Chronic GI Stasis issues….

[Nova]

Boon is not even nearly a year old yet and he has been in severe Stasis 3 or 4 times. Since his last bout of it, a few weeks ago, he never really fully recovered (he recovered after an aggressive enema – the motility meds did nothing).

But ever since then he does not eat hardly at all, but he gets extremely hungry. This is painful to witness. When I give him his hay, he jumps at it like he is starving but then he is full after only a few bites, and begins to bloat. He goes all day without pooping and then sometimes at night he will “explode” with large, mucusy sausage poos everywhere. 

He is on a strict hay and green leafy veggie only diet, although I do give him Oxbow pellets as a treat twice a day – such a small amount it shouldn’t cause harm.

He is also on…

Weekly Benebac

Daily belly rubs and exercise

Occasional Digestive enzyme supplementation

Simethicone as needed

Metacam as needed

If things get too bad for too long, I give .01cc mineral oil by mouth and an enema.

Motility meds are used with caution because I don’t want gim to get hooked on them or build tolerance to them. It seems they already don’t work too well anymore.

Worth noting, all he wants to do is hump everything. I think his hormones are stressing him out severely, but our rabbit wise vet says that because of his Stasis history, and now it’s chronic, she won’t operate on him, it would be too risky. 

On Friday he sees an exotic pet specialist who specializes in rabbits to try and find out what to do about his now chronic GI slowdown. It gets to the point of Stasis once every couple of days now. Prior to his last bout a few weeks ago, he was fine and pooping/eating normally for months……his last bout prior to the recent bout was probably in February. *sigh* don’t know what to do. Feel helpless and hopeless. I hope the exotic pet secialist can help him, and get him safely neutered too. He also seems to have Snuffles, but he’s dealt with that on and off his whole life (he was rescued very young from filthy conditions). The Snuffles did get worse in the last month though.

I will be sure to keep you all updated…but does anyone have any advice?

[LittlePuffyTail]

Have you ever had a vet check his teeth? Even young bunnies can have dental problems which can cause reluctance to eat and GI problems. I would definitely get your exotic vet to do a thorough dental exam. You want to rule everything out at this point.

[Nova]

Hi LPT,

Boon had his appointment w/ the exotic specialist today. I am having mixed emotions about it. Thank God it was not another sweltering hot day because the specialist is a 3 hour drive and the A/C was on high.

The specialist wants to be very thorough and scheduled Boon for endoscopies both of his GI tract and his respiratory tract, wants to take a “deep” culture from his lung and nasal tissue. He wants x-rays and bloodwork too. Said his front teeth at least look great – perfect even. Doc says his belly does feel like it’s constantly bloated, and he feels that there may be a “problem with the cecum.” He also said URI issues can cause the belly to fill up with mucus? Never heard that one before. But Boon’s URI is quite mild, and these Stasis issues occurred before he developed signs and symptoms of URI in any significant way.

at the same time the vet wants to neuter him because the stress of his hormones is well, stressing him out. He does not play anymore. all he does is humps and then gets tired and huffy and panty.

They wanted him to have an overnight stay for all of thise but there will be no staff there overnight so I said no. We scheduled for July 11th, will leave in the middle of the night to get there by morning, hang out in Cleveland/Akron area until he is ready to come home and after surgery.

I’m really scared that this will stress him into a bad stasis state. But the vet said it is a necessary risk we have to take because he just seems to be chronically backed up and we need to try to find out why. He says we want to try to keep meds to a minimum if possible and do a slight diet modification, but before any of that he needs to perform the scopes and other tests.

the badder news is that this is going to cost us into the thousands now in debt. So I am going to try to start a fundraiser for anyone who wants to donate. Can any of the forum leaders let me know if I can do this? Provide my Paypal email? I may also set up a Facebook page dedicated to this as well, and maybe I can just post the link to the FB page.

After the several emergency visits he’s had already, we have spent nearly a thousand in just the last half year alone.

Very exhausted and willing to do anything to keep my boon healthy and happy.

[RabbitPam]

I’m sorry Nova, but fundraising is strictly against the BB rules. I’m sure BB will get in touch with you privately, but I wanted to reply to let you and the other members know this as well. Here is a copy of the statement in the Rules:

G. Do Not Ask Directly for Money/Fees/Donations: (This includes rescues and humane causes but please see “exceptions” regarding this below)
• To prevent BinkyBunny from becoming a haven for money solicitation, do not ask for money/donations/fees directly.
• An individual on behalf of themselves is not allowed to ask for money….ever. (and that includes links to the individualssite where money is requested)

[Nova]

Okay, thats’ perfectly okay. I didn’t think it would be allowed, and must have overlooked that rule.

