Gi stasis, how much critical care should I feed?

[MotherPanda]

Hell all, long time no see. I used to be on here a lot 14 years ago or so! These days I have two lop rabbits, Athena and Deckle, both 8 years 9 months. Both have lived incredibly healthy lives, but sadly gi stasis has reared its ugly head and I'd love some advice on how much and how often to feed her.

Athenas not currently eating, She's currently on anitbiotics, pain releif and a gut stimulant so I think she has all she can get from the vet. I last saw her eat something herself Thursday morning when she ate some cucumber, I've been force feeding her critical care, since then, but the vet wasn't sure how much to suggest and just said little and often - even saying just 1ml would help. The amount suggest on the package seems huge. I've been managing about 12ml per feed, but really have to water it down. she was around 2.5kg on Wednesday, and was already down to 2.3kg on Friday so losing weight quickly. Would love some advise about what I should be aiming for. Currently I'm just pleased I'm getting anything into her, but if this is going to go on for a few days I want to make sure I'm not starving her, or causing more discomfort by overfeeding. I'm mixing one tablespoon of the CC into a kids plastic ikea bowl and putting in lots of water so it draws easily into a little 5ml syringe. I tried a 10ml calpol one before that, but it was too big for her and just made a mess. That bowl mix will last several feeds. If I went by what was on the package, she should be having more like 7.5 tablespoons of the Critical care food, she's probably getting 2 or 3 max at the moment.

I took her to the vets on Wednesday as she had a snuffly noise when breathing and her eyes were gunky and inflamed, so I was suspecting the start of snuffles. She was still eating then, but not as keenly as normal which was the first sign something was up. Lungs sounded fine so they think its just an upper respiratory issue - she was Prescribed antibiotics baytril (25mg) 1ml once a day and loxicom pain relief (1.5mg dog one) 0.5ml once a day both for 7 days. She also had fluids injected under the skin as I was worried about dehydration as her eyes seemed a little sunken. As she was off food agreed to supplement with critical care, watermelon, pineapple juice - anything to tempt her to have a nibble.

Thursday morning she seemed brighter, so the pain relief must have helped and she ate some cucumber, but then didn't eat again so I carried on with pineapple juice and critical care.

She went back to the vets again on Friday as had stopped eating any food independently on the Thursday. They spent an hour with her and had a really thorough check up , checked teeth checked glucose level, checked for blockages had a listen to tummy, heart lungs and couldn't pick up on anything concerning, other than no noises from the gut on one side. They gave her an injection of something to help with nausea and and a gut stimulant, and gave me a prescription of emeprid (1.1ml twice daily) as an oral gut stimulant for me to keep up over the weekend, and asked me to come back in the morning to see how she responds to the gut stimulant.

I fed her 3 hourly overnight, I have seen one poop! and took her back in to see the vet this morning, sadly it wasn't the same vet and I'm not sure he was particularly rabbit saavy, and hadn't read the notes on Athena, so the advice was just to keep doing what I'm doing and come back in on Monday. I'm happy to do that, but would have liked a bit more information on what to do if she goes downhill, how much to feed etc, when we should see things improving. He said she's got all the meds she can have for now, so lets just see how she goes.

I think due to her age no one is suggesting further tests or scans etc. I'm not sure it would be in her interests to do anything more invasive, especially as she's under the weather with snuffles or something like it, She's angry enough with me about the force feeding.

Thanks for reading, and sorry for everyone who has been through this before. Its so stressful!

 

[MotherPanda]

ooh an update, I saw her eat a little hay at lunchtime, and just now she had fresh cecotropes stuck to her fur, though she hadn't eaten them - they were stuck to a couple of dried up normal droppings.

Hoping this is a good sign, though she looks quite unhappy and more hunched up today.

 

[bunny momma]

I am sorry you are dealing with this in Athena. While oral fluids are better, I always gave sub q fluids at home for a rabbit who is not drinking. You may want to ask your vet about adding Cisapride gut stimulant too. It works on a different part of the GI system.
With Critical Care, I have some 12ml oral syringes with a curved tip that is tapered. The tip can be cut shorter to allow critical care to flow better. I fill it from the back by removing plunger and keeping my finger over the tip.
Syringe feeding is important because eating will stimulate gut movement and the liquid will rehydrate any contents in her gut. Yet it is stressful to many bunnies so you may not be able to give her as much as the package suggests. This is especially true if she is not pooping.
I also would not offer pineapple juice unless you dilute it due to high sugar content.
It is good that she is starting to poo, yet I would want her to get more pain relief for a short time if she is hunched.
Sending positive vibes for your girl.

