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Libby's chronic gut issues

nicki

Warren Scout
Hi everyone,

I have decided to start a new thread as the title of the last one doesn't really reflect her problems.
Libby, my lovely 7 year old wonderful bun, has been ill for a month.

It started with spot weeing and being wet underneath but developed into straining and pain when producing poos.

Libby has had ultrasound, x-rays and full blood/urine profile and all came back clear.


However both her gut issues and the wetness have not improved.

Her gut is like an engine that starts and stops and is only working because of the medication - high dose Metacam split over day, ranitidine and Metoclopramide and regular critical care. She goes between being bright, eating well and pain free and then plummets into pain and eating/gut slow down particularly in the early evening - so everyday I feel I am holding off stasis just. it seems to me that her pain comes on immediately after eating as things are moving through her stomach?

My vet is considering Cisapride and getting back to me re a referral for a second opinion.

If anyone has any further suggestions I would appreciate it as although Libby is having good spells - she is struggling.

Thanks,

Nicki:cry:
 
Hi Nicki,
My rabbit struggled with GI issues until we had a referral with an exotic specialist (Molly Varga). She carried out a full body scan (wasn't MRI but similar) and was able to identify which part of the gut was problematic. This meant that she could prescribe the most appropriate medication (Cisapride). Since then he has occasional bouts of GI stasis but we're able to treat with Cisapride (following vet exam) and he returns to his usual self in a matter of hours.
Until he had cisapride he was having other pro-kinetics/ gut stimulants but they weren't as effective as the Cisapride.
He's diet is also restricted - no pellets, lots of hay, dried herbs, dried leaves (blackcurrant leaves, raspberry leaves, dandelions), apple branches, small quantities of fresh lavender, fresh thyme and the occasional treat of dried chicory root. This seems to have helped too.
I hope that you can get a referral, it really made a difference for us. Up until that point it was getting stressful not being able to help my rabbitty friend when he was struggling,
 
Thanks Sarah,

That's really helpful thank you.

Libby's diet is similar to what you have described - she is currently having a few profibre pellets but might be good to cut those out too.

I have a follow up appointment with my vet and have left a message re: referral and Cisapride as it is really hard going for her.


I have also just noticed some scalding/exposed skin because of the constant wetness and have cleaned and applied Vaseline but any other suggestions would be great.


Thanks so much,
Nicki
 
Hi everyone,

I have decided to start a new thread as the title of the last one doesn't really reflect her problems.
Libby, my lovely 7 year old wonderful bun, has been ill for a month.

It started with spot weeing and being wet underneath but developed into straining and pain when producing poos.

Libby has had ultrasound, x-rays and full blood/urine profile and all came back clear.


However both her gut issues and the wetness have not improved.

Her gut is like an engine that starts and stops and is only working because of the medication - high dose Metacam split over day, ranitidine and Metoclopramide and regular critical care. She goes between being bright, eating well and pain free and then plummets into pain and eating/gut slow down particularly in the early evening - so everyday I feel I am holding off stasis just. it seems to me that her pain comes on immediately after eating as things are moving through her stomach?

My vet is considering Cisapride and getting back to me re a referral for a second opinion.

If anyone has any further suggestions I would appreciate it as although Libby is having good spells - she is struggling.

Thanks,

Nicki:cry:

Has the Vet mentioned that the problem could be related to the motility of a specific part of the GI tract- the cecum ?

As Sarah has said, a referral to an Exotics Specialist could be helpful as he/she may be able to pinpoint the precise location of the GI tract problem.

