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Forum HOUSE RABBIT Q & A More stasis questions

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    • Meg
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        Hey everyone! 

        So my 9-year-old, Teddy, is hanging in there but still in pretty bad stasis.  It’s been 12 days!!  I had to take him back to the vet for a recheck 3 days ago, and I think the stress of it set him back quite a bit.  They didn’t find much but sent out bloodwork which we should get back in 2 more days.  

        Yesterday Teddy wasn’t pooping much and then this morning I found this tar-like dried poop in his litterboxes, a bit on the rug, and even some on the wall!  And it was really hard to get off the wall, too — suuuuuper sticky and viscous and tough — truly like tar.  

        I’m worried the meds the vet put him on may have caused this.  He’s on simethicone and laxatone (1-2 CCs twice a day, the vet made me promise but I hate it), and now .85 CCs of omeprazole twice a day!  That’s just as a precaution, because he’s also on meloxicam.  But it smells so foul.  And I’m concerned that with all these different oily things, it’s perhaps a combination that makes things harder?  After reading more about laxatone on this forum I’m tempted to stop it unless he stops pooping altogether again.  

        What do you think?  (He’s also on cisapride and 50 CCs of subQ lactated ringer’s twice a day.)  

        Also: last night during a long and difficult force-feeding session, Teddy was sitting next to me on the bed digging as he usually does to get his frustrations out — and then he peed on me, like not just a little but a whole lot!!  Do you think he was just mad?  Or is this a cause for concern?  

        Thank you so much!!


      • Meg
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          p.s. A couple of times when I was feeding him just now, his stomach made a loud gurgling sound as I put him in a mostly reclined position. Is that a concern? I don’t think I’ve ever heard that before.

          I’m stopping the Laxatone for now, and skipping the omeprazole for tonight.


        • Bam
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            A loud gurgling sound means there’s movement in the intestines, which is good. (Stasis means a slowdown or full stop of intestinal movement). When the intestines “start up” like that, it can be painful for the rabbit, so meloxicam (and omeprazol to counteract the effects of meloxicam on the gastric walls) should be given. There can be painful gas that’s trying to get out, and for that you can give simethicone baby gas drops (0.5-1 ml). You can also try to elevate his butt a little to help gas escape. I wouldn’t risk massaging his belly, but elevating the butt a little bit can help.

            The sticky tarry poop sounds like cecal dysbiosis. Cecals have an extremely sticky coat of mucus on them. When there’s cecal dysbiosis the cecals don’t get properly separated from the fecal poop and you get very sticky, foul-smelling poop.

            You’re right about laxatone, it used to be recommended for rabbits, but it rarely is anymore. It can cause problems. I have never used it, but we have members that have.

            I think it’s a good sign that he peed, it means things are moving in there. That he didn’t have time to or didn’t feel well enough to get to the litterbox is of less importance imo. Although it is inconvenient for you of course, so next time maybe you should put down thick towels or puppy pee pads on your bed in case he goes there again.


          • Meg
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              Oh thank you so much, Bam, this is sooo helpful!! I really appreciate it!

              Question: someone else on here had mentioned that their vet had put their bunny on a med similar to omeprazole but said to give it an hour after all the other meds because it coats everything and could prevent absorption of the meds. On the other hand, omeprazole is usually given ahead of food. My vet didn’t say anything about when to give it in relation to other things, and they’re closed today. Do you know what timing would be best?

              This morning I just found a few tiny poops. I’m glad he’s pooping at all, but sad it’s progressing so slowly and not sure what else to do to help. He’s still not eating anything substantial on his own — just nibbling a tiny little bit of parsley or romaine or dried flowers here and there if we bring it right to him. I try to annoy him with the parsley until he grabs it, haha — but that only works once and then he hops away instead.

              But on the bright side, he’s getting cuddlier, which is new for him. And last night he licked me for the first time in the nearly 10 years I’ve had him!! I was petting him on the forehead with a finger that I had mildly burned yesterday, and he kept sniffing that finger and licking the burned part. He seemed very concerned. What a little sweetheart!!! I love him so, so much.


            • Bernard
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                Hi, I just thought I’d give you a message to say hang in there, my 8 year old bun has just had pretty bad stasis for a month, it started on Christmas Day and finally seems to have finished 2 days ago! He developed the soft tar like poop which I was horrified by at the time but it seemed to be linked with the meds and wasn’t until he hadn’t had any meds few a few days things returned back to normal and also the days where I didn’t get as much critical care (fibre) into him.

                Mostly just wanted to send you good vibes and there is hope at the end of the tunnel even if it does feel like forever !


              • Meg
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                  Thank you so much, Bernard!!  I really appreciate it.  That’s exactly what I needed to hear.  I’ve never had stasis go on this long with a bunny, so I do start to despair sometimes (and am calling my vet constantly).  I’m so glad your bunny is recovering now!!  That gives me hope.  

                  I just spoke with the vet (as they opened today) and they said it doesn’t matter what order you give the omeprazole in, as far as they know.  If anyone knows different, I’d be all ears!  For now I’m giving it after his medicines, and in between of his Critical Care mouthfuls.  (I don’t want to give it last because it smells so gross, I hate to leave that taste in his mouth!!)


                • Meg
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                    Hey guys! Teddy’s bloodwork came back today, relatively normal, so that’s a relief. We got him a bunch of special greens (mint, cilantro, dandelion, and kale as a special treat) in addition to his usual parsley and romaine, and he started eating a little bit of that last night, so that’s great. But right now he’s been making a tooth grinding sound that sounds just like eating hay, except he’s not… I’m worried it’s pain. It’s just a little bit higher pitched than his happy tooth grinding.

                    Poor little guy!! Please send him healing vibes. Today is day 15 of his stasis episode. I’m trying to be patient but I just want him to feel better. He’s my love.


                  • Doodler
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                      Sorry for what you are going through with Teddy! Healing vibes definitely being sent your way!!


                    • Bam
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                        How is he doing now? It can be difficult to distinguish between painful tooth grinding and a tooth purr just by the sound of it. You pretty much have to go by the general appearance of the bun – whether he’ll take a treat from you, how relaxed or tense his body position seems, if he’s being socially interactive or tries to hide away etc.

                        I’m guessing your vet has checked his molars for spurs, if not, that should be done. Even very small molar spurs can make a sensitive rabbit go off his food.


                      • Meg
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                          Thank you so much, Doodles and Bam!

                          Yes, Teddy did get a full mouth exam last Wednesday, and they did file down his molars, though they didn’t find anything major there.

                          Yeah, I’m not sure if I was reading any of this right, but it seemed like he was maybe going back and forth between pain and purring. A couple hours ago, just before my last post, I brought him all his favorite greens and he just sat in the middle of them, ignoring them all, grinding in what I thought was maybe pain. After 5-10 minutes of this intermittent grinding I was pretty worried and tried giving him a little massage. He did more grinding but seemed more relaxed (and not in too much pain to move, so he could have left if he wanted to, I’m pretty sure), so I thought that was a purr. Then he ate a few greens. Then more grinding, and I gave him more massage, and he ate a little more.

                          He seems a bit better now, fingers crossed. I just gave him his medicines (including gabapentin for his newly diagnosed spondylosis), Critical Care, and fluids, and I also tried giving him more massage while I had him up there on the bed. He seemed to enjoy it — he was in an open space where he’d been hopping around, but he stayed and leaned into it and ground his teeth more in what I hope was purring. Then, to my surprise, after I put him down he didn’t bolt into his hiding spot, but hopped around in the open, and a few minutes later ate several more greens! I like this.

                          Teddy was always pretty standoffish before (he was more of a bunny’s bunny, bonded to his BFF Athena, who passed away 4 months ago, and he didn’t have too much use for humans). But now he’s getting kind of snuggly with me and I am loving it. I just don’t want him to keep suffering or keep being tormented by me with these treatments! But I’m hopeful that he’s moving (if slowly) in the right direction. Thank you so much for your good vibes, they seem to be helping!


                        • FlemishDad
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                            Teddy knows you are giving him treatments. If he is getting more snuggly then he appreciates them and you are definitely doing the right thing.


                          • Bam
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                              How is Teddy doing now? I hope he’s still feeling better!

                              I think tooth purring can be self-soothing, it doesnt have to mean severe pain. Cats can purr when they are stressed, and that’s believed to be self-soothing. I’m glad he had his teeth checket and dealt with, I had a bun that had to be force fed for 3 weeks due to the tiniest molar spurs that my then vet didn’t think could be the cause of his inappaetence. Five days or so after the molar grind, he started eating normally again.


                            • Meg
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                                Thanks so much to you both! FlemishDad, that was really reassuring, thank you. And Bam, thanks for checking on us! Teddy is more or less the same, but last night he did eat some more greens on his own, not just me feeding them individually to him, so all in all he ate like half the normal amount of greens! That’s definitely better than in the past week, but he still doesn’t seem to be eating anything else. And he still chatters his teeth (grinding but faster and higher than the normal happy grind) quite a bit, almost as though he’s talking. He’d never done that before he got sick. Our vet said we can increase his meloxicam to twice a day for a few days and see how it goes — we started last night, and that improved greens eating followed his first extra dose, so maybe it does help.

                                A couple times in the past 24 hours I’ve tried giving him more belly rubs (while he’s up on the bed for treatment) and he’s started licking his own front paws while I do it, so I think it helps him. But then, iike, just now he was chattering a lot so I came up to try to massage him a little like before and he moved away. Poor little guy. I really hope it’s not some third thing (besides gas pain or spondylosis) that we’re missing, that didn’t show up in the bloodwork or x-ray. This chattering thing is so new. But I’m glad to hear it doesn’t have to mean severe pain. He’s too cute and precious for that.

                                This is a ways away, but 8 days from now we had planned to go away for a 4-day vacation. My hope is that he’ll be better by then, because it’s already been 17 days that he’s been sick and I hate to see him keep suffering! If he’s not, I don’t know what’s best — it stresses me out to think about it. If he’s not stable, I’ll just stay home. But if he’s pretty stable yet still needs treatments, I’m tempted to look into options, just because the last several months have been really stressful for us and I think a quick break would do us a lot of good.  I don’t know what to do, though. Our bunnysitter (who would come by twice a day) used to have a bunny of her own, so she’s experienced, but I’m not sure I can ask her to do subQ fluids and hour-plus feeding sessions. He’s a super nervous bunny and I think boarding at the vet would really stress him out. I could try asking if there are any vet techs who would be interested in sitting/treating for extra money… I don’t know. Does anyone have experience with this?  That is, are there ways to get a bunny stasis treatment while you’re out of town without stressing them out too much?  


                              • Meg
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                                  Hi again folks! It’s day 22, and Teddy seems much better now. For the past 3-4 days, he’s been eating all his greens (or, lately, about 150% of them because I give him extra and he eats that too) and eating a good amount of hay (but almost no interest in his pellets or Sherwood tablets). For the past 2-3 days, his poops have been consistently normal size, though they are slightly oval (which could be from the medication?), and he’s been acting like a happy bun (with one exception below): running around exploring, eating a lot, napping all stretched out and relaxed, etc.

                                  What do you think I should do from here? Shortly after upping the meloxicam frequency, the teeth chattering stopped, thankfully, and hasn’t come back since we reduced it back to once a day about 48 hours ago. Other than that, he’s still on all the same meds: that, cisapride, omeprazole, simethicone, and gabapentin for his spondylosis. I’ve just yesterday started reducing his subQ fluids since his skin pinch tests don’t suggest dehydration. I’ve also started cutting back a bit on the amount and frequency of the Critical Care (which he still refuses to chew until I put him down).

