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RWA conference...we're back...some notes added :)
- Thread starter Santa
- Start date
my vet went to the conference yesterday!! She said they are trailing a new gut stimulant called Motilium and apparently its been really effective. She said next time Noisette has a flare up (fingers cross it won't happen, but likelihood she will) she is going to try it on her!
Domperidone is so new in the UK that even Richard Saunders hasn't used it in rabbits. It has been more commonly used for horses with a similar condition. My exotics vet is using it for Thumper on Richard Saunders' advice. Ranitidine hasn't started his caecum working after 1 month of continuous treatment witth ranitidine /zantac. He was admitted for the 1st. dose to ensure he didn't get nasty neurological side effects.
I am not a vet. I only have long experience of evaluating new drugs for human use. I'd suggest a policy "stick with the devil you know if it works, & only use the new ones if your back is against the wall; or they have a very big advantage.
I'm relieved that my observations on cardboard/ woodpulp craving are correct. May I add that another issue with cardboard paper etc. is that the fiber size is too small to be of much benefit, & more importantly added chemicals (sizing material) make the chewed end product a sticky mush ball which is likely to obstruct. I totally agree with Jane that hay & grass are the 1st. to try, but if your bun still craves fiber, blackberry/bramble leaves (even in cities) are a safe diversion for them. You just need to avoid collecting where there are traffic fumes/weed killers/ & well above dog pooh level.
ETA I checked with an exotics vet that brambles cannot cause any worsening of any bunny GI illness, before recommending them here.
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VikkiVet
Mama Doe
:wave::wave::wave: Notes from the Vet Stream:
Rabbit Anaesthesia: As said before, lots of focus on accurate and timely monitoring, minimising stress before and after surgery and pre-induction oxygenation to make intubation (putting the tube in their throat) easier. She advised ALWAYS intubating and providing IV access before surgery, regardless of the procedure, plus local anaesthetics to reduce pain and encourage eating after surgery. And keeping them warm with various methods, including booties!!!
Rabbits should almost always be on fluids for surgery, mainly to keep gut contents hydrated as they're unlikely to be eating or drinking for several hours. Pre-op 4ml/kg/hr, during surgery 10ml/kg/hr until eating, then back to 4ml. Shock rate is 100ml/kg/hr.
As Alison said, metacam doesnt really touch the sides for any significant pain, so opiates should be used esp buprenorphine as its fairly long lasting in rabbits. Can combine with NSAIDs.
Pre-med: fentanyl, NSAIDs, buprenorphine
Induction: midozalam after fentanyl or metomadine/ketamine/buprenorphne
Brigitte's preferred protocol is hypnorm + hypnovel, isoflo and morphine top-up, and reversed with buprenorphine and sarmazenil (from USA)
- tend to be awake but groggy, but this is good as you dont want them to be excitable, should eat and be coordinated within 30min to 1hr
Endoscopy: main use = oral dental evaluation with magnification
Also to aid intubation, nasal endoscopy with smaller probes, aural imaging, bladder in female rabbits (!!), sinoscopy, diagnostic laproscopy.
Rabbit GI Disease: As previously mentioned, interesting stuff on diagnostics and x-ray signs. Domperidone is particularly good for hindgut movement. Stomach tube to relieve bloat, pineapple/papaya doesnt work as Alison said, and infacol lubricates and hydrates but doesnt relieve gas accumulation, so water or saline would have the same effect. Obstructions can be slid through small intestine into large intestine, where they will pass naturally, so that the gut itself doesnt need to be opened up. With true diarrhoea there are NO NORMAL DROPPINGS, and is mainly a problem of very young animals, and due to E coli, Salmonella or rotavirus. Mucoid enteritis is almost exclusively seen in 4-14 week old kits as they naturally produce more mucus in the colon at this age.
Adrenal Disease: Think the extra stuff we had is kinda too complicated to expand upon on the forum, but is worth considering as a potential cause of significantly increased aggression (to the point of requesting PTS) and/or sexual behaviour in a previously normal animal with no significant environmental changes etc.