In the meantime these links may be useful to have a read through


http://anyflip.com/dvpt/hzvv

http://wildpro.twycrosszoo.org/S/00dis/Miscellaneous/Caecal_Impaction.htm

https://pdfs.semanticscholar.org/ac07/9915d6e64fe1afe442204871cb21c282f31b.pdf

https://rabbitwelfare.co.uk/wp-content/uploads/2013/05/article-ROWinter10p7.pdf

http://www.medirabbit.com/EN/GI_diseases/drop/Drp_en.htm

http://www.medirabbit.com/EN/GI_diseases/GI_diseases_main.htm

http://www.ivis.org/proceedings/wsava/2008/lecture10/70.pdf?LA=1

Some info re Cisapride

http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Cisapride.htm


This thread is exceptionally long, but take a look at post 1476 if nothing else

http://forums.rabbitrehome.org.uk/s...ing-as-dysautonomia/page148&highlight=thumper
 
Hi Jane,

Thanks for the helpful links, which I have had a good look at.
Yes the cecum has been mentioned.
I will definitely pursue a referral when I see the vet on Monday.
My vet has been good and suggested a second opinion himself.
Libby is having a good spell this morning - it's easier when I'm at home at the weekend as I can keep up regular eating and spread the medicine out more efficiently over the day - 5-8pm is her worst time for pain as her appetite increases again.

Kind regards,
Nicki
 
We have not had a good last 12 hours,

Libby was seen at the local veterinary hospital yesterday by our usual vet.
She was prescribed Cisapride. I don't know if it is coincidental or not but within 30 minutes of taking it this morning - she has one eye half closed, a little blood shot and watery and appeared a bit dazed.
She is eating and producing small poos at the moment.
I am going to take her back into the vet shortly.


We are also bathing and treating her sore tail with hibiscrub and Dermisol from urine scald.
Her weight is down due to the ongoing GI issues - I am using a combination of critical care and pureed apple/banana which she eats from a bowl or spoon.
She is still on metoclopramide and ranitidine and we are trying to ween her off the Metacam.


I wonder if anyone has experience of side effects from Cisapride?

Vet is going to refer her to a specialist.

She definitely has pain after eating - wonder about gastric ulcer?


Very worried this morning,
Nickix
 
I've no experience I'm afraid, just wanted to say I really hope the vets can find the cause of Libby's discomfort. Sending loads of vibes for your bun xxx
 
We have not had a good last 12 hours,

Libby was seen at the local veterinary hospital yesterday by our usual vet.
She was prescribed Cisapride. I don't know if it is coincidental or not but within 30 minutes of taking it this morning - she has one eye half closed, a little blood shot and watery and appeared a bit dazed.
She is eating and producing small poos at the moment.
I am going to take her back into the vet shortly.


We are also bathing and treating her sore tail with hibiscrub and Dermisol from urine scald.
Her weight is down due to the ongoing GI issues - I am using a combination of critical care and pureed apple/banana which she eats from a bowl or spoon.
She is still on metoclopramide and ranitidine and we are trying to ween her off the Metacam.


I wonder if anyone has experience of side effects from Cisapride?

Vet is going to refer her to a specialist.

She definitely has pain after eating - wonder about gastric ulcer?


Very worried this morning,
Nickix


Hi Nicki

I am sorry to hear about Libby. You must be very worried about her.
I think the eye issue is probably separate to the gastro-intestinal issues but could indicate a weakened immune system.

Here is some info on Cisapride and it's side effects:

https://cdn.ymaws.com/www.aavpt.org/resource/resmgr/imported/cisapride.pdf

http://www.medirabbit.com/Safe_medication/GI_stimulation/cisapride.htm

If she is taking Ranitidine regularly, then the chances of a gastric ulcer are definitely much lower


I expect you've seen the vet already today? Did they comment on what the eye problem could be?
I am glad you will be taking Libby to see a specialist.
Did they say how long the referral would take?

Vibes for Libby and Hugs for you xx
 
Hi Mighty Max,

Libby was seen as an emergency by a specialist at the Royal Veterinary College in London on Tuesday. It was a bit of a trek in the snow with 2 bunnies in the back but worth it - I hope.

The vet seemed extremely knowledgeable.

She straight away diagnosed Libby with an ulcerated cornea using a special fluorescein which was missed earlier in the day.

She also felt that Libby's bladder was very inflamed and painful.

After watching her move on the floor, she said that she definitely also has arthritis which can affect bladder emptying.


Libby had a test for ECuniculi antibodies and we will get the results back in 10 days.


Libby is now on Gabapentin and Metacam for all her different pain and Cisapride, metoclopramide and ranitidine for her gut.


