Tummy Emergency -- Please read immediately!

[timetowaste]

Okay...we've all had problems with gassy bunnies.

Belle (a good friends bunny) has not pooped for the last 5 - 10 hours. She is clearly in some sort of discomfort, and would not take a Lofty or a banana, nor hand fed hay strands from her mommy the way she usually does. Belle has been laying in her litterbox (which she never does), and has had a tummy issue before.

Thea (her "mom") reports that she does not have a "doughy" tummy, nor does it feel hard at all, so she is not sure about it being gas. Her tummy was making gurgly noises earlier, but now, it is sparsely making noise. After IV fluids, canned pumpkin, many types of baby foods force fed to her, and Simethicon (and ample tummy rubs), Belle is now breathing very rapidly with her eyes half closed, CLEARLY in discomfort and pain.

No emergency vets around here are bunny approved by other bunny lovers. Our actual vet cannot see Belle until 10:30 tomorrow morning.

NOW WHAT?

PLEASE, any advice you have would be SO helpful.....


Tracy

ETA: She has no fever, but she did have very cold ears earlier tonight as well. What is the deal here? I am afraid she is going into stasis!

 

[aurora369]

So the bunny has had IV fluids, some canned pumpkin, baby food and simethicone?

I would give her a chance to calm down. She's probably very stressed from all the activity.

Provide her with some fresh greens or favourite foods and leaver her in peace to calm down for a bit.

It sounds like she could really use some pain meds, but that won't be possible until the vet tomorrow.

You can also try providing a sock full of rice that has been heated in the microwave. See if she wants to snuggle with it.

The cold ears also makes me suspect a bit of shock. So the heat will help with that.

Make sure she's warm, hydrated, and as stress free as possible until the vet visit in the morning. Those are the only suggestions I can think of.

--Dawn

 

[timetowaste]

Thank you, I'm desperate here. I fwd'd that on to Thea, of course.

Tracy

 

[aurora369]

No problem, hopefully you will get some more input as well.

I remember Randy saying that the most important thing for a bunny beginning or in stasis is hydration. Keep the bunny well hydrated and calm, and she should be okay until the morning.

Having a sick bunny is so stressful. But the bunny's can pick up on yours stress and get stressed themselves. So being calm around your bunnies when they are sick is very important.

Good luck, and keep us updated on the progress of the bunny. Warm wishes her way.

--Dawn

 

[naturestee]

:yeahthat:

For now I'd offer a warm rice sock or Snuggle Safe and let her relax. Give her another hour or two and then try some more tummy rubs. Vibrating tooth brushes are also pretty handy for getting gas bubbles moving, if that's what the problem is.

I find my rabbits' ears feel warmer or colder depending on their activity level, the house temperature, the phases of the moon and alignment of the stars... lol.

Most stasis issues are slow to resolve and need some patience, so just try to keep your friend calm for now.

 

[Pipp]

:yeahthat:

I just went through this with Sherry. She didn't come running for her pellets at noon yesterday, even though she was normal (pooping, peeing, eating hay) before that. We tried a treat test and she flunked.

After an all-day session of LOTS of simethicone (three doses over three hours using quarters of an adult extra strength tablet) and tummy rubs (with hands and a toothbrush), and keeping her warm (very important), she still looked awful so I finally gave her a quarter of a tab of Baby Motrin with some syringed water (with just a tad of juice), and a bit of pumpkin.

The only reason I thought she needed the pumpkin was that pain meds like Medicam and Motrin must be taken with food and water. Otherwise, I never force feed until they've gone without food for well over 12 hours, usually closer to 24 hours.

Sherry was moulting, so I did give her oral fluids seeing as the chances were increased that she was having a gas attack caused by a hairball (although I also think she may have eaten a bad bit of dandelion).

She started off with some gurgling, and then bloated up a bit. Just after I gave her the Motrin, as I was massaging her, I'm sure I actually felt a big bubble of gas on her right side gurgle and move and/or break up. A half hour later (nine hours after flunking the treat test), she perked up. Not sure if it was the gas bubble or the pain meds, but something worked.

I might have taken Sherry to the vet for an x-ray had they been open -- it's good to know for sure what you're dealing with, if there's a blockage, bloat, gas pockets and where they are, if there's another issue, etc. A sub-q at that stage certainly won't hurt, but oral hydration is good for directly hydrating a pre-stasis gut, especially with a molting bunny.

Hope Belle feels better soon.


sas :clover:

 

[timetowaste]

The three of you rock my world.

