To view this site you must be a
veterinarian surgeon or nurse.
Are you a Veterinary Surgeon or Veterinary Nurse?

No

​Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet rabbits

Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet rabbits a retrospective study on 210 cases 
Lee HW, Machin H, Adami C, Veterinary Anaesthesia and Analgesia (2018), https://doi.org/10.1016/j.vaa....


What did the research find?

The aim of this study was to determine the incidence and the associated risk factors of peri-anaesthetic mortality and gastrointestinal complications in pet rabbits. 

The study found:

  • Mortality rate of 4.8% (9 out of 185 cases).
    • 6 rabbits died during sedation or general anaesthesia (intraoperative deaths).
    • 4 (one of which euthanized) rabbits died during the first 72 postoperative hours.
  • Species-specific risk factors could not be identified, however, the odds for post-anaesthetic gastrointestinal complications increased significantly with body weight. 



    How was it conducted?

    185 pet rabbits admitted to a veterinary hospital over the period 2009-2016 where included in this retrospective cohort study. 25 underwent two anaesthetic events; therefore, data from 210 cases was used.

    Three possible outcomes were considered to evaluate the incidence of peri-anaesthetic mortality: alive, dead or euthanized within the 72 hours following the anaesthetic event.

    Food intake and stool production during the first 72 hours following the anaesthetic event were evaluated to investigate the occurrence of gastrointestinal complications. Risk factors such as administration of alpha-2 agonists, body weight, ASA classification and endotracheal intubation were tested against peri-anaesthetic mortality and gastrointestinal complications.


    Why is it important?

    Rabbits are becoming an increasingly popular pet in the UK which means there is greater demand for rabbit anaesthesia. Rabbits carry a greater risk of anaesthesia-related death and gastrointestinal complications than other domestic species. Some of the factors thought to contribute towards peri-anaesthetic complications are:

    • the anatomy of the oropharynx and the common development of laryngeal spasm make intubation difficult,
    • underestimation of anaesthetic risk as being prey animals means they don´t tend to show signs of disease,
    • the use of certain drug classes, such as the alpha-2 agonists (Grint & Murison 2008).

    Although the use of historical records posed some limitations in this trial, this study  identifies several important findings of specific clinical relevance for the general practitioner involved in rabbit anaesthesia: 

    • Although it is thought that the relatively small body size and the predisposition to develop laryngeal spasm could represent a risk factor for pet rabbits, this study found that endotracheal intubation is safe if performed carefully and by experienced personnel.
    • The study failed to confirm if alpha-2 agonists contribute towards peri-anaesthetic complications, but it is worth pointing out that 70% of the rabbits that died had an alpha-2 agonist as part of the anaesthetic protocol. It is, however, worth considering that besides alpha-2 agonists, the combination of medetomidine and ketamine, or possibly even ketamine alone, might have contributed to the negative outcome of these subjects.
    • Rabbits undergoing abdominal surgeries did not have a higher risk of developing post-anaesthetic gastrointestinal complications. Interestingly, 14.5% of the rabbits that did experience gastrointestinal complications had undergone two anaesthetic events, and in 80% of them gastrointestinal impairment was detected both times.
    • The incidence of nonfatal peri-anaesthetic gastrointestinal complications was also very high in the study population despite the use of metoclopramide or ranitidine.

    Undertaking preventive measures such as using opioids consciously, encouraging eating soon after recovery and syringe feeding in cases of inappetence, especially when dealing with overweight rabbits, is recommended by the authors.

    Link to the full article: https://www.vaajournal.org/article/S1467-2987(18)30045-X/fulltext

    Article by
    Carol Atkinson
    BVMS, MBA

    Marketing Manager

    Originally published: Thursday, 14th June 2018
    Last updated: Tuesday, 24th July 2018

    Keep reading... More news items that may interest you.

    Getting to the HEART of the matter - considerations for anaesthetising the cardiac patient.

    In this article Miranda discusses the challenges of anaesthetising patients with cardiac disease and how protocols can be modified to accommodate these patients.

    Read On...

    Paper summary: How does buprenorphine compare to butorphanol for postoperative analgesia in cats?

    A prospective multi-centre clinical trial comparing buprenorphine vs butorphanol for postoperative analgesia in cats.

    Read On...

    Paper summary: Analgesic effects of maxillary and inferior alveolar nerve blocks in cats undergoing dental extractions.

    With dental surgery one of the most commonly performed procedures in small animal practice, what benefits do dental nerve blocks provide in cats?

    Read On...

    What should we consider when anaesthetising patients, including geriatrics, for dental procedures?

    What should we consider when anaesthetising both adult and senior patients admitted for dental treatment?

    Read On...