I really felt I was going to lose her earlier in the week. It is still a rollercoaster with her gut pain and eating but she is having some good spells.
It's so much harder the days that I am at work and can't spread out the medicine and food intake!


Thanks for your support,

Nicki
 
Hi Mighty Max,

Libby was seen as an emergency by a specialist at the Royal Veterinary College in London on Tuesday. It was a bit of a trek in the snow with 2 bunnies in the back but worth it - I hope.

The vet seemed extremely knowledgeable.

She straight away diagnosed Libby with an ulcerated cornea using a special fluorescein which was missed earlier in the day.

She also felt that Libby's bladder was very inflamed and painful.

After watching her move on the floor, she said that she definitely also has arthritis which can affect bladder emptying.


Libby had a test for ECuniculi antibodies and we will get the results back in 10 days.


Libby is now on Gabapentin and Metacam for all her different pain and Cisapride, metoclopramide and ranitidine for her gut.


I really felt I was going to lose her earlier in the week. It is still a rollercoaster with her gut pain and eating but she is having some good spells.
It's so much harder the days that I am at work and can't spread out the medicine and food intake!


Thanks for your support,

Nicki


Aww Nicki you've all be through a lot since Tuesday!

I am glad she had a good assessment though, that must have felt worth it.
The snow was a bit random on Tuesday - I was out in it and had to be very careful. Heaven knows how you managed that with two buns in tow.

I hope those meds make her feel a lot more comfortable. That's the most any of us can do - enhance the quality of life of our lovely friends for as long as possible x
 
Thanks Mighty Max,

Do you know much about Gabapentin?

I'm not sure if it is slowing her gut and level of movement down more or not - she is on such a lot of medicine it is hard to know?

Nicki
 
Update EC Infection

Hi,

It's a mixed picture.

I have confirmation from the specialist from the royal veterinary college in London that Libby has an active EC infection. She tested positive for antibodies which show that she is beyond the first 35 days of the infection (IMDG?) I think. She has advised to treat both bunnies with Panaure puppy and kitten wormer as the dosage is lower and it is easier to administer. It is obviously upsetting the Oliver has been exposed to it too.

The specialist feels that the EC may not be the primary cause of Libby's illness but could have flared up as a result of something else going on/gut related possibly. She said that EC takes advantage of other problems.


On a more positive note, I lowered the Gabapentin dose last week and it seems to be working well in conjunction with the Cisapride, ranitidine and Metacam. Libby is much happier, with a reduction in pain levels and is eating well and her poos are looking much better. It has been great to see a bit of her sparky personality back. Her eye looks much better and she is urinating comfortably.


If she does not respond to the Panacur in two weeks and still needs meds to keep her gut working and control her pain, then the specialist has suggested that the next step would be scanning her gut to look for the problem.

I am very cautious about Libby's recovery but will just take her feeling better in herself for now. She is all cosy in her warm shed lying with her paws on a snuggle safe with Oliver and eating loads of Apple and Banana critical care from her spoon!


Any helpful experience would be appreciated.

Nicki
 
Panaure

Hello,

Libby has been on Panaure (Panacur) liquid for EC since Wednesday as advised rather than the paste which she is happy to take.
She is obviously on a lot of other medication - Metacam, Gabapentin, Cisapride and ranitidine.

However, since she started the Panaure - we seem to have more issues with softer droppings and a bit of diarrhoea. Her appetite is good on the whole.
She had put on a bit of weight last week but has dropped a little again this week.
The vet advised lowering the ranitidine slightly.

She is currently eating a few mature pellets, regular critical care, forage - blackcurrant leaves, plantain, dandelion, chicory root and a little parsley, basil etc.
I am putting Avipro in the water which she loves.
Doing my best to keep her comfortable

I am just wondering about topping up with a few porridge oats but am cautious due to her significant gut issues?

Nicki
 
Hello,

Libby has been on Panaure (Panacur) liquid for EC since Wednesday as advised rather than the paste which she is happy to take.
She is obviously on a lot of other medication - Metacam, Gabapentin, Cisapride and ranitidine.

