Please Note - Medical Advice
Please keep in mind that posts on this forum are from members of the public sharing personal opinions. It is not a replacement for qualified medical advice from a veterinarian. Many illnesses share similar symptoms but require different treatments. A medical exam is necessary for an accurate diagnosis, without which appropriate treatment cannot be given.
You should always consult your vet before following any suggestions for medication or treatment you have read about. The wrong treatment could make your rabbit worse or mean your vet is unable to give the correct treatment because of drug interactions. Even non prescription drugs can do harm if given inappropriately.
We are very grateful to members who take time to answer other members questions, but please do be clear in your replies that you are sharing personal experience and not giving instructions on what must be done.
Urgent Medical Advice: If you need, or think you might need, urgent medical advice you should contact a vet. If it is out of working hours phone your vet's normal number and there should be an answer phone message with instructions on what to do.
Did the Vet not give him any fluids under his skin or suggest he was admitted for IV fluids and medicating ?
If you don’t already do so offer him water from a bowl. Some Sick Rabbits are more likely to drink slightly warm water or water with a dash of unsweetened fruit juice in it.
I would aim to feed him every 4 hours with as much as you can get into him, or more often if you feel you can - but you also need sleep to get through the day shifts. The more he eats, the better he should feel, so it's a vicious circle at the moment. An empty gut isn't good, but you have to balance what you can get down him without stressing him too much or causing him to inhale instead of swallow it. Putting the syringe in the side of the mouth is better than aiming for the front as you are getting food in his mouth without forcing it down his throat. I also try to give meds about half an hour before food. That way, pain relief has had time to start working and you know the meds have gone in, rather than being spat out with food.
Trying to eat grass and producing some poo is a good sign.
I tend to make up a full day's worth of critical care in a small jar so I know how much I should be feeding overall, rather than making up small amounts at a time as you can lose track (especially when you are tired and worried). Keep it in the fridge and add a bit of hot water to the portion you are feeding to warm it through. It also thickens as it stands, so probably needs thinning a bit more as you use it. I always aim for at least 20ml of food per session, more if they will take it (mine are generally smaller bunnies up to 2kg).
Guidance on feeding rate for Critical Care:
http://www.oxbowanimalhealth.com/vet.../critical_care
It says to give 3 tablespoons powder / kg body weight daily. 1 tablespoon = 3 teaspoons = 9g.
I'm really sorry Ian is so poorly. You've had some really good advice already but I just wanted to give my input on what I'd do in your situation.
I'd follow the feeding regime Shimmer has suggested. It's frequent enough to keep the gut moving but it allows them a sufficient break in between. Try and time the CC feeds so you're doing it at the same time you're giving medicine, and that way you won't need to handle him more than necessary. I'd also syringe feed some water at the same time.
As Jane mentioned, the vetergesic will have had a marked sedative effect. Bunnies on vetergesic are so "flat" that it looks like they've given up. You probably won't get a true idea of how he's really feeling until it's out of their system. I think they say it should only take about 8 hours. However for one of my bunnies it can take as long as 72 hours.
Finally, I think you still have another throw of the dice when it comes to treatment. As mentioned above, injectable penicillin is a very effective antibiotic. Before making a decision to PTS, I would ask the vet if you can try it for a week first. I'd also ask for the highest dose of metacam for his weight so he has adequate analgesic cover. Often that in itself can be enough to trigger a significant turnaround. The advantage of metacam is that, unlike vetergesic, it doesn't have a sedative effect.
Good luck. I really hope that Ian is able to turn the corner.
What is his urine output like ? Colour and quantity ?
You mentioned the Vet noticed a smell coming from his mouth. Can you smell anything that resembles the smell of Pear Drops. From his mouth or from him in general ?
Has the Vet taken a blood test to check his renal function ?
If there has been no improvement at all over night I would contact a Vet today as IMO he needs to be on IV fluids as a supportive measure. Also, antibiotics given by injection are less likely to cause GI tract upset. Oral antibiotics can cause anorexia, which is obviously not helpful if the Rabbit is already reluctant to eat.
The vetergesic will be making him really dopey and not interested in much.
Stasis episodes can last for a week or two, IME, and you should always keep going with gut meds until they are definitely eating and pooing normally for a couple of days. I always find that stopping too early is counter productive. If they are not eating by themselves, then you must supplement with syringe feeding. Rabbits can't go without eating as some of the effects are irreversible. So keep going with the syringe feeding. Hopefully he will eat a little more by himself today - a bit of banana, grass and lettuce is a start. Lettuce has lots of water in it, which could be helpful at the moment, although he need more fibre for bulk to keep his guts working.
If I can get him to tomorrow I will ask my vet about the penecillin as well, thank you all <3
I would ask about reducing / removing the vetergesic and upping the metacam to maximum dose (twice a day) for a few days to see if that makes a difference. If recent blood results were Ok, there shouldn't be an issue. He will also be less dopey and may be more inclined to more normal behaviour. He also likes metacam. If it's that or consider PTS, I would be pushing for at least a trial week, and review after a few more days to see if it's working. It's still early days for the antibiotics and stasis, and he's feisty not 'flat', so hasn't given up - just needs some support for a while, then reassess his teeth, etc when he is brighter. And you are doing a good job with the nursing, which is an important factor.
I suspect the vet will want to continue with the course of antibiotics that he's already on, as that's standard practice - but there's no harm in asking about other options as well.
If you don't get an appointment tomorrow, you could talk to the vet on the phone about drug regieme changes (for pain relief).
I would resist any GA / sedation for a couple of weeks if possible (eg for X-rays) - he's had to go through a lot recently and needs to be well on his way back to normal before he goes through that again, unless it's an emergency, as it's likely to knock him back again.
My dental bun didn't do well after vetergesic, it wiped her out for days, and took ages to get her to anything like normal, however I was never given vetergesic to administer at home. As others have said, as Ian is not flat, that is in itself a good sign. I appreciate how stressful this is for you, but you are doing a great job, and I'm sure Ian knows you are trying to help him. Lots of us have been in this position, so can empathise with you. Big hug xx