Yet another comprehensive webinar provided by John Chitty with a really helpful, “What would you do?” section where cases are discussed and a highly informative question and answer session at the end of the webinar.
John started by talking about the factors which can affect gut mobility in rabbits. These include: dietary intake; fibre levels; and the systemic effects of hormones, metabolites and hydration status. The chronic causes include diet, dental issues and pain. Common causes of pain in rabbits that need to be on your list of differential diagnoses include spinal, dental, aural, orthopaedic and abdominal. The acute causes typically include diet, pain, climate, husbandry and foreign bodies. The focus of this webinar is on the acute causes.
Initially you need to distinguish whether the obstruction is complete or partial. This can be carried out by obtaining a history, clinical exam and diagnostic investigations. Pellet production can help you to identify whether the obstruction is complete or partial. It is pleasing that increasingly, rabbits are kept with a companion in terms of improving rabbit welfare but certainly makes it trickier to know who produced the pellets! John provides some helpful tips for trying to obtain a full history to help determine your next move. The clinical exam is also rather difficult because of the “rabbit rock” posture that is usually adopted in the consulting room. From John’s experience, poor prognostic factors include: temperature less than 92 degrees Fahrenheit (33⁰C); cyanosis; massively distended gassy viscus and respiratory distress. In terms of diagnostics; radiographs, blood samples, blood pressure monitoring and abdominal wash can all provide very useful information. John recommends always taking a blood glucose measurement because stress hyperglycaemia is both a prognostic and diagnostic indictor. Many radiographs are shared by John who talks attendees through several presentations of rabbits with gut stasis, showing examples of both medical and surgical cases.
Once an initial assessment has been made, Midazolam can be used to reduce anxiety and also consider providing a NSAID too depending on the clinical picture. John warned against using prokinetics until you are certain that the cause of gut stasis is non-obstructive. Both surgical and medical treatments are discussed which includes some fantastic advice so I would definitely recommend watching the recording of this webinar if you missed the live broadcast to help you feel more confident treating these cases. In addition, John offers advice on how to identify the underlying cause and how to prevent gut stasis in these cases in the future.