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PLEASE HELP Dental problems and not eating:Vet suggested potential PTS

If you're syringing, I would want to syringe water rather than food, as that can encourage eating (plus it's so much easier).

You must be so stressed. :(
 
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.

Yes she did give him fluids by injection, but said to get 10ml into him every hour, but she didnt say how long to do that for so maybe I've done enough for now?

He has water in a bowl but warming slightly and adding juice is a great idea! thank you!
 
I give sub q fluids-under the skin with bag and supplies from vet in addition to oral fluids.
Experiment with consistency of critical care. My bunnies are small and I only put a half cc of recovery food in their mouth and let them swallow. It takes less time because bunnny does not fight. Try to put cc innother side of mouth in case one side sore.
Otjers gave you a lot of good advice, so I will add more vibes for improvement.
 
How is he doing now? I would make sure he is well topped up before bed, and check on him through the night if he's still not eating.
 
He's still refusing to eat anything himself. He's done quite a few very small and dark poos (over 20) so things are moving, he just doesnt have appetite and I dont feel like I'm getting enough in him. I've tried the fruity water and he's not interested so it's still force feeding. I'll try my best to top him up before bed and will get up through the night to check on him. He is nibbling at grass but again I think he's biting it and dropping and isn't touching any of the food or treats that are out for him. He's now had his 4th dose of antibiotics so really hoping he'll start to feel relief from that. How much would you think would be a good amount to get in him before bed? and how long to leave him over night? I can't find any advice online about what to do over night.
 
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 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.


Brilliant, thank you! I'm just so worried about getting enough fluid into him as he is showing no interest in water. He just had a little nibble on some banana though. Not much but it's at least an interest in food which is some progress. 4 hours sounds like a good balance for overnight (I cant imagine me sleeping really so will probably be more likely trying to force myself to leave him alone than to be trying to get up to feed him!), hopefully with longer breaks he'll want to eat. Thank you <3
 
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.
 
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.


Thank you! The vet gave us quite a bit of vetergesic to give him every 8 hours, though that was the second vet we saw (not our usual vet). Is a higher dose of metacam instead a better idea? I'm trying my best to get him to monday so we can speak to our vet again but of course would love to see some turnaround before then
 
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.
 
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.

I'm not sure about his wee as he has absorbent litter but will try to get an idea. They said they checked his bloods pre surgery and everything seemed fine, and I asked because of his liver. He ate most of a lettuce leaf in the night (baby gem so not big but ate all the green off it) but is still not accepting food easily. He did happily take his metacam which he wouldn't yesterday so he might be feeling a little better? But I think he's immediately suspicious when the bigger syringe appears. I'll try smelling him (I hadn't noticed anything but will look out for a sweet smell).

My worry with the vets is it would have to be an emergency one and it's about an hour away and there's always a long wait which would be really stressful for him (our rabbit savvy vet is just round the corner) so really was hoping to get him to tomorrow morning then get him in to our vet. Of course my worry is she'll say he's been through enough and to let him go. I'm not sure how long is too long when it comes to force feeding as in the past he's picked up by now and started at least willingly taking the recovery :(

We luckily have a window to see in the room without bothering him and when I've looked he is lying comfortably (legs out to the side) and does move around the room a bit so I'm hoping that means he's not in too much discomfort?
 
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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.
 
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.

Thank you, that's reassuring. I guess it's that we need to fix the underlying cause of him not wanting to eat before he'll start again, I'm just hoping that that is the infection and the antibiotics will start to work and we'll see a difference. But I can tell he's more annoyed at me today :(
 
That seems low dosage of pain meds. Brko is 1.3 kg and gets 0.5 ML of metacam 12 hours, and Novasul (metamizole) 0.2ml every 12 hours. He also gets 2 antibiotics every 24hrs 0.3ml of Efloran (metronidazol) and 0.3ml of Summamed (azimitrocin 40mg suspension).

It is too bad they did not doo skull x-rays. It very might be some abscess or need of tooth extraction.

Some buns eat CC better with 1ml syrenges (you need a lot of them). I found that feeding 3 times 25ml worked well for my boy. But do what is best for yours. I also put a small spoon of baby banana/apple baby food or 100% apple juice. Just to flavour the CC. And also some gut motility meds. Gentle belly massage. Dry forage, pellets (selective are great). Just have that available for when he decides to eat.
 
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.
 
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.

Thank you! I'm pretty sure I'll get him in tomorrow, just not sure our vet is in but fingers crossed we can see her! It's really nice to hear you feel there is some hope and I agree about it being too much to put him under GA now. He's been through so much. I just blended up some apple and banana and he happily took that from a syringe (after his initial grunt of suspicion from syringes) so I used a 1 ml syringe, put a bit of that mix in, then mostly water, then finished with a bit more of the mix to get some water in him without forcing and he took 10ml before pulling it off me and chucking it. Hopefully that's a good sign?? He's also had a little nibble of some lettuce but not much and wont touch the herbs. I'm glad you've all said about the vetergesic because he does seem drowsy. I was worried it was pain because his eyes are very sleepy looking but his ears aren't generally suggesting discomfort. At the moment anyway. Thanks all again! It's nice to not feel alone in this hard journey!
 
Have you tried grated apple or carrot? Dandelion leaves usually go down well with mine, or celery leaves.
 
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
 
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

Thank you! It's reassuring to hear people have had bunny's refuse food for this long and still get their appetite's back. He's had a nibble on a couple of dandelion heads but hasn't touched anything else on his own. Still having to force feed him recovery but he's not spitting it out like he was. I'm really hoping that the pain killer is part of the issue now and I can change it for more metacam tomorrow and see if that helps, but will see what the vet says first jic. It's hard to tell because obviously when we took him in he was pretty subdued so it could be the illness but fingers crossed it's more the painkillers now. At 11 he's due his antibiotics so that'll be 3 full days worth of doses so again really hoping they'll have an affect. The bottle says it's for gastrointestinal infections, but presumably it will treat it wherever it is? I just wish he'd eat something so I can at least say I've seen an improvement. In some ways I think I have but I might be clutching at straws. He's done a lot of poos tonight after doing non all day. They're all very small and dark but there's quite a lot of them.
 
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