Bea's spay *update she's gone*

[a reader of books]

Either that, or it happened under GA. Using a mask offers no protection against aspiration, something I've just found out upon researching. I wasn't asked about using a mask, they just did this when they couldn't intubate her. I think, unless they witnessed coughing during her syringe feeding and failed to check her properly (which is possible) that it actually likely happened under GA.

That may explain why there was no symptoms of this. No gasping, no coughing, nothing. This is what I understand the 'passive regurgitation' to be. She only took a small gasp literally as she passed away.

The report was clear it was Ante-mortem. Bea was not left alone prior to death and we were watching carefully, there is no chance we missed symptoms you'd associate with this. So, I'm very confused. It also doesn't make sense why she'd even passively regurgitate at home, at rest either. Seems much more likely to me it would be under GA when masked.

But having spent my life thinking rabbits couldn't vomit (which is true) I wouldn't have ever considered then that they could regurgitate. It seems very unusual. If anyone has any experiences of this, please do share.

Yes, you're right about the reports. We'll soon be able to tell if they're omitting information that was relayed to me upon the phone calls and actually collecting Bea. If they omit important information, I will come down like a ton of bricks.

I just want this to be learnt from to be honest. That's all. xx

Ah, I see. It does sound like it's more likely to have happened under GA, then, yes... Surely not at home, at least, where you were watching her constantly and carefully. It had never occured to me, either, that rabbits can regurgitate. I really hope the vets will somehow learn from this, too, like you want them to. It's all so tragic...

 

[Graciee]

I'm so sorry

Idk if this is helpful or not really but I'll just say it anyway, it might not even be the same thing but.. I had a post mortem done on a bun that died whilst at the vets, she'd had stasis and a potential blockage and also suspected adhesions... So it wasn't looking good anyway, they decided to cut her open and look when blood glucose got to like 20 something.. Anyway she died immediately when they put her under. When they did the post mortem They found some food in her throat.. Now I don't think that's what killed her just be clear but it was one of the findings along with a load of other stuff, and I was asking my vet had I killed her and he said its very common thing to find when a bun dies.. Now it sounds like it was more than just some food in Beas throat, so obviously not the same, but I just thought I'd add it. Maybe speak to the specialist vets and ask their opinion on the findings? Idk if it's possible but sometimes someone can go through them with you and answer any questions you have. Just thinking then you can approach Vets4pets with a clear position. I'd also consider what you want the outcome to be here.

Hope that's not unhelpful it's just what I'd be thinking about if I was in your position x

 

[Omi]

Poor Bea

If she aspirated during the GA, then what was the food source? It couldn't have been the recovery food. Also if the food contents in the oral cavity had been aspirated whilst the recovery food was being given post op at the vets, I would have expected this to have been obvious to you when you collected her?

Was that the only observation on the PM report?

Regurgitation is not the same as aspiration. Rabbits cannot vomit, but they can aspirate food or liquid, which has gone into the lungs. I think the PM report mentioned 'froth', which suggests that it was aspiration.

 

[willow and squiggles]

I'm so sorry you are going through this. I don't have any advice but I offer healing vibes for you and you OH.

 

[JessBun]

typo

Poor Bea

If she aspirated during the GA, then what was the food source? It couldn't have been the recovery food. Also if the food contents in the oral cavity had been aspirated whilst the recovery food was being given post op at the vets, I would have expected this to have been obvious to you when you collected her?

Was that the only observation on the PM report?

Regurgitation is not the same as aspiration. Rabbits cannot vomit, but they can aspirate food or liquid, which has gone into the lungs. I think the PM report mentioned 'froth', which suggests that it was aspiration.

Bea died from aspirating the regurgitation Omi, this was stated earlier in the thread, quote from the report posted

'asphyxiation due to aspiration of regurgitated gastric content '

 

[JessBun]

If she aspirated during the GA, then what was the food source? It couldn't have been the recovery food. Also if the food contents in the oral cavity had been aspirated whilst the recovery food was being given post op at the vets, I would have expected this to have been obvious to you when you collected her?

