Rabbits diagnosed with full stasis-experience with enema asked...

[Clicquot]

He is called Hypoliet...

Don't know about Pyloric Stenosis...will ask ,but think vet would have noticed that on x-rays.

 

[Martine]

I send lots of vibes I hope they can relieve him, maybe in needs hospitalisation, so he can have all the injections and immediate attention in case of major problems, it's what I did for Chloé, and I felt more secured of her being there.. as she gots IV, rehydratation etc...

 

[Clicquot]

He just accepted a bit of parselie....I guess that's good, but still no pooing...

Hospitalisation would not be a good idea I think, he is taken better care of by his owner who will keep awake at night and monitor him... She's a vet student ,so knows how to give IV etc...

About Pyloric Stenosis, Esther said that this occurs mostly as a birth deffekt, not in later life ,with the exeption in case of an ulcer. But the pyloric looked ok on x-ray anyway.

 

[Maizey]

I think you are right.Its best for Hypoliet to be around his mummy who he trusts and loves.I really hope he comes through this.Still sending love and massive recovery vibes xxxxxxxxxxxxxx

 

[Martine]

you are lucky to have a vet student in that case..

so what does Esther think it could be ? any clue ?

 

[Jack's-Jane]

He just accepted a bit of parselie....I guess that's good, but still no pooing...

Hospitalisation would not be a good idea I think, he is taken better care of by his owner who will keep awake at night and monitor him... She's a vet student ,so knows how to give IV etc...

About Pyloric Stenosis, Esther said that this occurs mostly as a birth deffekt, not in later life ,with the exeption in case of an ulcer. But the pyloric looked ok on x-ray anyway.

What about giving an H2 receptor antagonist such as ranitidine or cimetidine?

 

[the bunny girl]

Sounds like a Pyloric stenosis then

http://homepage.mac.com/mattocks/morfz/pyloric.html

I have read that link and found some scarey but useful info on there thanks x

 

[Clicquot]

What about giving an H2 receptor antagonist such as ranitidine or cimetidine?

You mean to threat a potential ulcer? mmm... don't even know of the use in those in rabbits...
Esther agrees with vet...compleet stasis due to moulting...I think lots of bunnies are feeling a bit down now... had some minor problems with my pair as well the last few weeks, but nothing that a good massage didn't solve...

Complete stasis like this is much more rare , personally this is the first time I hear about a rabbit still eating ,but not pooing...

This evening he started eating again by the way, had quite some vegetables and hay, but still no pooing...

 

[Jack's-Jane]

You mean to threat a potential ulcer? mmm... don't even know of the use in those in rabbits...
Esther agrees with vet...compleet stasis due to moulting...I think lots of bunnies are feeling a bit down now... had some minor problems with my pair as well the last few weeks, but nothing that a good massage didn't solve...

Complete stasis like this is much more rare , personally this is the first time I hear about a rabbit still eating ,but not pooing...

This evening he started eating again by the way, had quite some vegetables and hay, but still no pooing...

I have seen great results with the use of Ranitidine. Aswell as being an anti GI ulcer med it has the beneficial side effect of increasing the rate of gastric emptying. I now always use Ranitidine as part of the treatment of GI stasis (after consulting my Vet of course !!)

I do hope things improve for this little Bun soon.

xx

 

[Clicquot]

ok, will tell her to try and get hold of vet...and do some research
Thanks Jane!

 

[Clicquot]

Minor good news...he just had 2 very small poos after massage!!!
But still no bowel-movement...

 

[Clicquot]

Jane, about the Ranitidine:

Esther said she never heard about the use of it in rabbits with stasis either ,but she says this is a histamine that diminishes the acid secretion of the stumach. With a full stumach like Hypoliet has now, you don't want that because this would create the ideal envirroment for all kinds of bacteries to get the upperhand....

 

[Jack's-Jane]

Jane, about the Ranitidine:

Esther said she never heard about the use of it in rabbits with stasis either ,but she says this is a histamine that diminishes the acid secretion of the stumach. With a full stumach like Hypoliet has now, you don't want that because this would create the ideal envirroment for all kinds of bacteries to get the upperhand....

Fare enough, but as I have said it has literally saved the life of some of my Rabbits including one with a Pyloric Stenosis.

