Is speed essential in treating GI Stasis/possible blockage?

[Dee]

Hi Everyone,
I haven’t posted in ages. Right now I’m an absolute wreck. My female lionhead, Precious, is prone to has. Several times in the past, I’ve rushed her to the emergency vet in the middle of the night, and spent $500 for a several hour wait and to be told her Xrays were fine, here’s 3 doses of Metacam. Then I would take her home and keep up the belly rubs and simethicone and she would recover. So the past couple times I just dealt with her gas bouts at home. Well, yesterday at 1pm I noticed she wasn’t eating. I started the simethicone, Metacam and ranitidine, kept her warm and rubbed her belly. My regular vets office closed at 6 and I really didn’t want to bring her to the emergency vet. My husband also said forget it, he wasn’t paying all that $$ again for nothing. So I stayed up all night and continued meds and force fed Critical Care. Now I was always afraid to do that in case there was a blockage, but Precious has had gas about 15+ times and no blockage. I waited to take her to my regular vet at 8:30 am. By then she hadn’t pooped or eaten in over 18 hours and I wasscaresand kicking myself for not taking her in to the Emergency Vet. But her temperature was good and she seemed ok through the night, even nosing her food like she was going to eat soon.

Well, my regular vet took an Xray and said her belly is very full, possible blockage and some gas. She didn’t feel safe dealing with it so she have me a CD with the Xrays and sent us to- you guessed it- the Emergency Vet. They are a top notch facility but they are so busy, they take forever and I never feel like they really care. We got here at 9:30am. They took Precious right away, but now it is 3 hours later and they are just sedating her now!! No motility meds, no pain meds. I feel like she is losing her chance at living because they are taking so long. I thought this was a medical emergency- is this normal? I’m so mad at myself for waiting, and not just telling my husbanx we are going and taking the chance on getting our usual brushoff here. And now I think there is no way she is going to make it because they are doing nothing for her. I asked the doctor is he thinks she has a chance And he said he thinks so, but they need to do more of a work up. Maybe an ultrasound now too. They already repeated the Xrays and took blood- shouldn’t it be evident if she needs Reglan and/or Propulsid and fluids?

Sorry, I’m just really scared and don’t feel right about this.

[Wick & Fable]

Every case is different, and I think we’d need to be tiny microbes and get into her gut to really evaluate what a worrisome wait time would be. Since that’s not an option, I think you should fixate on the fact that you were continually giving meds, CC, and belly rubs.

On one hand, it is useful for vets to hear what your rabbit has been given in the past and what has/hasn’t worked, so the mention is not bad. If you can get a hold of someone and express your concern, do so— the worst thing that can happen is they don’t do what you recommend, but you told them and they had that knowledge to work with, which is the primary outcome you want.

What’s the frequency of gas/time period this issue has spanned? Is hay consumption poor with Precious?

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Bam]

Every case of stasis is different, as Wick says. Stasis can have so many different reasons, and it is rather a symptom than a disease of itself. The underlying reason can be anything from a slight disruption of gut PH that causes a gut slowdown that in turn causes gas buildup, to something really, really serious. And it’s not possible to say which without tests like x-rays and blood samples.

I think they want to warm her up and stabilize her before they do any procedure. If the kidneys are the problem, it’s not always good to give fluids right away. Most vets just do x-rays, give warmed up fluids and hope for the best, but since you were referred from your normal vet, they are probably taking this more seriously. A blockage is more uncommon than a gut slowdown, and it’s also more difficult to deal with and might even require surgery.

Time is important in many cases, in some cases it doesn’t help to rush the bun to a vet. You can’t know which is which. If you have a gas-prone bunny, I think most people would try to deal at home first. You feel you recognize the symptoms, there’s been so many false alarms, you know the normal procedure and have the meds at home (simethicone, CC) etc.

[Wick & Fable]

If it is gas-prone-ness due to an unstable gut pH level, putting a small amount (like a few drops from a dropper) of apple cider vinegar *with the mother* in the water may help. The natural bacteria and enzymes in the mother of apple cider vinegar help regulate gut pH.

http://riseandshinerabbitry.com/2012/01/26/apple-cider-vinegar-for-rabbits/
http://madhatterrabbits.com/2013/12/11/using-apple-cider-vinegar-with-rabbits/
— Those are by no means academic research studies, but have some particularly valid scientific logic.