I am hoping that someone can comment on boon’s situation, though – his surgery and scopes seem extremely invasive o me and I am wondering if he might make it through all of them. To be neutered is one thing, but to be scoped up and down and through the respiratory tract, and then remove any blockage found or abscesses or whatever, what are his odds?

I ask because my rabbit wise vet, but not a specialist (not the one who ‘specializes’ in rabbits) said that the moment you operate on a bunny’s GI tract, that is when they die. That’s not going to happen is it??

I’m really scared because in October I lost my Beau to a routine neuter surgery performed by a vet who didn’t usually see rabbits and gave him total IV anesthesia. the anesthesia is what likely killed him. Boon on the other hand is going under by an exotic pet specialist who specializes in rabbits.

[LittlePuffyTail]

I’m sorry you have to face so many procedures with Boon. ((((hugs))))))

Did the vet detect any blockage or abscess? I would want to be 100% certain there is a need for surgery. Im far from an expert but it’s my understanding that bunny GI surgery is risky on any bunny, but most especially on one with compromised health.

Did Boon have a complete panel bloodwork? If not, this should be the first step.

It seems strange that the vet didn’t check his molars because those are the ones that cause the most problems. If Boon is going to be sedated for the cultures I would certainly say I want his molars checked out. It’s much easier for the vet and bun under sedation. You could always start with doing the nasal culture and then, if that shows nothing, do the respiratory culture. I’ve never heard of a respiratory culture being done. I always thought that the nasal culture would show if there were any respiratory bacteria.

[Nova]

He said that Boon’s Cecum felt swollen/distended, that he is definitely bloated, and that he definitely has a bacterial infection in his upper respiratory tract.

I wonder – should I call the vet’s office and ask them to have bloodwork and imaging done prior to surgery? That way maybe he won’t need all of it. Seems to me that the vet just wants to do everything at once and I have this bad feeling that will be too much stress for him to survive.

I’m also going to ask if he finds a blockage, how will he remove it? Surgically? Because the second they touch a bunny’s GI tract with a knife, they usually die.
That’s my local vet said.

The vet also said they’d have to keep him overnight – but they have no overnight staff – so if he died at 2am, no one would be there. Eff that! He is COMING HOME the day of surgery.

another question I have is – since URIs typically don’t respond to any type of antibiotic, what is the point of a culture?
And what treatment approach would be taken if his gut is just …. slow?

I’m going to call them tomorrow and ask these questions, among a laundry list of other questions.

If anyone else has any vibes on this matter, please let me know. I only spoke to the vet on the phone because my fiance had to take him – I am stuck home with a chronic health condition myself. The vet sounded very confident but also kind of egotistical. He told me it would be more stressful for me than Boon to stay overnight at the vet’s office. I did NOT like that statement, and it is what gave me the bad vibe.

Oh and BTW – the upper respiratory endoscopy examines the mouth and teeth as well.

[Nova]

http://www.ivis.org/proceedings/navc/2005/SAE/562.pdf?LA=1

Here is some extensive literature on the endoscopies on rabbits/birds, they even do ear scopes.

[LittlePuffyTail]

I would definitely ask for bloodwork and X-rays first. I wouldn’t do everything all once. Start with the basics and rule them out first.

I agree that a bunny shouldn’t be left overnight unsupervised after a serious procedure. Some vets want to keep bunnies on iv after surgery. He may not need surgery after all, though. Don’t let the vet push you into anything because, as you know, it’s very risky for bunnies. And it doesn’t seem like the vet is all that certain it is even necessary.

In an article on gi stasis, rabbit expert Dana Krempels (whose advice many rabbit owners swear by), she suggests bloodwork, a deep oral exam to check molars, radiographs and a complete urinary tract check as the preliminary tests for diagnosis in a rabbit with chronic stasis. 

You can find the article here: http://www.bio.miami.edu/hare/ileus.html

[Nova]

LPT,

Exactly, the link your provided does state:
“If your rabbit does not seem fully normal, even after the GI tract is moving well again, it’s time to ask your vet to do some blood work, a deep oral exam (to check for molar problems), radiographs (don’t forget the head!), a complete check of the urinary tract, and any diagnostics your rabbit-experienced veterinarian deems necessary to get to the root of the problem.”
Those are all things this vet is going to look at, in addition to his URI problems and he will be gettingneutered at that time as well.

