GI ulcers in bunnies

[Jolysium]

Has anyone had a bunny that has had a GI ulcer? My Harribunny has just been in the vet again with stasis and pain in his upper abdomen. He had the same a few weeks ago and they didn’t really get to the bottom of it but he made an apparent full recovery only to get similar symptoms over the last couple of days.

He had X-rays and ultrasound which didn’t show anything in particular. His bloods are pretty normal except for anaemia, unchanged from a few weeks ago. With the intermittent pain near his stomach and the anaemia the vet thinks it may be an ulcer.

Just wondered if anyone else had experienced this, how it was diagnosed, treatments, prognosis etc?

 

[InspectorMorse]

Yes. Diagnosed by gastroscopy. Treatment with Ranitidine, Sucralfate and paracetamol for analgesia. NSAIDs eg Meloxicam are contraindicated when a GI tract ulcer is suspected. The sucralfate was given for just a week as it can effect GI tract motility. He was on Metoclopramide as a prokinetic, but Ranitidine also has some prokinetic effects.The Rabbit had a few flare ups over the years, but these resolved with treatment mentioned. He could never have NSAIDs as analgesia again, if he needed pain relief for any reason alternatives were used.

Rabbits have a naturally very acidic stomach, so even a short period of anorexia can lead to a gastric ulcer. The gastric ulcer being the result of not eating, not the cause, if you see what I mean.

 

[Jolysium]

Yes. Diagnosed by gastroscopy. Treatment with Ranitidine, Sucralfate and paracetamol for analgesia. NSAIDs eg Meloxicam are contraindicated when a GI tract ulcer is suspected. The sucralfate was given for just a week as it can effect GI tract motility. He was on Metoclopramide as a prokinetic, but Ranitidine also has some prokinetic effects.The Rabbit had a few flare ups over the years, but these resolved with treatment mentioned. He could never have NSAIDs as analgesia again, if he needed pain relief for any reason alternatives were used.

Rabbits have a naturally very acidic stomach, so even a short period of anorexia can lead to a gastric ulcer. The gastric ulcer being the result of not eating, not the cause, if you see what I mean.

Thanks Jane. He’s been given ranitidine and they’ve changed him off his loxicom and on to gabapentin for his pain. I wonder if this is long term, he’s always had more episodes of stasis than my other bunnies and they’ve always seemed more of a mystery.

Do you know if NSAIDs can cause gastric ulcers in rabbits? I know their use is a risk factor in humans. He has been on the loxicom for years but then so have several of my other bunnies and they’ve been fine with it.

I don’t know whether it’s worth getting him scoped. He’s 11 and I lost one of my other older buns under GA so am a bit hesitant to risk it unless absolutely necessary. Thinking probably worth trying treatment and monitoring his symptoms rather than trying to get definite diagnosis at this stage.

 

[InspectorMorse]

NSAID use can cause gastric ulceration, but with Rabbits This-is generally less of an issue as a Rabbit should constantly have food going through their stomach. Also, I don’t know if the lining of a Rabbit’s stomach might have a natural protection from NSAID induced ulceration given that Rabbits have a naturally highly acidic stomach compared to other species.

I have had Rabbits on daily NSAIDs for years with no problems. But if they ever have any episodes of anorexia for whatever reason my Vet always prescribes Ranitidine. As I said before, Ranitidine also has some prokinetic effects. It increases the motility of the hind gut. Metoclopramide only works on the upper GI tract, increasing the rate that the stomach empties into the small intestines. Used together Metoclopramide and Ranitidine work well for the treatment of gut stasis and of course Ranitidine has dual benefits.

Personally I would not go down the diagnostic route and would just see how Bunny gets on with Ranitidine. Did the Vet say if the anaemia was regenerative or non regenerative ?

 

[Jolysium]

He said he thought there was slight regeneration. I didn’t fully understand, is that for seeing if it’s a chronic thing?

 

[Jolysium]

So… I just gave Harribun his dose of gabapentin. He took it ok, ate his parsley treat, then had a weird stress or pain episode, flopping on to his side and breathing really quickly. Lasted about five minutes max and I was about to ring the vet when he stood up, cleaned himself, and ate some hay! Breathing back to normal. Scared me silly. Maybe it’s painful for him being picked up? Any other ideas?

 

[Shimmer]

If it's regenerative anaemia, it should resolve when the cause of the loss of red cells has been sorted out. So may take a few weeks to get back to normal.
With non-regenerative anaemia, there's a problem with making the new red blood cells - which is more serious.

 

[InspectorMorse]

He said he thought there was slight regeneration. I didn’t fully understand, is that for seeing if it’s a chronic thing?

It’s indicative of blood loss from somewhere. Gastric Ulcers can bleed.

Is he primarily on analgesia for arthritis ? If so then what you describe could be due to acute pain that was triggered if he jarred himself when you put him back down.

 

[Jolysium]

Thanks. Hopefully if it is an ulcer the ranitidine will help it settle. He has been on medication for arthritis but to be honest I don’t think it’s been too big a problem for him, he still leaps on and off the sofa with no trouble. I wonder if it’s holding him that is exacerbating the pain from the suspected ulcer.

Unfortunately he’s a nightmare at taking his medicine. I hope it’s not going to cause him that amount of distress every time we have to handle him, poor boy [emoji20]

 

[bunny momma]

Sending vibes for your boy. I would not subject him to more diagnostics unless he does not look improve with mefication.