                                  Overall, he seems essentially normal, except for not showing much interest in his pellets or treats (though he will eat Oxbow digestive support tablets). But could that be because he’s eating more greens, plus the critical care? Should I keep going with everything until he’s eating those too? He seems pretty frustrated with the feedings, and digs the bed a lot, so I hate to stress him. But have harmed him by stopping treatment too early in the past.

                                  The one exception to his progress was this afternoon, though it was brief. He had run out of cisapride and the mail hadn’t come, so I gave him his usual treatment session, and then it came in the mail a half hour later. So I went and picked him up again and gave him the cisapride. An hour later I came back in to the room and he was facing the wall, and not interested in greens — I was so sad. But then I brought a tiny bit of kale, and he started eating that and some more greens, and with about 20 minutes he seemed back to normal, eating more and moving around. He seemed great after that. Do you think it was stress and/or digestive discomfort caused by his belated cisapride treatment, or what?

                                  Thank you so much! I’ve never seen a stasis episode nearly this long so am still kind of uncertain about how long I should keep up the treatments, or where I might possibly be slowing his return to normal by dragging the treatments on too long. Also, we’re supposed to leave for that 4-day vacation in less than 72 hours and I still don’t know if we’ll go — we’ll make a game-time decision. But part of me wants to try out scaling back the treatments and stopping them before we have to leave to see how he does, if that would be appropriate. Then if he regresses we could just stay. What do you think?


                                • Bam
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                                    I’m glad to hear there’s been this much improvement! Pellets is for unknown reasons often the last food-type a bun goes back to after an illness or surgery. Oval poop suggests a somewhat slow gut, but it can takes weeks before a bunny gut gets back to normal after a bad stasis episode, so I’d not worry too much about that since he is eating hay and greens.

                                    Gut motility drugs should be tapered out if the bun has been on them for any significant amount of time, because the gut need time to gradually resume it’s normal activity.

                                    Metacam is an anti-infammatory drug, so it’s “normal” to have to start out with a higher dose, then taper down to a maintenance dose.

                                    I don’t know if the half hour delay with the cisapride could have caused tummy discomfort. Maybe his gut can’t deal with food without cisapride now that its become used to the stimulating effect of cisapride. I’m glad he snapped out of it!

                                    I would try to get a sitter to continue a tapering out of the meds. Stopping them “cold turkey” could be detrimental.


                                  • Meg
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                                      Thanks, bam! That’s really helpful. He’s been on all his meds for just over 3 weeks. How long of a period should they be tapered for? And should we start now or wait until he’s eating pellets normally?


                                    • Meg
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                                        p.s. also, what about the Critical Care? should I reduce that or keep it going strong until he’s eating pellets? and is it true that subQ fluids are on an as-needed basis now, if his skin looks dehydrated, or should we keep them up as long as he’s on Meloxicam? he doesn’t seem to be drinking much from his water bowl, but he gets pretty watery CC and extra wet greens.

                                        Our bunnysitter had a bunny who always ate CC willingly from a bowl, so she’s never done forcefeeding before. And she’s afraid of needles so she can’t do fluids. I’ve asked at the vet if any techs would be interested in doing fluids for a generous fee, but no takers yet. I don’t know if I should leave if he’s not at 100% (and his progress has been so slow). He seems a bit more bonded to me now and I don’t want to stress him out by leaving for 4 days. We do definitely need a vacation, and I’d be bummed to miss out on this trip, but I wouldn’t go if I thought it could harm him. What would you advise?


                                      • FlemishDad
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                                          I don’t have direct experience with stasis but from experience with MY bun I think something must still be off if he is not eating pellets. My bun gets LOTS of greens and still goes nuts for pellets. A friend of mine stopped meds for her bun when he was mostly normal and, bam, he went back into stasis.

                                          If Teddy is eating greens and hay the critical care is less critical. That is, after all, everything wild rabbits ever get. I would taper it pretty quickly if I were having to force feed. You could try giving him greens 4x per day to make sure he eats frequently. I started that for mine when he was having tooth issues and was in kidney failure.

                                          I would not go on a trip if I thought my bun needed treatments he could not get without me. He’d probably be fine, but I would not risk it. I couldn’t enjoy a vacation in those circumstances anyway. If you could taper him off the invasive treatments it could be OK but 3 days is pretty short for taper and observation.


                                        • Meg
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                                            Thank you! Yeah, I definitely wouldn’t leave if he couldn’t get treatments another way (I should have clarified). I’m having the bunnysitter come by today to show her how to forcefeed and see how comfortable she is with it. If she’s not, I’d find someone else, or else stay home. I’m calling around to local bunny vets to see if they have any techs who could come by if needed.

                                            That’s a good idea about increasing the frequency of greens. I’d been giving a fresh plate 2-3 times a day but more could be even better. I didn’t know if it was too much, but I guess whatever keeps him eating and hydrated?

                                            I finally got my vet on the phone a couple hours ago and he gave us a plan for tapering: we’ve already started tapering the fluids, and yesterday started doing the simethicone twice a day rather than three times. Same with Critical Care. Then once the simethicone has gradually tapered out, over the long weekend, I’ll start trying taking cisapride down to once a day once we return (if we do leave). Then last would be the meloxicam and omeprazole. So I feel a little calmer with a plan. Wish us luck!

                                            Also, I’m still finding pieces of cecotrope about once a day. I don’t know how often they produce them? Teddy usually eats all of his without letting it hit the floor.


                                          • Bernard
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                                              Hey, hope I’m not too late with the advice. Bernard is still not 100% back to his perfect self after his month long stasis but I’ve come to terms with lowering my expectations with eating. So if he eats all his green which he is getting 3x a day I won’t be too worried about his pellets or give any critical care and this has been fine for him, I have started to scatter his pellets in his hay with a mixture of dried herbs and flowers which has made them more appealing and quite often I hear him getting excited in the night when he’s found them. If he dosent drink any water I chop up a grape and add it and that gets him to drink. His poops are all kind of crazy some huge that look uncomfortable to pass (closing his eyes on the toilet) and then quite sloppy cecotropes, but I try to empty the poops regularly and as long as he goes every 8hours or so I’m happy. I weaned his meds over a week and now when he looks uncomfortable I try to hold off for an hour and get him to eat something then he seems to pass the gas and start eating again on his own. I’ve really become a crazy bun mum but hopefully it might help a little.


                                            • Meg
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                                                Thanks, Bernard! I appreciate it. I think I’m going to stay home with Teddy — even though he’s doing better every day and we did find a vet tech as backup, I just can’t leave him, in my heart. I just want to be here for him.

                                                I hope that Bernard feels all the way better very soon!!


                                              • Meg
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                                                  Hi folks! Just checking in. A month in, Teddy is hanging in there, and is super feisty which is great.  (I did cancel my vacation to stay home with him last weekend.)  We’re continuing with a slow taper of his meds, and I’ve also just tapered him off the Critical Care by reducing 1 CC each feeding. I’m not sure how reactive to be — his poops are pretty small, but they’re still coming fairly plentifully, and he’s still eating fairly well, so I don’t know if I should give him more time to adjust on his own, or put him back on the Critical Care. He’s still eating about 50-90% more greens than normal (giving him extra since he likes them, so two big dinner plates piled high each day), eating hay, but not eating many pellets. He got into pellets a bit more earlier in the week, but hasn’t kept that up in the past few days.

                                                  At this point he’s finished tapering off fluids, simethicone, Critical Care, and most recently cisapride (last dose last night, after 3 days of 1x/day, and the vet says we can try stopping that one outright now). Next up is going down to every other day on meloxicam, and then if that goes well, omeprazole will be tapered last. The vet says we’ll watch him and see if he’s OK without meloxicam or if he needs that daily over the long term along with his daily gabapentin.

                                                  So yeah — his happiness and feistiness have continued to improve pretty steadily: he’s excited for his morning hay, he’s done a couple of little binkies, he he likes to explore and nap in the evenings, and he’s more and more resistant when I give him his medicines (lots of struggling free, digging the bed, etc.). So these seem like good signs. But he’s not eating quite as well as I’d like, and his poops are small, but I don’t know if he just needs more time.

                                                  Any thoughts/advice would be welcome! And thanks so much for all your help. : )


                                                • Meg
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                                                  • LeahM
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                                                      I don’t really have advice for you. I’ve been dealing with a bunny off his regular food and small poop for 6 days and I’m a total wreck! You must be exhausted! I hope Teddy continues to feel better, you’re awesome!


                                                    • Meg
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                                                        Thanks, Stamper! It’s tough no matter how long it’s been going on. (It’s definitely never been this long for us before; Teddy is almost 10 which may be part of it.) I hope you’re getting all the advice and support you need, and that your bunny feels better soon too!


                                                      • FlemishDad
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                                                          If he is eating greens, hay, and cecotropes I don’t think he needs critical care so I think you can stay off that. Glad things are going well!


                                                        • Meg
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                                                            Thanks, FlemishDad!  Yes, it *seems* like he’s started to eat his cecotropes in the last several days.  But I forgot to mention, tonight he had a matted bunch of poop on his bottom.  It seemed like some looser poop hardened flat.  It wasn’t a ton, and it wasn’t the kind of big mess we’ve seen before after he was given Laxatone and other meds, but still, poor guy!  I also saw one mushy poop yesterday.  I don’t know if this is just part of coming off the cisapride, or related to the banana suspension that the pharmacy puts his omeprazole in, or if it’s something to be concerned about? 

                                                            Also, I still hear tummy gurgles from time to time from him, which never used to be the case.


                                                          • Meg
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                                                              Aaaaaand this morning he was much worse, not eating much of anything, and facing the wall. Poor sweetie! Last night was his first night without cisapride, so that probably played a role — but also his poops have been real small since we took him off the Critical Care a few days ago. He also left cecotropes in the litterbox today.

                                                              I spoke with the vet tech and we’ll put him back on twice daily cisapride for two days, then to back to once a day. And 10 CCs of Critical Care twice a day too, and now I won’t pare back the Critical Care at the same time as anything else, so that we can be sure of what’s going on next time.

                                                              I spent some time poring over the logs I’ve been keeping of what medines he got when, his eating, pooping, and behavior, etc, and the thing that strikes me is that he was doing much better before we took him back to the vet, on Day 9, than he has since then. He was eating much more normally. During that vet visit they did a modest molar trim (not much problem was found) and drew blood, but that’s it (other than the physical exam). The one thing that changed was going on .85CC of omeprazole compound twice a day from then on (as a prophylactic for being on meloxicam). For a few weeks it was compounded in flaxseed oil (so stinky!) and now it’s in a banana-flavored oil from a veterinary compounding pharmacy. I called the pharmacy to ask if there was any form of sugar in the compound and they were *fairly* certain there wasn’t.   But I don’t know, just looking at the correlation — is there any chance that could play a role? 

                                                              Poor little guy!! I cried a lot when I saw him doing worse today. And while he’s been eating a bit better and seeming a bit happier since his feeding today, he does so hate the process of force-feeding and it takes forever. Has anyone found any tricks to get a bunny to eat Critical Care out of a bowl?? I read some reviews mentioning mixing it with baby food or apple juice, but I don’t know what would be safe for him. I’m so scared of causing dysbiosis with sugary stuff.

