Pascal Wilkie 1yr. MN European Rabbit

Presented at the R(D)SVS on Tuesday 14th of July 2015

• 3 day history of lethargy, inappetence/anorexia• Reduced drinking• Teeth grinding (bruxism)• Inadequate faecal and urine production • Attended emergency OOH at home vets over the weekend and

was treated with Metacam, Zantac and fluid therapy at clinic and owner was offering fibre supplement (critical care)

• Renal/hepatic parameters normal and NAD on radiographs

History:

On presentation:• Normal HR and RR.• Reduced gut sounds in right abdomen, absent in left. • No abnormalities on abdominal palpation – perhaps enlarged

bladder?• Oral/Dental exam - NAD• Temp 38.1 • Admission BW 1.84kg• Small, varying sized faecal pellets

Tentative diagnosis – Stress/nervous induced gut stasis

Treatment on Tuesday (14/7/15)

• Fluid Therapy: Hartmanns 15ml IV, 40ml SC (with hyaluronidase) TID

• Zantac PO: 4mg/kg BID • Metacam PO: 0.5mg/kg BID• Buprenorphine SC: 0.03mg/kg TID (q. 6-8hours)• Cisapride PO: 0.5mg/kg TID • Oxbow Critical Care: 15-20ml (q. 4- 6 hours)• Ad Lib hay and greens available, 20g pellets.• Water intake monitored

Wednesday (15/7/15)• BW: 1.92kg.• RR = 100bpm, HR = 145bpm, Temp = 39.0 • Noted eating hay last night, ate some pellets.• Urine passed and ~30 faecal pellets in enclosure• On Physical exam increased gut sounds on right and even

some on the left! • Stomach pliable but still slightly firmer than normal.• Kidneys and bladder felt normal• Sores noted on hocks – sudacream treatment recommended

• Fluid Therapy: Hartmanns 15ml IV, 40ml SC (with hyaluronidase) TID

• Zantac PO: 4mg/kg BID • Metacam PO: 0.5mg/kg BID • Buprenorphine SC: 0.03mg/kg TID (q. 6-8hours) • Cisapride PO: 0.5mg/kg TID • OxBow Critical Care: 15-20ml q. 4- 6 hours

At midnight changed Buprenorphine to oral Tramadol (5mg/kg SID).

Thursday (16/7/15)• BW: 1.89kg.• RR = 68bpm, HR = 140bpm, Temp = 39.4 • Eating hay, pellets (all 20g gone) and greens. Drank 70ml from

bottle over night• Urine passed and ~30 normal faecal pellets in enclosure• On Physical exam - increased gut sounds on right and some on

the left

Discharge instructions• Zantac PO: 4mg/kg BID• Cisapride PO: 0.5mg/kg TID • Tramadol PO: 5mg/kg BID • Metacam PO: 0.5mg/kg BID

FOR 5 DAYS

Recheck in 7 days.

Causes of gut stasis in rabbits • Lack of dietary fiber • Anorexia • Chronic dehydration • Environmental stressors:

• Proximity of predators • Proximity of a dominant/competitive rabbit • Change/destabilisation of group hierarchy • Sudden change of diet • Change of housing • Transport • Extremes of weather/temperature • Loss of a companion

• Pain • Post-surgical adhesions • Ingestion of toxins (e.g. lead) • Foreign bodies

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Clinical signs:• Small and/or malformed faecal pellets• No faecal pellets• Loss of appetite• Lethargy / hunched posture• Lack of gut sounds• Abdominal palpation –pain, distension, masses or an impacted stomach or

caecum.

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Treatment• Important to get rabbit

feeding – syringe feeding/oesophageal feeding tube

• Prokinetics• Analgesia• IV fluids• If a blockage of some

description is suspected then this must be ruled out before any prokinetic medications are given.

• Exercise

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Any questions?????

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