Rabbit gastrointestinal surgery – 15 top tips

Gastrointestinal surgery in the rabbit is generally performed to remove an intestinal foreign body. They can happen as a result of an inquisitive house rabbit eating man made fibres, which then get stuck due to peculiarity in the rabbit’s anatomy.

Posted: 14 May 2018

Rabbit gastrointestinal surgery – 15 top tips

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The two key anatomical issues are;

  1. The duodenum leaves the pylorus at an acute angle, creating an area in which intestinal obstruction may easily occur. This is probably the most common site for a foreign body impaction.
  2. The sacculus rotundus, located towards the end of the ileum, is another potential site of obstruction. There is a valve located at this ileo-cecal- colic junction, which prevents any retrograde movement of ingesta from the large intestine into the small intestine.

The surgical techniques to remove foreign body obstructions are similar to those required in dogs and cats, so for most general practitioners there should be no problems. There are a number of special considerations to make before making the first incision, so to help and remind you, we’ve listed 15 of them below.

1. Avoid enterotomy – surgery involving cutting into the lumen of the small intestine should be avoided unless absolutely necessary. Every attempt should be made to try to manipulate the material up into the stomach or down into the large bowel.

2. Care with closure – the lumen of the gastro-intestinal tract is smaller compared to dogs and cats. For this reason take extra care to avoid narrowing of the lumen after enterotomy surgery. This is best achieved by closing the enterotomy perpendicular to the incision site. Use longitudinal incisions and transverse closures.

3. Avoid adhesions – this can be achieved by;

  • Handling the tissues as little as possible
  • Ensuring that no blood clots are left in situ
  • Choosing suture materials that are absorbed by hydrolysis
  • Controlling hemorrhage with hemostatic clips
  • Using verapamil

4. Use analgesics - without pain relief, a rabbit can rapidly go into ileus after the surgery. The analgesia should continue until the animal is eating, defecating and urinating normally. Common drugs used alone or in combination include;

  • Tramadol q 12-24 hours
  • NSAID’s - meloxicam given x 5 days post surgery
  • Butorphanol q 4-6 hrs  
  • Buprenorphine - 0.02-0.10 mg/kg

5. Discharge early – in order to minimise the stress associated with hospitalisation, try to get the patient home as soon as possible.

6. Don’t mix anorexia and surgery - surgery should only attempted after the rabbit has been thoroughly assessed and prepared. Take bloods, xrays and scans and stabilise the patient with fluids and pain relief. Many patients will improve within 24 hours without the need for surgery.

7. Plenty of fluids - aggressive fluid therapy is important. Gain venous access and give fluids at 10 ml/kg/hr.  Use a 20-24 gauge catheter into the cephalic vein. If you are struggling to get a vein, an intraosseous catheter may be placed in the femur.

8. Delicate cecum – this is a thin walled structure that is easily be torn when mishandled in surgery. Take extreme.

9. Perioperative antibiotics – we are all aware of the need to be careful with the use of antibiotics, but there are significant benefits to giving antibiotics prior to performing surgery, and maintaining them for 24 hours afterwards. This is particularly important with rabbits suffering with a pre-existing infection such as snuffles. Enrofloxacin, sulfa-trimethoprim combinations and aminoglycosides may be used safely in rabbits.

10. Heat support – rabbits are prone to developing hypothermia during general anesthesia, so the body temperature should be monitored throughout. Heated air cushions, bubble wrap and surgical gloves filled with warm water all work well.

11.Clip with care – rabbits have thin skin and fine dense fur that is difficult to clip.  As a result clippers often cut the skin as the blades become clogged. For this reason, take your time and don’t rush. It’s important not to drag the blade across the skin. Keep checking the clippers to ensure they are clean, clear of hair and lubricated.   

12. Long incision – a long incision will heal just as quickly as a short incision, so make your cut from the sternum to the pubis to allow full examination of the entire gastrointestinal tract. 

13. Laparotomy sponges – these are very useful when isolating the particular section of GIT you need to cut into. Keep them moist and count them in and out.

14. Avascular incision – make your gastrotomy incision in an avascular region half way between the greater and lesser curvatures. This ensures you don’t compromise the blood supply to the tissue that needs to repair.

15. Help with motility – this can be supported postoperatively using metoclopramide to increase gastric emptying.

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