Wick gets it in his water. If anything, it at least nullifies the pee smell.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Dee]

Wick and Bam, thank you so much for your kind replies. Strange- I’ve submitted 2 replies already and they don’t show up. I’m probably doing something wrong in my stress.

I know I did what I thought was helpful, and focusing on that is better than beating myself up over what I didn’t do right. From reading up on the info given by the vet, Precious has bloat ?. It’s not looking good. I am pretty angry because everything I read says quick treatment is important and they did NO treatment until at least 2pm- just bloodwork and more Xrays.. We arrived at 9:30am. The set of Xrays they took was much worse than the ones the regular vet took- maybe because it has been over 3 hours and they did nothing to help Precious ?.

Her stomach is hugely swollen and her intestines are dilated to nearly twice their normal size. Has anyone heard of a rabbit surviving this? I won’t put her through surgery because the prognosis for surgery is so poor and the suffering is so great. She has already suffered enough because of my stupidity and the Emergency Vet’s lack of urgency.

I almost cried when I saw the Xray- all I could think of was me syringe feeding her Critical Care ?. The reason,I usually ran to the vet before with Precious is precisely for the reason that I know that the treatment for GI stasis is more harmful than helpful if there is an obstruction. But this time I kept telling myself,”of course she doesn’t have an obstruction! She’s hopping around, her belly is soft, her temp is normal- I’m not going to the Emergency Vet to stress her out and wait 3 hours only to be sent home!”

They are supposed to do a second set of Xrays after some treatment with Reglan, fluids and pain meds. I’m wondering why they didn’t mention relieving the pressure in her belly with a tube down her throat (I want think of the name for it- cant think straight).

I haven’t gotten any phone calls so I guess that’s good. The only thing is the pace there is so ridiculously slow that Im,not sure I even believe they are doing anything. I called up to check up as soon as I got home and tell them (like they done know!) that if she is to have any chance, she must be helped right away. They made me pay $1350 to keep her overnight. After I paid that they let me say goodbye. It was then that I discovered that she was still not receiving any treatment- she was in a freezing cold cage next to a barking dog. I asked if she was warm enough and the tech said her temp is normal. The paper on her cage said her temp was 100.00° which is 1 degree low. I am so angry at myself and at this “top-notch” facility. I’m not saying the name of the place in case they redeem themselves, but if that’s becoming pretty unlikely.

[Dee]

Just wanted to thank both of you for the great information too, on GI stasis and the medical treatment of it, and about the vinegar in the water. Also want to answer Wick’s questions-

Precious has always eaten lots of hay. She has some tiny points on the molars but not enough to inhibit eating or cause abrasion. And usually she stops eating suddenly- goes from begging for for food to refusing everything the next hour. Normally I give the gas treatment protocol and she is eating and pooping within 4-8 hours. She did have one bout that lasted over a day, where she stated eating a bit then stopped. And she had nice plentiful, round poops in her litter box from yesterday in between 12am and 1pm. The day before she had time of poop- and now that I think of it, maybe a bit more pee than usual. Nothing else weird, and pee was normal. Thanks!!

[Anna]

Big hugs to you and Precious.

I’ve been through a similar experience and know how stressful it is to find yourself questioning everything you’ve done. But you obviously care deeply for her, and are doing everything you can to help her.

Best of luck x

[Bam]

I’m keeping you in my thoughts today. (((((Precious)))))

[Dee]

Thank you so much, Bam and Anna. I haven’t heard anything and the liaison for info is only open during business hours. I’m encouraged that I haven’t heard anything, since they were supposed to call if her next Xrays were worse. Surely they wouldn’t just put her to sleep with calling me!?

I’ll keep you posted. I’m gathering my courage to call right now. This sick bunny stuff really does a number on our nerves, huh?

