Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Chris Geddes — Fri, 13 Mar 2020 09:55:09 GMT

Hello Livethedream,

I work for Docsinnovent who make the v-gels. In answer to your two questions:

1. V-gels are used very successfully for dental procedures. I'll put a link to a Youtube video below. This is quite an old video, so excuse some of the dentistry techniques used. They are "in the way" sometimes, which is why the new v-gel devices to be launched at BSAVA are "slimmed down". https://www.youtube.com/watch?v=lLu3O49-0lI

2. Whilst any anaesthesia expert would recommend capnography is used for any animal undergoing anaesthesia, we have to accept that it's not always going to be possible. Saying that, ex- human medical devices are very reasonable to get hold of second hand on the medical auction sites. But it's perfectly possible to a v-gel safely without capnography - you use other techniques to ensure the device has been inserted correctly. If the correct size is chosen (and we'll explain how), the devices do not move easily. If you buy the new devices when they come out, you will receive training, and we're always on hand to answer any questions.

In any case, hoping your bunnies will not needed any more procedures any time soon!

Chris

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Olivia Coulton — Thu, 12 Mar 2020 19:29:11 GMT

Hey

I know this is probably a little late but I thought I would reply anyway. I am glad your bunny is improving. You would need to intubate your bunnies with an ET tube in order to do a dental as the v gels are too bulky and you wouldn't be able to get the burr/rasp in their mouth. You do have to use a capnograph with the v-gels so you can see whether the device has moved and whether it has been placed correctly otherwise there is big risk of hypoxia. The v-gels are not in stock at the moment as they are just about to release the new design.

In regards to pain relief buprenorphine doesn't usually tend to slow the gut movement it is methadone that is known to do this but if your worried about it doing so you can just make sure your bunny is on metaclop and ranitidine or cisapride depending on what the preference is and whether you need some antiulcerative properties. when you have bunnies that don't want to eat you can give them abdo massages after every syringe feed to help with gut movement. If the rabbit is reluctant to take syringe feeds it is usually because they are painful you just have to work out where they are painful. In regards to the bruised liver it seems like it was an unfortunate event that you couldn't have prevented. Rabbits don't tolerate NG tubes they just tend to pull them out being nasal obligates which is why they are very rarely seen.

Hope your bunny continues to improve :)

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Livethedream — Sun, 15 Dec 2019 10:06:49 GMT

Thankyou very much for your replies unfortunately we do not intubate, I specifically made sure we have 3 rabbit sizes uncuffed tubes in, printed off lots of info on incubating and have looked into V-gels but the vets just won't try it ☹ I've considered buying my own V-gels for my own bunnies but they are out of stock at our suppliers at the moment and we tried to get a lunch and learn because we don't have a capnograph and need to know if they are safe to use without one but they won't do a lunch and learn until they have them in stock. The vets are also iffy about if the get in the way during dentals.

The good news is Charlie is doing much better now! He was still not good on Friday, pooping but not eating alot, bright but nor moving alot so we ran in-house bloods. Bloods weren't conclusive but possibly pointed towards liver so we clipped for a ultrasound and found a huge bruise, the ultrasound showed a small patch that possibly had a different texture (hard to be 100% as we've never uktrasounded a bunny before!) But that patch was on the same side as the bruise. PCV WAS 35% and no clotting issue as blood clotted quickly in the syringe. We emailed the bloods and photo.of the bruise to an exotics vets and started him in baytril encase of abscesses and metacam and tramadol.

The only possibly explanation for the bruise that I can think of is if Monday night he was sleepy and didn't make it into his litter tray properly, post GA and from Tuesday morning all he had was a shallow litter tray and bedding I see now other way and I can rule out all other suggestions from the exitoxs specialist. She suggested running heamatology which was planned for Monday as labs were closed by the time we heard back but since starting the new meds Friday night within a few hours he was hopping around and ate some nuggets and now he's about 90% back to normal.

Going to speak to my vet tomorrow see if she still thinks we need to run bloods but I'm hopefully that it's all caused by a very unlucky accident and a bruised liver

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Sal the 1st — Sat, 14 Dec 2019 23:15:05 GMT

Do you intubate your bunnies? Was just wondering if this is causing a problem post op with swallowing? Will echo previous poster re feeding tubes you will struggle to get one in if at all, rabbits just don't get on with them and the only time I have ever seen one used (in a New Zealand which was huge) was only used for fluid rather than feed as they block at the drop of a hat.

http://wildpro.twycrosszoo.org/S/00Man/VeterinaryTechniques/Indiv_TechniquesRabbit/NasogastricTubeRabbit.htm Found this if it is of use?

I used to work at a practice that saw a lot of rabbits and we did the same as you MMB (metacam, metoclop, baytril) - we used the baytril in case of subclinical disease as a one off and I think we got this from a CPD either from Sharon Redrobe or Anna Meridith.

We used to give liquid feed 5-10 mls a bunny dependant on size as soon as the rabbit was awake enough to swallow and found oxbow fine grind to be the most palatable. We also used bio lapis in drinking water.

One of our vets if it was a rabbit in poor condition having a GA used to request warm i/p fluids during the op as they said you could give a greater volume of fluid safely which was absorbed more slowly - I don't know where they got this information but it seemed to work and was well tolerated.

I hope your bun is recovering now

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Rachel Woodcock — Sat, 14 Dec 2019 20:47:38 GMT

How's your bun getting on?

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Livethedream — Thu, 12 Dec 2019 18:31:11 GMT

I didn't know it could reduce gut mobility! He was in pain a few days ago but now he is eating and pooping a little so maybe it's time to stop the vetergesic!

I found a long forgotten about bottle of cisapride tablets that knowone seemed to know we had hiding on the shelf so I've started him on 0.5mg/kg tonight.

The plan at the moment is if he's not eating better tomorrow to run bloods and take it from there.

Thankyiu!

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Rachel Woodcock — Thu, 12 Dec 2019 18:14:55 GMT

Bup can reduce gut motility so we only ever use it in cases of severe pain and then we only give TID

Are you giving metacam SID or BID?

We never use antibiotics due to their negative effect on the gut flora

Have you tried cisapride? It usually does the trick for our stasis patients

I worked at an exotic referral practice and never saw or even heard of the use of feeding tubes for bunnies. Given they are obligate nasal breathers I doubt they'd be well tolerated, especially in buns who as a species are stress heads

One of my buns had a dental in July and he got stasis afterwards. It's horrible being the owner rather than the nurse! Sometimes it just takes a bit if time to get things working again. You could try profibre too if he's swallowing

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

Livethedream — Thu, 12 Dec 2019 14:33:53 GMT

they have metacam and vetergesic as a part of the pre-med, dont routinely give analgesic post dental if its just a minor burr (otherwise go home with metacam)

Charlie was started on vetergesic 22 hours post dental q6h

RE: Rabbits- post GA gut stasis, naso-gastric tube feeding and prophylaxis

madelinepikevn@aol.com — Thu, 12 Dec 2019 07:36:58 GMT

What analgesia have you used after the dental?