ..don't really even know why I said that..just a thought

Is he any better???

 

[dquesnel]

Hi there, quick update.

He was still feeling badly and no poop, so we had to take him to the emergency vet

His ears were cold, so temp was down, we warmed him up and gave him some sub q fluid. I was afraid he was going to get shocky, no idea if it would have happened. At the vets he started moving about, wouldn't eat but sniffed the food so that was good. She said his tummy didn't feel completely empty, and his teeth were good.

He was also given a shot of metaclopromide, and sent home with critical care.

Upon coming home, he showed interest in food and nibbled a bit of lettuce/cilantro. He hasn't finished his veggies OR favorite pellets which is not like him the past few weeks, but not that different from what he was like over the summer either. He has nibbled some hay, and has pooped some strange mis-shapen poops in his box, but at least it is poop!

I am not too sure what is going on this time, but he seems ok, his appetite is decreased again. Its just so, so frustrating considering how well he was doing. Hopefully he is better tomorrow, but I have a feeling I will be following up with another visit to his regular vet tomorrow too.

 

[Maureen Las]

some vets will send metoclopromide home in an oralsuspension if they are fairly sure thatthere is not an intestinal blockage. I remember years back giving both cisapride and metoclopromide to my 1st rabbit.

some vets don't like to use motility drugs

I would guess that he went (pooped)because of the injection.

i would get him to a really good vet early tomorrow; he sounds as if he is on the edge. ray:
are you syringe feeding him?

 

[dquesnel]

Good morning,

The poops in the litterbox were full of extra hair- more than usual I would think. It might have been dry matter sitting there for a while, but he can't possibly be full of hair/food mass in the tummy and intestines considering he had a great appetite leading up to this.

I suspect he is in discomfort, rather than being 'full' as was the guess last time. I really want to get him on pain meds to see what happens.

He ate a few small romaine hearts last night, nibbled some hay and pellets. This morning he nibbled more hay and pellets, but doesn't want to seem to touch water or veggies. He has an appointment this afternoon. Because he hadn't eaten much, I did give him some syringed critical care and water, so at least he has that.

He was VERY active last night after the return from emergency. I guess it was the sub q's and the fact it was the evening, lol. He was not nearly as active this morning, could have been because he never really is in the morning or perhaps he is more uncomfortable than usual.

I will keep updating on Sass- it is so frustrating considering how well he was doing, how much he was eating...

 

[Maureen Las]

You know I haven't posted about my dental patient ,Beau, who had 6 teeth out 3 weeks ago but he is "on and off'
Sometimes when he is quiet during the day i get really worried but usualy he is more active at night anyway so I am forgetting his patterns. Maybe Sass is really quiet now because it is his pattern anyway
i agree about the pain med and

maybe you could get pedialyte to give him also as it would have the electrolytes in it that he would have gotten in the sq
please continue with updates

 

[Pipp]

The vibrations from the ride to the vet could have broken up the gas bubble and made him more comfortable, and then it re-formed again.

Of course there's still the issue of why is he getting gas even if that is the case. It's a byproduct of so many things -- diet issue, stasis, a virus, even stomach tumors. (Was he x-rayed?)

I'll be watching for an update.

Poor Sass.

sas

 

[dquesnel]

Sorry about the lateness of update- I had so much work to catch up on, only 4 billable hours last week as the majority of work has been 'freebies'. Sigh.

Sass went to see his regular vet and it is determined he had a partial obstruction. There is no other answer as to how it could have come on so quickly- he developed the gas or discomfort after the obstruction moved from his stomach, most likely. This could be caused in part by his sleeping for hours on end without a meal break- it might have been shutting down his gut, even though he had an appetite this time. He was given more sub q's as well. We did not do xrays this time, as so many were done as late as mid August and the xrays did not show any type of mass. If there was a hair/food mass, it was small, not compacted and hidden behind normal stomach contents. His stomach was palpated- no impaction was felt there or in his intestines, so the worst might be over.

It is believed that this is a continuation of the same problems he had in the summer. The vets believe he was not ready to go off the Cisapride at this point, and still needs it to keep things moving in there. Hair was present in the poop right after the abdominal discomfort, so that would explain a partial obstruction coming out. If this is not a continuation from his previous problem, then it creates a mystery as to why he cannot have a moving GI system. We do know he was doing well on medium Cisapride doses.

The idea of a rupture has me terrified, I personally know of rabbits that had it both with and without motility drugs. In this case, two rabbit savvy vets agreed that we were taking more risk by not using motility drugs, that the partial obstruction could have become a major obstruction and caused a rupture if he was not treated with them. He is pooping fine now, and his appetite is beginning to pick up so it looks as if there is no obstruction left. It scares me to hear that a bun can rupture yet continue to eat/drink etc as per normal... For days... How the heck do you know till it is too late? Although one bun I know had a rupture for not TOO long before he was in serious pain.

Now I have to worry about Chloe, boyfriend left our bedroom door open (not rabbit proofed well) and Chloe got under the bed for at least 10 minutes.:grumpy: I hope he didn't eat any of the cotton mattress, it was exposed. My mother doesn't think he'd be that silly- he hasn't eaten foreign substance before (even if he grabs something in his mouth by accident he will spit it out) and there must have been much more exciting things to do in the new, shiny bedroom so I am hoping my concerns are nothing. I don't know how long he would take to show complications from a foreign ingestion, it has been 6 hours and he is still eating/pooing fine.

