Presenter: Marie Kubiak BVSc Cert AVP(ZM) DZooMed MRCVS, Blacks Vets and Drayton Manor Zoo
‘Anorexia is not a single syndrome in rabbits’ was the big take home message delivered by Marie Kubiak in last week’s Platinum Members’ webinar. It is instead part of the ‘stasis’ syndrome in rabbits which consists of a set of clinical signs including anorexia, lack of faecal output, abdominal distension, abdominal pain and general lethargy. These are the signs most frequently encountered by the practising vet but often early symptoms are missed by the owner and include more selective feeding of favoured foods, fibre seeking behaviour and subtle changes in faecal pellets which often decrease in quantity, become smaller, darker and misshapen.
Marie explained an ongoing poor diet which consists of excess carbohydrate and low fibre is one of the major contributing factors underlying stasis in rabbits. It is thought this type of diet reduces normal stimulation of the gut, reduces motility and alters the caecal micro-environment. Marie explained, however, there is usually an additional factor to the diet which triggers stasis in rabbits. This could be in the form of acute psychological or social stress such as conflict with a companion or social isolation. Husbandry insufficiencies such as lack of hide areas and the exposure to extreme temperatures may also be a trigger. Pain such as that encountered with dental, orthopaedic and urinary tract disease may also have a similar effect. It is however interesting to note that primary intestinal disease is in fact a rare cause of stasis.
Marie delivered several ‘gems’ on how to treat these rabbits effectively, and turned her focus towards the delivery of the all-important fluid therapy and feeding to counter metabolic compromise. She advised splitting a rabbit’s fluid requirement of 100ml/kg/day plus losses between intravenous fluid therapy and feeding. No more than 50mls/kg/day of fluids should be administered to a rabbit intravenously in order to avoid overload. Marie prefers to deliver the required IV fluids in the form boluses every 2-4 hours in order to avoid the complication of rabbits tying themselves in knots when hooked up continually to a drip. The remaining fluid allowance should be delivered orally by syringing food and liquid every 2-4 hours as long as there is no evidence of intestinal obstruction. Marie advises continuing to offer a variety of foods including a rabbit’s usual diet from home. The use of pro kinetics to stimulate gut motility was also discussed and included the administration of ranitidine and metoclopramide although Marie advises caution when using metoclopramide in rabbits with an empty stomach as this can potentially cause stomach cramping. Marie also discussed her choice of analgesics in ‘stasis’ rabbits which included buprenorphine and meloxicam.
Diagnosing and managing intestinal obstruction were also discussed and, although rare, Marie advised that obstructed rabbits present shocked with bradycardia, hypothermia and low blood pressure and will usually rapidly deteriorate. If these signs are present alongside a palpably firm stomach and a blood glucose greater than 17 mmol/l, Marie will take these rabbits straight to surgery. These obstructions usually consist of either a foreign body, a trichobezoar or most commonly a desiccated faecal pellet which gets trapped at the pylorus or proximal duodenum. Marie advised rather than incising into already compromised gut it may be better to manipulate the obstruction down to the caecum where it can be comfortably passed by the rabbit.
Marie delivered an excellent practical and first opinion relevant webinar on a condition we commonly encounter as general practitioners. Having been in practice for the past 20 years I remember seeing these ‘stasis’ rabbits in the ‘olden’ days and struggling to help them with the minimal drugs available and in all honesty minimal knowledge which, more often than not, led to the majority not surviving. Although this is still sometimes the case, in my experience with today’s treatments and standard of care discussed within this webinar, these rabbits can do really well and are incredibly satisfying to treat. The additional ‘little gems’ of advice delivered by Marie will also help to smooth the road to a positive outcome for these rabbits and hopefully by understanding more about this multifactorial disease we can help to educate clients about how to correctly care for rabbits so that this life threatening syndrome doesn’t develop in the first place.
The Stethoscope (MRCVS)