Bunny keeps getting worse

[hototbunny]

Bunny had started sneezing in August, and with no exact signs of anything wrong, the vet wanted to wait it out. (I was moving, so they thought maybe dust from packing)

It continued until October, when she started having mucus discharge and then she went on antibiotics. She's been on different kinds until a few days ago when they decided it's been exasperated as a treatment and took her off.

And that wouldn't bee too bad, except she's stopped eating hay. She's had her teeth filed twice and both times it helped her eat veggies, but she refuses to eat hay at all. She's loosing weight rapidly and even though the vet's been great, there's no indication that she's going to get better. She's had about as many test as I can afford, including bloodwork and some radiographs with no definitive answers. She was tested for lead, and that wasn't high, she's still pretty active around the apartment, but she seems to be constantly uncomfortable. She was atleast 3.4 lbs in September and now she's only 2.6.She's drooling, she as urine stains on the inside of her legs, and her stools are always soft and are not regular consistancy. Her stools have actually been unformed for a while but now it's compounded with all these other symptoms of some unknown problem. She on critical care feedings, and I just read about how it should soak for a while before administering, so I'm doing that now.

She's only 4 years old, she's an indoor bunny, very social

If anyone has any suggestions, or has had experience with bunny's only not eating hay, I'd greatly appreciate ANY advice. Again, the vet has great resources and has been extremely compassionate, but I just feel like I'm getting desperate. I'd be greatful for any advice

 

[naturestee]

Did he do xrays of her teeth? How are her molar roots doing? If they're overgrown, she might be in too much pain to eat hay. Drooling is usually a sign of dental issues so there must still be something going on.

What antibiotic was she on? Were any others tried? Was a culture and sensitivity test done? Was the blood test done after she started staining her fur with urine (kidneys)? What about bladder infection?

The only reason I can think of that she'd have so many problems is that she is stressed (in pain?) and it's weakened her immune system.

Oh, and what is your location? Medications are different in different countries, especially between Britain and the US. In the UK, drugs have to be approved before using on animals whereas in the US we're much more free about what we can use.

Hopefully Randy will chime in with some help.

Oh, and welcome to the forum!:hug:

 

[Maureen Las]

I am wondering if the lingering URI weakened her immune system to the extent of allowing once dormant e-cuniculi to take over. She could be treated for this quite easily without a blood test.

What were the results of her blood tests?
Iwould be concerned re. the length of time the illness went on and also the type of antibiotics used?

was she tested for parasites?
all body systems seem involved at this point.

 

[ra7751]

Hi,

I think we need to take a much closer look at the pearly whites here. Drooling....aka The Slobbers.....is almost exclusively caused by a dental issue. And that dental issue may not be seen by a visual or by an inexperienced vet (no flaming intended to your vet) in interpreting mandibular rads. And honestly, sometimes the problem can't be seen. I suspect there is a molar issue. It could be molar spurs. They are nothing more than overgrown molors. Since the molars are curved, if they spur it will either start irritating and eventually bind the tongue (prevents drinking) or the lower arcade can overgrow into the roof of the mouth. I have also seen some viral issues (a virus is somewhat rare in a rabbit but they do happen) that causes ulcers....just like we get.

A couple of suggestions...keeping in mind that I am not a vet. Be cautious with the Critical Care. It is a great product (and the only Oxbow product I use) but it can be very dehydrating. Make sure it is mixed with plenty of water and give it time to absorb the water. Try to keep her hydrated. If she will eat greens, give her wet leaves of romaine lettuce (in moderation of course). If you have the capability, sub-q or IV fluids would be very helpful. If you aren't able to do that, use unflavored Pedialyte (the human electrolyte) and give it orally by syringe.

If you can get a copy of the labs, please post them or PM them to me.....my rescue e-mail is listed in my profile if you want to e-mail the labs. And if the x-rays are digital....send me a copy.And what antibiotics was she on? This might be a stretch, but if you would be willing to send me her entire treatment history....that might showsomething. I would ask your vet to do a very detailed exam of the jaw both by physical exam and additional rads if necessary. The doctor would be looking for signs of root impactions or spur overgrowth. I would also look very carefully for signs of soft tissue infections. This can bechallenging tosee. General anesthesia may berequired for a really good look....sevoflourane is the best gas if you have a choice....we do injectable anesthesias on most extensive oral surgeries. Your post leads me to believe there may be some type of infection in the head....quite possibly an abscess. An abscess can be slow developing and can be devastating if not treated properly. Very few vets have successfully treated mandibular abscesses...it's a work in progress with treating abscesses. If an abscess is the problem, I can discuss with your veta very successful non-invasive drug treatment using a very specific combo of unconventional antibiotics. The usual treatment for an abscess is surgical. That route is painful, expensive and often unsuccessful. I do not open abscesses. I would have your vet adminster fluids if needed. I would ask for pain meds. In this case, and especially if you can maintain hydration, I would use and anti-inflammatory like Metacam. It is a moderate analgesic but does well with inflammation....and the swelling is painful. Standard dosing protocols apply....but maintaining hydration is critical. If it is an abscess, I prefer some type of narcotic or narcotic-like aspect in treatment. The absolute best analgesic I have used is Buprenorphine (Buprenex). Good stuff, can be adminstered PO, SQ or IM and is long lasting...up to 12 hours. I use it for post-op pain management. It is a controlled drug so that might cause some concerns with the vet. An acceptable alternative is Tramadol. Few vets are aware of using this drug in rabbits....but it does great. It does have to be compounded into a suspension. I can provide your vet with formulary and/or dosing information. It might help to consider maybe a little shot of B Comp yo stimulate her appetite.