The point is, we don't know when it happened & that's what we're trying to find out. Only that Bea didn't eat at home, and showed no signs at home. The vet said on one breath that they can silently regurgitate, then in the other says you would expect there to be symptoms from this. None at all were witnessed at home other than the rabbit being extremely quiet (which was to be expected given the OP she'd have).

The food stuff has already been described earlier in the thread as 'A moderate amount of green-brown fibrous material was present in the oral cavity' (and oesophagus and fufll length of the trachea) - they have not stated what it was, but I have wondered if there's a way I can request testing of the material. Although it's likely to come back as pretty much what is says, fibrous food. Whether they can tell the difference between hay and recovery food I've no idea. I don't really think it matters what the food was to be fair.

The only reason it'd make a difference which it was, is to argue the point that it happened as a result of syringe feeding the recovery food. But there's no point arguing this, because the vets are trying to push that it happened as a complete accident at home, and could still argue this, even if it was the recovery food. There doesn't seem to be quite enough information of regurgitation in rabbits out there, other than it can happen under GA, and risks are increased with use of a mask.

I should probably add in general to my posts, I'm not looking to 'sue' or otherwise harshly chase the vets in question. It won't bring Bea back. What I am looking for, is information on the reports from what checks were done whilst intubating attempt, and what symptoms were witnessed after feeding of the recovery food. Like another poster has already mentioned, if anything were noted during this, I feel the vets are unlikely to be honest about this anyway, now.

I think what happened to Bea is very unusual and rare, and even if it DID happen at the practice, it was an unfortunate and unexpected accident, but that it can be learnt from.

Further to your points Omi, from my reading (though very happy to be told I'm wrong, it helps my understanding of things) it seems as if death from aspiration is not as instant as I may have expected. The asphyxiation can be culmative, think in terms of pneuomia due to aspiration.

That's my understanding upon reading some papers, but as I say, I may be very wrong and I'm happy to be told of such.

 

[JessBun]

I'm so sorry

Idk if this is helpful or not really but I'll just say it anyway, it might not even be the same thing but.. I had a post mortem done on a bun that died whilst at the vets, she'd had stasis and a potential blockage and also suspected adhesions... So it wasn't looking good anyway, they decided to cut her open and look when blood glucose got to like 20 something.. Anyway she died immediately when they put her under. When they did the post mortem They found some food in her throat.. Now I don't think that's what killed her just be clear but it was one of the findings along with a load of other stuff, and I was asking my vet had I killed her and he said its very common thing to find when a bun dies.. Now it sounds like it was more than just some food in Beas throat, so obviously not the same, but I just thought I'd add it. Maybe speak to the specialist vets and ask their opinion on the findings? Idk if it's possible but sometimes someone can go through them with you and answer any questions you have. Just thinking then you can approach Vets4pets with a clear position. I'd also consider what you want the outcome to be here.

Hope that's not unhelpful it's just what I'd be thinking about if I was in your position x

Thank you Graciee. Yes the difference is here that it was aspirated, so was found in her trachea, sadly. And that it happened ante-mortem obviously.

I'm very grateful of anybody sharing experiences - knowledge is power! There is always something to be learnt from these sad experiences, and discussions about them are helpful! Very sorry to hear you lost your loved bun too. These situations are so sad! x

 

[JessBun]

I'm so sorry you are going through this. I don't have any advice but I offer healing vibes for you and you OH.

Thank you Willow & Squiggles. x

We are surprisingly OK. It's not a nice way for her to go, perhaps hypothermia may have been kinder to her, I really don't know and I'm trying not to think like that, all I can say is she went very quickly. I am glad to have some answers.

To us upon really thinking about it, it does at least it seems what happened to her, was as a result of the GA in one way or another, whether it happened during or after, and was one of those unfortunate things that can just happen. I may be wrong, but it seems more likely this would happen due to GA than due to a healthy rabbit just sitting there. It seems far fetched to suggest it happened for no reason associated with the GA given she'd had it that day.

At least in addition, I can take Oscar for his neuter to the rabbit savvy vets and ask what can be done to check for risks like this during or after surgery. Awareness is key, as is knowledge. I can also ask about signs to look out for this, as there really was none. Thanks again, we are feeling OK. I am just looking forward to getting her ashes back and doing her memorial!

