Carmela: acute bloat in a 3 years old rabbit
Rachel
Ihlenfeldt and Barbara Schmeitz
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Causes of
bloat remain unknown. It is suspected that in most animals bloat may be
related to overeating and/or exercising immediately after eating. Additional
causes may be a lack of fiber in the diet, a change in the diet, excessive
drinking, dehydration, or stress. Recent necropsy studies concluded to
pre-existing problems prior to bloat, such as necrotic tissue at the opening
between the stomach and the duodenum (pylorus), presence of gastric ulcers or
bleeding of the stomach wall. Clinical signs
The rabbit is
in terrible pain. Pain indicators include moaning, grunting, and grinding teeth.
A rabbit may take an object into her mouth and bite down hard on it. Rabbits
suffering from bloat are often dehydrated and will refuse to eat or move. The
rabbit may appear depressed, sitting in a hunched position in one spot or in
a litterbox. Some rabbits will "crash"
their heads into their abdomens, where it hurts. Others may suffer breathing
difficulties due to the lungs being compressed by the distended stomach. Most
bloated rabbits are hypothermic. Diagnosis
The best and
safest diagnostic tools for bloat are a physical examination (palpation, hard
distended abdomen, low body temperature) and radiography. Since the pressure
of the bloated stomach on blood circulation and organs is life-threatening,
the rabbit must be stabilized and given a treatment for shock and hypothermia
including pain relief medication and lukewarm intravenous fluids (never
subcutaneous as the hypothermic body is unable to absorb these properly)
before taking abdominal radiographs. Bloat should
not be misdiagnosed for cardiovascular collapse and heart failure. Indeed,
bloat often leads to secondary cardiac conditions. Carmela,
rescued from a backyard breeder, was about 3 years old when she developed
acute bloat. The following radiographs were taken at Gulf Coast Veterinary Hospital
about 8 hours after Carmela was intubated. In both views, she presents an
extremely distended stomach, compressing her heart, lungs, and other organs.
Despite getting immediate veterinary care, Carmela could not be saved and was
humanely euthanized to relieve her suffering.
Treatment
Bloat is an
emergency situation. If it is suspected that a rabbit is suffering from
bloat, whether or not the rabbit is hypothermic, remove all food from the
rabbit's area to avoid overloading an already distended stomach and a
compromised digestive system. Emergency
veterinary intervention is necessary by a rabbit-knowledgeable vet. Still,
prognosis for acute bloat is poor and most bloated rabbits do not survive
longer than a few hours to a day after diagnosis. Steroid pain medication,
fluids, antibiotics and anti-foaming agents (e.g. simethicone)
bring little to no relief. Analgesic
drugs for use in rabbits are described here. Putting the
rabbit on its side and gently massaging its abdomen in the direction of the anus
may help. A handful of rabbits were saved after intubation with a rubber
catheter and aspiration of the content and gas of the stomach. The majority
died within 24 hours after relieving the pressure on the stomach. Rarely,
difficult intubation or repositioning of the catheter tube due to clogging by
food particles led to excessive vagal stimulation, swelling of the tissues in
the throat and caused a rapid death of the rabbit. Acknowledgements
In memory of Carmela, who suffered a
terrible episode of bloat on May 1st, 2010. Many thanks also to Esther van Praag, Ph.D.
(Switzerland) for the medical information, to Debbie Hanson (USA) and the
Gulf Coast Veterinary Hospital (1111 West Loop South, Houston, Texas, USA)
for their contribution and permission to use the radiographs of Carmela. |
e-mail: info@medirabbit.com
