Hello - Week 2 of Stasis (Long read sorry)

[MightyMax]

Hey folks,

So an update from the vet. Siddi is fine in the isolation ward of the vets. He seems bright, stable and was happy with critical care feed again.

They are not giving him IV at the moment. Because, they believe he is hydrated and bright enough without it. If they felt he was at risk, he would be straight on it. Instead of now, they'll be monitoring his intake to make sure it is what it needs to be.

2 vets have felt his stomach, neither seem to believe there is a blockage, he does have a low glucose count at 9.3 at the moment, so they are going to monitor that.

What they wondered about is that day he pooped too much, it was actually the meds speeding things through too quickly. So, they are going to monitor day by day for now.

They will also introduce fibreplex into him today, to see if this will assist him.

Also, the vet believes she has seen buns in much worse condition than him before and they've been fine and pulled through, she was actually shocked by his progress over the past week and says that there should be no reason to worry and working carefully to monitor him they can get his digestive system back to normal. Finally, they are going to seek advice from the RVC to see if there's anything further they can do.

Bloodwork and IV will be if needs must basis then.

My only concern is his seizure was at 23 ( I know I gave him a lot of treat on the day and he hadn't passed pellets for 3 days ), but now 9.3?? :|| Is that normal?!

Thanks again folks.

Love
Rich

Was the vet shocked by his blood glucose, because I don't see that as worrying?

 

[MightyMax]

This is from Frances Harcourt Brown's lecture that I attended
(she is a retired rabbit specialist vet):

Blood glucose is measured in mmol/ml (millimoles/litre)

Normal: 4-8 mmol/ml

2-4 mmol/ltr – needs food – rabbit is experiencing gut stasis
If less that 2 mmol/ltr, call vet

8-15 mmol/ltr Rabbit is stressed, but can stay at home
More than 15mmol/ltr, less than 20 – Call vet, start to worry…
More than 20 mmol/ltr, needs surgery.

 

[Sidditherabbit]

Good point, it was 8.3 btw sorry. They were happy with it I think, although mentioned it had obviously yo yo'd a lot in a week and a half!

 

[MightyMax]

Good point, it was 8.3 btw sorry. They were happy with it I think, although mentioned it had obviously yo yo'd a lot in a week and a half!

:thumb:

 

[Sidditherabbit]

All about his hydration and fibre intake then by the sound of it... ahhhhh Sid, why is this so complicated. You looked so well over the past few days Let's get this bit of the jigsaw sorted and it will be full strength all round...

 

[MightyMax]

All about his hydration and fibre intake then by the sound of it...

Really important in gut stasis!

http://anyflip.com/dvpt/hzvv/basic

 

[Sidditherabbit]

This is from Frances Harcourt Brown's lecture that I attended
(she is a retired rabbit specialist vet):

Blood glucose is measured in mmol/ml (millimoles/litre)

Normal: 4-8 mmol/ml

2-4 mmol/ltr – needs food – rabbit is experiencing gut stasis
If less that 2 mmol/ltr, call vet

8-15 mmol/ltr Rabbit is stressed, but can stay at home
More than 15mmol/ltr, less than 20 – Call vet, start to worry…
More than 20 mmol/ltr, needs surgery.

Is this right?

https://www.ncbi.nlm.nih.gov/pubmed/22659922

Blood glucose was measured with a portable glucose meter in 907 rabbits, including 238 clinically healthy ones. Blood glucose concentrations ranged from 1.2 to 30.1 mmol/l. Diabetes mellitus was not encountered. No significant effect of sex or sedation was found. Hypoglycaemia was seen in 16 rabbits including one with an insulinoma. There was a significant relationship between blood glucose, food intake, signs of stress and severity of clinical disease. Rabbits showing signs of stress had higher blood glucose than rabbits with no signs and rabbits that were totally anorexic had higher blood glucose values than those that were eating normally or those with reduced food intake. Severe hyperglycaemia (>20 mmol/l) was associated with conditions with a poor prognosis. Rabbits with confirmed intestinal obstruction had a mean blood glucose of 24.7 mmol/l (n=18). This was significantly higher than the rabbits with confirmed gut stasis, which had a mean value of **** 8.5 mmol/l (n=51) *****. The conclusion of the study was that blood glucose is a measurable parameter that can be used to assess the severity of a rabbit's condition and help to differentiate between gut stasis and intestinal obstruction in rabbits that are anorexic.

http://forums.rabbitrehome.org.uk/archive/index.php/t-319091.html?

