Telescoped bowel? - URGENT ADVICE NEEDED

Hello there, my two-year-old dwarf rabbit has just gone back into hospital - on Friday he went into GI stasis as he is moulting heavily which was causing blockages.... after 2 nights on IV antibiotics, painkillers and some kind of gut mover they were satisfied with his progress and as he was passing poo they released him on Sunday morning.

I monitored very carefully what he was producing and it still seemed to be too little, so I took him back in yesterday (Tuesday). The vet palpated his tummy and found a lump there, which she said could still be a blockage or worse, his intestines might have telescoped because of it.

She took him back in, saying that they would monitor his condition and try and pass the blockage with paraffin, but I should prepare myself that he might need an operation if this doesn't fix it. I have a little time (she said they would try this until Friday morning unless there are any changes), so is there anything I can be doing meantime - questions I should be asking - it's a 24 hour practice and they have a lot of vets, but I'd like to make sure that if he does have to undergo an operation it's with the best specialist rabbit surgeon possible. Money is no object where he is concerned!

Has the Vet taken abdominal Xrays and bloods ?

*If* he has a full obstruction then this requires immediate surgery, it really cant wait until Friday.

Is your Rabbit on IV fluids. This is *essential*

Liquid Paraffin is only appropriate *after* at least 24 hours of aggressive fluid therapy (IV and oral). Giving just LP will simply coat ingesta in oil and make water absorption into the impacted mass impossible. The ingesta needs to be rehydrated to break it up and enable it to be passed. Lactulose, an osmotic laxative would be useful along with the fluid therapy.

Surgery on a Rabbit's GI tract is always high risk. But if there is a full obstruction it is the only option. But as stated, it is a surgical emergency and needs prompt diagnosis and treatment to afford the Rabbit the best chance of survival.

Lots of luck for your poor Bunny.

Hi, are you still there?

Just spoke to one of the nurses ( vet is consulting at the moment and I will speak to her at 9.30) - he didn't pass anything overnight, so she said that they will probably "open him up" this morning to see what's going on - the vet is a rabbit specialist apparently - she is the one we saw yesterday who put him on LP - any advice?

Thanks for your speedy reply earlier.

A xx

Adela said:

Just spoke to one of the nurses ( vet is consulting at the moment and I will speak to her at 9.30) - he didn't pass anything overnight, so she said that they will probably "open him up" this morning to see what's going on - the vet is a rabbit specialist apparently - she is the one we saw yesterday who put him on LP - any advice?

Thanks for your speedy reply earlier.

A xx

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Have they done bloods and abdominal Xrays or U/S ?

Is he on IV fluids ?

Good news!!

Just spoken to the vet - he (the rabbit) passed a big poo so no need for surgery (fingers crossed)..... she now thinks it was a hard mass (which is already going down) rather than a telescoped bowel. They are keeping him in but he is much brighter, eating and drinking so now we just have to be patient while he passes the rest.

THank you so much for your advice - i did ask about the info you gave - she said he wasn't dehydrated so no need for IV fluids. So happy!!!

I do hope your bun will be ok. I know how you feel as mine had to be opened up with a bad statis blockage last year (after bloods and xrays first). Really long story but all was ok in the end and he made a good recovery. I completely changed his diet and even got him a girlfriend too just to keep him happy. I make sure he is brushed at least once a day while he's having his treats or when we have a cuddle (which isn't often as he hates to be picked up) as I'd hate for him to go through it all again. Let us know how he's doing and sending lots of vibes for a speedy recovery :wave:

Your bun was VERY lucky.....


Hello, thanks for your message

Your bun sounds like mine, he won't be picked up either and we've got him home now with a bottle of liquid paraffin and instructions to force-syringe-feed twice a day.... the vets make it look so easy! (Feral, they called him - a little unfair ;-).

Spending all day on research yesterday I found out that GI surgery on rabbits is very risky with an "abysmally low" recovery rate, SO glad to hear yours had a happy ending.

Still keeping our fingers crossed for Skipper, he was pooing fine when he left the vet's yesterday but overnight it is tailing off a little. Off to the shops to get some fresh pineapple to see if that helps things along.

All the best x

Everything crossed for Skipper.
A lot of buns hate being picked up, & mine hates any surface with "give" in it. He's the cuddliest & purriest bun in the world when I lie down on the floor with him, to stroke him

How is Skipper getting on?My bun had a mass in her tummy and liquid paraffin and gut stimulants did the trick

Bunnies' tummies

Maizey said:

How is Skipper getting on?My bun had a mass in her tummy and liquid paraffin and gut stimulants did the trick

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Hello, thanks for asking, he was fine up till today when the poo slowed down again.... last couple of days he had big slug-like poos then nothing all morning so I took him back to the vet's. Back on liquid paraffin - he seems ok in himself, plenty of energy to gallop around to avoid getting his dose!

What kind of gut stimulant did your vet use?