    Checklist for geriatric dental anaesthesia

    This article summarises and combines "Anaesthesia for the geriatric patient" and "What should we consider when anaesthetising patients, including geriatrics, for dental procedures?" into a single checklist for anaesthesia for the geriatric dental patient. A downloadable summary is also available by following the link.

    Read On...

    How do we recognise, assess and treat chronic pain in companion animals?

    In this article Ian Self, Associate Professor in Veterinary Anaesthesia and Analgesia, School of Veterinary Medicine and Science, Nottingham, reflects on the recognition, assessment and management options for chronic pain in companion animals

    Read On...

    The physiology of acute and chronic pain.

    In this article, which accompanies " How do we recognise, assess and treat chronic pain in companion animals?", Ian Self describes the physiology of acute and chronic pain

    Read On...

    What should we consider when anaesthetising the geriatric patient?

    With an increasing number of anaesthetics being performed in older pets is there anything we should be aware of or do differently? In this article Carl Bradbrook examines the management of anaesthesia in geriatrics..

    Read On...

    Paper summary: What effect does does rapid, high volume fluid therapy have on cardiovascular function?

    In this summary of a paper by Valverde (2012) we examine the effects of high-volume, rapid fluid therapy on cardiovascular function and hematological values during isoflurane-induced hypotension in healthy dogs.

    Read On...

    Paper summary: Pre-anaesthetic screening of geriatric dogs

    In this summary of a paper by Joubert (2007) we examine the value of pre-anaesthetic screening in geriatric dogs and how the results influence the anaesthetic process.

    Read On...

    Anaesthesia for Canine Cushing's disease: What should we assess and what should we monitor?

    Cushing's disease (hyperadrenocorticism) is relatively common in the dog and this article discusses the appropriate pre-anaesthetic assessment we should perform and why careful monitoring is essential.

    Read On...

    Paper summary: How frequently are intravenous catheters removed as a result of complications due to bacterial contamination?

    In this summary of a paper by Ramos (2018) we examine the incidence of bacterial colonisation of intravenous catheters removed as a result of cannula complication

    Read On...

    What's the Point? Peripheral Intravenous Cannulation.

    Peripheral venous cannulation is a common invasive procedure in small animals, but what are the best-practice insertion techniques and what can we do to avoid complications?

    Read On...

    Rabbit Anaesthesia – Understanding Your Patient.

    How does the anatomy, physiology, behaviour and response to drugs affect your decision making when anaesthetising the rabbit patient?

    Read On...

    Paper summary: Heated intravenous fluids alone fail to prevent hypothermia in cats under general anaesthesia.

    In this summary of a paper by Jourdan et al (2017) we examine the common practice of warming intravenous fluids and the effect on patient temperature.

    Read On...

    ​Considerations for anaesthesia of the brachycephalic dog.

    In this article Matt Gurney discusses the induction of anaesthesia and intubation of the brachycephalic patient.

    Read On...

    Watch the induction and intubation of a brachycephalic.

    Induction of anaesthesia and intubation of a brachycephalic dog with Matt Gurney.

    Read On...

    Paper summary: The effect of omeprazole on oesophageal pH in dogs during anaesthesia

    This summary of a publication by Panti et al., examines the effect of orally administered omeprazole on gastro-oesophageal reflux in the anaesthetised dog.

    Read On...

    How does a syringe driver benefit your patients?

    Syringe drivers are becoming increasingly commonplace in modern veterinary practice and are a useful tool for multiple applications. This article looks at the science behind constant rate infusions and the basics of syringe driver use.

    Read On...

    Paper summary: Pet owner opinions about anaesthesia, pain and surgery in small animals

    In this paper we explore perceptions and opinions of Canadian pet owners about anaesthesia, pain and surgery in small animals.

    Read On...

    Achieving Safer Anaesthesia with ASA and Joanne Michou MA VetMB DipECVAA MRCVS

    How can a Veterinary version of the ASA Physical Status Classification help you achieve safer anaesthesia? To find out how watch our webinar.

    Read On...

    Paper summary: ASA classification and risk of anaesthetic related death in dogs and cats.

    This scientific paper assessed whether the American Society of Anesthesiologists (ASA) Physical Status Classification correlated with the risk of anaesthetic death in dogs and cats.

    Read On...

    New! Methadyne, Our New Methadone Now Available

    This is our third product launch this year, and the latest addition to our anaesthesia and analgesia portfolio, Methadyne, contains 10mg/ml methadone as its active ingredient. It can be administered for analgesia of moderate to severe pain in dogs and cats, to provide neuroleptanalgesia, and as part of a patient’s premedication protocol prior to general anaesthesia.

    Read On...

    A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs.

    In this review we summarise a publication by Bini (2018) examining two protocols for the administration of methadone following TPLO surgery in dogs.

