Stasis stress!! :( Day 5 - still no poops!

[xEMMAx]

Hello! It’s been SO long since I posted here (combo of being very busy and being lucky enough to have very healthy buns over the last 10 years!) but I’m so stressed right now with the current stasis we have going on

My boy Sugar wasn’t right on Saturday morning, litter tray hadn’t seen much action overnight, he did 10 poops about 9am that morning… and nothing since.

He’s a free range house bun, 22 months old, always super friendly and sociable! We sadly lost his partner on 19th December They were a love at first sight bond who were inseparable as soon as he recovered from his neuter at 5 months old. He was very sad for a week, then seemed to be ok (as he was doing his daily ‘death flops’ again!).

But yeah now we have stasis! As soon as noticed, I gave him infacol and tummy rubs. Kept an eye on him all day Saturday and definitely wasn’t right. Refusing treats, not running over to me (usually when I wake up he’s by my bed and follows me around ). He didn’t seem like he was in pain though, and was still moving around, going up and down stairs…just not eating or pooping. The ‘local’ emergency vet is a 40 minute drive away and £300 just for a consult, so didn’t want to drive all the way there and pay the fee if they weren’t rabbit savvy… I did ask if they had a vet there who was more experienced with rabbits and got told ‘all vets are trained to the same standards’… ok that’s a no then. This vet also do video consults for £24, booked one of those and I did end up speaking to a lovely vet who actually sounded like she knew what she was talking about! (Unfortunately she wasn’t one of the vets on duty at the practice). I had metacam and emeprid at home, after a previous stasis episode, along with bio-lapis and critical care. Told the vet this and she said to try those and if he deteriorates even slightly get him to the practise.

Overnight he wasn’t moving around much, and no toileting, but again, still didn’t look like he was in pain or feel too bloated. He was also nibbling on dill and rocket, and I saw him drink from a bowl a couple of times. There was another local emergency vet who charged £100 for a consult (Sunday), and thankfully they got me in within an hour and were really good. She gave him a good check over, couldn’t feel any obvious blockages, I was worried about his bladder as he had to get it drained in August due to a bad case of sludge, but she said she couldn’t feel anything there. Also said gut noise was there but very infrequent, mostly silent. She gave me cisapride and upped the dosage of the emeprid. Said if no change overnight get him in to my usual vet today.

Before I had a chance to call my vets today, they called me 20 min before opening to check on Sugar as they’d had the notes through from the emergency vet! (My usual vets are brilliant, very rabbit savvy). Booked me in for opening time, so off we went - another thorough check and feel of everything, again, no obvious blockages, said only quiet noises in gut. Discussed extra pain relief, subcut fluids, blood test, X-rays, IV fluids… as he was still pretty alert we went with subcut fluids, blood glucose (came back as 13), and he had a injection of Vetergesic and Prevomax. Now keeping everything crossed that helps enough to get his gut moving!

Said if no improvement overnight to bring him back tomorrow for X-rays and an all day stay with IV fluids.

Since we got home at around 10am he’s not eaten anything, but I have seen him drink from his bowl. Still no poops. He’s going from sitting normally and being alert(ish) to being COMPLETELY out of it. He’s moved from the kitchen to the lounge and back a couple of times, but not eaten.

I’m assuming him being in and out of being ‘with it’ is down to the Vetergesic?? Is this also why he’s not eating? He’s taking syringed critical care ok.
For others who have experienced Vetergesic side effects is this pretty normal and how long does it take for them to bounce back? Has anyone found that after it wears off bun DOES start eating again?

Also when I searched for Prevomax I can’t find anything on it for rabbits! Like I said, my vets are very rabbit savvy so I assume there was a good reason they gave it. But if anyone else has had experience of that please let me know how you found it and if it helped!

Sorry that was so long! Just wanted to get all the details there. All my other stasis experiences bun has bounced back pretty quick, so I’m just so worried about Sugar!

Added a photo just to show who he is (my morning wake up call! )

 

[InspectorMorse]

Vetergesic (buprenorphine) is an opioid analgesic which often causes marked sedation. Being very sedated means the Rabbit usually doesn’t eat for themselves.I assume if the Vet has ruled out a blockage (full examination, blood glucose testing, abdominal X-ray) that you have been advised to syringe feed him ? This is an essential once no blockage has been confirmed.

Prevomax has a similar mode of action to metoclopramide (Emeprid). It is supposed to have a superior pro kinetic effect compared with metoclopramide. I have not had a Rabbit who has been prescribed it so I cannot comment from personal experience. As is the case with many medications it is used ‘off licence’ in Rabbits via the Veterinary prescribing cascade.

[Withdrawn] The prescribing cascade for veterinary medicines (VMGN 13)

Veterinary medicines guidance note for vets about how to use the prescribing cascade for veterinary medicines.

www.gov.uk

I have found that cisapride is the most useful pro kinetic. I assume you were given doses to continue treatment at home ?

IME ongoing fluid therapy (subcutaneous or IV) is extremely beneficial when treating gut stasis. It can make a tremendous difference.