I just called the vet’s office and told them that I need some time to ask them a questionnaire. I told them I’m not being a smartass, I just have a LOT of questions before the big day, and most of them only the vet can answer, so if I can speak to him when he has the time, I’d appreciate it.

they told me he wasn’t there today, so he will call me tomorrow.

I then asked for a list of procedures to be done that day – dont know if they gave it to my fiance or not but if they did he misplaced it – and whether some things can be done prior to the major stuff. They said they will send it in the mail because there are over 10 things the vet is going to do.And as far as the imaging, bloodwork, etc, to be done prior to the big day, that I will discuss with the vet tomorrow. They said a lot of it is “minor” though – I don’t care. I’d rather get the minimal stuff done first.

One thing I always noticed about Boon’s poops is that they smell like McDonald’s food. lol. I’ve never smelled that from a rabbit before, so maybe this vet is onto something about his cecum being malfunctional. But if that is the case, how is it treated? And his URI…. those never respond to antibix unfortunately, at least not in my experience. 

I wonder if perhaps this vet may feel he has a Clostridium overgrowth, I keep thinking back at his comments about Boon’s cecum being malfunctional, which would make sense considering his smelly poops which are occasionally encased in yellow mucus. He gets large sausage poos too (like big turds instead of little round pellets) that are moist when he gets slowdown. He gets those about once a day.

my main concern is, the BOTTOM LINE is, I want to minimize his stress and I don’t want any surgeries being performed on his gut. nope nope nope.

In addition to all my questions, I’m going to be asking the vet all of these too: http://www.rabbit.org/faq/sections/spay-neuter.html#good-questions

If anyone can think of anything else, it is so appreciated. Will let you all know what the doc has to say tomorrow!

[LittlePuffyTail]

I think it’s great that the vet is going to take time to talk to you first. It’s very important you feel comfortable bringing Boon in.

So the vets plan is to neuter and do some of the procedures at the same time? Getting the blood work and X-rays done ahead of time is best because it will show if he’s healthy enough to undergo anesthesia.

Good luck talking to the vet.

[Nova]

Hi LPT

Sorry for having two active posts in this same forum… I feellike I’m being a major in the cottontail.

I spoke with the exotic pet specialist vet today who will be performing the procedures on Boon. He was rather annoyed that I didn’t trust him and he acted like everything he does is so routine that he never screws up, and he thinks I’m paranoid. Anyway, I told him it would make me feel better to have some questions answered.

Q: Can I have the less invasive procedures such as bloodwork and x-rays done prior to surgery?
A: Yes but it doesn’t matter either way.

Q: Wouldn’t that be a better idea because then we can know whether he is even healthy enough for surgery?
A: We don’t even have to do the surgery if you don’t want to – but yes
(my response: I DO still want the surgery done – he needs neutered and is terribly sexually frustrated).

Q: What is the rate of loss your practice has on rabbits?
A: I don’t know what you mean by “rate of loss” but it’s been so long I can’t even remember.
Q: So, would you say about 1% or less?
A: I don’t have any percentages! But since it’s been so long I’d say yes, less than 1%.

Q: Do you do closed or open neuters?
A: I do both depending on the rabbit’s anatomy.
Q: Wouldn’t a closed approach be less traumatic?
A: Not necessarily.
Q: But doesn’t the open approach involve a larger incision?
A: Only by a millimeter, so it doesn’t matter, and again, it depends on the unique rabbit’s anatomy. I am comfortable doing it both ways.

Q: What type of anesthetic will you be using? I ask because in October 2011 I had a rabbit die during a routine neuter surgery and the anesthesia they used was total IV anesthesia – they said it was the same they do for cats.
A: Well, I do not do that, so don’t worry about it.

Q: Will my rabbit be intubated for respiratory support while he is under anesthesia?
A: Yes.

(Here I tell him I have only a few more Qs and he scoffs and sighs because he is very busy)

Q: Are we checking Boon’s teeth during the scopes and x-rays?
A: Yes

Q: Will you be performing any type of surgery to his ACTUAL G.I. Tract? I ask because I heard from my local veterinarian that sees rabbits that rabbits often do not recover from surgery to their GI tract because that is their most important organ.
A: I didn’t have any plans on it, no. But I disagree with your local veterinarian. I perform surgeries on rabbits’ GI tracts routinely and they all go on to have a high recovery rate.