Supportive Care of the Rabbit: Keeping the Patient Alive

S. Redrobe
Bristol Zoo & University of Bristol, UK.

Rabbits do not necessarily get sick and die faster than other species; but because they are prey species and so behave differently to the common pet "predator" species (dogs and cats) vets and owners often ignore the warning signs. Recognising how sick the rabbit is gives the clinician and owner a better understanding of how to manage the patient and is a very important step. Aggressive management is often the only way to succeed and this will include all of the following; fluid therapy, nutritional support, pain management, gastrointestinal tract motility agents and a stress free environment.

Aggressive medical management is required to prevent further deterioration and death in any sick rabbit. Nearly 10% of fundic ulcers were found to be associated with anorexia or caecal impaction, in a survey of gastric ulceration in the rabbit [1]. Hepatic lipidosis is a common complication and cause of death in rabbits, with prolonged gastric stasis and ileus. Rehydration, of both the patient and stomach contents, with both oral and intravenous fluids may be required depending on the severity of the case, 100ml/kg/day is the maintenance volume in the rabbit. Analgesics, such as buprenorphine (0.01 - 0.05 mg/kg, subcutaneously, every 6 - 8 hours) or butorphanol (0.1 - 0.5mg/kg subcutaneously or intravenously, every 2 - 4 hours), in the first instance, and then once rehydrated, non steroidal anti-inflammatory drugs e.g., meloxicam (0.1 - 0.6mg/kg subcutaneously or per os, every 24 hours) or carprofen (2 - 4mg/kg subcutaneously, intravenously or per os, every 24 hours) are also appropriate. Prokinetics are required to stimulate gastrointestinal tract motility. Metoclopramide (0.5mg/kg per os or subcutaneously every 8 - 24 hours), is a dopamine antagonist having both central (antiemetic and depressant) and peripheral (prokinetic) effects. The prokinetic effects of metoclopramide are not as potent as cisapride and are limited to the proximal gastrointestinal tract. Ranitidine has prokinetic effects equal to cisapride and its antacid actions makes ranitidine (2 - 5mg/kg per os every 12 - 24 hours) a very useful drug in the treatment of gastric stasis and ileus. Dimethicone (20 - 40mg/kg per os every 6 hours) may be useful if a large amount of gas is present. Exercise will also stimulate gastrointestinal tract motility and should be encouraged.

Nutritional support to reverse energy balance and stimulate motility can be achieved by syringe feeding commercially available high fiber recovery diets e.g., Critical Care for Herbivores (Oxbow Petlife International Ltd., Bury St. Edmunds, Suffolk, UK), ground up rabbit pellets or pureed vegetables and grass, four-five times a day. A wide variety of fresh vegetation should be offered daily, to encourage the rabbit to eat. Nasogastric tubes are easily placed in a conscious calm or weak rabbit, in a similar manner to that used in a cat. Alternatively an esophagostomy tube can be placed [4]. Radiography is always recommended to ensure the tube is in the correct position. Some rabbits will tolerate the tube without an Elizabethan collar, which will enable eating, caecotrophy and is less stressful. Blended and strained food can then be fed; flushing with 5ml of water before and after feeding will keep the tube patent. Nasogastric tubes can be left in place for several days. Antibiotic therapy such as enrofloxacin (25mg/kg subcutaneously, every 24 hours) is advisable to help prevent rhinitis, which may develop if nasal tissue was traumatized.

Therapy for gastric ulcerations specifically depends on the severity of the ulceration and whether the underlying cause is detected. Rabbits with perforation and peritonitis have a very grave prognosis. Symptomatic or prophylactic treatment could be considered in higher risk cases such as females in late gestation, rabbits with anorexia, enteritis or chronic disease. This would include decreasing acid production, protecting ulcerated mucosa, fluid therapy, analgesia, antibiosis and supportive nutrition. Sucralfate (25mg/kg per os every 8 - 12 hours) either a crushed tablet slurry or viscous gel has been shown to bind to pepsin substrates in tissues resulting in very effective prevention of experimental induced peptic esophagitis in rabbits and may be effective in treating gastric ulceration.

 

[Clicquot]

Thanks Jane, will pass this along, don't know wether she knows this article or the author.
I think it is highly usefull to discuss these things, since we can all and allways learn more!!! We don't always need to agree on everything, we can learn a lot by discussing things like this even by just motivating why not or why to use something!