[Dee]

I just got a call. She was doing better, pooped and nibbled hay overnight, they thought she would be going home tosay- then she died as they were doing Xrays today. I am just devastated. She was only with me for 14 months, she had an untreated broken hind leg before she was abandoned and rescued- she had been through so much. I feel like I really screwed up on this, and no matter which way I try to spin it, I should’ve known better than to let a rabbit go for over 12 hours without pooping without veterinary care. I let myself be influenced by the fact that I always brought them in “over nothing” and cost my husband hundreds of dollars and stressed the rabbit. And the vet said, one thing they look for is body temp as a sign of failure and hers was notms

[Dee]

Sorry, pressed send. Her body temp was fine all through the night with me and with them, except for dropped to 100°. I really hope they didn’t drop her or anything, and that she really got the right care. The vet on the phone did sound nice, so that’s something. I just keep thinking of the delay in my bringing her and their delay in treating her once she got there. Maybe that sealed her fate…?

Anyway, they are doing a necropsy because given how well she was doing and the fact that she seemed almost ready to go home, they are worried about either e. Cuniculi or some other bacterial infection, and I have to think of Luke. I’m praying there was nothing like that, and will be watching Lukie like a hawk. His stomach was making its usually loud noises last night and I was driving him crazy, following him around trying to feel his belly.

The one thing I take away from this, and want to share with anyone else reading this, is never to put off taking a bunny to the vet even if you think they can “probably” wait. I spent the whole night rationalizing my decision not to bring her, and she did really seem stable- but if there are any signs like not pooping or not eating that have either never happened for that rabbit OR have never gone on that long- bring them in if at all possible. Maybe she wouldn’t have made it anyway, or maybe if she lives this time, the next time or the next, I would have been working an overnight shift and not found her until I got home. I guess that would have been worse. But for the other bunny parents, please don’t let anyone or anything make you doubt your guidelines for when to bring your rabbit in to the vet. At least then, if the worst outcome should occur, you know you’ve done everything you could. I’ll always have that doubt, maybe she would’ve lived…

Thank you to Wick, Bam and Anna for your support and advice. I really appreciate it! I’ll let you all know the results of the necropsy.

Oh, also- this was news to me: the vet said that repeated GI episodes can be caused by e. Cuniculi. I never knew that. She also said that she does not recommend giving a course of Panacur without getting the bunny tested first, because they have actually lost rabbits to bone marrow supression due to the Panacur. The shelters I know give Panacur as a prophylactic to all their rabbits, and I did that with Nelli and BunBun- for Nell, it was too late as she had already been affected by the parasite. It ultimately caused kidney failure and killed her.

Ok, sorry for the veeerrreee long and extremely depressing post. It just helps in a way to “talk” to people that get it. Thanks again for being here.

[Bam]

I’m so very sorry, Dee. Bloat has a very poor prognosis. It’s cause is unknown, but I’m thinking there could’ve been something wrong with her intestines to begin with, something congenital having to do with the innervation of the gut or sth else that caused her to have all those episodes of gas. Maybe this tragic outcome was inevitable and would’ve happened no matter what. But nobody really knows what causes bloat and it’s all so terribly sad. I’m so sorry the ER vets seemed to prolong her suffering by being slow about treating her.

[Dee]

Thank you so much, Bam. I had actually thought the same thing- that she may have had an underlying GI problem. She got gas so much- thinking back now, it seems that it was about once a month if not more often. Every time I thought I had discovered the cause- alfalfa hay, carrot greens, banana, tap water- it would happen again. Another thing is she had that healed broken hind leg- I wonder if she could have had scar tissue in her belly from an injury? Although that is probably unlikely because how many bunnies would survive an abdominal injury that serious?

I am so sad, but at least I was with her right up until she went to the vet. I stayed up all night with her and she knew she was very lived. My fear had been coming home from an over night shift and finding her cold and dead. Then I would be haunted by the thought of her being all alone and in pain.

I guess I just need to let go of my anger at myself at the vet facility. At least they did get her comfy enough to nibble hay and poop.

Thanks again for your kindness, Bam ❤.

[Dface]

Im so sorry to hear about your loss, I really am.
Your story really resonates with me as I lost a rabbit a little while ago who I’d had for a similar time frame as you, not to bloat, but a similar “wait til the morning to go to the vet ” situation.

I think about it a lot to be honest, it’s hard to wonder the what if’s and the maybes. But sometimes I think it was just the time he chose to go. Like the reality of having to get a surgery, and then another vet visit, and another forever until it finally caught one of us out…maybe it was a bit like this for your girl?

