BLOAT ~ DIAGNOSIS and TREATMENT

From ~ L. Seeman, MSN  (January 2004) at http://www.bunnylu.org/bloat.html

From ~ ~ http://www.ohare.org/images/harelines/v13n2.pdf  ~ “Harelines” ~ the newsletter of the Buckeye HRS ~ Spring/Summer 2009 ~ Volume 13 Number 2 ~ by Dr Barbara Oglesbee, DVM ~ Capital Veterinary Referral & Emergency Center ~ Columbus, OH


DIAGNOSIS ~

Care must first be taken to stabilize the rabbit with fluids and pain meds.

Physical Exam ~ findings will include ~ dehydration, an “abnormal” feeling abdomen, that is, distended from an accumulation of gas (tympani), and a low body temperature.

X-Rays ~ an abdominal x-ray is the most valuable diagnostic tool.

X-rays carry a significant risk in bloat because the rabbit is often on the verge of cardiovascular collapse due to the pressure the gas places on the chest cavity.

The x-ray of a rabbit suffering from bloat reveals a hugely distended stomach located in the upper abdominal area, and may also reveal gas shadows in the small intestine closest to the obstruction.

X-rays show a stomach that is over-filled with gas and/or air, with little or no air in the rest of the intestinal tract.



TREATMENT ~ L. Seeman, MSN  (January 2004) at http://www.bunnylu.org/bloat.html

When the diagnosis of bloat has been determined, the rabbit needs to be given warmed Lactated Ringers solution, preferably intravenously.  Rabbits cannot absorb subcutaneous fluids when they are in shock.

An external heat source to regulate body temperature must be provided

Analgesics for pain are extremely necessary


ONCE THE BUNNY’S CONDITION IS STABILIZED ~

A stomach tube is placed to decompress the stomach

The author’s vet usually uses a red rubber catheter (Fr 15)

A 20 cc syringe usually provides enough suction to withdraw the stomach contents manually

A rabbit’s mouth and esophagus limit the size of the stomach tube that can be inserted, so that in many cases the small sized tube becomes clogged with food particles and fur. If this happens, the tube needs to be repositioned and gently irrigated until the stomach contents are withdrawn.

A rabbit’s stomach should never be decompressed with a needle puncture, or peritonitis and death can occur.


WHEN THE RABBIT RESPONDS TO TREATMENT ~

Simethicone can be given 

Gentle abdominal massage can be done to break up the gas bubbles


AS IMPROVEMENT CONTINUES ~

The bunny should be encouraged to engage in some mild exercise to reestablish normal GI movement

Provide a wide variety of veggies to encourage eating


PROGNOSIS ~

Interest in exercise and eating is a good prognostic sign

There is a possibility that gastric distention associated with bloat can recur

Usually if a rabbit bloats a second time within a two day period, the author’s vet encourages euthanasia

Surgery to remove the obstruction should only be used as a last resort



TREATMENT ~ http://www.ohare.org/images/harelines/v13n2.pdf ~ by Dr Barbara Oglesbee, DVM ~ Capital Veterinary Referral & Emergency Center ~ Columbus, OH

The first step in treating bloat is to decompress the stomach and correct shock.

To decompress the stomach, the rabbit is tranquilized and a soft rubber tube is passed into the stomach to draw off fluid and air.

Meanwhile, an I.V.catheter is placed and shock treatment is begun.

The next step is to decide whether or not to go to surgery.

In most cases, the chances of survival are best if the rabbit is taken to surgery to remove the obstruction.

In a few cases, the obstruction may pass with supportive care, but the stomach may have to be decompressed again before the obstruction passes.

Also, the rabbit needs to be continually monitored, on I.V. fluids, with x-rays taken throughout the day to see if the obstruction is passing.

If you are lucky, the obstruction may pass, but most of the time it has to be removed surgically.


PROGNOSIS ~

Unfortunately, even with surgery, the prognosis is sometimes poor.

If the obstruction is removed very quickly, there is a good chance for full recovery.

However, very often the problem is not discovered until after blood flow to the kidneys and other organs has been severely compromised.

This leads to problems that may not be correctable, such as death of the stomach wall, or kidney failure from lack of blood flow to the kidneys.

Sadly, many rabbits who survive surgery die from acute renal failure within 1-3 days.

The veterinary care after surgery can be as important as the surgery itself or the care beforehand.

Do not be completely discouraged, however. If caught early enough, the obstruction can be removed before permanent damage has occurred.

THE KEY IS TO RECOGNIZE THE SYMPTOMS OF BLOAT AND TO HAVE AN EXPERIENCED RABBIT VETERIARIAN WHO CAN DIFFERENTIATE BLOAT FROM GI STASIS.

KNOWING WHAT TO LOOK FOR CAN MAKE THE DIFFERENCE BETWEEN LIFE AND DEATH.