 

[Sidditherabbit]

Another vet update just now (8pm)

Sid in himself is fine, bouncy boppy and content it would appear, they said there's no obvious signs of pain and it would be quiet enough in the ward to hear teeth grinding.

However he hasn't pooped or eaten today. So, they are going to up his critical care medicine back to every two hours instead of four and keep him hydrated.

Tomorrow night if he's not pooped or eaten by himself theyre going to blood test him.

This is just heart breaking atm, they don't even acknowledge his leg injury now as it's healed and he's now stuck with stasis bugging him

I hope for all the world he starts pooping, it took him close to two days to poop on last visit so hopefully overnight there is progress. His belly feels good and his glucose is in a safe zone so there's no reason for him to be in danger. Just needs to get the ignition going again

 

[Omi]

Do you think that the reason he hasn't eaten or pooed today is that he is away from his home? This is actually quite a common occurrence. Have the vets actually done anything with him today that you couldn't have done at home?

Sometimes fluids are administered via sub-cutaneous injections, if they felt they didn't want to give it i.v.

Have they said why they didn't want to take bloods from him today?

Is he still on all his meds?

 

[Sidditherabbit]

Hey Omi,

Reason for no blood at the moment was it can be stressful and they're trying to keep that to as low as possible at the moment.

As for the vets changes, theyve added cisaprimide, fibreplex to his diet today plus changed his critical care to 2 hours as they think fibre needs to given quicker. It took him a few days at the vet last time to poop. As much as I want him at home, I think that this is perhaps a better bet so that he can be regularly monitored in an isolation ward and fed more consistently.

I will get 2 hours with him tomorrow night if all goes to plan.

 

[MightyMax]

Hey Omi,

Reason for no blood at the moment was it can be stressful and they're trying to keep that to as low as possible at the moment.

As for the vets changes, theyve added cisaprimide, fibreplex to his diet today plus changed his critical care to 2 hours as they think fibre needs to given quicker. It took him a few days at the vet last time to poop. As much as I want him at home, I think that this is perhaps a better bet so that he can be regularly monitored in an isolation ward and fed more consistently.

I will get 2 hours with him tomorrow night if all goes to plan.

Taking blood from a rabbit can be very stressful, and it sometimes doesn't give a full enough sample to analyse. I guess their priority is to get his gut moving. I hope they give fluids - IV or sub-cut - to help with this. IV is better whilst he's at the vets

 

[Jack's-Jane]

Hey Omi,

Reason for no blood at the moment was it can be stressful and they're trying to keep that to as low as possible at the moment.

As for the vets changes, theyve added cisaprimide, fibreplex to his diet today plus changed his critical care to 2 hours as they think fibre needs to given quicker. It took him a few days at the vet last time to poop. As much as I want him at home, I think that this is perhaps a better bet so that he can be regularly monitored in an isolation ward and fed more consistently.

I will get 2 hours with him tomorrow night if all goes to plan.

I hope that Siddi has had a comfortable night. In view of how his condition is evolving I would ask the Vet if a liver injury may have been involved. I have my reasons for musing about this as I have seen it before in a couple of other Rabbits. Bunny Buddy on here also had a Rabbit that also suffered a Liver Lobe Torsion (diagnosed by Frances Harcourt-Brown). Bunny Buddy's Rabbit (Rudy) survived, the Liver is one organ that can regenerate. But I believe that Rudy was very poorly for a while, as Siddi has been.

http://www.exoticpetmedicine.com/article/S1557-5063(14)00104-9/abstract

Bunny Buddy's Thread from 2013 giving details of Rudy's condition:

http://forums.rabbitrehome.org.uk/s...o-longer-anaemic&highlight=liver+lobe+torsion

And from a thread 4 years later

Thanks for the support everybody, his loss today has come as a bit of a shock as he just kept bouncing back.

This is what was found on PM:
Rudy had an invasive tumour in his leg. He also had an abscess, not a tumour in his chest. One liver lobe was missing, which fits with my provisional diagnosis of a liver lobe torsion in 2013. I think the lobe must have atrophied.

I'd got it completely fixed in my head that the chest and leg issues were connected, but not the case.

The reason I keep mentioning a blood profile is because that would give the Vet information re Liver Function. Of course I am in no way qualified in Veterinary Medicine and I'm certainly no 'expert'. I am just relaying my unqualified ponderings based on my own experience.

I hope that you receive a positive update from the Vet today x

 

[Sidditherabbit]

Morning,

Normally get the call for the daily am check from the vet around 11:30/12 so currently being very nervous twiddling fingers. If there was something majorly wrong they would call straight away anyway so... Touchwood he's fine atm.

I agree about this, bloodwork is the next crucial step to getting a proper prognosis. The vets want him pooping and eating first for a bit to get him calm. The 3 times he's now been in, the first 2 have taken him 1/3 days to settle and to poop(second visit only) and then eat by himself. Hopefully the critical care and the quietness of the isolation ward bring this into play either today or tomorrow.

As pointed out yesterday, the physical injury that was the first symptom that bought him to the vet (hanging right hind leg) has completely gone now, so internally blood and the stasis are the places they will investigate. Even if they don't think that's the case, I'm prepared to pay up for the gold RWAF accredited vet to (Up in Bedford, we are in St Albans, Siddi is in Watford 24 hr vets) (All next to the M1), he doesn't appear to be in pain now, (they've not noted hunched positions, teeth grinding or any obvious signs) I know rabbits hide it but some stuff is just clear to see.

He's certainly hanging in there so I will make sure I do too. Will update you later.

Rich

 

[Sidditherabbit]

Howdy,

So, the vet happened to be the one to pick up the phone this morning, she only has the nurses notes from overnight as she hasn't done her walkthrough yet and will ring later but so far.

Sid has nibbled a bit by himself again and has started to poop a bit, they're also bigger than before too.

They've agreed to keep him in the quiet isolation ward for the duration of his stay and he can stay until he poops normally.

Next step is a blood test today along with constant monitoring. It's great he's pooped and munched a bit. Hopefully the fibreplex and cisapride they've added in has helped him. Touchwood all the blood work comes back normal now and they can focus on poop output going forward.

 

[Jack's-Jane]

Howdy,

So, the vet happened to be the one to pick up the phone this morning, she only has the nurses notes from overnight as she hasn't done her walkthrough yet and will ring later but so far.

Sid has nibbled a bit by himself again and has started to poop a bit, they're also bigger than before too.

They've agreed to keep him in the quiet isolation ward for the duration of his stay and he can stay until he poops normally.

Next step is a blood test today along with constant monitoring. It's great he's pooped and munched a bit. Hopefully the fibreplex and cisapride they've added in has helped him. Touchwood all the blood work comes back normal now and they can focus on poop output going forward.

I am glad to hear that he has some better output now and I hope all will be well with the blood test x

 

[Sidditherabbit]

I'm a bit worried about this blood test now but he needs to have it..

Is the torsion rare?

 

[MightyMax]

Morning,

Normally get the call for the daily am check from the vet around 11:30/12 so currently being very nervous twiddling fingers. If there was something majorly wrong they would call straight away anyway so... Touchwood he's fine atm.

I agree about this, bloodwork is the next crucial step to getting a proper prognosis. The vets want him pooping and eating first for a bit to get him calm. The 3 times he's now been in, the first 2 have taken him 1/3 days to settle and to poop(second visit only) and then eat by himself. Hopefully the critical care and the quietness of the isolation ward bring this into play either today or tomorrow.

As pointed out yesterday, the physical injury that was the first symptom that bought him to the vet (hanging right hind leg) has completely gone now, so internally blood and the stasis are the places they will investigate. Even if they don't think that's the case, I'm prepared to pay up for the gold RWAF accredited vet to (Up in Bedford, we are in St Albans, Siddi is in Watford 24 hr vets) (All next to the M1), he doesn't appear to be in pain now, (they've not noted hunched positions, teeth grinding or any obvious signs) I know rabbits hide it but some stuff is just clear to see.

He's certainly hanging in there so I will make sure I do too. Will update you later.

Rich

Is Siddi in Medivet Watford?

 

[Sidditherabbit]

Max, you're one wise old thumper

 

[MightyMax]

Max, you're one wise old thumper

Good vet :thumb:

 

[Sidditherabbit]

Yeah they've been really lovely.

These are our plan b incase he needs additional help in recovery:

https://www.scottveterinaryclinic.co.uk/rabbits