Has he passed urine? As he has a history of bladder sludge it is possible that the primary cause of the gut stasis is related to a urinary tract problem. It’s not always possible to rule this out just from an examination.So further diagnostics (urinalysis, abdominal X-rays, full blood profile) might be needed.

Has he been passing faeces ?

 

[Omi]

I presume his teeth have been checked as far as is possible in a conscious rabbit?

 

[xEMMAx]

Vetergesic (buprenorphine) is an opioid analgesic which often causes marked sedation. Being very sedated means the Rabbit usually doesn’t eat for themselves.I assume if the Vet has ruled out a blockage (full examination, blood glucose testing, abdominal X-ray) that you have been advised to syringe feed him ? This is an essential once no blockage has been confirmed.

Prevomax has a similar mode of action to metoclopramide (Emeprid). It is supposed to have a superior pro kinetic effect compared with metoclopramide. I have not had a Rabbit who has been prescribed it so I cannot comment from personal experience. As is the case with many medications it is used ‘off licence’ in Rabbits via the Veterinary prescribing cascade.

[Withdrawn] The prescribing cascade for veterinary medicines (VMGN 13)

Veterinary medicines guidance note for vets about how to use the prescribing cascade for veterinary medicines.

www.gov.uk

I have found that cisapride is the most useful pro kinetic. I assume you were given doses to continue treatment at home ?

IME ongoing fluid therapy (subcutaneous or IV) is extremely beneficial when treating gut stasis. It can make a tremendous difference.

Has he passed urine? As he has a history of bladder sludge it is possible that the primary cause of the gut stasis is related to a urinary tract problem. It’s not always possible to rule this out just from an examination.So further diagnostics (urinalysis, abdominal X-rays, full blood profile) might be needed.

Has he been passing faeces ?

Thank you!
He’s had 2 x vet exam, 2 x teeth check and a blood glucose today (came up as 15 - this was after all the injections, so he was pretty stressed bless him). No X-ray yet, plan is to go back tomorrow (or tonight if he goes downhill). But yes been advised to syringe feed, so been giving critical care regularly, alongside bio-lapis and water.

Then yes, at home I have cisapride, emeprid and metacam which were all prescribed.

Oh that’s good to know - I’ll ask about another round of subcut fluids tomorrow as he managed those without even flinching today.

Urine - yes a few times. I’ve noticed he’s been drinking on his own tonight too. I am definitely worried about his bladder so thank you for suggesting which further diagnostics to ask for, I’ll definitely ask about those tomorrow.

He’s also seemed a bit more ‘with it’ in the last few hours and has shown interest in herbs and veggies - only nibbling so far. Moving around a bit more too, and did manage going up the stairs just now. I can hear him hopping around up there too.

I’ve not noticed any faeces at all since the 10 he did on Saturday morning. They were normal size, then nothing since.

 

[xEMMAx]

I presume his teeth have been checked as far as is possible in a conscious rabbit?

Yes! Both vets he saw (yesterday and today) had a good look at his teeth

 

[bunny momma]

You got good information from Inspector morse, so I will just add some positive vibes for his continued improvement.

 

[SarahP]

You could try peppermint tea. I've found it miraculous in the past for getting things moving in the gut (obviously not alone, but in combination with the prescribed meds). Cool it down, although slightly warm can also help.

 

[InspectorMorse]

Thank you!
He’s had 2 x vet exam, 2 x teeth check and a blood glucose today (came up as 15 - this was after all the injections, so he was pretty stressed bless him). No X-ray yet, plan is to go back tomorrow (or tonight if he goes downhill). But yes been advised to syringe feed, so been giving critical care regularly, alongside bio-lapis and water.

Then yes, at home I have cisapride, emeprid and metacam which were all prescribed.

Oh that’s good to know - I’ll ask about another round of subcut fluids tomorrow as he managed those without even flinching today.

Urine - yes a few times. I’ve noticed he’s been drinking on his own tonight too. I am definitely worried about his bladder so thank you for suggesting which further diagnostics to ask for, I’ll definitely ask about those tomorrow.

He’s also seemed a bit more ‘with it’ in the last few hours and has shown interest in herbs and veggies - only nibbling so far. Moving around a bit more too, and did manage going up the stairs just now. I can hear him hopping around up there too.

I’ve not noticed any faeces at all since the 10 he did on Saturday morning. They were normal size, then nothing since.

How is he doing today ?

 

[xEMMAx]

You got good information from Inspector morse, so I will just add some positive vibes for his continued improvement.

Thank you!

 

[xEMMAx]

You could try peppermint tea. I've found it miraculous in the past for getting things moving in the gut (obviously not alone, but in combination with the prescribed meds). Cool it down, although slightly warm can also help.

Oh fab, I have that here so I’ll make some now, thank you!

 

[xEMMAx]

How is he doing today ?

He’s definitely been more active (but don’t know if it just seems that way because the Vetergesic has worn off), mind you he did jump up on sofa earlier and he’s not done that since Friday.
He’s been drinking on his own quite a bit, still only having nibbles of veg/herbs now and again though. Still no poops Was feeling more hopeful this morning, but with nothing still coming back out have booked vets at 3pm today.