Liver Torsion: Lots of details on surgery etc, but again worth considering in rabbits with grumbling repeated bouts of stasis as can be a partial twist that occurs then untwists repeatedly. Also may be a cause of sudden death, so PMs are important when there are no other signs, especially in larger breeds The examples they gave were from a few specific breeders so i suspected a genetic cause, but was to shy to ask about it so glad someone else did!
Therapeutics: The antibiotics bit was most interesting to me - that Baytril has its uses but needs to be dosed appropriately. Some issues with use of fluoroquinolones and Clostridium spiroforme, but need to be EXPOSED to it, not overgrowth, to cause death. For abscesses, some of the old therapies may be better e.g. gentamycin beads, antirobe capsules etc which have gone out of fashion. for syphilis 1 dose subQ of penecillin per week for 4-5 weeks is most effective.
Fenbendazole (panacur): Only thing i can add is that its only effective if the rabbit catches EC while being dosed with panacur. So thats really unlikely. Best recommendation is to dose if suspected clinical signs, otherwise not a lot of use. 28 days is probably too long due to side effects. But there is a new study out soon.
Q&A Session: suspect post-surgery adhesions with grumbling stasis and/or urinary tract issues. Prevent with wet swabs and extensive lavage, very fine non-braided suture material and small needles, verapamil if high risk or suspected.
Amy (friend in final year) and i had a horrible night in Birch Travelodge - despite the outside temperature the heater in the room was on 25!!! We had the window open all night but the travelodge backed onto the lorry park so we were woken up every hour, particularly by a guy delivering newpapers with his stereo on very loud at 6am!!!! But it was worth it, lovely to meet everyone, see you next year!!!
Rabbit Anaesthesia: As said before, lots of focus on accurate and timely monitoring, minimising stress before and after surgery and pre-induction oxygenation to make intubation (putting the tube in their throat) easier. She advised ALWAYS intubating and providing IV access before surgery, regardless of the procedure, plus local anaesthetics to reduce pain and encourage eating after surgery. And keeping them warm with various methods, including booties!!!
Rabbits should almost always be on fluids for surgery, mainly to keep gut contents hydrated as they're unlikely to be eating or drinking for several hours. Pre-op 4ml/kg/hr, during surgery 10ml/kg/hr until eating, then back to 4ml. Shock rate is 100ml/kg/hr.
As Alison said, metacam doesnt really touch the sides for any significant pain, so opiates should be used esp buprenorphine as its fairly long lasting in rabbits. Can combine with NSAIDs.
Pre-med: fentanyl, NSAIDs, buprenorphine
Induction: midozalam after fentanyl or metomadine/ketamine/buprenorphne
Brigitte's preferred protocol is hypnorm + hypnovel, isoflo and morphine top-up, and reversed with buprenorphine and sarmazenil (from USA)
- tend to be awake but groggy, but this is good as you dont want them to be excitable, should eat and be coordinated within 30min to 1hr
Endoscopy: main use = oral dental evaluation with magnification
Also to aid intubation, nasal endoscopy with smaller probes, aural imaging, bladder in female rabbits (!!), sinoscopy, diagnostic laproscopy.
Rabbit GI Disease: As previously mentioned, interesting stuff on diagnostics and x-ray signs. Domperidone is particularly good for hindgut movement. Stomach tube to relieve bloat, pineapple/papaya doesnt work as Alison said, and infacol lubricates and hydrates but doesnt relieve gas accumulation, so water or saline would have the same effect. Obstructions can be slid through small intestine into large intestine, where they will pass naturally, so that the gut itself doesnt need to be opened up. With true diarrhoea there are NO NORMAL DROPPINGS, and is mainly a problem of very young animals, and due to E coli, Salmonella or rotavirus. Mucoid enteritis is almost exclusively seen in 4-14 week old kits as they naturally produce more mucus in the colon at this age.
Adrenal Disease: Think the extra stuff we had is kinda too complicated to expand upon on the forum, but is worth considering as a potential cause of significantly increased aggression (to the point of requesting PTS) and/or sexual behaviour in a previously normal animal with no significant environmental changes etc.
