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Dr. Jeanne Morford

Winter Park Veterinary Hospital Winter Park, FL

Rabbit Emergencies

Consider it an EMERGENCY· if Your Rabbit Can't:

./ Eat
./ Poop
./ Urinate
./ Breathe
./ Walk OR if Your Rabbit is in PAIN for Any Reasonn

Signs of Pain in Rabbits:

• Hunched posture

• Teeth grinding

• Anorexia

• Holding the head in an elevated, extended position

• Rapid, often shallow, respiratory rate

• Abdominal breathing

• Splinting on palpation

• Lethargy

• Hair pulling

• Excessive licking and grooming over the painful area

• Aggression in a normally passive rabbit

• Decreased interest in the environment

• Various degrees of immobility and/or reluctance to move

• Appearance of straining (to urinate or defecate)

• Bulging or staring, unfocused eyes

• Vocalization

Medical Conditions That May Cause Emergencies

• Gastrointestinal Stasis

• Dental Problems

• Malocclusion

• Molar Spurs

• Tooth Root Abscess

• Urinary Obstruction

• Bladder Stones

• Urinary Sludge

• Trauma

• Fractures

• Lacerations and other Wounds

• Heat Stroke

• Disease

• paraSites}

• Infection

• Cancer

Affecting the Heart, Lungs, Liver, Kidneys and Urinary Tract, Gastrointestinal Tract, Reproductive Tract, Musculoskeletal System, Or Nervous System.

Underlying Causes of Gastrointestinal Stasis

Stress "==I~ Physical Emotional

Malocclusion Molar Spurs Root abscess

Trauma Fractures

Lacerations or other wounds Heat Stroke

&1 Stasis

Disease

Parasites Infection Cancer

Heart, Lungs, Liver, Kidneys and Urinary Tract, GI Tract, Reproductive Tract, Musculoskeletal System, Nervous System

Urinary ObstNCtion Bladder Stones

Urinary Sludge

RABBIT DIGESTIVE TRACT

Esophagus

Jejunum

COLON

:[ Wei.g.QI; =!OQ' 'Con1EJnt: 1'O"~"30 g

Fusus Coli

Anus

Downward Spiral of Factors Related to Gastrointestinal Stasis

STRESS

~

DECREASED &1 MOTIUTY

~

INAPPET ANCE

~

IMBALANCE OF CECAL FLORA/DEHYDRATION

~

OVERGROWTH OF YEAST AND Clostridium spp.

~

&1 TRACT PAIN

~

FURTHER DECREASE IN MOTIUTY / PERSIST ANT ANOREXIA

~

LIVER DAMAGE DUE TO TOXINSILIPIDOSIS

~

DEATH

-

Recognizing the Signs of Gastrointestinal Stasis

Some or all of these signs may be present:

• Decreased Appetite or Anorexia

• Abnormal Fecal Production

~ No stool or greatly reduced size/volume of stool ~ Runny stool (malformed cecotropes)

~ Mucoid stool (indication of enteritis)

• Indications of Pain ~ Hunched posture

~ Loud tooth grinding

~ Shallow, rapid respiration

~ Abdominal tenderness on palpation

• Abnormal Intestinal Sounds

~ Loud gurgling (gas accumulation pOSSibly indicating imbalance of cecal flora)

~ Absolute silence (cessation of peristalsis)

• Abnormal Body Temperature

~ Hypothermia (normal body temperature is 101-103°F but the temperature can be higher in small breeds, during periods of elevated ambient temperatures, and in rabbits that are stressed.) A temperature of 98°F or lower is not uncommon during GI stasis and may be even more dangerous than fever.

Medical and Supportive Treatments for GI Stasis

In the Hospital:

• Normalize Body Temperature

• Administer Analgesics (Pain Relief)

• Rehydrate

• Restore GI Motility

• Stimulate Appetite

• Syringe Feed

• Prevent/Treat Enterotoxemia

• Surgery (Gastrotomy) - THE ABSOLUTE LAST RESORl1!

At Home:

• Continue any Medications Started in the Hospital

• Syringe Feed

• Administer Oral Fluids

• Provide Access to Plenty of Fresh, High-quality Grass Hay and

Water

• Administer Gentle Abdominal Massage

• Provide Regular, Moderate Exercise

• Reduce Stress

Traditional Treatments: Helpful or Harmful?

Probiotics

• Do not give yogurt to a rabbit in GI stasis because the milk starches and sugars provide a high-energy substrate, which may promote overgrowth of yeast and Clostridium spp.

• Although some veterinarians use powdered Lactobacillusto try to help restore normal cecal flora balance, at this time there is no clinical evidence to suggest that this is effective.

• Feeding cecotropes from a healthy rabbit might help supply normal intestinal flora, but the stress of this procedure may outweigh the possible benefit.

Hairball Remedies

• Only fresh or frozen pineapple will provide active enzymes (bromelain).

However, neither bromelain nor papain (papaya enzyme) dissolves keratin, the main protein component of hair. The sugars in pineapple juice may actually promote overgrowth of Clostridium spp.

• It may be inadvisable to use petroleum-based laxatives such as Laxatone, as these products may coat an intestinal mass, making it more difficult to hydrate.

Antibiotics

• Antibiotics are not recommended unless the stasis is known to be caused by a bacterial infection or if enterotoxemia is suspected. Your veterinarian will make the decision to administer antibiotics based on the rabbit's clinical Signs.

Gastrotomy

• The mere presence of a mass of hair and food in the stomach should not be an automatic indication for surgery. A mass of ingesta in the stomach is almost always better treated medically than surgically unless a true obstruction is suspected by your veterinarian on physical examination and/or radiographs. Survival after surgery of the digestive tract, particularly gastrotomy, is low in rabbits.

Diagnosing the Underlying Cause of GI Stasis

Unless the primary cause of gastrointestinal stasis is determined, the condition may return or become chronic. Thorough physical examination of the rabbit, with emphasis on some of the most common disorders known to result in GI stasis, will help to identify the underlying cause.

The following are some of the diagnostic tests that might be recommended by your veterinarian to help diagnose the underlying cause. However, if the rabbit is stressed or compromised, diagnostic tests may need to be postponed until the patient is stabilized.

• Diet (Not enough high-quality fiber, too many high-carbohydrate and/or high-sugar treats): Patient history .

• Dental Problems (Overgrowth, abscess): Oral examination under anesthesia, skull radiographs.

• Urinary Tract Disease (Renal failure, toxicity, urinary tract infection, bladder stones or sludge): Abdominal radiographs, CBC, chemistry, urinalysis, urine culture, abdominal ultrasound.

• Skeletal Lesions (Fractures, dislocations, joint disease): Radiographs.

• Soft Tissue Abnormalities (Tumors, abscesses): Radiographs, ultrasound, aspirates/cytology, biopsy.

• Liver Disease (Lipidosis, toxicity): CBC, chemistry, abdominal ultrasound.

• Parasites (Coccidiosis in young animals): fecal exam

• Psychological Triggers (Loss of bonded companion, separation from owner, move to new territory): Patient history.

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