 

[MotherPanda]

Thank you for your suggestions, she really doesn't like the feedings, but I'm pleased she at least has the energy to give me attitude about it. I've cut out the pineapple juice now - the vet had suggested it before we ruled out a blockage and as something tasty to tempt her, but she's had the sub q fluids on Wednesday, and I've been squirting watery CC down her throat since then. I need to stop leaving vegetable and fruit treats out to tempt her too, as her companion Deckle is just hoovering up and don't need her ending up with stomach issues too! They very rarely get fruit and veg - don't worry, this has very much been an emergency measure!

We are back to the vets on Monday morning, so just need to get through the next day, have just given her the pain relief, will keep an eye on that as wonder if the one dose isn't quite enough to get through 24hrs. She's hopped out in her run now, so it definitely helps her to move about which in turn will help her gut of course.

 

[bunny momma]

I have noticed the pain relief often wears off before 24 hours. After the initial dose, I have been known to split the dose and give it every 12 hours with vet ok. Also, I ask my vet to calculate the max dose which I will only give if absolutely necessary for 2-3 days if initial dose is not sufficient. A second pain reliever can be added too.
Mine do not get any fruit, yet in the past I have tried to flavor critical care with unsweetened applesauce or diluted juice to make it taste better. They sell critical care with apple/banana flavor too.
You can also grind up pellets (I have a small coffee/spice grinder) and add the powder to the critical care to make it taste more familiar. I tried just using pellet powder without critical care but it does not stay evenly mixed.
If you can get carrots with the green tops, mine liked the green tops. Mine also liked dandelion greens.
Though it can be a challenge when their friend eats things first.
Sending you and your bunny positive vibes.

 

[SarahP]

My vets always prescribes Metacam every 12 hours nowadays. There is no way it lasts for 24 hours, in my view.

One thing I'd definitely recommend is peppermint tea. Sometimes they seem to enjoy it, but if not (my bunnies never did), syringe it. Just slightly warm helps. In my experience with stasis, syringing fluids was always the most helpful thing (alongside the meds, obviously!)

 

[Shimmer]

If she's snuffly, a mucolytic may help. Your vet could give you eg a sachet of Bisolvon. You just add a small pinch of the powder to food once a day. A sachet lasts for ages.

Critical care flows better in a syringe if you add some baby food apple / pear / carrot puree. It may also make it more palatable. I woud feed as much of the recommended amount as you can. Every 2-3 hours would be good, but every 4 hours if she really doesn't like being handled. You said you squirt it down her throat - I would syringe it into the side of her mouth and across the tongue. She will have to swallow it but will be less likely to accidentally inhale it (which would result in inhalation pneumonia if it gets into her lungs).

 

[bunny momma]

Sending more vibes for you and your girl.

 

[a reader of books]

Ah, it's such a struggle when they don't want their syringe feed, isn't it. I know the amount the bag recommends can seem like a lot, but bunnies do need a lot of food in their tummies to keep them going, so that's definitely the amount I'd aim for, though I realise that's only possible if the bunny will actually take it. Have you tried a different brand syringe feed? They can like some better than others. How disappointing that the vet appointment on Saturday wasn't more helpful. I hope today's visit was better. Do they think she's not eating because of her respiratory issues? I'd find it concerning if they didn't suggest any further testing because of her age; unless she's a giant, 8 isn't all that old, and even if it were, gut slowdown is usually caused by other issues, so you'll be able treat her much better if you knew what's causing her not to eat. I'm sending Athena so many vibes

 

[MotherPanda]

Thank you for all your good wishes and suggestions, yes I think its just the respiratory/bacterial issue that has caused her to stop eating. Her glucose levels are fine, so it doesn't suggest anything more sinister at work, If she was still unwell despite the antibiotics then I think they'd look deeper but at the moment I agree that's the most likely cause of the problems. I don't want her going under anaesthetic whilst having snuffles or similar, though she is less snuffly sounding already.

We made it through the weekend, and had a breakthrough yesterday evening when Athena nibbled a little bit of mint and a little bit of hay, and is producing regular droppings at last, still a bit small and dry but regular. Today she has eaten, dill, mint and carrot tops enthusiastically, so I'm offering a tasty herb every hour and reducing the critical care to see what her appetite is like. Vet check was positive this morning, she has more gut sounds than before and doesn't seem dehydrated. She's lost weight, but that's to be expected, so we are going to keep up the gut stimulant, pain relief and antibiotics till Wednesday and review again then.

The night feeds are starting to get to me and I'm feeling really tired out, so will be such a relief if she does start eating for herself! I won't take my eye off the ball too quickly though, but if she eats well this evening I might be able to skip the 3am feed at least and get a few more hours sleep.

Oh, and when I say squirting it down her throat, I actually mean I squirt it in the side of her mouth, don't worry! No drowning bunnies here!