Thea gave her a dose of metacam, and after some time, she came around. She started binkying and running around with her partner in crime, Zeus.

She even ended up laying a poo or two!

Of course she will still be visiting our friend Dr. Holmes in the morning, much to her dismay, but all is well in the house of Belle and friends now!!

Thank you guys for the advice. Truly wouldn't know what to do without this forum.

Tracy

 

[Bo B Bunny]

When Bo did that we used a nice warm towel from the drier and I held him to keep him warm. It seemed to help - he enjoyed it. The heat from the towel warmed his belly. It's worth a try.

 

[Maureen Las]

Hey Tracy

how is she'?
what did the vet say???

 

[Bo B Bunny]

I was wondering also.

 

[timetowaste]

A letter from Thea to the people that helped her, including you guys

Belle and I (Zeus, daddy and Baby too!) want to say thank you all so very, very much for all your help and support last night!!!!! While it was touch and go more than a few times, Belle turned a corner in the wee hours of the morn and is doing great now! Dr. Holmes concurs.

She's still coming back and isn't 100% yet but she was,all spit and vinegar overnight once things moved out. Dr. Holmes agrees that it was the Metacam (thank you Anne!!!) that finally was what she needed to hurt less and allow the meds/fluids to kick in. As a result she and Zeus played in the living room until about 3a when he took himself to bed. She stayed up hopping around and then he decided he was missing all the fun so he came back out and they played a while longer. At about 5a she had moved into our bedroom and was on the floor next to the bed (where she loves to hang out). The two of them were up all night long with me so I think it's safe to say she's doing well.

Dr. Holmes gave me injectible Metaclopromide in case this happens again. Overall he said I did everything right - so thanks to all of you...yay!!! By stablizing her with the meds and fluids and then by giving her the tummy massages, heating pad, forced feedings, etc. I was able to help her hang on. I swear though...twice last night I thought I was losing her. I think, however, Baby must have been here and was telling her that it's not time yet for her to join him...and that Zeus and I still desperately need her. I even called the emergency vet place and told them what I did and they said they would do probably the exact same thing so it wouldn't help to take her to see them. At least I was on the right track and it obviously made all the difference hence the outcome! We're happy today and I'm so grateful to each of you for all the support, advice and guidance! I owe you guys HUGE!!!!!!

Thanks so much everyone!!!!! I am so blessed to have such wonderfully kind, understand and generous people such as you in my life! Belle and I are eternally grateful!

P.S. I just gave her an injection of Metaclopromide - like a pro! She's eating hay, drinking water and enjoying a relaxing afternoon in the living room with her beloved Zeus.

-- Thea

 

[Bo B Bunny]

I think this is the best news I've heard all week! I am so glad she's doing well!

Give her kisses for me!

 

[ra7751]

Hi,

Just saw this thread. A few things from my experience. The most important thing you can do it to not over react. We have had rabbits in stasis for over a week at a time. Hydration by any means is the most effective treatment once stasis sets in. Sub-q or IV is much more efficient than orally....but any hydration by any means will help. And hydration before nutrition....don't offer food until proper hydration levels are reached. It is also important not to force too much food since that will tend to build pressure....and increase pain. Some pain meds will slow the gut....like any other medical treatment, the key to offering pain meds is knowing exactly how the pain meds work and compare the risks to the potential benefits. The one thing that really alarms me is the Metaclopramide. In my non-professional opinion, there should be a federal law to make it illegal to offer any GI motility drug to a rabbit. They should be considered totally inappropriate in any situation. Using these drugs date from a time that it was thought a rabbit and cat were treated the same. Even with all the negative evidence, some vets just insist on continuing to prescribe these drugs. All of my vets are exotic specialists....and none of them will use these drugs. This is one class of drugs that I can say the risks always outweigh the total lack of benefit these drugs offer. I have been treating very sick rabbits for years....these drugs will not be used on any of my rabbits...period. Again, just my non-professional opinion....there is just no way to medically justify using these drugs. In reality, the best treatment for stasis or any gut issue is prevention. But no matter how hard we try and how correct we are in diet, things happen. But in gut situations, hydration is our best friend.

Randy

 

[Offspring2099]

Randy,

Is Cisapride considered a GI motility drug?

 

[Pipp]

Offspring2099
Is Cisapride considered a GI motility drug?
[/quote]

I'll answer for Randy...

Yes, Cisapride is a newer gut motility drug and widely considered the lesser of the evils. It works on increasing gut motility/contractions particularly in the lower GI tract and the stomach unlike Reglan which works mostly on the upper GI tract. Some vets will prescribe them in combo.