Sometimes an animal just has a time to go, and you gave her the chance for a life she might otherwise have never experienced.

I just wanted to post here to let you know that you arent the only one who has felt like this or felt let down by the vets that you trusted to help .

[Dee]

Dface,
Thank you so so much, you have no idea how much that helped me. Or maybe you do, having been there. I am very sorry about your bunny too ?, and appreciate you sharing your loss with me. It put things in perspective and although I wish nobody else has to go through that, it helps to know I’m not alone in going through this doubt and selfblame.

It was the same thing for Precious- she hadn’t gone through a surgery, but we had been through bouts of gas pretty much every month, sometimes more, for the 14 months I had her. And who knows how often her belly hurt, just not enough for her to stop eating and make me aware. I think of times I would see her laying down and her ears would be trembling a bit. I would check her and she would seem fine, but maybe she suffered more than I knew. Then of course, the poor thing had a broken leg sometime before being left on the side of the road by some despicable non-person. The leg was splayed out to the side a bit, and showed up on Xrays as a healed fracture- I think it was never taken care of properly. So yeah- a lot of pain for a young bunny, and maybe just her time to go. You voiced the same worries I had- “until it caught one of us out”. How true! When a bunny has a unpredictable, chronic health issue like that, we never know when it will strike. No matter how much we love our rabbits, we can’t be there every second. I haven’t gone on vacation since I got Precious- I have to work overnight shifts twice a week and I was always so afraid she would get sick when I was working and suffer all night alone. It was just bound to happen, whether it was bad timing or an error in judgement or fate.

Your bunny was so blessed to have you- I can tell from your words how much you loved him. After hearing from you, I do realize that the best thing either of us can do is remember that we gave our rabbits a great life and lots of TLC, and that is all anyone can do for another being that is dependent on them. Thank you again for sharing your experience. {{{❤}}}

[jerseygirl]

Oh Dee, I am so very sorry. So much stress for you. Like you and like Dface, I’ve been through those “what if’s” and “maybe’s” for a long time. I can relate to the “lets treat this at home, we’ve been through this before – no need for e-vet”. And Ive been through hospitalising a rabbit and then in hindsight realising that he didn’t get the care I thought he was getting. Both scenarios can play on your mind a lot for a long time. But I have to remind myself that the decisions I made are what I thought was the best at the time. It’s possible that even if I decided things differently, the outcome would have been the same.

I do realize that the best thing either of us can do is remember that we gave our rabbits a great life and lots of TLC, and that is all anyone can do for another being that is dependent on them.

That is exactly right. 

 
Binky Free, Precious. You are loved so dearly.

[Dface]

I’m glad it has helped you some!

Something that actually helped me a lot was something a person I met said;

Shortly after I lost him someone told me that they really believed animals like ours, the little sick ones that battle really hard against odds, find people like us for some reason thats not always clear, but they only ever stay with us for just exactly as long as we need them, no more than that.
At the time I thought it was a stupid thing to say-I still needed his lil happy face to greet me in the mornings.

But, now I think I believe her. I hope when you look back in time, you’ll see it too.
It’s helped me a lot to realize that all the time I spent looking after him, he was in his own way, looking after me, and when the end came, it was partly a release from all the pain the world put on him. And maybe Precious was with you for a similar reason, even if its not clear right now

[jerseygirl]

Dface, I love that. <3 Thanks for sharing it.

[Dee]

Hi Jerseygirl and Dface,
Thank you for your replies- you are both so kind and I know that you understand. It seems that many of us look back and doubt our decisions- Ithink it’s the fact that our bunnies are completely dependent on us and we love them so much. It’s a blessing but also a huge responsibility.

Jersey, I’ve always looked to you for advice on my rabbits- I feel like you’re one of those bunny parents who always knows what to do! So to know that you have even gone through the “what if” thoughts makes me feel better. Not that I’m glad you have gone through that- I wish none of us had to see our rabbits be anything but healthy and happy. But, just not how life goes ?. And you’re right, in many situations the outcome would probably be the same.

Dface, that is absolutely beautiful, and brings me comfort to think of. I do believe that there is a reason for everything, even if we can’t see it sometimes.

