Plus-Hex CLINICAL
Rabbits
Previously , it was advised that rabbits were to be fed up to 3 hours before the induction of anaesthesia and encouraged to eat as soon as they recovered [ 40 ] . However , in these patients , it is now recommended that food be removed 1 hour before anaesthesia to minimise the presence of food in the oropharynx and to decrease the pressure on the diaphragm from the stomach ( Figure 3 ). Assisted feeding should be discontinued 30 minutes prior to anaesthesia [ 22 ] . The use of Elizabethan collars should be avoided , where possible , as these increase stress and inappetence , and will limit caecotrophy [ 40 ] .
A study in 2022 [ 41 ] identified that the administration of butorphanol or morphine temporarily slows gastrointestinal transit in healthy rabbits , whereas tramadol does not . However , the opioid buprenorphine prolonged gastrointestinal transit time and was unaffected by the co-administration of cisapride , which is important when considering pain relief and adjunctive medications to prevent gut stasis in these patients [ 42 ] .
Figure 3 . It is now recommended that a rabbit ' s food should be removed 1 hour before anaesthesia .
Conclusions
When malnourished or anorexic patients are admitted to the clinic , parenteral nutrition is valuable when enteral nutrition is not possible , and should be provided if the anorexia is significant or has resulted in a loss of 10 % of body weight [ 17 , 43 ] . Ideally , any nutritional compromise should be remedied prior to surgery , and the patient should be stabilised , if possible , and its nutritional status monitored regularly [ 43 ] . Post surgery or anaesthesia , patients will struggle to recover and heal if their nutritional needs are compromised . For this reason , their nutritional status should be monitored regularly post surgery [ 43 ] to prevent a potential increase in wound breakdown , dehiscence , infection , morbidity and mortality risk [ 17 ] . Water should never be withheld from any patient for more than 2 hours prior to anaesthesia due to the risk of dehydration and hypovolaemia [ 21 ] .
REFERENCES
1 Mancinella E . Updates in perioperative care – ideas from the human field . Vet Times . 2018 . Available from : https :// www . vettimes . co . uk / article / updates-in-perioperative-care-ideas-from-the-humanfield / [ Accessed 1 November 2022 ].
2 Martinez M , Twist V . Enhanced recovery after surgery . Vet Times . 2021 ; 51 ( 35 ): 4 – 6 . Available from : https :// www . vettimes . co . uk / article / enhanced-recovery-after-surgery / [ Accessed 1 November 2022 ].
3 Venara A , Neunlist M , Slim K , Barbieux J , Colas PA , Hamy A , et al . Postoperative ileus : pathophysiology , incidence , and prevention . Journal of Visceral Surgery . 2016 ; 153 ( 6 ): 440 – 446 . Available from : https :// doi . org / 10.1016 / j . jviscsurg . 2016.08.010 .
4 Dugdale AHA , Beaumont G , Bradbook C , Gurney M . Veterinary Anaesthesia : Principles to Practice . Oxford : John Wiley & Sons , 2020 .
5 Hisamuddin N , Kamarudin N , Sulaiman MR , Shaik Mossadeq WM . Effect of Zingiber officinale on spasm . Pertanika Journal of Scholarly Research Reviews . 2019 ; 5 ( 1 ): 28 – 36 . Available from : https :// core . ac . uk / download / pdf / 234560138 . pdf [ Accessed 15 December 2023 ].
6 Moss E Difficult to stomach scenario : small animal gastrointestinal disorders . VN Times . 2023 ; 24 ( 11 ): 4 – 6 . Available from : https :// www . vettimes . co . uk / article / difficult-to-stomach-scenario-small-animalgastrointestinal-disorders / [ Accessed 9 December 2023 ].
7 Schuurkes JAJ ( 1999 ) Pharmacotherapy of gastrointestinal motor disorders . In Herbert MK , Holzer P , Roewer N . ( eds .) Problems of the Gastrointestinal Tract in Anaesthesia , the Perioperative Period , and Intensive Care . Berlin : Springer ; 1999 . p . 12 – 22 .
8 Azuma YT , Suzuki S , Nishiyama K , Yamaguchi T . Gastrointestinal motility modulation by stress is associated with reduced smooth muscle contraction through specific transient receptor potential channel . Journal of Veterinary Medical Science . 2021 ; 83 ( 4 ): 622 – 629 . Available from : https :// doi . org / 10.1292 / jvms . 20-0490 .
9 Clark M . Drugs used for appetite stimulation in dogs & cats . Clinician ' s Brief . 2022 . Available from : https :// www . cliniciansbrief . com / article / veterinary-drugs-appetite-stimulation-dogs-cats [ Accessed 15 December 2023 ].
10 Waring N . Premedication considerations for dogs undergoing general anaesthesia . The Veterinary Nurse . 2017 . Available from : https :// www . theveterinarynurse . com / review / article / premedication-considerations-for-dogs-undergoing-generalanaesthesia [ Accessed 16 November 2022 ].
11 Seymour C , Angell L . Premedication with alpha-2 agonists – procedures for monitoring anaesthetic . VN Times . 2015 . Available from : https :// www . vettimes . co . uk / article / premedication-withalpha-2-agonists-procedures-for-monitoring-anaesthetic / [ Accessed 16 November 2022 ].
12 Camilleri M , Atieh J . New developments in prokinetic therapy for gastric motility disorders . Frontiers in Pharmacology . 2021 ; 12 : 711500 . Available from : https :// doi . org / 10.3389 / fphar . 2021.711500 .
Volume 39 ( 1 ) • February 2024
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