Surgery or not? How to make decisions e.g. for bloat

Hi all,

*content note: having to say goodbye to a rabbit*

This is my first post, I have used this site for years as a reference guide for years but never posted. So first thanks to Tamsin and everyone who contributes it has helped me on many occasions.

I am disabled and have an Msc in public health. Whenever I or family members need treatment I always consult resources like the Cohrane library, which pools studies that have been done on various interventions so you can see statistically what the best option is.

I had to make a difficult decision on Saturday night and heart breakingly the outcome was not good. We have had Sammy (ginger dutch) since we adopted her in 2012. She has always been a "runt of the litter" type though very big personality, and I frequently have had to give her tummy rubs for gas. But on Sat pm she was hiding as obvs in a lot of pain. Her tummy was very bloated and she was completely uninterested in even her favourite treat (banana). After syringing her some mushed up at advice of vets and seeing no improvement, I took her in to emergency vets and they did a glucose test which was 18.5 (unsure of units). They made a disparaging remark about the fact her tummy was so bloated "even I, her owner, had noticed" (grrr, I know her tummy better than mine!) and said she probably had a blockage but hoped that with IV fluids, pain relief and syringe feeding they could stimulate her gut to pass it. 2 hours later I got a call saying she was even more bloated (hard and distressing to believe) and as her glucose was now over 2 they protocol was surgery. My partner and I had to make a decision whether to go ahead, given that she was 8 and with all the risks of surgery, not knowing where the blockage was (she said no point in xray as it could be fur in which case wouldn't show up? which seemed odd as surely it would be apparent from surrounding tissue), and the concerns of general anaesthetic and bunnies. She said she had only known 1 rabbit survive with that level of glucose without surgery.

We decided to go ahead, thinking of her other half Lily (8 yr old American sable) and that she too would want us to do everything to save her. Sammy survived surgery, blockage was pushed manually towards end of intestine so it could be passed, small amount of blood was found it her stomach probably due to pressure. But died while coming to, of a cardiac arrest they couldn't bring her back from (Thank you for others' threads on how to manage death in a bonded pair, we let Lily spend a few hours where she could come and go next to her body. Lily seems remarkably ok. She was visibly creeped out after investigating Sammy a few times, perhaps when she realised who the dead bunny was).

We are devastated and I'm left feeling that I made the biggest medical decision - which hopefully was the right one despite outcome - without any of the stats that I normally am armed with when I even decide which cold remedy to take.

So my question is: how can we rabbit lovers find firm information about treatments ie not just recommendations but the statistics to back it up? Is it just that the knowledge isn't out there due to lack of funding?

Any pointers hugely appreciated.

(I am also a bit stunned by the £2300 bill. It was out of hours but still, much more than similar ops for other pets we have had. Maybe London prices?!)

Lots of love,

Clare xx

and Matt the human and Lily the rabbit xxx

So sorry for your loss. I don't know where you would find statistics to back it up but I am lucky to have found a brilliant exotic vet specialist and trust him completely. Doughnut was really ill when she was 1, she is now 8 and I paid out about £2,000 trying to get her diagnosed, but no one recognised she was ill or knew what it was, she was constantly wet with urine and rubbing her throat. He recognised she was really sick and it turns out she has acid reflux and slow gut mobility, so in terms of treatment, I would always go with what he said. And from what the emergency vets told you, I would have opted for surgery too, you did all you could so please don't beat yourself up.

Doughnut is now 8 and had dentals so had gas but he only gasses her the least amount possible so she comes round quite quickly. It does take ages in older rabbits so is a worry but I think the main thing is having a great vet but if it is out of hours you can't always go to the one you want to.

As for the bill, are you insured?

I would also maybe get recommendations of exotic vet specialists in your area if you feel they gave you the wrong advice. People on here are great at recommendations.

Thanks @cpayne , not necessarily that I think she gave bad advice. Just that I know they can't know everything, as my experience of Drs as a disabled person has taught me all too well! Although bloat must be a common one for vets (though not many bunnies seen in London). Sometimes even a treatment that is considered gold standard can be shown to be incorrect once a meta analysis has been done, so i always like to see the stats!

No not insured, we decided to put aside the money instead so we are lucky we did have the savings to pay. May reconsider as was 50% more than what I would have expected.

Give doughnut some strokes from me x

Well you acted quickly and went with their advice so I think you should be proud that you did everything you could for your bunny.

I will x

I too am very sorry for your loss. Any surgery on the GI tract of a Rabbit is considered 'high risk', but in the case of a full obstruction it is the only option. There are no 'official' statistics on survival rates. Much depends on the individual Rabbit, their overall health, where the obstruction is, how much handling of the intestines are needed,how bloated the stomach is, how the individual Rabbit copes with the GA..................... the list is endless, no case will be exactly the same. It sounds as though there was no option but to attempt surgery, it is tragic that it was not successful

RIP Sammy

Really sorry for your loss

I don't think there's anywhere really for that kinda advice, I just make sure I'm dealing with a rabbit savvy vet, research stuff online myself and think it through, also posting on here for opinions always helps me. I think just having the knowledge and understanding helps a lot.

I like to have a set of things I do for each medical problem, so for gut stasis I have - notice issue, vets asap, when we get there I want an xray, blood glucose test, physical examination, painkillers, gut stimulant as a bare minimum, and to know if I should be syringe feeding or not, because wouldn't want to do that incase there was a blockage etc. Depending on severity I've had more than one painkillers and more than one gut motility drug before too. I like to know my options basically and make sure the vet has covered everything I expect them to. <this is just an example of what I do for this one thing, I have other lists for different medical problems etc and ways I like to handle them. But really I think the best thing to do is learn about it all lots and then if you're seeing a vet who doesn't seem to be doing the right thing, or not what you want, request the things etc. It's hard sometimes if you can't see the right vet etc. I'm no bunny expert though far from it, I normally bounce ideas off people on this forum

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Sending my sincere condolences on the loss of your bunny.