                                                              Thanks so much for your help. This is my first experience with stasis that doesn’t resolve quickly, and though I’m always consulting with his vet and trying to be obervant, I still feel like I don’t know what the **** I’m doing. :/ I wish I could be better at this, for Teddy’s sake.


                                                            • LeahM
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                                                                Aww I’m so sorry. Two steps forward one step back.


                                                              • Meg
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                                                                  Thanks so much!!  I really appreciate it.  

                                                                  And if anyone on here has advice, I’d be so grateful.  


                                                                • Meg
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                                                                    Hi all.  If any of the forum leaders, or other experienced folks, have any advice, I would be so grateful!!  I just feel so lost.

                                                                    Today Teddy’s appetite was a little worse than yesterday, despite our restarting the cisapride and Critical Care and simethicone.  I’m also still finding mushy poops, among regular (but smallish) ones — some very big ones that today look almost like cecotropes except the pieces are much bigger, more like the size of regular poops.  And another hardened flat one.

                                                                    I’m trying to stay hopeful but sometimes it’s hard to fight off despair at this point.  I have no idea what’s wrong. 


                                                                  • LeahM
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                                                                      hugs to you and teddy! I don’t have advice, you seem so skilled and knowledgeable. I would probably try to go back to what you were doing that was working and try to restabilize again for a few days. Is he still on pain meds? Is metoclopramide an option?


                                                                    • Bam
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                                                                        I’m very sorry for this recent set-back. Are you giving Teddy any probiotic supplement? It can sometimes help with cecal dysbiosis. Benebac is a much used brand, in Europe there’s other brands that I personally am more familiar with.

                                                                        Plain canned pumpkin can be used to mix CC with. Not pie filling, just plain pumpkin. It’s high in fiber and not very sweet.

                                                                        The apple-banana flavored CC has been much more popular with my rabbits than the “original” aniseed flavor.

                                                                        I havent used omeprazol for a rabbit, but I have to take it myself on a daily basis. When my bun needed meloxicam, he was prescribed ranitidine to protect his stomach lining. It is a less potent drug than omeprazole, but it has a different mechanism of action and might be better tolerated by your bun. Ranitidine can be sold as Zantac or generic. I got pills that I crushed between the blades of two spoon, stirred up with water and then measured up the prescribed dose of. One advantage with the pills is that there’s no sugar or flavoring. Ranitidine also acts a gut motility drug. Metoclopramide, another gut motility drug that is more potent than cisapride can be used together with cisapride and ranitidine for a synergistic effect. Maybe something to ask your vet about?

                                                                        I found this about gut motility drugs in a 2012 article on GI stasis by Michelle Clarke and Richard Saunders in VetTimes:

                                                                        “Prokinetics help kick start the GI tract and are recommended in GI stasis. However, if intestinal obstruction is suspected, these should not be used. Ranitidine is moderately palatable, easily available and fairly inexpensive. It also has antiulcerative qualities – useful in stressed rabbits that may also be on a high dose of NSAIDs. It is the authors’ first line choice. Domperidone should not be given within two hours of ranitidine and not in conjunction with metoclopramide. It appears more effective than ranitidine alone. Thus, it is the authors’ second line treatment for recalcitrant or high-risk cases – usually with ranitidine. Cisapride has re-emerged on to the veterinary market in tablet or suspension form, and appears to help some rabbits when ranitidine is not effective. Metoclopramide acts on the foregut and should, ideally, be used with ranitidine or cisapride for a synergistic effect. Cisapride and ranitidine may be used in conjunction, synergistically, at the lower end of their dose ranges.”


                                                                      • Meg
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                                                                          Thank you so much, Bam and Stamper!! I really, really appreciate your advice.

                                                                          I just started him back on Benebac 2 days ago, so he got his second dose today. I’ve only been giving 1/4 tsp of it, since the 1 tsp they recommend sounded like a lot and I was nervous about it. But do you know if it’s safe to give at that dosage?

                                                                          I have the new CC flavor too, but still no dice. And last night, to find out which type of food he’d be most likely to eat out of a bowl, I put out a plate with a little spoonful each of 4 options: 2 types of baby food, canned plain pumpkin, and unsweetened applesauce. He wouldn’t touch any of them!! ;D I also tried a 1/2 Tbsp of one of the baby foods in with his CC last night, but it had zero effect on his willingness to syringe-feed. It smelled a lot better to me that way, but I guess not to him!

                                                                          The only thing I haven’t tried is the “banana water” that MooBunnay posted about in 2008. But I’m nervous because the past couple years I’ve noticed that even a tiny piece (1/2 tsp) of banana, given on a rare occasion, will give Teddy mushy poops, so I had to stop ever giving him any.

                                                                          Thank you so much for that article, Bam — I have a call into the vet and will ask him about ranitidine and about adding in metaclopramide. There are no more mushy poops so far today, but the poops are smaller, and Teddy is still only about 1/2 as interested in food as he was a few days ago.

                                                                          One last question: Is it possible I should reduce the greens we offer him to just one plateful at dinner, like we usually do? Is it possible that having two plates a day is harmful in any way, like in having him fill up on that instead of more hay? (But the past couple days he’s been only eating about half of each plate anyway.)

                                                                          Thank you so much!!


                                                                        • DanaNM
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                                                                            So sorry for your set-back.

                                                                            I agree that canned pumpkin can make CC more appealing to some bunnies. Most buns also LOVE the taste of bene-bac, which bam mentioned, so you might try mixing that in as well. You can try offering a bit on a spoon or a smeared on a plate. Some also like to eat it in “critical care cookie” form, but then you don’t get as much moisture into them. This recipe is from an article about megacolon bunnies, but it might be good for Teddy to add some nutrition:
                                                                            “Patricia’s Treats for mc bunnies is taken from the Facebook MC Page. -There are three ‘flavors’ of Critical Care. One is Apple Banana and the other is Anise (Anise flavor has similarities with some other spices, such as star anise, fennel, and liquorice). There is a third without flavoring called “Fine Grind”. Patricia posted that you can “mix the plain one with dried cilantro”.

                                                                            -Cookies are roughly a 50% mix of water and solid or until fairly thick
                                                                            -Preheat oven to 375
                                                                            -Lightly coat a glass pan with olive oil
                                                                            -Spoon mixture onto pan – In dime to nickel sized portions {I use a half teaspoon}
                                                                            -Bake for around 40 minutes or until it is to your bunnys desired consistency.
                                                                            Can be made with Critical Care by Oxbow or Recovery by Supreme Pet Foods to add fibre to the diet.

                                                                            Note: Patricia’s Treats are based on a post (on FB) by Gretta that talks about rabbit critical care cookies. Patricia experimented with this until she got to the recipe above.”

                                                                            I wonder if the ciscapride was stopped too abruptly, considering he was on it for a while, right? I found this on medirabbit about ciscapride:
                                                                            “Since the body adapts to the presence of a gut motility drug, and stops producing its own molecules that normally stimulate the GI tract, it is advisable not to stop the administration of gut motility drugs abruptly. If so, the onset of stasis is often observed. Their dose should be decreased daily over a period of a week or more, so that the body can start the production of its own molecules/hormones gradually again.”

                                                                            It does sound like it was tapered off, but maybe a bit too quickly?

                                                                            It is really hard to know what went wrong when things relapse, but try not to do anything too different from what you have been doing. I would keep up with supportive care as much as possible, and try to be as consistent as possible with the treatments that worked before, as stasis can be like “trying to jump start a train”. It could be that the stress of the molar trim set him back a bit, but it’s impossible to know for sure.

                                                                            . . . 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
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                                                                              According to a webinar on gut health by Molly Varga, prebiotics cant really be overdosed. The surplus is just pooped out. Its debated whether they do any good, but they wont harm.

                                                                              I’d not give banana if hes reacted badly to it in the past.

                                                                              Its difficult to give advice on the greens. If cutting back on greens (cut back very slowly if you decide to cut back) makes him eat more hay, then it’s great because hay is so beneficial. But there is the possibility that he’ll just eat less greens and still not want hay, which would make matters worse.


                                                                            • Meg
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                                                                                Thank you sooooo much, DanaNM and Bam!!! I really, really appreciate your help. That’s really valuable information from MediRabbit, thank you! Yes, next time I would taper the cisapride more slowly now. I was concerned about MediRabbit’s warning about gabapentin having bad side effects, since the vet put my bunny on it a month ago for spondylosis. Have you heard anything about gabapentin yourselves?

                                                                                I have the benebac powder, and it’s good to know I can’t overdose him. I’ll try more, then. But it sounds like you’re talking about the gel form? I’m tempted to try it but see it has sugar in it — have you all used the gel form without causing problems in bunnies?

                                                                                Thanks for the recipe for Critical Care cookies — that’s cool! I wonder if they would be similar to the Oxbow Digestive Support “cookies”, which Teddy usually loves as a treat in the morning, but has been snubbing most of the time he’s been sick. But worth a shot! And thanks, I will skip the banana then; that sounds like a good idea.

                                                                                Do you think I should also be feeding him Critical Care more times a day? Right now I’m just doing 10 CCs twice a day (it is a real ordeal each time), and he’s eating a good amount of greens (about a dinner plate full a day, maybe a little more — roughly 4-6 cups) and eating a decent amount of hay. He’s not really eating pellets though, and his poops are still pretty small.

                                                                                Thank you sooo much!! I really admire this little guy. It’s been 5 weeks now and he’s still going strong despite not feeling well — he still digs up a storm when we put him on the bed for his feeding sessions, and struggles to get out, and gives us a good stomp and/or foot flick when we return him to his room. And despite his small poops and shunning of treats and pellets, he’s been eating at least a fair amount of greens and hay most of the past couple weeks. I feel awful that the vet and I haven’t figured out what’s wrong, and/or given him the right treatment yet. But I’m grateful that he’s sticking it out so far despite my bumbling. He’s a strong bun.


                                                                              • DanaNM
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                                                                                  He does sound like a little fighter!

                                                                                  I think 2 times a day is enough if he’s eating some hay and greens on his own. Pellets are usually the last to return after stasis… I think buns know they aren’t the best for them.

                                                                                  I think CC cookies have much more fiber and are more balanced nutrition, vs the digestive support cookies, which are meant to be a treat.

                                                                                  I haven’t had problems with the bene-bac gel. The amount isn’t very much, so I would hope the sugar wouldn’t be enough to cause problems.

                                                                                  I’m also sure you don’t want to make any major diet changes, but what greens is he getting? Sometimes more natural forage (like certain weeds) can help buns with tummy upsets. Plantain (narrow and broad leaf), dandelion, sow thistle, mint, and fennel can all be good for buns with tummy issues. The veggies we grow for us humans have less fiber than natural forage, so are mostly important as a source of water and some extra nutrients for buns, and they end up getting their fiber for their hay.

                                                                                  There was recently a discussion on gabapentin and it’s side-effects on another thread: https://binkybunny.com/FORUM/tabid/54/aft/170157/Default.aspx#613586

                                                                                  Some members have used it for their dogs, or arthritic buns. There is some concern about the side-effects, especially if it’s being used to treat something with symptoms similar to the side-effects in long term situations.

                                                                                  I do somewhat wonder about his molar trim, and you mentioned they drew blood, and he started doing worse again after ward. Is there a chance a tooth was cracked? Or it might have caused an infection that set things back and is causing pain?