However, since she started the Panaure - we seem to have more issues with softer droppings and a bit of diarrhoea. Her appetite is good on the whole.
She had put on a bit of weight last week but has dropped a little again this week.
The vet advised lowering the ranitidine slightly.

She is currently eating a few mature pellets, regular critical care, forage - blackcurrant leaves, plantain, dandelion, chicory root and a little parsley, basil etc.
I am putting Avipro in the water which she loves.
Doing my best to keep her comfortable

I am just wondering about topping up with a few porridge oats but am cautious due to her significant gut issues?

Nicki

Personally I would try increasing her protein intake rather than carbs (porridge oats). Increasing carbohydrates can make 'soft poo problems' a lot worse. Sugars/starches in a Rabbit's diet are probably not 'dangerous' as such, but for many Rabbits carbohydrate overload = soft poo

https://www.harcourt-brown.co.uk/ar...are-sugars-and-starches-dangerous-for-rabbits

Increasing Libby's protein intake could be achieved by changing her from a 'Mature Rabbit' pellet feed to one made to suit Baby/growing/lactating Rabbits. Is she eating any type of hay ? Dried grass such has Readigrass has a high protein content, but it wont be much good if she will not/cannot eat it.
 
Thanks Jane for replying,


That was my caution - increasing carbs could make matters worse.


She is eating Ings/Timothy hay and I got some Readigrass yesterday remembering that it was high in protein.
Changing her mature pellets to more protein based ones for junior/growing rabbits sounds like a good idea also and I could try that gradually.

Best wishes,
Nicki
 
Thanks Jane for replying,


That was my caution - increasing carbs could make matters worse.


She is eating Ings/Timothy hay and I got some Readigrass yesterday remembering that it was high in protein.
Changing her mature pellets to more protein based ones for junior/growing rabbits sounds like a good idea also and I could try that gradually.

Best wishes,
Nicki

Alfalfa hay is higher in calories. Maybe you could add a bit of that too, in moderation. Assuming that Libby does not have any history of bladder sludge issues.
 
Thanks Jane,

I did wonder about Alfalfa hay but wasn't sure because of the calcium content.

Libby's bladder was clear on x-ray but she has had problems emptying it and the specialist felt it was very inflamed - due to EC/arthritis/other underlying issues?


I really appreciate your help Jane. She has so many issues at the moment - it's hard to feel optimistic and I've been struggling today!
Small victories - her ulcerated cornea has healed and urine scald cleared and skin much improved. She's also eating well again after a rough night.


Nicki
 
Thanks Jane,

I did wonder about Alfalfa hay but wasn't sure because of the calcium content.

Libby's bladder was clear on x-ray but she has had problems emptying it and the specialist felt it was very inflamed - due to EC/arthritis/other underlying issues?


I really appreciate your help Jane. She has so many issues at the moment - it's hard to feel optimistic and I've been struggling today!
Small victories - her ulcerated cornea has healed and urine scald cleared and skin much improved. She's also eating well again after a rough night.


Nicki

Probably best not to feed Alfalfa Hay then, it's just good for getting some weight on a Bunny.

So pleased that her sore eye and skin have improved. Hopefully she will now be feeling better within herself and her appetite will improve x
 
Thanks Jane,

I did wonder about Alfalfa hay but wasn't sure because of the calcium content.

Libby's bladder was clear on x-ray but she has had problems emptying it and the specialist felt it was very inflamed - due to EC/arthritis/other underlying issues?


I really appreciate your help Jane. She has so many issues at the moment - it's hard to feel optimistic and I've been struggling today!
Small victories - her ulcerated cornea has healed and urine scald cleared and skin much improved. She's also eating well again after a rough night.


Nicki


Alfalfa hay isn't usually recommended, especially if there are any bladder issues. Perhaps giving junior pellets instead of her normal ones?

Porride oats have been vet-recommended without any issues, and also by the wonderful lady who started this whole Forum - Tamsin.
I wouldn't hesitate to use them to build up a rabbit's weight :)
 
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