Q: Boon’s poops always smell awful – like bad McDonald’s food. Is it possible that we are dealing with a bacterial component due to that fact? Or a problem of too much bad bacteria in the cecum?
A: Well that sounds like bad news for McDonald’s. Ha ha.
Q: I’m serious.
A: Well that is what this all could very well come down to – and a small change in his diet with the additional of probiotics may be the answer he needs.
Q: I give him a full course of Benebac as directed every week though. However, I do notice when it is time for his second dose of Benebac – I give him 1 tube for 2 days, wait 3 days then give him another 1 tube for 2 days – his poops smell worse between his Benebac doses.
A: Is that all…? I am very busy today.
Q: Yes. What do I do now as far as scheduling?
A: Talk to the office staff and schedule what you want done first and then we may have to reschedule the neuter and scopes.

So that was that….. I’m going to call tomorrow to schedule his bloodwork and x-rays (dr also mentioned barium x-ray)….then see if we have to reschedule his neuter/scopes.

thoughts? advice? comments? help? please?

I’m going to be writing Dana Krempels as well.

[LittlePuffyTail]

Well, I can certainly understand how busy vets are but he seems like a pretty snarky fellow. At least he answered your questions.

When are you getting Boons bloodwork done?

[BinkyBunny]

I agree he sounded snarky! Doesn’t mean he is not an excellent vet (maybe why he is so busy). I do not like any vet or any health professional that makes you feel like you are inconveniencing them. It is beyond insensitive.  Maybe the staff did not relay the message properly about you having alot of questions.  Ideally he should have asked you if he could call you back when he wasnt so pressed for time otherwise I find his reaction rude.  I guess I am lucky as my vet sets times for call backs during the day or after her shift. However if she calls me during her call back break she will let me know how much time she has to spare and I will be mindful of that and if the convo gets longer I will normally ask about her time and she will either say go ahead and ask or she will ask if she can follow up later.

However in your case if your access to exotic vets is limited you may have to choose expertise over a a good bedside manner.

[jerseygirl]

Your description of his poos reminds me of bunnies that have “cow-poop syndrome”. Sometimes called cow pile syndrome, megacolon or congenital aganglionosis. If you are still planning to write to Dana Krempels, I suggest you ask her for current info on this condition. I believe she knows a bit and has had a few rabbits herself with it.

{{{Boon!}}}

[BinkyBunny]

Posted By jerseygirl on 07/01/2012 06:29 AM

Your description of his poos reminds me of bunnies that have “cow-poop syndrome”. Sometimes called cow pile syndrome, megacolon or congenital aganglionosis. If you are still planning to write to Dana Krempels, I suggest you ask her for current info on this condition. I believe she knows a bit and has had a few rabbits herself with it.

{{{Boon!}}}

AH!!  Good point Jerseygirl!   

Here is a link to Dana Krempels helping out another forum member wrote Dana about her bunny’s issue — very detailed with pictures too.  It might be helpful http://www.allexperts.com/user.cgi?…ID=4834527

[Nova]

Hi Binkybuns!

Thank you for responding. I haven’t been around what with the weekend before the 4th and then the yard sale which fortunately raised us a little bit of money to help with Boon’s vet bills. About a quarter of what we need. I started a FB page for him but that hasn’t done squat.

I would say snarky is the appropriate word for this veterinarian, but moreso leaning towards egotistical. I mean, he is just so completely “smarter” than any other vet or human being on the planet (that is his attitude) when it comes to rabbits. As BB mentioned, I think I have no choice but to put up with his terrible bedside manner just for his expertise.

Jersey, I have heard of cow pile syndrome and one of my rabbits (who lived 10+ years no less) suffered from it chronically despite a perfect diet. She never had a brush with GI Stasis, though.

boon’s poops I would describe as chronically malformed, often large and wet or tiny and dry….usually nothing in between. It’s one extreme or the other. and they stink mlike bad McDonald’s food!!! ugh.

I haven’t had time to write to Dana yet, but when I do, I will let you guys know what I wrote, and maybe you guys can help me formulate some questions for her.The cow pile syndrome is an excellent point to bring up.

also, is it okay to give Boon Benebac as directed every week? That would be 4 doses per week, with each dose given as…. one tube for 2 days separated by 3 days, then another one tube for two days. It really seems to help.

Also, does anyone know of a good place to get digestive enzymes for him? I know we are not supposed to rely on these types of things but I think Boon is an exception to that rule as his gut motility issues are chronic and at times severe.I have the white bottle with the red cap but according to excellent sources, there is not nearly enough enzymes in those little sugary snacks to help with digestion at all.

Let me know! And thank you!! Love you guys!!

[Author]

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