GI stasis… Please help

[Fjarl]

This started two weeks ago when Agatha (4 yr old Flemish giant) would not eat anything (including her favorite treats). We took her to the vet right away where she got sub q fluids and we started force feedings. After two force feedings she started eating produce on her own, and was eating her hay and pellets by the next day. She was back to normal for a week. Then our friend pet sat for us while we were out of town for five days (we were home the morning of the first day and back the evening of the last day). Agatha was fine when we got home, and had been eating and pooping normally while we were gone. We got back Monday night. Tuesday morning she was acting normal, but by the evening she would not eat her pellets. We were able to get her to eat some critical care and produce on her own. Wednesday morning she still had not eaten or pooped so we took her to the vet. They gave her more sub q lactated ringers and started her on force feedings again, as well as metoclopramide and Metacam. By wednesday night she was more lethargic and had stopped urinating so we took her back in. They started her on baytril (they said it would help prevent “bad” bacteria from taking over her gut), and cyproheptadine to stimulate her apetite. Thursday morning she could not ambulated more than a foot or so and seemed extrely weak, she also stopped eating the small amounts of fresh herbs she had eaten before when hand fed. I slept next to her on the floor and she whimpered throughout the night. The vet preformed an X-ray and blood work. Her liver and kidney levels were both elevated (they said likley due to dehydration and anorexia induced hepatic lipedosis). The X-ray showed that her cecum is full, but they don’t know if it’s from the gi stasis, or if it could be an obstruction. They said the next diagnostic option would be exploratory surgery. We decided to continue treatment, because we ate afraid of the risks involved in surgery, and they don’t know if it’s an obstruction or not. She was given more sub q fluids, which they sent home with us to continue. They also prescribed Buprenex for the pain. Today she started urinating again, and is still very lethargic and has difficulty moving, but she started grooming her front paws again. I thought I felt a firm area in her abdomen, so they said to bring her in again. They could not find the firm area and offered surgery again. They said we could also try feeding stool from our healthy rabbit to Agatha. We opted to take her home again, and will try the fecal solution tonight. Now she has a thick white secretion coming from her right eye. We called the vet, and I think he said it could be a secondary infection, and that we should continue the baytril. Agatha normally eats unlimited Timothy hay and water with three cups of greens and a half cup of oxbow pellets with one to two slices of trader joes freeze dried bannannas (just bannannas, no added sugar or oil) as treats. At this point I don’t know what to do. The vet said if she stays the same and continues to consume her force feedings we can wait as long as Tuesday to make a decision about the surgery. I’m afraid of waiting too long if it is an obstruction, and I’m afraid of going ahead with the surgery if it isn’t. Also, the rabbit savy surgeon dosent work again until Wednesday. Please help!

[jerseygirl]

She sounds like she is in great care between yourselves and the vet.
I can definitely understand your reluctant for surgery.
So at this point is she passing stools at all?

Was the X-ray taken abdominal?

I wonder if further X-rays (when she’s more stable) of her spine and teeth should be done? It rather sounds like there is an underlying health issue causing the bouts of stasis. It may not be directly something to do with her gi tract.

{{{Vibes}}} for Agatha!

[jerseygirl]

Her liver and kidney levels were both elevated (they said likley due to dehydration and anorexia induced hepatic lipedosis).

Yes, I think it’s common for liver enzymes to be elevated during stasis.
It may be worthwhile doing further bloodwork when she’s well recovered though.

Are you able to monitor her temperature?

…and cyproheptadine to stimulate her apetite.

I have to say, I’m a little wary about this.

[Fjarl]

Thank you, the x ray was abdominal. The vet looked at her teeth during the exam, but no x ray. The last time she passed stool was two small pellets Tuesday night. We haven’t been monitoring her temp, but we could start. What is concerning about the appetite stimulant? Could it be harmful? Thank you for your help.

[jerseygirl]

We haven’t been monitoring her temp, but we could start.

It’s definitely something that will help you determine how she’s doing. If she starts dropping under 100F you would need warm her up and get her seen again. 101 is the low end of normal range. So even 100F is concerning.

What is concerning about the appetite stimulant? Could it be harmful? Thank you for your help.

I guess because I’ve not seen that used for stasis in rabbits before. It can cause drowsiness too. Plus she’s already on an opioid med (buprenex) that can have sedating effect. If your vet is experienced with exotic pets, i guess they know what they’re doing!

[MimzMum]

I’m not a vet but from what I have read before I think to check for an obstruction in the gut the vet also has to monitor the rabbit’s blood sugar levels. Was a test done for this? If the levels are high it might indicate a blockage. This article may help.
http://www.ncbi.nlm.nih.gov/pubmed/22659922

Is she still taking sub q fluids or is she drinking on her own? Hydration is key to getting a sluggish gut going. I’m thinking you might want to decrease or eliminate the banana for the moment as this is very sugary food and can cause some bacteria to grow more, especially in a slowed gut. (Of course limiting treats when bunny is unwell seems cruel, but you don’t want to feed the problem either.) Are there any herbs she likes you can substitute for the moment? My bunny Mimzy is particularly fond of mint, for example. Don’t worry about trying anything new at this stage though since we don’t want to upset her stomach further.

With the sudden appearance of the white substance coming from the eye it may also mean the stasis is secondary to another infection and a result of her harboring illness elsewhere, especially since this has been going on for two weeks already, or the stress of stasis is bringing out other issues as your vet suggested. Baytril is a good cover antibiotic but if she’s got something else going on, something stronger may be needed eventually. Your vet will direct you to what’s best, if they’re rabbit savvy. Obviously they will want to get her tummy working again first.

Sending (((((((healing vibes))))))) for Agatha. I hope the cecal therapy will help also.

ETA: After reviewing the Dana Krempels webpage on stasis,
http://www.bio.miami.edu/hare/ileus.html
I see at the bottom under appetite stimulant, this antihistamine has been used in some cases, Jerz. Odd I hadn’t noticed this before. And of course the only case where force feeding would be counterproductive is during a blockage, but as the vet hasn’t determined this yet it’s hard to say if it’s benefiting this rabbit. Fjarl, you said she hasn’t pooped since Tuesday? Is she passing any gas or mucous or anything else at all? What does her belly feel like to the touch?

[Fjarl]

Thank you, she’s not passing any gas or mucus that I have noticed. Her abdomen was soft, but the firm area I felt yesterday is larger. The clinic we were taking her to does not have any rabbit savy vets in today, so we called a specialist, and they had us bring her in as an emergency case. At this point they are reluctant to do any more lab work because she is so unstable. They are monitoring her in the back, and I’m sitting in the waiting room waiting until they can look at her. The vet said that there is a very high probability that she won’t make it. They might try another X-ray. She won’t eat anything on her own, so she has not had any bannana since Tuesday morning. She is still on sub q fluids. Thank you both for your help and support.

[Fjarl]

We had to put her down… The X-ray showed that her intestines had twisted around themselves. They don’t know if it was a cause or a result.

[MimzMum]

Oh no…I’m so very sorry. :'(
Binky free Agatha.

Sending you huge hugs. You must be heartbroken. I’m so very sorry.

[jerseygirl]

I’m so sorry.
Such a traumatizing experience.
You’re in my thoughts.

**Binky Free Agatha**

[jerseygirl]

@MimzMum, thank you for pointing that out in Dana’s article. I had it open just yesterday but only to reference normal temperature range.
Ive not noted that before about the antihistamine either.
Time for a thorough read.

[LittlePuffyTail]

I’m so very, very sorry for your loss.

(((((Binky Free Agatha)))))

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