    Read On...

    Practical Acute Pain Assessment

    In this summary of acute pain assessment, Carl Bradbrook examines why we should be monitoring patients for pain and looks at the commonly used scoring systems.

    Read On...

    Alfaxan for the maintenance of anaesthesia: Peer reviewed clinical papers.

    In this article we have identified the key clinical peer reviewed papers to support the use of Alfaxan for maintenance of Anaesthesia in Cats and Dogs.

    Read On...

    TIVA or not? (Total intravenous anaesthesia).

    In this article the Jurox UK Technical Team discuss the use of intravenous agents to maintain anaesthesia in the dog and cat.

    Read On...

    Benzodiazepines - can they help reduce anaesthesia related side effects?

    In part 4 of this series on premedicant agents we examine the pros and cons of benzodiazepines.

    Read On...

    Paper summary: Effect of benzodiazepines on the dose of alfaxalone needed for endotracheal intubation in healthy dogs

    This paper examined whether a benzodiazepine, administered as a co-induction agent with alfaxalone, improved endotracheal intubation, and reduced the dose of alfaxalone, in the dog

    Read On...

    Putting methadone in its place in your pain management.

    In this article we examine why methadone could be considered the analgesic of choice for many of our patients and understand its importance in modern veterinary medicine. The article includes a link to a downloadable summary sheet.

    Read On...

    Food for Thought: Pre-anaesthetic Fasting

    In this article Karen examines why we fast our canine and feline patients prior to anaesthesia and what the current recommendations are. Karen also investigates why rabbits are different and should not be starved before anaesthesia.

    Read On...

    ​Purr-fecting Pain Management

    In this article summary we examine which of the two opioids, buprenorphine or butorphanol, provides the most appropriate analgesia following ovariohysterectomy in the cat.

    Read On...

    Perspectives on Premeds - Phenothiazines: from Mental Health to Premedication

    In this article from the Perspectives on Premeds series, Karen takes us through the properties and uses of phenothiazines in modern veterinary practice.

    Read On...

    Methadone with Acepromazine - when is enough, enough?

    This study looks at the effects of three methadone doses combined with acepromazine on sedation and some cardiopulmonary variables in dogs.

    Read On...

    AceSedate®, Our New Acepromazine, Available Now.

    We have extended our anaesthesia and analgesia portfolio with the launch of AceSedate®. Containing the tried and trusted, long-acting sedative agent acepromazine as its active ingredient, AceSedate can be used for the premedication, sedation and tranquilisation of cats and dogs.

    Read On...

    Time: is 30 minutes long enough?

    This recent study examined whether the application of EMLA cream, for 30 or 60 minutes, would be a useful tool to improve patient compliance prior to intravenous cannula placement in the veterinary clinical practice setting.

    Read On...

    Caesarean Section Survival Guide. Part 2: Anaesthetic Protocol Selection & Peri-operative Considerations.

    In this second instalment of the 2-part article, we explore premedication, induction, maintenance & monitoring, recovery and analgesia for the Caesarean section patient.

    Read On...

    Buprenorphine: it’s not all static in rabbits

    Opioids are well known for causing gastrointestinal stasis in mammalian species. This recent paper examined the effects of a single high dose of buprenorphine on the rabbit gastrointestinal tract using non-invasive imaging techniques.

    Read On...

    Caesarean Section Survival Guide. Part 1: Physiology & Pre-anaesthetic Considerations.

    In the first instalment of this 2-part review Karen examines the physiological changes that occur during pregnancy and how those adjustments can affect the selection of anaesthetic protocols for the increasingly common Caesarean section.

    Read On...

    No leeway for the spay: A comparison between methadone and buprenorphine for perioperative analgesia in dogs undergoing ovariohysterectomy.

    This recent paper compares post-operative pain scores and requirement for rescue analgesia following premedication with methadone or buprenorphine, in combination with acepromazine or medetomidine, in 80 bitches undergoing ovariohysterectomy.

    Read On...

    Cardiac arrest - the human factor

    Cardiac arrest in dogs and cats is, thankfully, relatively rare. However, when it does happen it can have devastating consequences for the animal, owner and the veterinary team. This study examined the common causalities leading up to a cardiac arrest with the aim of changing protocols to improve outcomes.

    Read On...

    Are you Using Safety Checklists in your Practice?

    In this article, Carl focuses on the benefits of introducing a safety checklist in practice to reduce patient morbidity, mortality and to improve communication between members of the veterinary team. The article contains links to the AVA safety checklist as well as a link to a customisable list that you can adapt to your practice needs. 

    Read On...