Liver Torsion: Lots of details on surgery etc, but again worth considering in rabbits with grumbling repeated bouts of stasis as can be a partial twist that occurs then untwists repeatedly. Also may be a cause of sudden death, so PMs are important when there are no other signs, especially in larger breeds The examples they gave were from a few specific breeders so i suspected a genetic cause, but was to shy to ask about it
so glad someone else did!Therapeutics: The antibiotics bit was most interesting to me - that Baytril has its uses but needs to be dosed appropriately. Some issues with use of fluoroquinolones and Clostridium spiroforme, but need to be EXPOSED to it, not overgrowth, to cause death. For abscesses, some of the old therapies may be better e.g. gentamycin beads, antirobe capsules etc which have gone out of fashion. for syphilis 1 dose subQ of penecillin per week for 4-5 weeks is most effective.
Fenbendazole (panacur): Only thing i can add is that its only effective if the rabbit catches EC while being dosed with panacur. So thats really unlikely. Best recommendation is to dose if suspected clinical signs, otherwise not a lot of use. 28 days is probably too long due to side effects. But there is a new study out soon.
Q&A Session: suspect post-surgery adhesions with grumbling stasis and/or urinary tract issues. Prevent with wet swabs and extensive lavage, very fine non-braided suture material and small needles, verapamil if high risk or suspected.
Amy (friend in final year) and i had a horrible night in Birch Travelodge - despite the outside temperature the heater in the room was on 25!!! We had the window open all night but the travelodge backed onto the lorry park so we were woken up every hour, particularly by a guy delivering newpapers with his stereo on very loud at 6am!!!! But it was worth it, lovely to meet everyone, see you next year!!!
Jack's-Jane
Wise Old Thumper
How do you intubate a Rabbit that is having a Dental :?
prettylupin
Wise Old Thumper
At the risk of disagreeing with an exotic expert
I don't agree with this, from my own personal experience of its use alone which admittedly is limited to one rabbit but a rabbit I know inside out. I would be interested to know if this statement is based on randomised controlled trials or from anecedotal evidence in clinic alone. I may have a completely unique experience of its beneficial effects but the use of simeticone has been invaluable when our bun has had his acute bloating episodes. I do not dispute for a minute the grave importance of immediate pain and fluid relief and our bun always receives these first, incl opiate pain relief, non-steroidals rarely control his abdominal pain, but I am 100% confident that what I observe in my rabbit within a short-time of administering simeticone is directly related to its cohesive action on gas bubbles in the stomach and throughout the gut to make the gas easier to pass the only way it come can out - the far end. That's not to say it works in isolation for us, it does not, and without the interactions and cummulative effects of all necessary supportive therapy... pain relief, fluids (oral and sub-cut), prokinetic drugs and syringe food, but it certainly shifts the gas in my bun in waves within a certain length of time of administering, depending on where the gas is. It works best for us on gas in the stomach however.
It is because when my bun is in a stupor following opiates and in pain from distension, he lies across my lap for hours at a time whilst the opiates wear off to keep his body heat up, he does not tolerate them well at all. At these times he is receiving intensive care from me, he is hydrated extensively and has had his prokinetic drugs, but there are long-periods of no bowel sounds nor waves of peristalsis visible. As soon as we adminster simeticone (hourly in his acute phase) often within 10-15 mins the gas gurgles start up - loud gurgles, and the gas begins to move in a wave. I can see it, feel it and hear it, and my stupified bun suddenly lifts his head and then does a big sigh as the temporary relief comes of relieving some gas and distension. This is repeated every time we use it, nothing else has been administered at that moment and this is not just one experience but since winter my bun has bloated almost weekly until we found the source of his pain, and each time in the acute phase this is the result we got from simeticone. Anecodotal indeed, but I do wonder what rabbit admitted in clinic is held in a silent room across a lap for 3-4 hours at a time to have a similar experience. Like i say, this is only my experience, but I felt it was a shame for simeticone to be disregarded certainly from my point of view, and because it is chemically inert and there is no harm in its administration provided the owner gets the other immediate treatment necessary from a vet or through admittance I personally feel its use is justified, even at the outside chance other buns may benefit as we do here.
parsnipbun
Wise Old Thumper
I agree absolutely with Pretty Lupin from the same experiences with several rabbits.
Although gaseous distension has not been a major issue with us, I agree with parsnipbun & pretty lupin on the matter of simenthicone. I have always given it when my bun is in ileus.
The reason for so doing is to prevent gas produced by fermentation of static gut contents from forming foam. The foam is very difficult to propel forwards to the anus, whereas free gas passes much more easily. I understand from veterinary literature, that foam can trap in a bowel loop & behave like a solid obstruction. This does not happen if the foam can be converted to free gas.
I have never been under the misconception that rabbits can burp up gas - they can't. My rationale has always been to facilitate it's rapid passage to the anus. Obviously some intestinal motility is necessary for this.
ETA I have wondered whether when a gastric tube is passed for bloat as a penultimate resort, simethicone could be likewise used, & the bunny so positioned to allow the pocket of free gas to form at a suitable place, so the tube can be directed into it. I am told of the technical difficulty of removing foam & ingesta through what has to be a very small tube. Similar use of position MAY in theory even help free gas to move onward through the pylorus, providing that there is no physical obstruction.
The reason for so doing is to prevent gas produced by fermentation of static gut contents from forming foam. The foam is very difficult to propel forwards to the anus, whereas free gas passes much more easily. I understand from veterinary literature, that foam can trap in a bowel loop & behave like a solid obstruction. This does not happen if the foam can be converted to free gas.
I have never been under the misconception that rabbits can burp up gas - they can't. My rationale has always been to facilitate it's rapid passage to the anus. Obviously some intestinal motility is necessary for this.
ETA I have wondered whether when a gastric tube is passed for bloat as a penultimate resort, simethicone could be likewise used, & the bunny so positioned to allow the pocket of free gas to form at a suitable place, so the tube can be directed into it. I am told of the technical difficulty of removing foam & ingesta through what has to be a very small tube. Similar use of position MAY in theory even help free gas to move onward through the pylorus, providing that there is no physical obstruction.
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abbymarysmokey
Wise Old Thumper
Ditto what others have said about stasis...I think all the info given has been known for quite a while.
I use infacol/simethicone and will continue to do so. If it doesn't cause harm, and might actually help, then it can't be a pointless thing to try.
Also the bit about not giving antibiotics for stasis...My vet gives antibiotics if there is a mass of impacted food in the stomach/intestines...the thinking behind this is that a mass of decaying food *might* cause infection of the GI tract...Anyone else got any opinions on this?
I use infacol/simethicone and will continue to do so. If it doesn't cause harm, and might actually help, then it can't be a pointless thing to try.
Also the bit about not giving antibiotics for stasis...My vet gives antibiotics if there is a mass of impacted food in the stomach/intestines...the thinking behind this is that a mass of decaying food *might* cause infection of the GI tract...Anyone else got any opinions on this?
prettylupin
Wise Old Thumper
I think the risks are minimum as I would assume that gastric acidity in buns to be high enough to neutralise common bacteria in the stomach from food ingested. Our vets have never once prescribed cautionary antibiotics for stasis or bloat unless there is a known infective agent at play... i.e the stasis is the result of an infection somwhere, but as this has not been the case for us we have never had antibiotics prescribed and I would have something to say if they did!
:lol:Jack's-Jane
Wise Old Thumper
I would say that the use of abx or not is something the Vet would consider on a case by case basis ie never say 'never'.
giantbunnymummy
Warren Veteran
All very interesting, thanks for all the notes I'm certainly going to copy them for future reference.
I look forward to updates on the panacur question once the research is published - to panacur or not certainly seems to be the most common source of confusion whenever the question is asked on here.
I'm certainly going to copy them for future reference. I look forward to updates on the panacur question once the research is published - to panacur or not certainly seems to be the most common source of confusion whenever the question is asked on here.