 

[InspectorMorse]

He’s definitely been more active (but don’t know if it just seems that way because the Vetergesic has worn off), mind you he did jump up on sofa earlier and he’s not done that since Friday.
He’s been drinking on his own quite a bit, still only having nibbles of veg/herbs now and again though. Still no poops Was feeling more hopeful this morning, but with nothing still coming back out have booked vets at 3pm today.

Yes, definitely needs to be seen by a Vet again. If there has been no poo at all then personally I would try to get him seen straight away. I would tell the Surgery that he has had no poo output at all and that you are very concerned.

 

[xEMMAx]

Yes, definitely needs to be seen by a Vet again. If there has been no poo at all then personally I would try to get him seen straight away. I would tell the Surgery that he has had no poo output at all and that you are very concerned.

He’s just had a good extended much of veg/herbs, including celery which is usually one he leaves until last - so don’t know if that’s a good thing?

I’ll call and see if they can get us in earlier, they did say if he deteriorates at all to call back. They are a good surgery - most of the staff seem to have rabbits themselves! And they are on the RWAF list

 

[xEMMAx]

Back from vets - had X-ray, definitely no blockage but is bloated and has quite a lot of gas in his intestines. They said it looks like it is moving slowly now it’s not in his stomach, and the gas will need to come out before faeces does.

He’s had more subcut fluids, and I’m continuing with all of the other meds, so hopefully he’ll improve over the rest of today

Said if no change to come back tomorrow so he can be admitted and have IV fluids.

My favourite nurse was there today - she’s honestly the best I’ve seen by far over 30 years! She said last year it took one of hers a week to start producing faeces, so that was good to hear too. Stasis with my buns previously it’s always moved along within a couple of days! She actually suggested peppermint tea too! So I said funnily enough I’ve just started giving him that today

I got some fibreplex too, as he’s not being great at taking critical care, so hoping he’ll be a bit better with something different.

 

[xEMMAx]

24 hours on and still no poops
He’s been brighter today, and has been drinking and weeing quite a lot (including a huuuge wee on me when I was giving him a tummy rub!). He’s still nibbling on veg/herbs and a bit of Readigrass too. Started fibreplex and he’s taking that much easier than critical care. He’s looked a bit more relaxed in his sitting positions today. The past couple of days he’s mostly been sat in one spot in the kitchen under a chair (he knows it’s difficult for me to pick him up when he’s there!), but today he’s been upstairs and moving around quite a bit up there (I have a security camera on him!). I’m sure I can hear a few more gut noises than the last few days too so fingers crossed!

I phoned the vet earlier, as didn’t want to take him in unless it was definitely needed, as he gets so stressed being there bless him, and it’s a 25 minute drive from home too. The vet he saw yesterday said if he’s drinking and weeing freely that’s a good sign, and to keep him at home today but keep a close eye on him (obvs keep up meds and I’ll syringe CC and Fibreplex too).

Has anyone else had cases where bun seems to be perking up but still no poos? How long have you found is the longest it can take for them to poop again and have a full recovery?

 

[InspectorMorse]

Personally I would want him examined by a Vet tonight. The lack of output is very concerning. Continuing to push syringe feeds might make things a whole lot worse if what is already in his GI tract is not moving. IMO he needs another full examination, including blood glucose testing and abdominal X-ray.

 

[xEMMAx]

Personally I would want him examined by a Vet tonight. The lack of output is very concerning. Continuing to push syringe feeds might make things a whole lot worse if what is already in his GI tract is not moving. IMO he needs another full examination, including blood glucose testing and abdominal X-ray.

He had an X-ray yesterday which showed no blockage, just gas in his intestine, so they think it’s slowly moving through? And said it can take up to a week for poos to appear? The nurse that was there backed that up and said with one of hers recently it was a full week. I just didn’t know how common that was.

Blood glucose on Monday came up as 13. I’ll definitely take him back tomorrow for a second X-ray and blood glucose as it will obviously be good to compare and see if things are going the right way. I was just hoping a day at home today might help and relieve a bit of stress for him, I just don’t know what’s best

 

[xEMMAx]

Very sad to say that Sugar passed away a couple of hours ago He was honestly doing so well today, then so so suddenly turned, and within 10 minutes he was gone Absolutely devastated.

 

[InspectorMorse]

Very sad to say that Sugar passed away a couple of hours ago He was honestly doing so well today, then so so suddenly turned, and within 10 minutes he was gone Absolutely devastated.

I am so very sorry From all of the information you posted I feared that he was extremely poorly

RIP Sugar

 

[xEMMAx]

I am so very sorry From all of the information you posted I feared that he was extremely poorly

RIP Sugar

Thank you. I just can’t believe it. He was the most loving little boy

I was really worried but I was also so hopeful after how he was literally up to that point. I NEVER thought he’d be gone by the end of the day. He was drinking lots, eating more, running around… I just don’t understand I do think it was bladder related as when he passed, a lot of thick chalky liquid came out straight after… but surely that would be picked up on the X-ray they did if it was sludge??

So I don’t know. I just feel numb and keep thinking of what else I could have done