Added note: From what I've read, Cisapride doesn't work at lower therapeutic doses, and it's the only one that works on baby rabbits. I believe it can not be taken at the same time as narcotics and maybe some other meds, so it should be prescribed by a vet with care.

Cisapride, like all GI motility drugs, should never be used without an x-ray to confirm the nature of the stasis and rule out a blockage, and should not be the first line of defense with a gut slowdown, hydration and fiber are much better bets. Many here think it shouldn't be used at all.


sas :bunnydance:

 

[Offspring2099]

Got it. Thank you.

What is bad about it? (liver damage?) What is considered a small doze?

 

[Pipp]

The main issues I think are discomfort for the rabbit and the potential damage to the tract and possibly behavioral issues?

Here's a note from Rabbit References:

--------
Reglan® (metoclopramide) and Propulsid® (cisapride) are gut motility drugs which are given to bunnies when they have GI stasis. In some countries, Propulsid is called Prepulsid.

Reglan® stimulates movement of the *upper* GI tract through a direct effect on dopamine receptors in the brain. It reduces nausea, slows/soothes the stomach and intestine, and improves the absorption of other oral medications.

Propulsid® stimulates the release of the hormone acetylcholine at key nerve endings along the *lower* GI tract. It restores rhythmic contractions in the intestines, so food moves out of the stomach at a faster rate. It is more specific and targeted in its effects than metoclopramide, with fewer side effects.

Many vets do not prescribe these drugs if there is a suspected blockage because they believe they can rupture the stomach/intestine.
---------

And another link with some good info...

http://www.veterinarypartner.com/Content.plx?P=A&C=31&A=523&S=0

 

[ra7751]

Thanks Pipp.

The danger is using motility drugs has several concerns. One is the extreme pain they cause. I think everyone has experienced cramping stomach cramps.....they can be excruciating. Now think how a rabbit responds to pain. It's "oops....a predator has me in his mouth and it hurts" type of thing....and we all know how poorly rabbit deal with pain.

And those contractions induced by motility drugs add more misery to an already bad situation. What happens when you add compression to something? It compresses and gets tighter. In the event of a blockage, the muscles continue to contract against something that can't be compressed any more....pain. Compressing an impaction is the exact opposite of what you need to happen. There is no way a large ingesta impaction is going to come thru those tight curves and small diameters in a rabbit's gut....and they can't come back up (not and have the rabbit live anyway). It needs to be broken apart....not compressed tighter. The irriation of a changing pH and that of the harmful bacteria that grows in a GI event will start to erode the thin intestinal lining and will develop a lesion much like a gastric ulcer. This creates less integrity of the intestinal wall. It is a time bomb.A naturally very thin intestinal wall (also a reason for an untrained person to never attempt an enema) that is thinned even more by an ulcer....and then you apply the pressure of the contractions induced by motility drugs. You get a perforated ulcer. The good thing...any suffering is short lived. There is only one resolution to a perforated ulcer....and it's not a good one.

I am not a vet so this is a personal opinion based on my years of experience in rescuing "special needs" rabbits. There is no way for any reason that any motility drug will ever be used on one of my rabbits for any reason whatsoever. I still contend this treatment is from a time in which it was considered proper protocol to treat a rabbit and a cat the same. A rabbit's gut is a far cry from an omnivore or carnivore gut. I have had rabbits in ileus for over a week....nothing in, nothing out. But they survived. My gut protocols, based on proper hydration, are much safer and effective than the drugs. All of my consulting vets are exotics specialists and as far as I know, they don't use these drugs either.

It's critical you know what you are dealing with in a gas/bloat/stasis/ileus situation. Simethicone can be life saver for gas/bloat but it can slow the gut down..as can many pain meds. You have to decide the lesser of the evils. I am always cautious on force feeding in a stasis situation. Not only does this increase pressure inside the gut since you are adding things while nothing is coming out....forced feeding a dehydrated animal (and most animals in stasis are dehydrated) compounds the dehydration as the food you are forcing in not only adds pressure but they are taking precious hydration from the gut. It's something I really push hard with my volunteer rehabbers in dealing with rescued wildlife....and the same goes for a rabbit in stasis....hydration before nutrition!Animals will die from dehydrationlongbefore they die of malnutrition.I don't want to add a lot of pressure by forcing pumpkin or Critical Care before I get something moving. And while Critical Care is about the only Oxbow product I use....it can really dehydrate a gut. Look at how hard it is to mix properly....it just consumes fluids....and it really expands and sits very heavy. That is something to consider....carefully.

Randy