Possible fecal impaction... Any advice?

Has anyone ever dealt with a fecal impaction, or what looked to be one according to an x-ray? What did you do to help your bun?

My Mini Rex, Zoe, started having digestive issues yesterday. Digestive woes are common for her; she has megacolon, and underwent anesthesia on 7/19 to have a small growth removed from her ear.

She wound up back at the vet's on 7/21, when the problem seemed to start. She appeared to have gas (more so in the intestines) and decreased gut sounds on her lower left quadrant. She was given injectable meds.: Reglan, Metacam, sub-Qs and, unfortunately, a dose of Laxatone. (If my regular vet's colleague had mentioned Laxatone earlier, I'd have told her to not give it to Zoe. For all I know, it could be contributing to the current issue.

Zoe was examined yesterday, too. She had a temp. of 104-deg. F and normal gut sounds. The vet felt quite a bit of gas in Zoe's intestines. We also discovered a cut on the back of her right hind leg that was hidden until it was stretched out. The cut was treated, and I was advised to treat her with sub-Qs, Cisapride (which she's been on long-term), Reglan, and Metacam.

Zoe didn't pass any fecals after 10 am yesterday and barely touched any food--except what I syringed to her--after that time; hence her return to the vet's office today. She'll receive sub-Qs three times today, and I'm to also give her injectables--Reglan, Metacam, and Baytril--tonight. She'll return to the vet's for further observation tomorrow morning. (My vet isn't a 24/7 clinic, and the staff had to leave early today for training/instructional purposes.)

I continue to hope and pray that Zoe makes it through this digestive slowdown bout. She's been through many before, but I've never seen an x-ray of her showing a potential fecal impaction before now.


Thank you,

Jenk

sorry i can't help but bumping it up in the hope that maybe someone with more experience will come along.

Sue:wave:

I'm so sorry to hear this news Jenk.

I understand that the mainstays of treating impaction are hydration -both subcut fluids & orally to soften the mass of dry ingesta & so ease it's forward propulsion, together with the gut motility agents as is being done.

I'm not aquainted with Laxatone - is it an oily, or water repellant substance?

With every good wish for speedy onward movement & prayers for Zoe, & thinking of you.

Please keep us updated about her progress.

ETA do you know where the impaction is?

Fluids are one of the main things to help try to break down any impaction. Try giving your bunny water in a bowl with a dash of boiling in to make it luke warm. Mine tend to drink more when it is like this.

The alternative is to have your bunny admitted an put on a drip to ensure it is getting enough fluids (or sub cut). Pain relief also.

It is not normally advised to syringe feed a bunny with a blockage as it could make things worse.

I hope that she is feeling better sooon.

bunny babe said:

Fluids are one of the main things to help try to break down any impaction. Try giving your bunny water in a bowl with a dash of boiling in to make it luke warm. Mine tend to drink more when it is like this.

The alternative is to have your bunny admitted an put on a drip to ensure it is getting enough fluids (or sub cut). Pain relief also.

It is not normally advised to syringe feed a bunny with a blockage as it could make things worse.

I hope that she is feeling better sooon.

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You're absolutely right bunny babe. Thankyou. Sorry Jenks I was thinking of caecal impaction.

thumps_ said:

I understand that the mainstays of treating impaction are hydration -both subcut fluids & orally to soften the mass of dry ingesta & so ease it's forward propulsion, together with the gut motility agents as is being done.

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Zoe has been receiving sub-Qs for the past two days' time. Unfortunately, the sub-Qs I gave her at 8 pm last night weren't fully absorbed by 12 am. :shock: I stayed up past 1 am with her and got up twice more during the night to place her on a heating pad (on the lowest setting).

I'm not aquainted with Laxatone - is it an oily, or water repellant substance?

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Yes. Laxatone is a petrolatum-based product sold in the U.S. and is primarily used to prevent hairball issues in cats. Some rabbits-savvy vets use it, some feel negatively about its use in rabbits. (So confusing!) I lean toward not using it, especially if fluids need to reach a fecal mass.

With every good wish for speedy onward movement & prayers for Zoe, & thinking of you.

Please keep us updated about her progress.

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Thank you so much for the well-wishes and prayers. Zoe could use them more, but even I could, too. I am soooo tired. (It's been three days' worth of this late-night/during-the-night routine. Oy.)

ETA do you know where the impaction is?

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There appeared to be "ropes" of ingesta material in her lower intestine, the portion that loops around and rests just below the cecum. Does that make sense?

In addition to what has already been suggested, I'd look into the possibility of getting your vet to administer a strong opiate painkiller like vetergesic (Buprenorphine), so the muscles relax and bun can pass a large mass of poop more easily

abbymarysmokey said:

In addition to what has already been suggested, I'd look into the possibility of getting your vet to administer a strong opiate painkiller like vetergesic (Buprenorphine), so the muscles relax and bun can pass a large mass of poop more easily

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Good point AMS :thumb: because buprenorphine has little effect on gut motility, unlike the other opiates. It's very much the drug of choice in severe stasis.
NSAIDs aren't very good for gut pain in humans. Pain in buns causes a sharp rise in cortisol which slows down the gut enormously.

ETA yes Jenk what you say makes a lot of sense.
What tends to happen with impaction is that fluids pour into the gut behind the obstruction which is nature's way of softening it. The fluids come from the circulation & soft tissues.
Most water is absorbed slightly further on in the colon & it's really increased if bunny is low on fluids in the tissues & circulation so the poops get very dry & both difficult to push forward & mould. If the colon is slowed down more fluids than usual get extracted.

It's good that she's absorbing her subcut fluids more slowly it means that her body has made up for fluid loss into the bowel so she's not going to dry out the stuck poops so badly.
I think you need to check with the vet whether you need to reduce the volume injected or not. With good kidney function, she should be able to wee out any excess easily.

I'm sorry I'm not too good at advising what to do - not thinking very well - also tired for the same reasons as you!. I'm too used to trying to prevent impaction in a bun whose a sitting duck for it.
As I understand it it's OK to syringe fed buns with impaction in the lower gut but it does need careful monitoring by a vet.

Yes, in the UK we usually avoid giving oily substances for impactions but given the site of impaction & anticipating a slow journey through the water absorbing megacolon part, I can understand why it was done.
It could be that you've only just reached the stage of fluid balance when things can begin to start moving. Impactions do take a long time to get moving.

Unfortunately, Zoe didn't pass any fecal material overnight. (I had her home from 8 pm until 7:30 am today, when I brought her back to the vet's for treatment.)

When I speak to the vet today (who isn't her regular vet, but a colleague/employee at the clinic), I'll ask her about Buprenorphine.

I'm also going to ask about the possibility of the vet giving Zoe at least one enema (using a pediatric ear-bulb syringe). The vet who's treating Zoe today won't give an enema to rabbits, but Zoe's regular vet said she'd be willing to try it if Zoe doesn't improve. Well, now Zoe's not improving, and her regular vet is to be in the clinic but not treating animals today; so I don't know if Zoe stands a chance of getting an enema today--unless my husband and I attempt to give her one this evening. I really don't want to, but I'm starting to feel desperate....

Jenk

Im so sorry for what you're going through
Apart form echoing what everyone else has said I wouldn't want to suggest giving her an enema by yourself, but my Pie had 2 enema's when she was in bad stasis and it helped her hugely.

Maybe someone else on here can give you any tips for self-enemas?
Oh I really do hope Zoe makes it.
C'mon little girl, stay strong!

Still sending Zoe lots of passing poop vibes. I hope your vet has given her some treatment today that will help her.

Jenk, I share Pie's concern about giving Zoe an enema yourself, for several reasons.
The 2 main reasons are
a) megacolon buns have a massively stretched colon with a paper thin wall - they perforate easily.
b) if the impaction is as deep inside as I think it is (proximal colon) it's a long way round for an enema to reach. They're much more effective when the impaction is near the anus.

How is Zoe today?