                                                                                  Then again though, stress of too many visits can really delay stasis recovery, so it’s a fine line. I find myself always going back to this article (in case you haven’t read it):http://www.bio.miami.edu/hare/ileus.html

                                                                                  This line always stands out to me (the author put it in all caps, not me!): “PLEASE RESIST THE TEMPTATION TO FORCE ADDITIONAL, AGGRESSIVE TREATMENT ONCE THE RABBIT BEGINS TO RECOVER. RECOVERY FROM GI STASIS IS SOMETIMES MADDENINGLY GRADUAL.”

                                                                                  It may be that you are doing everything right, he just needs more time.

                                                                                  (((more vibes for Teddy!)))

                                                                                  . . . 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.  


                                                                                • LittlePuffyTail
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                                                                                    I’ve never had problems with the Benebac gel. Never used the powder form. And I agree with Dana that 2x day Critical Care is probably good if he’s eating a decent amount of hay. Pellets are the least important.

                                                                                    (((((Healing Vibes))))))


                                                                                  • Meg
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                                                                                      Thanks so much to you both!! I really appreciate it.

                                                                                      That’s a good reminder about the ileus article. I have a hunch/hope that he will get better, he will just take his time doing it. I hope that’s right. The vet suggested we could hospitalize him for a week, but I really think that would do more harm than good; he hates leaving the house sooo much. The same with taking him in for acupuncture, which he also suggested; I will look into whether any rabbit acupuncturists make home visits around here.

                                                                                      Good to know about the Benebac gel — I’ll try that too! And keep it on hand for the future. Meanwhile I gave him a full teaspoon of the powder today mixed in with his Critical Care.

                                                                                      Oh man, I would feel so bad if the molar trim cracked a tooth or something! Is there any way I could find out without taking him back to the vet again? He’s been chewing on willow at times, so hopefully his teeth aren’t too painful…

                                                                                      Thanks so much for the gabapentin thread! That does worry me… though I read the MediRabbit article and it did seem like the effects were anecdotal, rather than from a study. But it’s something to keep an eye on — his balance does seem just a little bit worse since he went on it.

                                                                                      Thanks for asking about his greens — he’s getting ample romaine, dandelion, parsley, and cilantro, as well as smaller amounts of mint and basil, and tiny bits of kale. I’m trying to tempt him with variety.

                                                                                      So I finally got to speak with the vet at length, and I have mixed feelings about it. On the one hand, he is going to help us switch from omeprazole to ranitidine, and try some Periactin and Vitamin B12 for appetite stimulation. On the other hand, he moderately discouraged adding reglan due to possible neurological side effects. He said it was up to me.

                                                                                      Despite Teddy reacting so poorly to the shorter weaning of cisapride, and not reacting when I had to ration his meloxicam for a day and a half, the vet still thinks this is a pain issue, and that he may need to be on not only gabapentin but also meloxicam for the rest of his life. (And then probably also ranitidine or omeprazole, and possibly also cisapride.) This thought makes me sad, and I’m inexperienced but it doesn’t seem to jive with how he’s acted — daily binkies for the two months prior (and almost never before then!), then suddenly not eating. He definitely was in pain a few weeks ago when he was tooth grinding, and he responded well to doing meloxicam bid for a few days. But my hunch is that that was GI pain, not back pain; he did just fine when we reduced to once a day again, and generally he’s otherwise *appeared* pretty comfortable — lounging, grooming a lot, doing little sprinty hops across the room at times, etc. But I know bunnies tend to hide pain; what do you think?

                                                                                      He was better with eating today, munching through the afternoon instead of just sitting under the bed, so that’s an improvement, though he’s still leaving oversized cecotropes. I’m encouraged and want to give him a few days to keep going, let the Benebac work, try the appetite stimulants and ranitidine, and maybe some fluids in addition to his other meds. If that doesn’t work, I might try adding Reglan for a few days. But that’s a good point about not being too aggressive while he’s recovering.

                                                                                      Thank you SO much for all of your help and support; I really appreciate it!!


                                                                                    • jerseygirl
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                                                                                        Oh gosh. I’m really behind on what’s been going in with Teddy.
                                                                                        Just wanted to stop by and offers some (((vibes))) for the dear boy!

                                                                                        Bookmarking this thread to come back & read more thoroughly tonight.

                                                                                        Hope you’re doing okay, Meg.


                                                                                      • Meg
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                                                                                          Kate!! Thank you soooo much, I’m thrilled that you’re here!! Thank you so much for reading and I’ll be so grateful to hear what you have to say.


                                                                                        • jerseygirl
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                                                                                            This thought makes me sad, and I’m inexperienced but it doesn’t seem to jive with how he’s acted — daily binkies for the two months prior (and almost never before then!), then suddenly not eating. He definitely was in pain a few weeks ago when he was tooth grinding, and he responded well to doing meloxicam bid for a few days. But my hunch is that that was GI pain, not back pain; he did just fine when we reduced to once a day again, and generally he’s otherwise *appeared* pretty comfortable — lounging, grooming a lot, doing little sprinty hops across the room at times, etc. But I know bunnies tend to hide pain; what do you think?

                                                                                            I wonder if perhaps he had a bit of a back sprain that just taken time to heal and you’re now seeing him moving about a bit more like he was before?

                                                                                            Ive just read the thread from top to bottom. You are doing great with him. Quite the slog!
                                                                                            I made some notes of various questions as I went along.

                                                                                            My first thoughts were on the gabapentin and i was glad to read by the second page that you were questioning this yourself. When did he start on it? What’s the medication schedule for this? [ETA: nevernind, I found your older thread which answered this question.]

                                                                                            I personally think this is something to revisit if his appetite and stasis troubles coincide with him being on gabapentin. As you’ve read, there are anecdotal report of it affecting appetite but it also mentions ” Decreased urine output or urinary
                                                                                            retention”. This raises a flag with me also and given that he is an older bun already with some spondylosis. You mentioned him doing a big pee on you. Did he sit on you and positioning himself to be able to urinate more easily? (TimTim has had a bit of sludge and hangs his butt down between the bed and wall so he can get it out). Have you noticed any other odd peeing habits? His trying to go in the box but then not really doing anything? If his is retaining urine, this could cause his bladder to become extended and put pressure on other organs also.

                                                                                            Gabapentin is addictive so if he is to come off it, it would need to be done gradually. I *think* he could still be on it along with NSAID (he is on metacam so…) but I wonder if he could go onto a second NSAID as coming of gabapentin, if the vet thinks pain is at the core of his issues. Something like Carprofen(Rimadyl) perhaps?  

                                                                                            As for long term, you may find you can lower pain meds from time to time if you find something like acupuncture helps him. Or even cold laser treatment. : ) But going on the right dosage and right type of med initially is what would help confirm what his main issue is which could be bringing on secondary issues like stasis. 

                                                                                            What is his current dose of metacam?

                                                                                            Were the x-rays he had from when the spondylosis was picked up or did he have another set done during this stasis episode?


                                                                                          • jerseygirl
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                                                                                              I agree with Bam that ranitidin (zantac) might be worth a try rather then omezprazol. Another option would be sulfracrate but I dont think it has the secondary benefit that zantac has. If he were being weaned of cisapride, zantac would still hopefully act as the remaining pro-kinectic, along with being a gut protectant.

                                                                                              The Vitamin B12 can’t hurt and might help appetite. Id personally try that before bringing in Periactin. Im assuming the Periactin would be used as anti-emetic for the appetite? (Reglan is an anti-emetic also). It’s just difficult finding the balance with coming off some things that might be causing issues, and bringing in new meds to combat those same issues!

                                                                                              Your mention of banana water reminded me of Hay Tea. Had you read about that? BB member Ellie first mentioned it. Basically pouring hot water over hay and letting it steep like you would for tea. Strain water off and allow to cool. Im not sure if you meant banana water to mix with CC or just to offer as a drink to get fluids in. But Hay tea could be worth a go.

                                                                                              Already lots of great suggestions in the thread so im probably repeating many. With CC, have you tried an “uncooked” soft cookie version? Basically making a little patty of thick CC mix. Could be mixed with just a little water, or pumpkin as mentioned. Or you could puree a fresh herb you know Teddy likes and use that to bind the CC mix into a patty or soft pellets.

                                                                                              Another trick would be to mix it into a slurry and drizzle over his greens… Id only attempt that with a small portion of greens at first, in case he turns his nose up.

                                                                                              You mentioned feeding him CC while on the bed. Are you holding him off the bed when you syringe it or he still has 4 feet on the bed?


                                                                                            • Meg
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                                                                                                Hi Kate, thank you soooo much for your replies and for heroically reading through this super long thread. I really appreciate it!!

                                                                                                That’s an interesting thought about a back sprain; that could be.  His painful (tooth-grinding) period was about 2 weeks into his stasis treatment, which is one of the reasons why I think it was GI-related.  He really responded to tummy massages around that time. 

                                                                                                That’s a good question about the peeing.  My sense is that he was just mad (or had to go) those couple of times; it hasn’t happened since, and I haven’t noticed anything else unusual.  He didn’t hang his butt down, he just peed while standing facing away from me, several inches away.  But I’ll keep an eye on it!

                                                                                                His most recent x-rays were done on January 15th, the first day of his stasis.  I couldn’t see what the vet was pointing to on the x-ray, but he said he seemed to have one or two fused vertebrae from spondylosis.  At that point he started him on 1.5mL of gabapentin twice a day.  He mentioned we could decrease the dosage if he seemed lethargic.  Teddy was 3 lbs 12 oz at the time of the diagnosis (normally 4 lbs, and now down to 3 lbs 7 oz which makes me sad – I’m trying to feed him more and include a bit of the Sherwood weight gain recovery mix in with the Critical Care now).  I’ve also been trying out going down to like 1.3 mL.  At the same time, ever since the January 15th, he’s been on 0.6 mL of meloxicam once a day, except for a few days of twice a day during his painful episode about 3 weeks ago. 

                                                                                                What would you say the signs of pain in a bunny are?  Teddy does so much digging, exploring, grooming, jumping up to the 2nd floor of his cardboard castle, etc. that I’d be surprised if he’d do that voluntarily with joint/back pain.  But then I know bunnies always try to hide any pain/illness…

                                                                                                It seems like either our vet is right and the problem is chronic pain, or he’s not right and all the pain meds may depress Teddy’s appetite.  I’m tempted to try out weaning him off the meloxicam a bit, if he continues to do well, and seeing how he responds. 

                                                                                                Thankfully Teddy seems to be back to where he was before now, since the downturn of this weekend (after stopping cisapride too quickly).  We’re keeping up the 10CCs of assist feeding twice a day (using a mix of Critical Care, Sherwood Recovery Plus Weight Gain, and Critter Be Better powder that’s similar to his pellets) to keep up the momentum and also hopefully help him gain weight.  He’s still very feisty and strong.

                                                                                                So basically the deal is that he’s eating a lot of greens, about 6-8 cups a day, a good amount of hay, and is acting pretty normal (exploring, napping, munching).  He’s now eating small amounts of pellets, but not the normal amount.  We’ve stopped offering him treats for this week, to focus on trying to correct any gut flora imbalance he might have.  So the main issue is that his poops are still small, ranging between 50-70% normal size, even with the assist feeding.  Yesterday his cecotropes looked more normal and it looked like he’d eaten about half, but of course he shouldn’t be leaving any.

