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Rabbits/URGENT decision has to be made about possible abdominal rupture

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Lane wrote at 2014-01-14 20:59:57
Dear Dana,

Heís been back for two days and Iím delighted to report heís steadily improving.



Believe me, the last thing I wanted to do was leave him overnight at the emergency vet hospital, but it was the only way I was going to get the medication, testing, and treatment he needed.  Most local vets refused to even see him because they felt unqualified.  The vets at the hospital were at least willing to try.



Most of his tests came back quite normal with the following exceptions:  RBC and Hemoglobin were low (4.5 and 10.2 respectively, while glucose was high (173.0).  Eosinophils were WAY above normal at 24.0 but someone had written in ďmay be heterophilsĒ.  All other tests were normal range.  They also handwrote ďFecal Clostridium 1-3pHPF.Ē  Iíd love to know how significant that is.  In any case, I insisted on a prescription for Questran.  I also left with Metronidazole, Metacam, Buprenorphine, and Metroclopramide.  I already had Ciserpride on hand.



Since then, itís been fits and starts but thatís often the case with G.I. stasis.  Youíre so right about the hydration.  Iím doing sub-cutaneous and also just trying to get him to drink through a mouth syringe.   When heís well-hydrated he will eat some timothy hay and fresh greens.  Iíve given him a few tiny pieces of apple when his appetite turns poor.  I know the sugar is not a good idea but the tiny amount does seem to inspire him to eat.  



Heís gradually eating more and producing more.  Much of what he produces is very wet, half-formed, and unusually smelly but quality is slowly improving.



One thing Iíd really appreciate advice on is how much Questran and for how long.  They had prescribed  Ĺ a packet (which is about 1.5 teaspoons) in 20 cc of water.  Iíve had your article on ileus for YEARS and it seems to suggest .5 teaspoons in 20 cc of water.  Thatís a 3rd of what they were prescribing.  I decided to split the difference after reading what I could find, which wasnít much.  Iíve been giving 1 teaspoon but making sure he got 30 cc of water.  I have no idea how long to keep it up.  Was the amount listed on his test results ďFecal Clostridium 1-3pHPFĒ  a significant elevation?  How long would you suggest I keep him on it, especially since he seems to be recovering?



You had listed some questions:

1.   What color is he?  Heís a 6.5 lb lop, mostly white but with speckles of brown and black, dark brown eyes.



2.  For the time you've known him, has he produced normally shaped/textured fecal pellets, or have they been relatively large and misshapen?  Of all my houserabbits, he has had the best poop until recently, beautifully and consistently formed - both high quality and high quantity



It's possible he has a congenital intestinal disorder if he's white with pigmented eyes and spots, and has produced misshapen pellets in the past (on a regular basis).  Neither is the case



Oral hydration and hydration via enema can help hydrate a mass like this, even if it's high up in the intestine.  Lactulose will serve as an osmotic laxative.  DO NOT force Critical Care.  Water, water, water only, to get that mass moving.  Definitely working on the water.  Iím still puzzled this ever started since his diet and digestion have worked so well until recently.  The only trauma heís had was somehow an insect (probably spider) got inside and he got a bite on the ear.  I immediately took him to rabbit-savvy vet.  Unfortunately I had to see the assistant who isnít as experienced, but I think she treated it appropriately.  He does have a few issues with teeth points but heís been examined several times recently and they are not troublesome yet. I will have the rabbit-savvy vet look again next week.



If it's in his stomach, then the hospital staff might not realize that a rabbit's stomach is never empty, and that's normal.  I think youíre absolutely right



I think you may have seen this, but the hospital staff might not have.  I hope it helps:



http://www.bio.miami.edu/hare/ileus.html  



Not only do I have it and the article which went into the exotic vet magazine, Iíve consulted both regularly over the years.  I try to tactfully offer them both to inexperienced veterinarians (INCLUDING the ones at the emergency hospital).  However, I doubt they really pay attention.



Dana,  THANK you for everything you do for rabbits, especially the wisdom thatís saved my bunnies many times.  I appreciate any advice, especially on the Questran and significant of the ďFecal Clostridium 1-3pHPFĒ.  I am more grateful for your time and wisdomthan I can say.




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Dana Krempels, Ph.D.

Expertise

I've lived with companion rabbits for more than 35 years, and consider them members of my family. I can answer any questions about the biology and health of rabbits, from the commonplace to the unusual. But please note:

RULE #1:
THE INTERNET IS NOT THE PLACE TO SEEK HELP IN AN EMERGENCY.

...it is an EMERGENCY.

Find a rabbit vet at www.rabbit.org/vet for immediate help, and don't risk your bunny's life by spending time asking questions online! If you can't get in touch with your vet, read these Emergency Sick Bunny Instructions.

If you have found a wild baby rabbit, please read these EMERGENCY INSTRUCTIONS FOR WILD BABY RABBITS and then use this link to FIND A LOCAL WILDLIFE REHABILITATOR who can give you the right advice.


RULE #2:
Help me help you! Please make your subject line informative if you have an urgent question. then LET ME KNOW IN THE SUBJECT LINE so I can give your question highest priority over non-urgent questions. If you don't do this, then I can't guarantee timely assistance!

For all the best, most accurate rabbit health, care and behavior information, visit The House Rabbit Society.

Experience

I have been rescuing and rehabilitating domestic and wild rabbits for about 30 years. I have written articles for many rabbit rescue publications, as well as for the veterinary journal, Exotic DVM. I own EtherBun, the internet's largest listserve dedicated to health, care, and behavior of domestic rabbits.

Organizations
Houserabbit Adoption, Rescue, and Education, Inc. (H.A.R.E., Inc.) president National House Rabbit Society (Board member)

Publications
Exotic DVM
Warren Peace (Journal of the House Rabbit Society of Miami)
Various newsletters of the House Rabbit Society, nationwide

Education/Credentials
Ph.D - Biology
B.S. - Biology
B.A. - English

Awards and Honors
Lightspan Academic Excellence Award for web site on rabbit health and biology
(http://www.bio.miami.edu/hare)

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