[Dee]

Sorry, for some reason I hit submit all the time in this phone.

Dface, at the time I adopted Precious, things were not going very well for me. I had lost my mom the year before, then my rabbits BunBun and Nelli died, and my daughter was going through some major problems that were very frightening and heartbreaking for me to watch. Seeing watching how happy Precious was really did bring me so much happiness and helped take my mind off my problems. It helped me to be able to make her life wonderful, although I wasn’t able to help my daughter at the time. Thank God, my daughter is doing better now, and life is better… So now that I think of what your friend said, I realise how true it is.

I’m still working through how let down I feel by Tufts and the delay in treating Precious, but I’m starting to forgive myself and realize that I really did the best I could. I’m also looking for a different vet, because I never want to be in that situation again, when I bring my rabbit for help and they send us elsewhere. I need a vet like I used to have, that has the experience and knowledge to treat a serious emergency instead of referring me out and losing valuable time. I’m going to start calling places next week, and bring my little Luke in for an introductory visit/checkup when I find a vet I like.
Thanks again for your support- it really has made such a difference to me.

[amammal]

Hi Dee,
I’ve had a strikingly similar experience with my Donut, involving GI stasis, Tufts, E. cuniculi, and a terribly mismanaged case. I’m working on writing up my story so as to spread the word to bunnies everywhere about the apparently recent discovery of a link between GI problems and an otherwise subclinical E. cuniculi infection. In the meantime I’m posting to recommend to you Dr. Brendan Noonan at Angell Memorial. He’s a board certified Birdologist, but also a general exotics specialist and his knowledge of bunny gut physiology is second to none. He is also the first vet in ten years to recommend fecal cytology AND poop bacterial cultures. I had no idea that even existed. Had those diagnostic procedures been offered before, and if there’d been a more widespread understanding of the insidious nature of E.cuniculi, a lot of my bunnies would still be alive. Apparently you, me and our buns have been on the cutting edge of Veterinary medicine, which unfortunately could stand to be a bit sharper.

[jerseygirl]

Posted By amammal on 1/27/2018 10:00 PM

Hi Dee,
I’ve had a strikingly similar experience with my Donut, involving GI stasis, Tufts, E. cuniculi, and a terribly mismanaged case. I’m working on writing up my story so as to spread the word to bunnies everywhere about the apparently recent discovery of a link between GI problems and an otherwise subclinical E. cuniculi infection. In the meantime I’m posting to recommend to you Dr. Brendan Noonan at Angell Memorial. He’s a board certified Birdologist, but also a general exotics specialist and his knowledge of bunny gut physiology is second to none. He is also the first vet in ten years to recommend fecal cytology AND poop bacterial cultures. I had no idea that even existed. Had those diagnostic procedures been offered before, and if there’d been a more widespread understanding of the insidious nature of E.cuniculi, a lot of my bunnies would still be alive. Apparently you, me and our buns have been on the cutting edge of Veterinary medicine, which unfortunately could stand to be a bit sharper.

That is really interesting!  Thanks for posting about it, amammal.  I hope you’ve been able to find what treatment works best for Donut.

Many years ago I read this very vague speculation of a connection between EC and gut problems.  It always stayed in my mind. It was at the end of a section about cow poop syndrome, but was not mentioned again it the sites info about EC- strangely.  Most articles on EC really only cover the more common symptoms. 

It is also possible that the neurological symptoms (or stress) resulting from the Encephalitozoonosis cuniculi cause problems of intestinal malfunction. 

source:http://translate.google.com.au/translate?hl=en&sl=it&u=http://www.casafreccia.it/salute_malattie_gastrointestinali.html&ei=qw3wSrazCovVkAW538ybBw&sa=X&oi=translate&ct=result&resnum=6&ved=0CB0Q7gEwBQ&prev=/search%3Fq%3Dmega%2Bcolon%252BFrances%2BHarcourt-Brown%26hl%3Den%26rlz%3D1T4GGLR_enAU252AU252%26sa%3DG

[Bam]

Thank you for posting, amammal!

EC is probably underdiagnosed. It would make sense for it to affect the gut, there is a whole nervous system in the gut (the enteric nervous system). This is so interesting and more knowledge really could make a difference for rabbits all over the world.

[Author]

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