                                                                                                We’re getting ranitidine (over-the-counter tablets from CVS) today, but still waiting on the vet to reply about the dosage.  I’ve read 2-5 mg/kg bid, but don’t know where he should be in that range; I’ll try calling the vet again.  I also just found this article that says that ranitidine and cisapride can either work synergistically or antagonize each other depending on the dosage of the cisapride (https://www.sciencedirect.com/scien…via%3Dihub) but I have to do some research to figure out what our cisapride dosage would translate to in the units they’re talking about.

                                                                                                And thanks, we just started the B12 last night (basically just a drop because it’s very concentrated) and will see if that helps before adding Periactin (both would be to stimulate appetite).

                                                                                                I haven’t heard about Hay Tea, thanks!  It seems like he’s drinking a little water now but it’d be good to do more.  He did not have any interest in the apple juice dilution I offered.

                                                                                                The Banana Water would have been to tempt him to eat Critical Care from a bowl (or at least more willingly from a syringe) but I won’t try that due to his issues with banana.  We gave the baby foods and canned pumpkin and unsweetened applesauce a few tries each (on a plate and in syringes) with no effect whatsoever, so I’m giving up on that for now and just syringe-feeding him the critical care mix. 

                                                                                                No, I haven’t tried the soft CC cookie either – I’ll add that to the list.

                                                                                                The way I feed him is by sitting on the edge of the bed, draping a towel over my lap, and propping my feet up so that my thighs are up at an angle.  Then I pick Teddy up, hug him to my chest, and lean him back so that he’s on his back in a little hammock that the towel makes.  I keep him secure in there and he often (not always) gives me a couple seconds to drop some medicine or food onto his mouth before he struggles away (and I let him escape and dig his frustrations out for a bit before starting again).  It’s a bit less stressful for him than the burrito.  But I’ve tried several versions of letting him have 4 feet on the bed or my lap and it is a total non-starter.  He is *very* feisty and he absolutely will not accept a syringe in or near his mouth if he has any say whatsoever, and will just keep wriggling his head away.  He even sometimes tries to bite or head-butt the syringe when he’s in the hammock.  He is really a fighter!  The vet found ulcers in his cheeks when we took him back for a recheck on Day 9, from me sticking the oral syringes in his mouth, poor guy, so since then I’ve been dropping the liquids onto his teeth and he usually will lap them up eventually.  He rarely does this with critical care, though, so all I can do is paint about 1/3 of a CC onto his lips and then let him go, and once he’s free he’ll usually lick it off his lips.  Otherwise, he just sits there with his mouth still.  I’m careful to avoid aspiration but this method is the best we can do it seems.

                                                                                                Thank you SO much for everything!!  I’d love any thoughts on all this and/or on how to read whether he seems to be in pain now.   


                                                                                              • Meg
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                                                                                                  p.s. the one other thing that’s unusual is that the past few days I’ve been occasionally hearing a little squeaky gas sound from him. Sort of like when you leave a soda bottle with the cap just slightly loose. There’s usually just one sound per day, maybe two. I’ve been adding more simethicone to his regimen for this, but I’m not 100% sure what it is.


                                                                                                • Meg
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                                                                                                    p.p.s. of course, in the hour after I wrote that he’s made like 3-4 more of those sounds. he just ate and he doesn’t appear to be uncomfortable; he’s napping right now.


                                                                                                  • FlemishDad
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                                                                                                      My bun gets a lot of greens and I think his poops get smaller and less round on them. There is a lot less indigestible matter to poop out, after all.

                                                                                                      Given how hard it is to syringe feed I would really consider tapering off the critical care. Based on my friend’s experience and yours I think it was stopping cisapride that caused the problem.

                                                                                                      My bun will eat greens with liquid medicine on them if it’s not nasty. He is more of a pig than Teddy, though. He never leaves greens on the plate except stems and summer squash.


                                                                                                    • Meg
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                                                                                                        That’s great to hear, thank you so much, FlemishDad!!  I agree that stopping the cisapride as suddenly as we did was the main catalyst.  Though his poops did get a bit smaller when we weaned him off the critical care.  I’m concerned about his weight, though, and that’s the main reason why we’re keeping the CC up right now.  But do you think we should just keep weighing him and see if he’ll eat more on his own if we wean him off the CC again?  (I’m sure he would enjoy not being tormented so much!)

                                                                                                        That’s good to know about greens. As long as he’s still interested in hay, maybe we should experiment with scaling back the greens a bit?  

                                                                                                        Thank you so much!!

                                                                                                        BTW, I finally got the zantac (ranitidine) dosage from my vet (7.5mg bid).  I just crush a 75mg tablet, dissolve the powder in 1ml of water, and then give him 0.1ml.  Will make fresh each time.  

                                                                                                        He also said to stop the Sherwood recovery plus weight gain powder because the alfalfa could make his tummy hurt more, so we’ve done that.  And we’re going to hold off on the Periactin for now.  

                                                                                                        Thanks for everything, folks!  If anyone has thoughts on how to discern whether he’s in pain (discussed in my last long reply), that would be great.  


                                                                                                      • FlemishDad
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                                                                                                          Animals can get very underweight before the underweight itself causes trouble. Weight loss is usually more of a symptom of a real problem. Since bunnies have so much trouble with stress I think Teddy would be better having less stress with you while you look for some other way to get some more calories and fiber in him. It sounds like he is eating fairly well so I think this might be a time to trust his body to make the decision of how much to eat.

                                                                                                          In terms of the standard rabbit fattening foods, you said he did not care for the pumpkin and I would not want to use oats because of the strange sugars going to the cecum, but what about carrots? You could also try a raw winter squash like butternut; he might like that better than the cooked pumpkin in a can.

                                                                                                          My thought on the greens is more that mildly small poops are to be expected on a high greens diet so don’t worry about it. Especially if he is not a good water drinker I would bring that to normal only after fixing everything else first.


                                                                                                        • Bam
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                                                                                                            The sound you heard could have been farting. I once heard my bun Yohio fart. It was a soft little shoo-shoo sound. You don’t often get the privilege to hear it =) . Sometimes you can smell when a bunny has farted, we have other bun owners here that have reported on this.

                                                                                                            As for pain – osteoarthrosis pain is a variable condition. I have a dog with CT-confirmed osteoarthritis. She has good days and bad days. Mostly good days, but the summer was tough for her because it was so hot. She’s on a low dose of NSAIDs. We started out on a higher dose but we’ve cut back to a small dose that seems to keep her problems in check. I tried several times to take her off the NSAID altogether (on my vet’s suggestion), but that made her problems return. Dogs and rabbits are not the same but I think energy, interest in the surroundings, willingness to move around etc are pretty good indicators. When my dog was in pain, she panted and paced the apt and refused to leave the car to go for walks. If you are observant of Teddy’s behavior, it’s not dangerous per se to cut back on the pain meds – but you need to be prepared to put him back on them swiftly if he seems to deteriorate.


                                                                                                          • Meg
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                                                                                                              Thanks so much to you both! FlemishDad, that’s a big comfort, that he’s not necessarily in immediate danger right now with the weight. We’ll keep weighing him every few days and monitor. And thanks for the advice on food! Small poops have been the main thing keeping us treating him for the last week, so it’s good to know not to freak out too much… I’ll experiment with squash and carrots!

                                                                                                              His poops are over 80% normal size now, and I still haven’t seen cecals in like 3 days, so I’m thrilled!

                                                                                                              And thank you so much, Bam. Yes, I’ll keep up the simethicone a bit in case it was gas I heard. And thanks for the pain advice! Teddy sure doesn’t usually seem to be in pain, so I’m skeptical of my vet’s suggestion that he may need both gabapentin and meloxicam every day from now on. But that’s a good point about keeping everything on hand in case he has a bad spell.

                                                                                                              We’re starting to slowly pare back the critical care by 1CC per feeding again. If he gets through that still eating and pooping well, then I think our next move will be to try decreasing his meloxicam dosage slowly over 3-4 days and see how he does with that.  (This is where your advice about signs of pain will be especially handy, thank you.)  If he seems OK, I’ll have a talk with my vet about gabapentin vs. meloxicam for the long term (it seems like gabapentin can have weirder side effects and doesn’t help inflammation per se, whereas meloxicam does but can also be rougher on the kidneys and stomach lining?).

                                                                                                              I’ll keep Teddy on the cisapride until we have all this sorted out, and then wean that off last — very slowly this time! (My vet had recommended decreasing the frequency rather than the dosage, but I can’t imagine why that would be better?)

                                                                                                              Thank you so much again!!


                                                                                                            • Bam
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                                                                                                                Meloxicam is anti-inflammatory and it can be hard on both tummy and kidneys. The same goes for other NSAIDs. My dog is tested for kidney function (bloodtest) every six months. I have occasionally given her omeprazol (prescribed by her vet), but most of the time, her tum seems fine. According to Medirabbit, long term treatment with meloxicam is well tolerated by buns. http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

                                                                                                                The dose should be gradually lowered until you find the lowest effective dose. (For inflammation you commonly start out with a higher dose to quench the acute inflammation. Once the acute inflammation is sufficiently subdued, you try to take the animal (or human, because it’s practically the same thing with humans only we often get diclofenac or naproxen) off the med or, if that doesn’t work, find a low dose for maintenance medication.

                                                                                                                Medirabbit warns about Gabapentin for rabbits, you may have read this already, but here it is in case others are interested:
                                                                                                                http://drive.google.com/file/d/1x4wqcsuWFlNw0HLZ8ZQJC3pXhOtFvfjX/view?usp=sharing

                                                                                                                I have Gabapentin for my dog too, and initially she was supposed to take 300 mg twice per day. That is the recommended dose for a 28 kg dog, but it made her into a total zombie. She was somnolent, unfocused, un-coordinated, wobbly etc. So maybe some of the side effects mentioned in the Medirabbit article was a question of dosage? Now I have 100 mg capsules and I give her 2/3 of a capsule (have to empty out 1/3) if she has flare ups. It’s not anti-inflammatory but it makes her fall into deep sleep, which can be good and beneficial if you are in pain, of course.

                                                                                                                Studies have been made that show that people with x-rays showing bad ostearthrosis can be pain free, and some, whose x-rays don’t look at all as bad, can experience severe pain. So x-rays alone are not enough to tell if a person is in pain. With animals it’s of course more difficult because we can’t ask them how they feel, so we must try and interpret their behaviour.


                                                                                                              • Meg
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                                                                                                                  Thank you so much, Bam, that’s really helpful to know! Especially about how pain levels and x-rays don’t necessarily correlate that closely. That helps me understand why it might be that the vet saw spondylosis in the x-ray but Teddy just seemed *so* happy before, with lots of binkies and no signs of pain. Maybe he got a flare-up, or maybe it was unrelated, when he got the stasis.

                                                                                                                  Thanks, I did see the gabapentin warning, and I’m sure others would be interested. I’ll talk to our vet; it seems like meloxicam might be the more logical choice… I think a prior question might be what his day-to-day pain levels are, if any, so I guess we will just have to experiment with decreasing his pain meds and seeing how he does… I am definitely worried that we’re over-treating him with the gabapentin and that that’s causing some of the decreased appetite and stuff. But hard to tell without testing that theory, I guess.

                                                                                                                  I’m thinking it would be easier to start with weaning the meloxicam because it’s not as addictive — is there any reason that wouldn’t give us a good reading on whether he’s currently in pain?


                                                                                                                • Bunny House
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                                                                                                                    Weaning the meloxicam can tell you if he’s in pain or not. I would say that if you continue meloxicam,
                                                                                                                    To do kidney and liver blood tests regularly to make sure everything is still working right as he’s been through so much and the liver processes it heavily and it can damage both organs.

                                                                                                                    Right now one of my buns is on gabapentin and she hasn’t had any issues beside it may be hurting her liver so she will have a retest of her values in a month. What strength and how much and how often are you giving the gabapentin and how much does he way? He might be getting to much of it.


                                                                                                                  • Meg
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                                                                                                                      Thanks, Bunny House! That’s helpful. The vet prescribed .15ml twice a day of gabapentin that’s 50mg/ml, so 7.5mg twice a day. He mentioned we could decrease the dose if he seems too lethargic. Lately I’ve been giving .13ml. What strength is your bun on? (Teddy is about 3 and a half lbs, slightly more at the time of prescription.)


                                                                                                                    • Bunny House
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                                                                                                                        My bun is on 50mg, 0.6ml 2x day and she’s 10 pounds so that dose sounds about right. I wonder if lowering it to 0.1 would do anything? And you might already know this by reading that link but since it does flow through the blood vessels of the brain, and affects how it operates as it’s used as an anti seizure med, dialing back a bit might help the brain act more normal


                                                                                                                      • Meg
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                                                                                                                          OK, that’s good to know, thanks! I just emailed my vet about if we can decrease the dose further. I don’t want to hurt his kidneys, but one plus of meloxicam instead of gabapentin would be not worrying that it’s making him not quite himself, I guess. He does seem just a little more sleepy lately.


                                                                                                                        • Meg
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                                                                                                                            Hi folks!  Teddy is still eating great and pooping pretty well (ranging between like 60-85% of normal size depending on the time of day, but plenty of volume).  At FlemishDad’s advice, we’ve been weaning off the Critical Care 1 CC per feeding, finishing tonight.  He’s still eating twice his normal greens (so about 8 cups a day), eating hay nicely, and starting to eat more pellets.  Coming off the CC doesn’t seem to have affected him in that regard.   

                                                                                                                            If he’s still doing well tomorrow, we’ll try weaning off the meloxicam and watching him closely.  Do you know what the right pace would be, to make sure it’s not too abrupt?  He’s been getting 0.6ml once a day.  Decrease by 0.1ml a day, then?  

                                                                                                                            Thank you so much, and wish us luck!   

                                                                                                                            p.s. The vet now says that he’s already at the low end of the range of gabapentin and we couldn’t give less, though we could switch him to a different med like Tramadol.  I’ve still been giving 1.3ml instead of 1.5, and I want to verify whether he’s in daily pain before consigning him to permanent heavy pain meds.  So we’ll revisit this later.  


                                                                                                                          • Bam
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                                                                                                                              I’m glad to hear he’s doing so much better! When I cut back on my dog’s antiinflammatory meds, I simply gave half the normal dose for a couple of weeks, then stopped them. It took about 1-2 weeks for her problems to return after stopping. I then put her back on half the initial dose. We tried to discontinue the NSAID again, but her problems always returned. It was easy to see with her, because stopping meds affected her ability to move around and lowered her enthusiasm for walks.

                                                                                                                              You can of course go slower, but NSAIDs are non-addictive so it’s not a med that has to be weaned off. I think you can do pretty much as you feel is right for Teddy.


                                                                                                                            • Meg
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                                                                                                                                Thanks, Bam! That’s really helpful.

                                                                                                                                In the last 2 days Teddy’s started to eat a lot more pellets, which is great. And he’s slowly gaining weight again! Today is his first day without any Critical Care and I might give him one more normal dose of meloxicam tonight just to make sure that he’s really in good shape without the CC. I want to try to eliminate any confounding factors when we decrease the pain meds, and it sounds funny but I wonder if the fact that when he doesn’t get CC he doesn’t spend like 45 minutes twice a day doing vigorous exercise (digging a lot to show his indignance, and also that he’s FAR too busy to be interrupted for feeding ) could make a difference in the short term. So we’ll just give him one more day or so to adjust to his new routine.

                                                                                                                                And thanks so much for the advice about the meloxicam weaning. It’s good to know it wouldn’t cause withdrawal per se… I guess just want to do it gradually enough that his body can adjust to the feeling of no more NSAIDs. But maybe I’ll decrease by .15ml per day.

                                                                                                                                Then, if he can stay off the meloxicam, we’d stop the ranitidine… do you think that has enough of an effect on gut motility that it should be weaned over the course of at least a week, like cisapride? Or what would be the right pace?

                                                                                                                                Thank you so much for everything!!


                                                                                                                              • LeahM
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                                                                                                                                  omg hooray!


                                                                                                                                • Meg
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                                                                                                                                    hey thanks, Stamper! and I’m so glad to hear that Frank is doing well and flopping!!


                                                                                                                                  • FlemishDad
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                                                                                                                                      I like your plan for gradual decreases because the stasis might be a symptom of pain and you don’t want that to come back! Even more so with the rantidine. So glad he’s doing better and you can both skip the force feeding.


                                                                                                                                    • Meg
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                                                                                                                                        Thanks, FlemishDad!! We’re both so grateful to you for your help in nixing the force-feeding!

                                                                                                                                        So you do think the ranitidine should be weaned extra slowly due to gut motility factors? I wasn’t sure how strong an effect on motility it has.


                                                                                                                                      • Bam
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                                                                                                                                          It’s so great that he’s doing so much better! Yay Teddy!

                                                                                                                                          I think I’d taper down the ranitidine much the same rate as the metacam. I can’t see that it would hurt, but going cold turkey could potentially cause problems.

                                                                                                                                          Anti-inflammatory meds have a somewhat lingering effect, because they subdue inflammation and it takes the body a bit of time to get full-blown inflammatory processes going. So the effect of the Metacam can last a while after the med itself is out of the system. As previously stated, it took about a week- two weeks for my dog to develop problems again after stopping her NSAID. (Then it took about a week for her symptoms to go away again after re-starting the NSAID).


                                                                                                                                        • Allow's human
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                                                                                                                                            Need some help please. Rabbit is six months old and have had him for about three months. He’s suddenly sneezing and has a scab on his nose. He eats normally, drinks water and plays. His coat looks great otherwise, no eye issues. His ears aren’t hot. Thank you.


                                                                                                                                          • Bam
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                                                                                                                                              Hi Allow’s human!

                                                                                                                                              Sometimes a bunny sneezes from getting hay dust in it’s nose etc – so it all depends on how often he sneezes and whether theres any discharge, if he tries to clean his nose with his paws so the fur on his paws get all matted, if his eyes are runny and things like that. The scab on his nose – could he have sustained an injury by gnawing at cage bars? Is he living with other rabbits?

                                                                                                                                              This thread is not the best place for your questions, I would suggest that you start a thread of your own. You can do that by following this link: https://binkybunny.com/FORUM/tabid/54/afv/post/aff/2/Default.aspx

                                                                                                                                              It’s good if you can explain a little bit more about your bun’s symptoms, and a picture of the scab would be great too. If you run into any problems starting a new thread, please PM me or one of the other leaders =)


                                                                                                                                            • Meg
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                                                                                                                                                Thanks so much, Bam!! Allow’s human, I’m sorry I don’t know about your question, but I want you to get the most help you can which you will if you get your very own thread. Thanks to Bam for helping out with that!

                                                                                                                                                And thank you so much, Bam, I’ll do that with the ranitidine. With the meloxicam, the more I read about it, the more I think that would make the most sense for osteoarthritis (spondylosis), vs. gabapentin, so I’ll talk to my vet about that.

                                                                                                                                                But right now, my goal is to find out whether Teddy is really dealing with daily pain or not. (As I mentioned, he was so spritely up till the day before he stopped eating, this is still a question in my mind.) I want to do this to gauge whether he needs to stay on multiple daily pain meds for the rest of his life, or whether we could just watch for flare-ups and keep meloxicam on hand as needed. I certainly don’t want to *produce* problems (like gabapentin withdrawal) while weaning his meds, which is why I was thinking weaning meloxicam by removing 1/4 dose each day for 4 days might give us a read without upsetting his system too much. It sounds like there may be lingering effects, but I’d also assume that if he were substantial pain he would show signs of it fairly soon after weaning the meloxicam, right? If it seems to go well, we’d next wean the ranitidine over 5 days before we’d possibly start on the gabapentin, so we’d have more time to look out for signs of trouble.

                                                                                                                                                I found a longer list of pain signs here: https://rabbit.org/the-importance-of-analgesia-pain-control-for-pet-rabbits/ so I’ll look out for those. They sound like what the bunnies have shown while in pain (they also sometimes shift positions a lot, like they can’t seem to get comfortable). If Teddy does seem to be in pain, I definitely will make sure he has meloxicam and/or whatever he needs to abate it! I just don’t want to put him through other health risks if he doesn’t actually need it.

                                                                                                                                                Meanwhile I’ve just reintroduced one Sherwood Joint Support tablet per day, which he and Athena had been on in their golden years, and seemed to make a difference — it’s got turmeric in it so it may also help with inflammation a bit. (I’d stopped all forms of sugar completely for the 9-day course of Benebac as he was having some mushy poops and cecals — now all seems better on that front, and he’s eating his cecotropes!

                                                                                                                                                Thank you so much again!! You are sooo generous to help us in this long journey, and I am so, SO grateful.


                                                                                                                                              • Meg
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                                                                                                                                                  Maaaaan… Teddy seems to be eating less today (though still pooping well so far) and staying under the bed a little more. I haven’t even decreased any of his meds at all yet! I’ll hold off on that now. All that’s changed is being off Critical Care (and giving him one Sherwood Joint Support tablet last night… I wouldn’t expect that to be enough cause an imbalance, especially so quickly, but could it?)

                                                                                                                                                  I’m so confused and frustrated and worried and sad. (I’m also in a crunch period at work so that, although I can work from home, I’ve been up super late all week and working round the clock when I’m not caring for Teddy, so I guess that makes me less patient/resilient right now.)


                                                                                                                                                • Meg
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                                                                                                                                                    But good news!! Teddy seemed much happier by late last night, and super happy this morning! He seems to now have shifted to eating all his normal pellets and not much more than his normal greens. Anyway, I’m so glad we held off on experimenting with weaning the pain meds, or I would have thought it was because of that.

                                                                                                                                                    We’ll see how it goes and if he’s in good shape tonight we might try starting it then. But I am thinking, if this experiment goes well and I want to get him off the gabapentin, maybe I should actually having him back on the meloxicam for that? Because before he’s off it (and through any withdrawal), it’ll be impossible to tell whether he’s OK with *no* pain meds. I’d rather get him off the gabapentin first and then see if we can gradually reduce his meloxicam dosage (he’s currently on 0.6/kg once a day, so maybe he could go down to half that?). What do you think?

                                                                                                                                                    So the experiment right now would be not to get him off meloxicam for good, necessarily, just to see if he’s in pain to the point where he definitely needs *both* pain meds.


                                                                                                                                                  • FlemishDad
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                                                                                                                                                      If he is still eating a reasonable amount of hay, greens, and cecos it’s not a crisis. It’s *possible* the joint supplements threw his gut flora off a bit because they have a lot of sulfur. If he goes more than 6 to 8 hours without eating give him some critical care.

