Changes

===Procedure with a case of gastric dilation===

===Procedure with a case of gastric dilation===

Radiograph under opiate analgesia - fentanyl/fluanisone ((Hypnorm; Janssen-Cilag) 0.2-0.3ml/kg SC once only or buprenorphine 0.01-0.05mg/kg SC/IM/IV q 6-12hrs (Vetergesic; Alstoe) plus meloxicam (Metacam; Boehringer Ingelheim) 0.1-0.3mg/kg SC/IM q24h or carprofen (Rimadyl; Pfizer) 2-4mg/kg SC/IM q24hr. Prepare orthogonal radiographs - lateral and dorso-ventral with legs extended or ventro-dorsal views. Observe the dilation of the stomach and the presence and distribution of fluid (liquid and gas) in the gastrointestinal tract to identify location of obstruction. Note the degree of contact of the dilated stomach with the ventral abdominal wall. Assess the amount of gas in the small intestine and look for gas in the large intestine. If no gas in hindgut and stomach severely dilated it may be best to go for euthanasia. Free gas in peritoneum indicates rupture of the gastrointestinal tract and justifies euthanasia. A search for other pathology may indicate other problems like bladder stones, spinal arthritis etc and may also indicate euthanasia.

Radiograph under opiate analgesia - fentanyl/fluanisone ((Hypnorm; Janssen-Cilag) SC once only or buprenorphine (Vetergesic; Alstoe) plus meloxicam (Metacam; Boehringer Ingelheim) or carprofen (Rimadyl; Pfizer).  

Prepare orthogonal radiographs - lateral and dorso-ventral with legs extended or ventro-dorsal views. Observe the dilation of the stomach and the presence and distribution of fluid (liquid and gas) in the gastrointestinal tract to identify location of obstruction. Note the degree of contact of the dilated stomach with the ventral abdominal wall. Assess the amount of gas in the small intestine and look for gas in the large intestine. If no gas in hindgut and stomach severely dilated it may be best to go for euthanasia. Free gas in peritoneum indicates rupture of the gastrointestinal tract and justifies euthanasia. A search for other pathology may indicate other problems like bladder stones, spinal arthritis etc and may also indicate euthanasia.

Pit-falls of radiography: Caecum and large intestine generally do not have large amounts of gas in normal rabbits BUT caecum and large intestine generally do not have no gas in obstructed rabbits Caecum and large intestine with gas and dilated stomach seen in cases carrying a better prognosis.

Pit-falls of radiography: Caecum and large intestine generally do not have large amounts of gas in normal rabbits BUT caecum and large intestine generally do not have no gas in obstructed rabbits Caecum and large intestine with gas and dilated stomach seen in cases carrying a better prognosis.

Serial radiographs (every 30 – 90 minutes) looking for gas in hindgut. If gas in hind gut this indicates that the obstruction is moving - administer NSAIDs (carprofen or meloxicam) if not already administered (see above) - followed by prokinetics if still anorectic after 2-3 hours.

Serial radiographs (every 30 – 90 minutes) looking for gas in hindgut. If gas in hind gut this indicates that the obstruction is moving - administer NSAIDs (carprofen or meloxicam) if not already administered (see above) - followed by prokinetics if still anorectic after 2-3 hours.

Fluid accumulation in stomach leads to deficit in intra- and extra-cellular compartments. Parenteral fluids required. Give 10-20 ml Hartmann’s/kg /hr IV

Fluid accumulation in stomach leads to deficit in intra- and extra-cellular compartments. Parenteral fluids required. Give Hartmann’s IV.

Exploratory surgery may be attempted. Decision of whether to embark on surgery or conservative treatment depends on the time of presentation:  

Exploratory surgery may be attempted. Decision of whether to embark on surgery or conservative treatment depends on the time of presentation and on  financial considerations:  

*Day => conservative treatment  

*Day => conservative treatment  

*Night=> surgery more likely  

*Night => surgery more likely

===Surgical Procedure===

===Surgical Procedure===