Luckily I never lost a rabbit by stasis... so my personal experience is not that big... I always have been able to solve problems with massages, fluids and painmedication... I think even that mecanical stimulation was wath got things moving again in my case.... so I am a big supporter of masages and think they can prevent the rabbit getting worse...

 

[Clicquot]

@Jane, just information that I got from Esther on the article you posted.

She agrees with the article but...she says this from experience, reading and hearing stories:
In a stumach wich is filled with food, the danger is that these kind of medicines will cause such severe contractions that the food will be pushed trhough the very narrow pylorus, causing rupture. The vets who have seen this is rabbits now don't use any kind of gut-stimulating drug anymore when there is food in the stumach.
Furthermore there is the danger of excessive growth of pathogenic bacteries that can cause ulcers, blood-intoxication ,toxicosis, etc...

If there is a blockage in the intestin and the stumach is empty, no problem giving ranitidine and it is good to give it in that case . It will protect the stumach against acids en the painkillers you would be administering at the same time.



Hypoliet is still not pooing...
We are thinking about Enema... but if this helpt is would only help for lower part... could help because lower part is most dehydrated I think...but am still discussing it wit Esther...
Has anyone here has any experience with enema? Doen it themselves or seen it donè? Or know about a rabbit who got better/worse because of it?

 

[Jack's-Jane]

Thankfully none of my Rabbits have needed the proceedure.
It is certainly only a job for a skilled Vet as perforation of the bowel could occur if done incorrectly

This is a quote from Dana Krempels on the All Experts Site:

A very *cautious and gentle* shallow enema can also really get things moving, but this should NOT be done by anyone inexperienced with rabbit enemas, and NEVER NEVER with a French catheter or anything that will go deeper than about 1/2" into the rectum.

 

[Clicquot]

A small change...4 little and very hard poo's this morning and his tummy is making some noises, but not always... offcourse he is in pain now...poor thing...

She called her vet again this morning...he said to wait untill friday, just continue with cisaral... was againts iv-fluids...
Sometimes I really don't understand vets... I mean this rabbit hasn't pood properly (only 8) since wednesday... how would he think that he could poo when she wouldn't have hydrated him????
The biggest problem with compleet stasis is the deshydration of the intestin... we all know how much it hurts when we can't go to the toilet for a few days...imagine what that would do to a bun...

 

[Jack's-Jane]

A small change...4 little and very hard poo's this morning and his tummy is making some noises, but not always... offcourse he is in pain now...poor thing...

She called her vet again this morning...he said to wait untill friday, just continue with cisaral... was againts iv-fluids...
Sometimes I really don't understand vets... I mean this rabbit hasn't pood properly (only 8) since wednesday... how would he think that he could poo when she wouldn't have hydrated him????
The biggest problem with compleet stasis is the deshydration of the intestin... we all know how much it hurts when we can't go to the toilet for a few days...imagine what that would do to a bun...

Can't she consult a different Vet
I certainly would

 

[Clicquot]

You know what's funny Jane... this is a different vet...and one that has oxbow-hay and pellets imported from the US... one who goes to ALL lectures about rabbit-medicine in the Benelux...we thought after the first visit that we actually discovered a real good vet for rabbits in the Antwerp region.....

The whole story of this girl and her rabbits is incredible...she came on our forum (dutch) after seeing 2 different vets woth her 3-month old rabbits... they both had regular soft poo... we advised her to again another vet and ask for test on coc...so she did... and got back with a diagnose that was so strange to me... so I gave her the adres of my old vet in Belgium and she drove an hour to go see them... coc was comnfirmed, rabbits threated, all well....

She then changed her initial choice and chose to start veterinairy science...

A while afterwards...time for first vaccin...Hypoliet develops myx as a reaction on the vaccin....4 weeks of intensive care and he was ok...

A fex months afterwards....Eufrasie, his friend, gets regular stasis...again multiple vet-visits... finally discovered that she had some neurological symptoms....EC...

And now....a few months all well and Hypoliet got complete stasis...

These were her first buns!!!

 

[Clicquot]

Good news...after 9 days...Hypoliet is pooing again!!!!:wave: