OK Vita, I'll come clean.
Yes, I'm trying to protect you in this acute stage of grief. I have an old fashioned way of understanding loss. The initial response to sudden deep loss is usually shock/disbelief, rapidly followed by a mixture of anger & guilt. Guilt is by far the most difficult emotion to resolve, especially when even slightly misplaced.
I can empathise a little with you. Fortunately I worked in a speciality where there were few human deaths, but every time there was a death or things didn't go as expected, I'd go back to the beginning & tear my whole diagnosis & management apart. Could I have got the right diagnosis earlier? Did I pay insufficient attention to something the patient said, something found on examination, or a test? Should I have been more aware of new advances? If my treatment had been different would it have altered the outcome significantly? I could only do this deeply painful excercise, because although sad, I was not experiencing the confusion of emotions of bereavement.
Absolute truth. In 1977 I cared for a 16 year old girl, so seriously injured that even in 1995 with much more advanced technology she should have died. I had a good registrar who understood that the only way through, was fast & meticulous control of the factors which were killing her, but do
nothing with drugs or operations which although indicated in a less severely ill person, would have killed her because her body couldn't take any more - there was no reserve left. She walked out of hospital 3 months later & eventually got a PhD.
I this good clinical judgement.
Even with human experience, I was totally reliant on vets for good clinical judgement for Thumper, because I didn't have the extensive experience of treating rabbits required to attain good clinical judgement.
You can see on Thumpers thread that I started with a truely gifted vet. Marie. When she left, she was succeeded by vets who had worked in the top centers in Europe, & had incredibly high academic qualifications. None of them had Marie's gift of amazing clinical judgement, or even approach Marie's ability to understand how one problem, his tiny molar spurs, were causing huge problems in totally different parts of his body. Problems which would not have arisen had he been otherwise well.
By far the biggest factors which suppress a bunny's immune system, & general ability to recover, are
pain &
stress, which can be physical or emotional.
I was quite shocked that Immodium was advocated on the link. It is contraindicated in human bacterial diarrhoea because we want the pathogens out of the gut as fast as possible, not building up inside the gut. The only indication would be if we were losing the battle to keep bunny/human hydrated with IV fluids or sub cut fluids.
Acute GI problems in bunnies & humans are often associated with a massive migration of fluid from the circulation to the gut lumen. It is incredibly difficult to know that a bunny is dehydrated. I knew that Thumper was dehydrated when he only passed a few ml of urine. He once soaked up 150 ml subcut fluids in an hour but had absolutely no signs whatsoever of dehydration, except poor urine output. :shock: Poor circulating volume, & pain can cause cold, grey, ears amongst other things. Thumper's ears would warm up at the vets cos he was scared & the adrenalin started to flow, increasing blood flow to the ears by increased BP & heart rate, but the treatment was
restoring circulating volume & pain relief. It's the fluid loss from the circulation which kills humans. It must be a major factor in bunnies although they are more complicated.
Keeping bunny warm means that they don't have to use so much energy from their small energy stores to keep themselves warm. It conserves their strength to fight the illness. Also unlike us, bunnies
have to keep eating. They have tiny energy stores & can't utilise fat properly like other animals. Mine was simply impossible to syringe feed by anyone! We had to get his gut started quickly, & a bit of glucose in his subcut fluids.
I know Thumper was older, but bunnies are adult when 6 months old. There were times when he just passed caecals of black "ink". He had dysbiosis as well as his TB. because his gut was so thickened & slow. I'd be sweating bricks!
:shock: We suspected E coli (& at 1 time I was
misled into thinking it was clostridia). I was about to give him
questran twice, just waiting for his meds to get down far enough to risk it, but blackthorn leaves sorted it out quickly every time.
Yes, we discussed ABx but there are a lot of cons in bunnies. For a start, the essential, beneficial microorganisms are more susceptable to ABx than the pathogens. The only effective way to recolonise the gut is to give them caecals from healthy rabbits orally, the which is fraught with difficulty.
Goodness I've written a treatise here!
I find that so much is written about the drug treatment of buns, but omits the indications, or potential problems with the treatment.
Hardly anything is written about the disease process, so we can understand what is happening, & at which stage the drugs should be used.
Virtually nothing is written about the very simple nursing & dietary care which do so much good, no harm whatsoever & should be the bed rock of our treatment.