 

[JessBun]

Maybe speak to the specialist vets and ask their opinion on the findings? Idk if it's possible but sometimes someone can go through them with you and answer any questions you have. Just thinking then you can approach Vets4pets with a clear position. I'd also consider what you want the outcome to be here.

Hope that's not unhelpful it's just what I'd be thinking about if I was in your position x

This is our thoughts and we are going to try this tomorrow. I have a feeling they wouldn't want to offer this 'advice' free as such, but we can certainly try! We do need a bit more information about why it happens around GA events.

So far the vets have offered every possible explanation of it happening at home, but not one possibility of it happening in the practice. At this point I did get a bit firm with them and say 'there has to be a bit of honesty here, for the sake of learning from this' - we are very willing to accept it may have happened at home, but are not happy with them not even considering it happened in the practice. We have requested the reports now, and I'll be interested to see what happened around the intubation attempt in particular, and what checks for aspiration were done, if any.

As I say, not necessarily a blame game, I think this was extremely unusual and not commonly checked for as a result. I have also told them clearly I am not looking to legally pursue this, so I'm hoping this may encourage some honesty and reflection on what could maybe have been done differently in practice as well.

 

[bunny momma]

I had a bunny regurgitate as I was waiting to see a vet on emergency. The situation was similar to Graciee's bunny. My bunny went into stasis and was syringe fed hours before. As vet was running diagnostics her mouth and chin had recovery food I did not recall being there before. Vet said she was obstructed and possibly perforated. Emergency surgery was an option yet she was so ill she did not have a good prognosis so was pts. For years I wondered if I made the right choice and today Graciee's post shows there was no right answer.--So sorry to you both.

Did report indicate a possible reason intubation was difficult?

 

[InspectorMorse]

Either that, or it happened under GA. Using a mask offers no protection against aspiration, something I've just found out upon researching. I wasn't asked about using a mask, they just did this when they couldn't intubate her. I think, unless they witnessed coughing during her syringe feeding and failed to check her properly (which is possible) that it actually likely happened under GA.

That may explain why there was no symptoms of this. No gasping, no coughing, nothing. This is what I understand the 'passive regurgitation' to be. She only took a small gasp literally as she passed away.

The report was clear it was Ante-mortem. Bea was not left alone prior to death and we were watching carefully, there is no chance we missed symptoms you'd associate with this. So, I'm very confused. It also doesn't make sense why she'd even passively regurgitate at home, at rest either. Seems much more likely to me it would be under GA when masked.

But having spent my life thinking rabbits couldn't vomit (which is true) I wouldn't have ever considered then that they could regurgitate. It seems very unusual. If anyone has any experiences of this, please do share.

Yes, you're right about the reports. We'll soon be able to tell if they're omitting information that was relayed to me upon the phone calls and actually collecting Bea. If they omit important information, I will come down like a ton of bricks.

I just want this to be learnt from to be honest. That's all. xx

Sorry this will be brief reply, v poorly

I had a Rabbit who regurgitated all the contents of her stomach as she was PTS due to a full obstruction caused by post spay adhesions.

 

[JessBun]

I had a bunny regurgitate as I was waiting to see a vet on emergency. The situation was similar to Graciee's bunny. My bunny went into stasis and was syringe fed hours before. As vet was running diagnostics her mouth and chin had recovery food I did not recall being there before. Vet said she was obstructed and possibly perforated. Emergency surgery was an option yet she was so ill she did not have a good prognosis so was pts. For years I wondered if I made the right choice and today Graciee's post shows there was no right answer.--So sorry to you both.

Did report indicate a possible reason intubation was difficult?

So sorry to hear bunny momma. Did the rabbit aspirate it as well? The issue here is the aspiration mainly.

No, I don't even know if the difficult intubation was mentioned on the necropsy referral. Perhaps I should ask for a copy of the referal as well.

 

[JessBun]

Sorry this will be brief reply, v poorly

I had a Rabbit who regurgitated all the contents of her stomach as she was PTS due to a full obstruction caused by post spay adhesions.

Thank you for replying even though you are poorly Jane. I hope you are feeling better as soon as possible.