                                                                                                                                                      It’s also possible he’s having some back pain, too. You are probably best at sussing out what is bothering him.

                                                                                                                                                      How is his shedding?


                                                                                                                                                    • Meg
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                                                                                                                                                        Thanks, FlemishDad!! I think our messages may have posted at the same time.

                                                                                                                                                        That’s good to know about the Sherwood joint support tablets. I didn’t know they had sulfur. They seemed to help Athena when she got stiff, and I’d like Teddy to have the turmeric and other benefits. But do you think they’re not worth the problems? His poops haven’t been mushy which is good.

                                                                                                                                                        Teddy’s shedding is not bad — he’s so fluffy that the extra seems to stay caught in the fuzz. I do see a slightly stringy poop here and there lately but not much.

                                                                                                                                                        I was worried about pain too but then late last night he did two binkies within a couple hours of each other!

                                                                                                                                                        I’m not sure what your background is, FlemishDad, but you seem to know a lot about veterinary medicine. What’s your opinion on what the best med(s) for osteoarthritis would be?


                                                                                                                                                      • FlemishDad
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                                                                                                                                                          I’m a semi-retired research biologist, so I kind of know the theory of veterinary medicine but not the practice. My opinion on the best med for osteo is: there isn’t one. NSAIDs and chondroitin/glucosamine sulfate have theoretical reasons to work, but clinical trials show very little, and possibly no, effect on function for either. OTOH if you think it works I’m not going to disagree. CS/GS have a much better safety profile so they would definitely be my first choice. 

                                                                                                                                                          I don’t think chondroitin sulfate would cause significant problems in the long-term, but in the short-term it could cause digestive upset as the gut biota adjusts to a different higher-sulfur environment. Digestive upsets is the first listed complication of CS in people and apparently the most common, and there is a lot more going on in the rabbit hindgut than ours, so I would expect (without having any actual data) that rabbits would be more prone to that than people and even more so (again without any actual data) in a rabbit that had been having tummy troubles for, what, 2 months now?

                                                                                                                                                          Edit: BTW, the Sherwood joint treatments have banana in them, unless I was looking at the wrong ingredient list. Not a lot in an absolute sense, I’m sure, and you said you didn’t see mushy poops, but it’s in there.


                                                                                                                                                        • Meg
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                                                                                                                                                            Thanks, FlemishDad! I really appreciate it.

                                                                                                                                                            Yeah, it’s been a month and a half that Teddy’s been on meds. Though honestly I sometimes question how much of what’s been going on is me misinterpreting things (like when I didn’t realize smaller poops are to be expected with more greens in the diet), or doing things that set him back: In the first week, I stopped his treatment too quickly and slowed him down. So then the vet had me bring him back in on Day 9 for a recheck even though he was normal that day. Then the stress set him back into stasis again (as vet visits have several times before). And I didn’t give him enough Critical Care at that point, in retrospect. Then they made me promise to give him laxatone twice a day for like a week until I refused again, and his poops got all weird (seemed like dysbiosis). He did have a painful episode about a month ago, but after a couple days of extra meloxicam that resolved. Then we stopped the cisapride too quickly, which set him back again. Since then it’s mainly been his reluctance to eat pellets, and his smaller poops, while eating twice his normal greens (8+ cups) plus hay plus Critical Care that’s made me think he’s still sick, but that may also have been to be expected for a bun eating that many greens (and he’s recently started going back to his normal eating habits, re: pellets and greens, of his own accord). So I do wonder how much of this is my own missteps, slash my misinterpretation, slash him being on so many meds including gabapentin.

                                                                                                                                                            That said, I don’t want to cause any more trouble! He’d been on 1 Sherwood Joint Support tablet daily for the past 2 years or so (until stopping while sick) and since he has osteoarthritis I don’t want to take it away… but I could hold off more till he’s been out of the woods for a while, if you think that’s best. Thanks for mentioning, it does have a little banana, but the tablets are pretty small so it must not be enough to bother him most of the time. I gave him 1 tablet each of the last two nights but could stop again now if needed.

                                                                                                                                                            Thank you so much!!

                                                                                                                                                            p.s. Hmm, this article is old, on humans, and sponsored by the manufacturer, but it does show efficacy of meloxicam on osteoarthritis pain in a large sample: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485487 But anyway yeah, it seems like there are no easy answers here. :/


                                                                                                                                                          • FlemishDad
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                                                                                                                                                              If he seems ok now just continue the joint pellets. If you are suspicious take him off a few days and then try again with half doses if possible.

                                                                                                                                                              I looked up gabapentin because I thought it was primarily for neuralgia and not helpful for most pain. I found it is mostly used to intensify other meds. So if you wean him off meloxicam he will effectively be off pain meds because by itself the gabapentin does very little.

                                                                                                                                                              I am thinking that since ups and downs are very normal you should wean off meds even slower. Things are pretty Ok right now, right – not too hard on you or Teddy, not too much $ on meds? These are fairly safe meds – I don’t think another week or two is a big issue. I always say if it ain’t broke don’t fix it.


                                                                                                                                                            • Meg
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                                                                                                                                                                Thanks, FlemishDad!

                                                                                                                                                                Hm, interesting. I think our vet was thinking gabapentin for the spondylosis, meloxicam for the GI pain during stasis. But he’s recently said either one is fine, they each work better on some individuals than others, so we can just experiment and see what works for Teddy.

                                                                                                                                                                And thanks, he seems OK so I’m keeping up the joint support tablets.

                                                                                                                                                                Yeah, I don’t mind the cost (not that I’m rich but I can’t imagine withholding anything from a bunny over money), and he’s OK. He really does hate being picked up and force fed meds twice a day so I’m hoping we can soon get him on few enough that we can sneak them into food/treats, and hopefully get him off more of them. Now, not to jinx it, but he seems fine, so I don’t want to keep putting him through unnecessary treatments. But of course the weaning process will be a long one.

                                                                                                                                                                So we’ve started experimenting with the meloxicam, down from his normal 0.6ml each evening to 0.4 the night before last and then 0.2 last night and then none tonight. So far he seems fine; I’m keeping a close eye on him. If he keeps looking fine, we’ll add the meloxicam back for now in order to try a slower wean of the gabapentin, over 6 days (and he’s only been getting about .125ml). The vet said we could do half the dosage (still bid) for 3 days, then move to half the dosage once a day for 3 days, then stop. That’s consistent with stopping gabapentin in humans… and in Teddy’s case he’s on a very low dose. Do you think that will be slow enough?


                                                                                                                                                              • FlemishDad
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                                                                                                                                                                  Don’t treat me like an expert on this because I am not but that sounds like a good plan to me. Hoping for continued progress!


                                                                                                                                                                • Meg
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                                                                                                                                                                    Got it, thanks so much! He seems to be doing well now having been off the meloxicam for 48 hours, and tonight we’ll add it back temporarily and start weaning the gabapentin.

                                                                                                                                                                    Thanks again!


                                                                                                                                                                  • Meg
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                                                                                                                                                                      Oh man, Teddy was doing great, eating and pooping normally, as we went from .125ml of gabapentin to .07ml and held for 5 days.  then all of a sudden yesterday we had to be gone for 14 hours to meet relatives out of state, and when we came back he’d barely eaten anything!!  =(  nothing was different except our being gone.  poor little guy.

                                                                                                                                                                      last night he ate a decent amount of food, and today he’s nibbling and we’re keeping a closer eye on him, and have gone back to the .125ml of gabapentin as well as adding simethicone and benebac and some oral fluids.  if he doesn’t eat well we’ll have to do CC again, sigh…  

                                                                                                                                                                      What do you think was the matter?  The vet said that .125ml gabapentin is so little it probably wasn’t doing much, and he wasn’t worried about withdrawal… and Teddy had no reaction to our quick wean of meloxicam before (and he’s been back on full strength all weak) so I’d be surprised if it’s pain… I’m so sad that this happened and that I don’t know why


                                                                                                                                                                    • FlemishDad
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                                                                                                                                                                        Isn’t this the longest time Teddy has been alone in ages? How was he acting when you got back?


                                                                                                                                                                      • Meg
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                                                                                                                                                                          Yes, that’s true, it’s the longest he’s been alone during the day. From late January until this past week, I just stayed home with him all of the time basically. Then this past Tuesday through Thursday I did leave the house but for like 4-8 hours at a time. I just feel awful because I was loathe to leave him, but my fiancé’s mother and sister had traveled across the country to meet us because they wanted to shop for wedding outfits together about 3 hours from here. I already made them mad by insisting we do a day trip rather than stay the night!

                                                                                                                                                                          Anyway, he was acting semi-normal when we got home, though he didn’t want kale at first (he usually loves it). He did run to his castle and do a mini-binky on the way, and hop up to the second floor to get treats! He didn’t seem like he was in pain. I just winced at the sight of all his greens and pellets sitting there nearly untouched.

                                                                                                                                                                          Last night I slept in his room for part of the night. In the morning he’d eaten a fair amount (about 2/3 of his greens and 1/2 his pellets). But today not so much: he ate a good amount of hay but fewer greens and pellets, though I spent more time with him. I know I probably should have given him Critical Care tonight but I wimped out (I gave him all his medicines and a few CCs of water orally). He’s still eating hay and his poops are better than yesterday (about 75% of normal size), though he left part of a cecotrope for the first time in a week or more. I just wanted to give him one more chance before putting him through the stress of the force feeding again. I could well be wrong. :/

                                                                                                                                                                          One other thing that’s been going on on and off lately is that one of his eyes has sometimes been watery. It came back maybe a week ago, and it varies from day to day. I finally got up the courage to look it up on this forum the other day and of course now I’m terrified that it’s a tooth poking up into his tear duct. But it comes and goes, and it doesn’t seem to correlate with him acting painful or eating less (he was doing terrific this week until Saturday) so I really, really hope it’s just hay. He does quite often get hay stuck in his fur around his face.

                                                                                                                                                                          This poor little sweetie. I hate SO much that I can’t seem to figure out what he needs or how to take good care of him like he deserves.


                                                                                                                                                                        • Meg
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                                                                                                                                                                            Thankfully Teddy seems to be bouncing back pretty well, knock on wood.  Hopefully it was just our being gone longer that day and nothing else medical.  (Though if he’s now bonded to me in a way that will keep producing distress if I’m gone more than a few hours, that will be another thing I’d need help figuring out — but for now, my priority is just getting him all back to normal hopefully.)  


                                                                                                                                                                          • Bunny House
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                                                                                                                                                                              Maybe you can get him a stuffy that smells like you and you can leave it with him when you leave. I’m glad he slowly getting better!


                                                                                                                                                                            • Meg
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                                                                                                                                                                                Thanks, I’ll try that! He was kind of facing the wall when I came home from a meeting the other day (I’d been gone about 4-5 hours), but I came in an offered him a treat and he perked up. This morning he seemed happier and more active than we’ve seen him since before he got sick (two months ago)! I’m so grateful he’s doing better. We’re trying to wean the gabapentin again, and I’m going to stick around as much as possible at least till he’s better. (And maybe he’ll go back to being his independent self once he’s all back to normal, if we’re lucky enough to have that happen.


                                                                                                                                                                              • Meg
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                                                                                                                                                                                  Hey, just checking in: Teddy’s been doing great, and he’s off the gabapentin now.  His left eye is still a bit watery :/ and I don’t know why but in case it’s something uncomfortable, I’m thinking we’ll try to wean the cisapride next rather than the meloxicam.  He doesn’t show any clear signs of being in pain, but I’d rather not risk it at least right now.  