 

[a reader of books]

Ah, that's such good news, well done, Athena I'm glad she's starting to feel better, with her eating more on her own and having more gut sounds and her not being so snuffly. I'm not surprised she's lost weight, either. I know night feeds can be so tiring; I hope you can see her eating well enough this evening so you can maybe get some more sleep tonight.

That would make a lot of sense if she's not eating well because of her respiratory issues and feeling under the weather, and I can definitely understand why you don't want her to go under anaesthesia right now. Hopefully the tasty herbs will be tempting enough to keep her eating until she feels well enough to get her normal appetite back.

 

[bunny momma]

It is nice to read a positive update. Well done. Sending more vibes she will continue to improve and you can soon skip the overnight syringe feed.

 

[SarahP]

Night feeds are awful! You have my full sympathy there. Fingers crossed for tonight.

 

[MotherPanda]

She's stopped eating again, I'm starting to think this might be the end of the line, as she looks miserable. Back to the vets at lunchtime. Feel very tearful. Its a couple of weeks now since this started, so was hoping to see more progress by now.

She last had a check up on Wednesday, where Athena wiggled free and tried to escape when the vets took her out back to try another glucose test! vets decided as she was clearly feeling more energetic to see how she goes at home without the stress of frequent check ups, and continuing the gut stimulant, pain relief, critical care and she was also eating fresh herbs. only tiny strands of hay and never pellets.

I fed a variety of fresh herbs which she ate happily up to yesterday when she has stopped eating again. She's back to being sleepy and hunched and doesn't put up much of a fight when I pick her up for syringes.

I don't know what to ask the vet for, if I should ask for her to be euthanised, or if I should just carry on force feeding, but she hates it and I feel awful. Poor thing.

 

[a reader of books]

Oh, I'm so sorry to hear she's stopped eating again and she looks miserable and hates all the syringe feeding, poor girl. I know it must be so difficult to see her like this Is she still snuffly? Is that still the suspected reason she's not eating well? I hope the vet can help you decide what's the best thing for her, if they can tell you more tests might be helpful, or maybe more pain relief in case she's hurting. I'm sending her so, so many vibes.

 

[Shimmer]

I would get a general blood profile done, make sure there's no gut blockage palpable (so you can continue to syringe feed), check her teeth thoroughly (they won't be wearing down if she's not eating normally and may need burring down), body temperature & weight, and reassess her breathing / lungs.

If she's not breathing well and her teeth are getting longer, she will struggle even more to eat. If a blockage has been ruled out, she really needs food input to get everything kick started.

Nebulising with saline or adding a pinch of Bisolvon to her food daily are worth discussing if her lungs /breathing / snuffles are an issue. I'm sure there are other antibiotics available if needed, as well.

Ask if you can increase the pain relief for a couple of days to see if that helps.

 

[SarahP]

I totally agree with Shimmer.

If the breathing is an issue and nebulising is an option, you can buy them online. I have one here that I've used with guinea pigs with F10 and saline. Bisolvon is great stuff too for congestion.

Another possibility, if it hasn't already been explored, is E Cuniculi - I had all sorts of stasis issues with my rabbits with that.

 

[Shimmer]

I use a nebuliser like this, although mine is an older version:

Amazon.co.uk

Spares are also readily available for the branded ones like Omron.

 

[MotherPanda]

Thank you all, Vet was quite positive and felt that behaviourally she seemed better, despite not eating - she jumped onto her carrier and was a lot more wiggly and evasive! they've upped her pain relief from 0.5ml to 1.3ml and going to see how she goes over the next day or two. Tear ducts have been flushed today just in case that was causing a problem, so hopefully that helps her be more comfortable, although the vet said there really wasn't enough blockage to cause an issue in their opinion. teeth, tummy, heart, lungs, temp checked again and all look good. They spent an hour with her so very thorough.

The snuffles or whatever the respiratory issue was cleared up quickly with the antibiotics, so I'm not too concerned about that now, I think we got to it very quickly before it could become a bigger issue, there are no noises on breathing etc anymore and luckily it never got to her lungs, so I don't think I need to try nebulising.

I don't think she shows any obvious symptoms of E Cuniculi specifically, but I suppose a parasite of some sort is possible? I'll ask the vet if its worth trying panacur or something just in case, though I'll need to syringe feed it. She now looks like a healthy rabbit, just not eating or drinking and is stressed out.

 

[a reader of books]

That's really good that things are looking more positive. Your last post sounded very worrying! I hope the higher pain relief dosage will help. They do sound very thorough, though I'm wondering why they didn't suggest further testing, like bloods and/or imaging, since they haven't established a cause for her not eating? If the respiratory issue has cleared up, it can't be that.