GI slowdown treatment – does this sound right?

[Chelsea]

Background: Ever since a bout of serious stasis about 2 years ago, Silas (3 year old mini-lop, 6 pounds) has had a lot of odd shaped poops. About a month ago we noticed a distinct increase in the frequency of too big/too small/sticky droppings, and started trying to determine if a particular food is bothering him. We saw improvement for a week or so by switching from Oxbow pellets to Sherwood Forest pellets and limiting greens to Romaine with some mint. Then this week his appetite started to decrease. When I got up this morning, he hadn’t touched his pellets or hay basket, and there were a lot of tiny poops all over the floor. I offered him a variety of fresh greens from the garden, and he ate, but would stop every 30 seconds or so, turn away and then return to eating. I called the vet and made an appointment from home. When I arrived to pick him up, he had eaten most of the greens, and even some hay. We live in a rural area, and the vet who sees rabbits also sees farm animals. While she is very nice, she is older and I don’t think that up-to-date on house rabbits. She gave us some good advice before (benebac, buprenex, metoclopramide) but also some very questionable advice, like feed him yogurt.

Today she used a special tool to check out all his teeth and throat (no x-ray) and said his mouth looks great. His weight is normal, and his health good overall except for some gas and a moderate fur mite infestation. Here’s what she recommended:

• Revolution – puppy/kitten <5 pounds (Silas is 6 pounds) to be started on November 1st when Advantix II has worn off.
• Benebac 2x a day
• Metoclopramide 2x a day
• Buprenex 2x a day

Does this sound reasonable? I know nobody here is a vet, and can’t substitute for vet care, but because I’m lacking in confidence in this vet I’m wondering if others have received similar recommendations or other ones that were helpful. I think we might have some baby gas drops for instance that I should have asked her about. Thank you!

[Bam]

Yoghurt is not necessary. It used to be recommended when there was no Benebac or other bunny-appropriate probiotics, on the off chance theat the lactobacillus in the yogurt would help restore a healthy gut microbiota. But research shows that practically all lactobacilli die in the very acid environment in the rabbit stomach. Benebac has some bacteria that tolerate this acidity and have the capacity to colonize the intestines. You can’t overdose a probiotic, if you give too much, the “unused” bacteria just get pooped out.

Revolution is good stuff, it’s bunny-safe and kills many different parasites, both external and internal parasites. I suppose your vet suspects intestinal parasites, unless you’ve seen a lot of dandruff or itchiness or sth.

Metoclopramide is a gut-motility drug that helps the intestines move and push their content along their lenght. It’s good.

The buprenex is more questionable in my opinion. I’m not a vet though, as you know. But buprenex is buprenorphine, a semi-synthetic opiod derivate, and as such, it has constipation as a side-effect. All opiods and opiates have this slowing effect on the gut. I think it’s far more common nowadays to prescribe Metacam (meloxicam) for pain due to GI stasis issues. It’s an NSAID, and those can be hard on the tummy, but it appears Metacam is well tolerated by rabbits even for long term treatment. Here is a list of safe analgesics for rabbits:
http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

The stated lowest dosage for Metacam is a bit low though, it’s been found that rabbits metabolize meloxicam much quicker and more effectively than cats and dogs, so they need a higher dose/kg body weight. My tummy-trouble bun used to get 0,3-0,5 ml per kg bodyweight, once per 24 hours.

Not scientifically proven to be effective in the treatment of rabbits with gas, but much used by bun-owners and recommended by Medirabbit and Dana Krempels is simethicone, baby gas drops. It’s not absorbed by the body, so it’s considered safe to give. It often helps a gassy bunny within 20-30 minutes, and a bunny with GI trouble often gets gassy from time to time.

This is my favorite article about GI stasis, by Dana Krempels. It has good info and good advice, although some of it wion’t apply to your specific situation:
http://www.bio.miami.edu/hare/ileus.html

[Chelsea]

Thank you bam! I wonder if I should call back and ask for metacam instead. The thing is, he is eating a bit now, so I don’t want to give him unnecessary drugs, especially if they might actually make it worse.

The revolution is for fur mites. She was surprised the advantix II didn’t kill them, but said revolution should for sure. I wish she had just given us revolution in the first place.

[Bam]

Great that he’s eating a little bit =)

Advantix II has some permethrin in it, and that’s generally very effective against fur mites. But it’s not considered completely bunny-safe and Revolution is bunny safe, so I don’t know why she prescribed the Advantix first.

Metacam can be good to have at home just in case. Pain can make a bunny refuse to eat and gas can be very painful. The intestinal movement caused by the metoclopramide can also be painful according to some vets. But it’s of course always about weighing the pros against the cons. You are the person who knows your bun best, so you are the person best equipped to judge whether he’s experiencing pain or not.

[Chelsea]

I doubt she’ll prescribe advantix II again for rabbits after seeing mites crawling all over his back side He last had it on October 5th, so it may have been partially wearing off, but still.

Do you think I should go back to Oxbow essentials rabbit food, or stick with the Sherwood Forest?

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