Back to Sass- I am to continue full Cisapride doses, he might be on it for a few more months until he is deemed ready. In the meantime, he is eating lettuce (odd, not his favorite) attempting to eat paper, eating some hay and pellets. So he is getting something! I will continue to syringe as well, if he does not freely eat his critical care (also would be odd- he loves the stuff and it makes him bottom twitch). Thanks for the support- I will keep updating how this mystery of a bun is doing- and if Chloe ate anything naughty :shock:

 

[Maureen Las]

I agree that this case is complicated. he got a partial obstrucion while on cisapride.
the dangers of motility drugs are their ability to move stomach contents and compact those contents in areas of the gut where they shouldn't be thus creating a worse obstruction.

I know that this is alarming but I am think that your bun should be getting more GI x-rays to track the course of the obstruction or partial obstruction.

it seems there is no other course than to continue with the drugs per your vet's advice but you may want to get a 2nd opinion on such a chronic issue
I wish you the best as you are indeed in a bind

 

[dquesnel]

Time for another update!

Sass was eating ok as I mentioned in the last post. However today he seemed pretty uncomfortable and was not interested in eating. He would sit in one place, not hunched, not lying down, just stationary. I called vet with update, they agree he is uncomfortable so he was scheduled to come in for pain meds.

I syringed him critical care in the a.m, and then he did eat a wee bit of pellets and hay throughout the day. I brought him into the vet, he was given a shot of Buprenorphine. Vet wants to see how he does over the next 8-12 hours (the length the shot lasts) before deciding if he should be on regular pain meds. If he eats, then pain is reduced and that is good, but if he doesn't eat while on the pain meds then there is something else.

Right now he is knocked out- vet said he would be lethargic and sleep heavily for a couple hours then should be euphoric after that. His tummy was felt at vets- it apparently feels fine (normal to me too) if he was obstructed he would be pretty sensitive and bloated they say. If there was an obstruction, he also wouldn't be pooping, which he has been. Right now he is resting in his hutch, he just looks really tired and possibly confused. The thing about the Cisapride is it is only useful at a certain doseage- I might be giving him 0.5mL or less at a time for example and it may not have any effect on his body. So he was on a low dose when this happened Monday, basically the Cisapride may not have been working for the past couple weeks. So that was interesting to find out, it makes tapering hard to do as well.

"I know that this is alarming but I am think that your bun should be getting more GI x-rays to track the course of the obstruction or partial obstruction."

I know, I am alarmed as well. It scares me to think he may already have a rupture too. Because he is pooping, and his stomach/intestines do feel good, they don't think an xray will tell us anything else. I do not know if that is absolutely true, but an xray will be the next thing if he does not improve with pain meds.

I'll make another update when the sleepiness wears off on whether he is euphric and eating, or not.
:bunnydance:

 

[Maureen Las]

I hated to talk that way about an obstruction but I felt thatI had to to be as informative as possible.
I watched the thread today to see if you responded because I feel bad about him and you..he is so cute and looks like my Jacques (RIP) and it is so hard when a person doesn't know exactly what is wrong.

Ireally hope that he comes out of his sedation -euphoria and then proceeds to eat and poop normally..

Bunnies are really hard pets healthwise

 

[dquesnel]

angieluv wrote:

I hated to talk that way about an obstruction but I felt thatI had to to be as informative as possible.
I watched the thread today to see if you responded because I feel bad about him and you..he is so cute and looks like my Jacques (RIP) and it is so hard when a person doesn't know exactly what is wrong.

You are so right about that.

Well just as I was beginning to think about panicking (he was staying drowsy in his bed, unresponsive to food) BUT he finally has moved his wee bum. He was really, really tired but is now in his litterbox, hopefully going to the bathroom, and he nibbled some hay. I was going to syringe some more critical care in a couple hours but he seems to be interested in food again, so I will let him be until at least the morning. I would think really that the pain meds is wearing off, so really all it did was make him really tired. I don't think it was the best one to try, it is an opiod and not a NSAID. I am sure there was a logical reason for this- vet believes if they are in bad enough pain, the pain meds will make them so relieved that they will eat.

I wouldn't exactly call him euphoric now- but who knows what was going on in that little brain of his. Perhaps he was hallucinating about fields of carrots and simply didn't see the point of eating :rainbow:

 

[Maureen Las]

Did he poop Denise..how is he?

 

[dquesnel]

Hi, he did make some small poops. I did end up giving him more critical care at 3am, and he has pooped a bit more since then.

I found him looking comfortable asleep this am, and woke the rabbits to give them breakfast. He doesn't seem interested in pellets right now, though it does look like he had a mouthful overnight. He has shown a bit more interest in veggies right now and ate a bit of lettuce overnight- he is eating a bit more now. Whenever he goes to eat them though it looks like it is such a task for him. He is eating bits of hay too. He has gone to his litterbox once and did the hunch position, as though he were straining or uncomfortable perhaps. He has since gone back to eat a bit more lettuce, I can give him more critical care in a while but since he is attempting to eat on his own I'd like to encourage that too. He does seem more comfortable today.

 

[Maureen Las]

I'm glad that he's more comfortable but it sounds as if he has a ways to go yet...