                                                                                                                                                                                  I really hope it’s not a tooth blocking a tear duct, because I really don’t want to put him through another major procedure, poor sweetie.  They didn’t notice anything during his mouth exam a couple months ago, but would that kind of thing be visible in an exam like that?  I emailed our vet to ask if he can see anything in the x-ray they took, but it may not have been at the right angle (and I forget if it included his head in any case).


                                                                                                                                                                                • FlemishDad
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                                                                                                                                                                                    So great Teddy is better!

                                                                                                                                                                                    If it’s a blocked tear duct I don’t think it is worth operating. My mother in law had an operation for blocked tear duct and did not think it was worth the hassle, and she had a much less serious surgery than tooth root removal in a rabbit. Just be on the alert for eye irritations as a cause.


                                                                                                                                                                                  • Meg
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                                                                                                                                                                                      Thanks, FlemishDad! I agree, I wouldn’t want to operate unless there was something worse going on — Teddy just really really hates the vet and does not respond well. I washed his face extra well today… he doesn’t *seem* bothered by the tearing but I’ll keep a watch on things.

                                                                                                                                                                                      Thanks so much!


                                                                                                                                                                                    • DanaNM
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                                                                                                                                                                                        So happy to hear he’s doing better! Bertha has actually had a watery eye recently too… but she just had a check up and they didn’t notice anything amiss. So just monitoring it…

                                                                                                                                                                                        . . . 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.  


                                                                                                                                                                                      • Meg
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                                                                                                                                                                                          Thanks, DanaNM! I’m sorry about Bertha. But yes, from what I’ve read on these forums, sometimes it’s serious and sometimes it’s not and goes on for years with no other issues. Fingers crossed we’re in the latter camp (or it will resolve soon)!

                                                                                                                                                                                          We’re weaning cisapride now, slowly: we’ve been at .4ml bid so we’re keeping the frequency the same and decreasing by .05 per day (same dosage both feedings). I’m hopeful that if that goes well, then we could put his ranitidine (in a drop of raspberry B12 solution) on treats, and trick him into eating meloxicam in greens perhaps, and be able to stop the forcefeedings!! I know he’d be a huge fan of not getting picked up all the time.


                                                                                                                                                                                        • Meg
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                                                                                                                                                                                            Just a quick update: things are going well!    We’ve tapered down the cisapride really slowly, going down by .05ml and then holding there until his poops get bigger, then decreasing again.  Now he’s at .1 and should be completely off in a couple more days, knock on wood!   

                                                                                                                                                                                            His eye is still watery, but he doesn’t seem bothered by it.  He did some binkies the other night and has resumed rocketing around the room every time he’s about to get treats.     I am soooo grateful!!  


                                                                                                                                                                                          • LittlePuffyTail
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                                                                                                                                                                                              Glad to hear he is doing well.


                                                                                                                                                                                            • Meg
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                                                                                                                                                                                                Thanks so much, LittlePuffyTail!!! I was not sure if he was going to bounce back, so I am beyond thrilled!!! (Knock on wood )


                                                                                                                                                                                              • FlemishDad
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                                                                                                                                                                                                  It’s great to hear Teddy continues to improve. Thanks for keeping us posted!


                                                                                                                                                                                                • DanaNM
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                                                                                                                                                                                                    Yay Teddy! Way to go!

                                                                                                                                                                                                    . . . 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.  


                                                                                                                                                                                                  • Meg
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                                                                                                                                                                                                      Thanks, DanaNM! I am so grateful. I don’t want to jinx it, but he is doing great and we are so thrilled. Tonight or tomorrow we’ll start trying to give him his couple of remaining meds via treats/food. Over the past two and a half months of treatment I have to admit I wasn’t always 100% sure he would pull through. But he’s a strong bun and (knock on wood) I am so relieved!!


                                                                                                                                                                                                    • Bunny House
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                                                                                                                                                                                                        Yay!! There’s always doubt when dealing with a sick bun, and for a long time too, I felt the same way, I’m just glad he’s doing so good, I hope he can be back to his old self and not need any care for a long time!


                                                                                                                                                                                                      • Meg
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                                                                                                                                                                                                          You guys you guy you guys you guys you guys!!!!!!!!!! ?????

                                                                                                                                                                                                          Guess what??? Teddy had his first day fully off cisapride (after a very slow taper) and he did great, even better than normal! this means we were going to get to go down to just one force-feeding session a day of his remaining 2 meds, meloxicam and ranitidine. BUT THEN he was a superhero bunny and accepted them both via food/treats!!! So unless he changes his mind on that, we’re all done with the force-feeding medicine and he doesn’t have to be tormented on a daily basis anymore!!!! ????????????????

                                                                                                                                                                                                          I am soooo thrilled!!!!! I was able to get the ranitidine/B12 solution onto half an Oxbow digestive support cookie, and just gave it half a minute to let it sink in. He’s usually wary of new foods so I was not optimistic, but he ate the whole thing right away!!

                                                                                                                                                                                                          Then, since he’s been into basil lately, I took a large basil leaf, washed it, and then dried it with a clean paper towel so it would hold the medicine better. Then I emptied the oral syringe of meloxicam onto it and spread it around thoroughly so that it covered the whole surface and wouldn’t drip off. Happily, he ate that up at once too!!

                                                                                                                                                                                                          I don’t have words to express how grateful and thrilled I am.

                                                                                                                                                                                                          And I am SO thankful to all you very kind souls who gave your advice and company so generously over nearly 100 posts now!!! Thank you so, soooo much. This forum has been my lifeline.

                                                                                                                                                                                                          Love to you and all your bunnies!!


                                                                                                                                                                                                        • Meg
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                                                                                                                                                                                                            p.s. Thanks so much, BunnyHouse and FlemishDad, for your messages too!! I don’t seem to get notifications reliably anymore and I somehow didn’t see your messages till now. But thank you!!


                                                                                                                                                                                                          • Bam
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                                                                                                                                                                                                              Yay for Teddy!!!! Lovely news, fingers crossed hell keep taking the meds on food!


                                                                                                                                                                                                            • Meg
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                                                                                                                                                                                                                Thanks, Bam!! This morning he was happier than ever, and came racing out for food doing little binkies!!!! We are in happy bunny heaven!!!!!


                                                                                                                                                                                                              • FlemishDad
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                                                                                                                                                                                                                  With all the sad stories about bad outcome for sweet rabbits with caring human companions it is so great to see a crisis coming out well.

                                                                                                                                                                                                                  You should train him for extra brushing so you can brush the heck out him for his next molt. Considering how much hair comes out of my short haired Flemish I don’t know how longhaired rabbits even survive!


                                                                                                                                                                                                                • Meg
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                                                                                                                                                                                                                    Hi everyone!  I just wanted to come back and say thank you so much again for all your help!!  Teddy really did stay well after my last entry, thank goodness!!  He’s still with us a year later, and we’re so grateful.  He didn’t have any more problems with eating until we took him to the vet for a checkup in October, haha — he hates car rides.  (But then he recovered pretty quickly.  Plus his exam and bloodwork came out normal!)  He did have one more slowdown just recently, but he seems to be recovering well and we’re hopeful we’ll be able to all celebrate his 11th birthday in a few weeks.  We feel so lucky and grateful!!

                                                                                                                                                                                                                    I spent so much time last year in despair — fearing that since he was in stasis/slowdown for sooo long, there must be no hope for recovery.  So in case anyone else is in this boat, just know it is possible!  🙂

                                                                                                                                                                                                                    Also, we’ve learned some tricks: in his case, he likes meloxicam and simethicone and will lick them off a plate so we don’t have to put him through syringe-feeding.  So it turns out that if we mix his famotidine (had to switch to that after ranitidine was pulled from shelves) into the meloxicam (famotidine doesn’t have much taste and you only give a tiny bit), and mix his cisapride into the simethicone at a ratio of 1:3 c:s, he will eat all his medicines off a plate!  (With coaxing sometimes.)  It’s such a help especially when they’re getting much better but you still need to taper the meds slowly.  (Teddy seems to need this, anyhow.)

                                                                                                                                                                                                                    Thank you all so much again!!  I have no idea how we would have gotten through that without you.


                                                                                                                                                                                                                  • jerseygirl
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                                                                                                                                                                                                                      Thanks for the update.  Teddy is a star!!! That is so great he is being a doll about the meds. Means for less stressed humans and less stressed bunny!

                                                                                                                                                                                                                      How did you find the famotidine in comparison to the ranitadine? Do you think it’s been helpful?  I suppose with all the meds he was on, its hard to gauge just want med is most effective.


                                                                                                                                                                                                                    • Bam
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                                                                                                                                                                                                                        <p style=”text-align: left;”>This is lovely news, thanks for the update! It really is very encouraging for those who struggle with stasis buns.</p>


                                                                                                                                                                                                                      • Meg
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                                                                                                                                                                                                                          Thank you SO much, Kate!!!  Your advice and moral support was just such a lifesaver during this ordeal!  You’re so kind.  🙂  Bam, I just saw your message — thank you so much too!!!  🙂

                                                                                                                                                                                                                          Yes, we’re so lucky about the meds!!  Teddy has stayed on daily meloxicam (just 0.35 CCs) plus ranitidine or famotidine once a day over the past year, but he’s been a doll as you say, and eaten them off a plate or sandwiched between basil leaves.  So that’s been no stress.  Only the past couple weeks that he’s had a slowdown have we added other things.

                                                                                                                                                                                                                          In early January of this year I couldn’t find any more ranitidine at the store, since it was being recalled here in the US.  So I called our vet who said we could switch to famotidine (in a slightly smaller dosage).  In his case, we take a 10mg tablet of famotidine and add 1CC of warm water, and after a couple minutes it dissolves.  We then draw all of it up into a syringe and dispense 0.06 (barely two drops).  In any case, we haven’t noticed any changes in the effects, so far.   I don’t know if famotidine has the motility benefits of ranitidine, but nothing changed for Teddy when we made the switch.  The one benefit is that while ranitidine tastes bitter, famotidine doesn’t really taste like anything, so he’s less reluctant to eat it.  That may be why he’ll now lick it off a plate if it’s mixed in with the meloxicam.

                                                                                                                                                                                                                          Thank you so much again!!!  🙂 🙂 I hope you’re keeping as well as possible under these crazy circumstances.  Hugs!  🙂


                                                                                                                                                                                                                        • jerseygirl
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                                                                                                                                                                                                                             I don’t know if famotidine has the motility benefits of ranitidine, but nothing changed for Teddy when we made the switch.

                                                                                                                                                                                                                            Apparently it does! They’re known as H2-receptor antagonists that work on the smooth muscle in the lower end of GI tract. I dont know if one is more effective over the other. But they both also are antacids.

                                                                                                                                                                                                                            The ranitadine (zantac) recall is worldwide I think. Its not available here in Australia.  I had some liquid Zantac and have had to use it recently for 2 of my rabbits. It really helped. I hope it will be available again in near future.


                                                                                                                                                                                                                          • Meg
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                                                                                                                                                                                                                              Oh wow, that’s good to know! Thanks for this info. I hope famotidine helps your bunnies too if needed, until Zantac comes back.

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                                                                                                                                                                                                                          Forum HOUSE RABBIT Q & A More stasis questions