    The Big Chill - Temperature Management in Sedated and Anaesthetised Patients

    The effects of hypothermia are very far reaching throughout the peri-anaesthetic process. In this article, James takes us through the interesting mechanisms of body cooling and warming, the clinical relevance of hypothermia and what we can do to prevent it.

    Read On...

    Keeping the Finger on the Pulse -  Nuances in CV Monitoring

    All patients are exposed to the risks associated with general anaesthesia. Continuously monitoring anaesthetised patients maximises patients safety and wellbeing. In this article, Dan takes us through the common monitoring techniques that provide information about the cardiovascular status of your patient. 

    Read On...

    Effect of Maropitant on Isoflurane Requirements & Postoperative Nausea & Vomiting

    Despite being widely recognized in humans, postoperative nausea and vomiting (PONV), and the role of maropitant in reducing inhalational anaesthetic requirements have been poorly documented in dogs. This recent study evaluates PONV and isoflurane requirements after maropitant administration during routine ovariectomy in bitches.

    Read On...

    New! Alfaxan® Multidose Now Available

    We are happy to announce we have enhanced our anaesthesia and analgesia portfolio with the introduction of Alfaxan®Multidose for dogs, cats and pet rabbits.

    Read On...

    Sevoflurane requirement in dogs premedicated with medetomidine and butorphanol

    Little information is available about the effect that different doses of medetomidine and butorphanol may have when using sevoflurane for maintenance of anaesthesia in dogs. This recent study evaluates heart rate and median sevoflurane concentration required at different dose rates.

    Read On...

    Capnography II - What happened to the elephants? A summary of abnormal traces

    In this second article of the capnography series, James provides a guide to a few of the most common traces that you will encounter during surgery. Scroll to the end of the article to download a printable capnography cheatsheet. 

    Read On...

    Pain, what a Pain! (Part 2) – Practical Tips On How To Perform Dental Nerve Blocks In Companion Animal Practice

    In this second article of the Pain, what a Pain! series, Dan takes us through the LRA techniques associated with dental and oral surgery. In this article, you will find practical tips and pictures on common dental nerve blocks as well as safety concerns to consider.

    Read On...

    Pain, what a Pain! How Locoregional Anaesthesia can Improve the Outcome and Welfare of Veterinary Patients (Part 1)

    In this first article out of a series of two, Dan takes us through an introduction and practical tips for appropriate local anaesthesia delivery. Find out why these anaesthesia techniques, that are well recognised in human medicine, have seen an increase in popularity in veterinary medicine over the recent years

    Read On...

    Perspectives on Premeds – Opioids

    Perspectives on Premeds is a series of articles touching on different pharmacological, physiological and clinical aspects of pre-anaesthetic medication. This second article aims to provide a refresher on opioids.

    Read On...

    Effects of Dexmedetomidine with Different Opioid Combinations in Dogs

    Read the highlights of a recently published research paper that evaluates cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone and in combination with morphine, methadone, meperidine, butorphanol, nalbuphine and tramadol. 

    Read On...

    Preoxygenation Study Highlights

    This study evaluates the effectiveness of two methods of preoxygenation in healthy yet sedated dogs and the impact of these methods on time taken to reach a predetermined haemoglobin desaturation point (haemoglobin saturation (SpO2) of 90%) during an experimentally induced period of apnoea.

    Read On...

    Capnography – Not Just a Load of Hot Air

    Capnography is the measurement of inhaled and exhaled carbon dioxide (CO2) concentration. The graphical illustration of CO2 within respired gases versus times is known as the capnogram.

    Read On...

    Perspectives on Premeds – Alpha-2 Agonists

    Perspectives on Premeds is a series of articles touching on different pharmacological, physiological and clinical aspects of pre-anaesthetic medication. This first article aims to provide a refresher on α2 agonists.

    Read On...

    We are ‘injecting’ a bit of fun into BSAVA Congress!

    We will be ‘injecting’ a bit of fun into BSAVA Congress on our stand (stand 702).

    Read On...

    Alfaxan - now licensed for use in pet rabbits

    Jurox Animal Health is delighted to announce that Alfaxan is now licensed for cats, dogs and pet rabbits. This is an exciting advance and could change the way rabbits are anaesthetised in the U.K.

    Read On...

    Best Practice Rabbit Anaesthesia Roadshows

    Jurox Announces eight country wide events on Best Practice Rabbit Anaesthesia

    Read On...

    Considerations in Rabbit Anaesthesia at the 2017 London Vet Show

    Jurox to host talks on Considerations in Rabbit Anaesthesia at the 2017 London Vet Show.

    Read On...

    Vets needing more support for anaesthesia

    Jurox research reveals that veterinary professionals have questions about their anaesthetic protocols

    Read On...
    Repeatable. Reliable. Relax.