rabbit enucleation bleeds

Re: rabbit enucleation bleeds

David Mills — Sun, 08 Jan 2012 18:43:33 GMT

[quote user="Mark Rowland"]

I suspect this rabbit died due to complications with the anaesthetic protocol. Were pre op bloods done? What pre op analgesia was used? were intra op fluids given? was core temperature monitored? A triple combination is not what I would use for a case like this. I dont suppose they allowed a pm?

[/quote]

Stray rabbit brought in by one of the nurses having been found in her garden, and being a charity we have to be careful economically with blood samples etc - being a Friday afternoon it was a patch-up job really. Meloxicam good dose and buprenorphine pre-op analgesia, was on surgical fluid rate during GA, temperature normal throughout. No real choice re triple combo as rabbit very jumpy, and low doses given - essentially was sedated - and needed propofol (no alfaxan here) to reach surgical anaesthesia (twitching eyelid when suturing lids at start). May PM tomorrow. Assistant did use lysosopt and as I say the haemorrhage did stop, but is was a musing whether that would stay clotted/sealed once the rabbit woke up and BP increased.

Anyone any experience of alfaxalone IM in rabbits?

Blood did run down the NL duct in this one (was tubed).

Re volume of blood, I would have been surprised if that was enough to kill it but equally don't think it would have helped.

Re: rabbit enucleation bleeds

Evelyn Barbour-Hill — Sun, 08 Jan 2012 18:03:32 GMT

[quote user="Fiona Dale"]I have always been under the impression that as long as the skin is sutured so that a good seal is formed, if it does bleed all that will happen is that the orbit will swell and bulge, but it is a fairly small cavity and the pressure will soon equalise with blood pressure and the bleed will stop. [/quote]

I don't know about rabbits but I wouldn't rely on that theory in the cat or dog!

[quote user="Fiona Dale"]I guess the only place the blood could exit from is via the nasolacrimal duct, but I have never seen this happen. [/quote]

In the dog or cat it can do exactly that.

Re: rabbit enucleation bleeds

Evelyn Barbour-Hill — Sun, 08 Jan 2012 17:58:53 GMT

[quote user="Gerry Henry"]haemostatic marshmallow[/quote]

Lovely!

Excellent stuff . Lyostypt. Also known as Collastypt.

Re: rabbit enucleation bleeds

Mark Rowland — Sun, 08 Jan 2012 11:59:14 GMT

[quote user="Gerry Henry"]

Probably would have used bipolars then packed with LYSOSTYPT foam; bit like haemostatic marshmallow; sorry to be dissenting voice but I would have thought losing 10mls would have been quite significant.

[/quote]

Its generally accepted that for venepuncture you can take 0.5-1% bodyweight safely. In a 2kg rabbit this would be 10-20mls.

That said, It would be another reason for intraoperative fluids.

Re: rabbit enucleation bleeds

Gerry Henry — Sun, 08 Jan 2012 11:55:17 GMT

Re: rabbit enucleation bleeds

Mark Rowland — Sun, 08 Jan 2012 10:49:28 GMT

I would usually insist on pre op bloods in an older rabbit for this type of surgery and if renal function is OK go with Opiod + meloxicam premed and probably low dose alfaxalone iv induction or mask induction, intra op fluids and continue with opiod analgesia post op.

Hope this helps

Re: rabbit enucleation bleeds

CatherineThomas — Sun, 08 Jan 2012 10:05:46 GMT

[quote user="Mark Rowland"]

A triple combination is not what I would use for a case like this.

[/quote]

What would you use for a case like this?

Re: rabbit enucleation bleeds

Mark Rowland — Sun, 08 Jan 2012 09:11:20 GMT

Hello,

Re Celox, it provides good haemostasis but only for superficial wounds, It is not designed for internal use so i wouldn't use it in a case like this. Before Dechra took it on I was asked to trial it for exotics at my practice. I use it for shell injuries and other causes for haemostasis with very satisfactory results.

If these sinuses are traumatised, I usually use lyostypt and digital pressure. Rabbit blood tends to clot quickly. A good seal will result in haemostasis, 10mls of blood isnt very much to loose for most rabbits. I have never lost one for this reason.

Goodluck

Re: rabbit enucleation bleeds

Alan Tevendale — Sun, 08 Jan 2012 08:35:18 GMT

Has anyone tried Celox yet? They were marketing it at BVZS congress this year. I guess as a wound packing material it wouldn't be ideal - not sure I'd want to leave it in there - but meant to be fantastic at stopping haemorrhage. Might be very useful for intraoperative bleeds.

Re: rabbit enucleation bleeds

Fiona French — Sat, 07 Jan 2012 22:36:48 GMT

I have always been under the impression that as long as the skin is sutured so that a good seal is formed, if it does bleed all that will happen is that the orbit will swell and bulge, but it is a fairly small cavity and the pressure will soon equalise with blood pressure and the bleed will stop. I guess the only place the blood could exit from is via the nasolacrimal duct, but I have never seen this happen.

Re: rabbit enucleation bleeds

jose targa — Sat, 07 Jan 2012 20:30:37 GMT

Hi David.

I´m so sorry to know this bad news.

For your first question: i don´t think that digital presure is enough to make a good haemostasia in the rabbit eye enucleation. Did you think in hemoclips? What about bipolar electrocoagulation? we love to use CO2 laser for this purpose.

I think that vagus relex is very typical, but rarely diagnosed in the surgical theatre duriing the eye surgery. Atropine premedication would help to prevent that problem. Despite of this, general anesthesia in a rabbit is always a dangerous procedure.

I´m so sorry.

Best regards from Spain.

Re: rabbit enucleation bleeds

Kate Richardson — Sat, 07 Jan 2012 16:29:13 GMT

[quote user="David Mills"]Likely lost about 10ml in total, so unlikely to kill it but unlikely to help also[/quote]

Unless it was already anaemic

Sorry, not much useful to add