There was no mention of adhesions, or obstruction. Did your rabbit aspirate the regurgitation? Assuming not seeing as it was being put to sleep.

Sorry to hear you suffered this loss. Thank you everyone for sharing your experiences.

What I'm most confused about is the aspiration of the regurgitation

 

[InspectorMorse]

Thank you for replying even though you are poorly Jane. I hope you are feeling better as soon as possible.

There was no mention of adhesions, or obstruction. Did your rabbit aspirate the regurgitation? Assuming not seeing as it was being put to sleep.

Sorry to hear you suffered this loss. Thank you everyone for sharing your experiences.

What I'm most confused about is the aspiration of the regurgitation

would have thought that the PM should have included PM lung findings if aspiration pneumonia was being assumed. There would be clear evidence on lung tissue.

 

[Babsie]

Hello JB Just to say you are still in my thoughts and I hope you can get more answers. X

 

[JessBun]

would have thought that the PM should have included PM lung findings if aspiration pneumonia was being assumed. There would be clear evidence on lung tissue.

The vet mentioned aspiration pneumonia, the post mortem report as far as I can tell doesn't specifically mention pneumonia.

There is a lot of info on the report. For most every day people, the terms are a load of gobblygook that needs googling. So whilst I have read it and (mostly) comprehended it, I am focusing on the cause of (likely) death, given.

 

[JessBun]

Hello JB Just to say you are still in my thoughts and I hope you can get more answers. X

Thank you Babsie. I am happy with the answers I have, if no more are to be found. I have researched and it's quite obvious the regurgitation was likely triggered (whether at the time or later) by GA and surgery, with the timing of course that it happened same day. I am still confused why she breathed it in, but the most likely answer I seem able to find is this was because of the use of a mask. Or, I assume, just failing health post surgery.

There was no symptoms to suggest this happened just prior to death, and caused 'immediate' aphxyiation, although I suppose it's somehow, a possibility. From a common sense point of view though, I can't see how it's possible. We were observing her the entire time and as the vet says, you would have expected coughing or other symptoms.

Thank you for keeping us in your thoughts x

 

[JessBun]

Just a thought Jane. If you feel relatively confident to understand a lot of the info given in PM findings, I could copy and paste this in a message to you. I of course have googled some terms, but what they mean in relation to usual findings is obviously lost on me, not being a vet. I don't know how much you know about usual PM findings etc. Really the vets should be doing this with me, but honestly, I feel it comes from a place of complete bias to be honest.

I know you said you are poorly, so please don't feel obliged at all. I think I am mostly understanding what happened, unless folk think I am coming to conclusions of course. It does seem as if this is the consensus for some reason, although perhaps I am misinterpreting. I just don't see how this aphyxiation could have been immediate at home, seeing as we witnessed the death and the (lack of) associated symptoms prior.

 

[bunny momma]

So sorry to hear bunny momma. Did the rabbit aspirate it as well? The issue here is the aspiration mainly.

No, I don't even know if the difficult intubation was mentioned on the necropsy referral. Perhaps I should ask for a copy of the referal as well.

She was already very lethargic when I noticed the recovery food on her mouth, and no pm done after pts.
Bunnies are obligate nasal breathers that makes aspiration difficult, they can get aspiration pneumonia as another person mentioned... Does your vet recommend withholding food before surgery.

 

[InspectorMorse]

Just a thought Jane. If you feel relatively confident to understand a lot of the info given in PM findings, I could copy and paste this in a message to you. I of course have googled some terms, but what they mean in relation to usual findings is obviously lost on me, not being a vet. I don't know how much you know about usual PM findings etc. Really the vets should be doing this with me, but honestly, I feel it comes from a place of complete bias to be honest.

I know you said you are poorly, so please don't feel obliged at all. I think I am mostly understanding what happened, unless folk think I am coming to conclusions of course. It does seem as if this is the consensus for some reason, although perhaps I am misinterpreting. I just don't see how this aphyxiation could have been immediate at home, seeing as we witnessed the death and the (lack of) associated symptoms prior.

I am obviously unqualified but I am happy to take a look at the full report if you PM me a copy. Cant promise to reply today as I have a lot on and the report may be way beyond my comprehension, but I will respond ASAP