I'm going to get a second opinion from another vet who specialises in "difficult" rabbit cases, as today's one is suggesting opening him up to see what's causing the slowdown.... she can feel a lump which could be a telescoped bowel or a tumour, but this operation has an "abysmally low" survival rate, so I'm only going to consider it if there is no other option. Horrible dilemma to be in.

Hope your bun is fine!

Best wishes
AP

Adela said:

Hello, thanks for asking, he was fine up till today when the poo slowed down again.... last couple of days he had big slug-like poos then nothing all morning so I took him back to the vet's. Back on liquid paraffin - he seems ok in himself, plenty of energy to gallop around to avoid getting his dose!

What kind of gut stimulant did your vet use?

I'm going to get a second opinion from another vet who specialises in "difficult" rabbit cases, as today's one is suggesting opening him up to see what's causing the slowdown.... she can feel a lump which could be a telescoped bowel or a tumour, but this operation has an "abysmally low" survival rate, so I'm only going to consider it if there is no other option. Horrible dilemma to be in.

Hope your bun is fine!

Best wishes
AP

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Which part of the country are you in?

South-east London. I've found a good vet online who does referrals. Going to phone them in the morning. Skipper is sitting behind me at the moment still rather angry about all the manhandling he's had today.

I'm really surprised at the lack of fluid therapy your bunny is being given. Usually the fluids help soften the mass which then enables it to pass through the intestines and it really helped my bun when he was in stasis. He was given IV fluids for about 12 hours and then I had to inject some sub-q during the night to keep his hydration up. It worked a treat.

NLENG2000 said:

I'm really surprised at the lack of fluid therapy your bunny is being given. Usually the fluids help soften the mass which then enables it to pass through the intestines and it really helped my bun when he was in stasis. He was given IV fluids for about 12 hours and then I had to inject some sub-q during the night to keep his hydration up. It worked a treat.

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If the bowel has telescoped in on itself (intersusception) The central hole is much smaller so even normal contents are difficult to get through. There can be issues with the blood supply to the gut which forces us into surgery. We can sometimes sort it out in humans without surgery, but I don't know about bunnies.

Jack's Jane's vet Chrystobel is very well worth considering in your part of the country. You may like to pm her for details.

With every good wish for Skipper.
Please keep us updated.

Thank you everyone who advised about suspected telescoped bowel/tumour - U/D

Skipper is up and about today, eating and pooing quite well, almost back to his usual self today, though still rather wary because he has not appreciated being dosed with LP by us amateurs.

I asked the vet about fluids when we were there (he was on an IV drip last time).... she said he's not dehydrated so not necessary this time.

Fingers crossed, this episode seems to be passing but I'm still worried about the long term. The vet compared his condition to a time bomb - he could go back into stasis at any time - she says it's better to operate on him when he is healthy to give him the best chance of recovery. Which is a horrible dilemma to be in - give consent for an apparently healthy bun to undergo an operation which he may not survive?

I'm going to get a second or even third opinion (will contact Jack's Jane's Chrystobel for details, thanks before we make any decision to operate.

I've also asked about ultrasound or needle biopsies (though these still would need to be carried out under anaesthetic). Our vet says that ultrasound is unreliable on the intestines as they are constantly moving, and I understand that a needle biopsy could damage surrounding organs. Anyway, they will probably reveal what she can feel anyway by palpating.

What would you do if he was yours?

Adela said:

Skipper is up and about today, eating and pooing quite well, almost back to his usual self today, though still rather wary because he has not appreciated being dosed with LP by us amateurs.

I asked the vet about fluids when we were there (he was on an IV drip last time).... she said he's not dehydrated so not necessary this time.

Fingers crossed, this episode seems to be passing but I'm still worried about the long term. The vet compared his condition to a time bomb - he could go back into stasis at any time - she says it's better to operate on him when he is healthy to give him the best chance of recovery. Which is a horrible dilemma to be in - give consent for an apparently healthy bun to undergo an operation which he may not survive?

I'm going to get a second or even third opinion (will contact Jack's Jane's Chrystobel for details, thanks before we make any decision to operate.

I've also asked about ultrasound or needle biopsies (though these still would need to be carried out under anaesthetic). Our vet says that ultrasound is unreliable on the intestines as they are constantly moving, and I understand that a needle biopsy could damage surrounding organs. Anyway, they will probably reveal what she can feel anyway by palpating.

What would you do if he was yours?

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Contact Jack's Janes vet if you are in her neck of the woods without a doubt!

So sorry you are going through this and hope they he is feeling better soon (without any ops).

What would I personally do in your situation?
Get him seen by Chrystobel fast, get the diagnosis right & if it is intersusception, & do what she advises, [which may well be an operation]. That gives him the best chances.

There are very good bunny vets & a few outstanding ones.
Chrystabel is your nearest outstanding one.

It's rare, but it is just possible that the lump is cancerous. I had a bun who was in and out of statis for a few months. We did have to have her put to sleep in the end and she turned out to have cancer of the caecum. You do need to know what is going on - I gather that the position of the lump is significant as some areas are easier operated on than others. I agree - you really need an experienced vet.