This might not be your rabbit's problem....but all the markers you mentioned in your post..primarily weight loss, past URI issues, indications of pain and drooling all lead me to look first for dental and/or mouth issues. I have seen all of this many times and have successfully treated these problems.

Don't hesitate to contact me if you need any information or if I can assist your vet. If you could post your general location in your profile....I have contacts all over the US and parts of Canada that might can assist your rabbit.

Randy

 

[hototbunny]

Thank you so much for all the feed back. The drooling and urinating on her legs started about two weeks ago, while the weightloss and unformed stools have been going on for almost two months. She started on an anitbiotic back in November and although I don't have the record with me, I believe it was something like Floxin. Afterthat, she was one Baytril and Metronidazole with the Metacam pain killer for four weeks and was taken off of them last week. She's still on the Metacam andTramadol was added at her last visit. I don't have access to her records right now, but I will ask on Monday. I know she's gotten blood work done just about each week and although I don't have the numbers with me, nothing stood out to the vet as in indicator of anything. She did have a WBC at 17 and now it's at 13 but I don't remember the breakdown of what kind of WBC's they were. She had a low lead level on her last visit andthat sparked a lead test which showed thather level was too low to be considered a problem. (I think it was a two and ten was when it wasconsidered capable of being an issue, but I'm not entirely sure.)

She has had someradiographs, but mostly of her chest to see ifthere was an infection that spread to her lungs, which it hasn't.Shedid have a dental exam last week where they put her under anesthesia. That showed some points on her teeth, but those were caused by her grinding from pain.They also searched for any foreign objects that may have been in her nose and causing irritation, but found nothing. There was no xray that I remember paying for for her mouth though and as far as I know, she hasn't had one. An ultrasound was suggested a few weeks ago, but since she's had gas recently, they said that would interfer with the view and may ruin the view of anultrasound. Also, I do not remember a seperate test for parasites.

I'm in Philadalphia right now, I recently moved here fromoutside Boston and I may be going back up there for a few days in January. If I go, I'll obviously be bringing Bunny, so if you know of anyone in either place, I can bring her there. In Philly, I've been going to UPenn, and like I said, they've been great. I'm not posting for lack of faith in their analysis or treatment, I'm just feeling desperate at seeing her loose so much weight.

 

[Maureen Las]

I have reread your initial post over and over to attempt to find some kind of a pattern.
I wondered if your bun was from a shelter and/or do you know her history.
Angela and Randy were correct in that drooling almost always indicates dental disease.

Ididn't catch it becauseI saw the drooling and urinating on herself as possibly being something neurological.

is there any other behaviors with your bun that you didn't post yet that are 'different"

A person would think that a painful condition like this would show something in the labwork if it isn't her teeth.

Iwonder if some of the GI issues are related to mega-colon in a hotot. One of my buns with some of the hotot genes had a condition similar to the description of mega-colon.

anyway i'm fairly sure that Randy can hook you up with someone in your area.

Please post anything that you can regarding your bun; it does seem like a mystery

How terrible to be having all this work done and not getting any helpfor her

 

[ra7751]

I really think they are looking in the wrong place. Molars do not get spurs from grinding their teeth in pain. Molar spurs are caused either by a lack of hay (chewing is the primary way to keep the teeth down) or malocclusion. An occlusion issue can be caused by many things. Usually if it's genetic, it will show itself before now. If the malocclusion happens later on...it's usually either an injury such as a broken tooth or jaw...or an infection thatloosens the teeth and causes them to move slightly out of occlusion. This is a common thing with impaction abscesses.

Interesting choice of antibiotics. Any of the "floxacins"...Baytril and Cipro....are in my non-professional opinion just about totally useless in rabbits. Again, keep in mind that I am not a vet. I do treat very sick rabbits. I have not used Baytril in years (in rabbits). I will use it in chinchillas, some birds and reptiles. Metronidazole (Flagyl) is an antibiotic that is often used for a controversial treatment in rabbits. In many GI events, the beneficial bacteria will become stressed and start to die. Since the good bacteria controls the bad bacteria, that event allows the bad bacteria to start controlling the gut.....Clostridium is a prime example. Flagyl is very effective at helping to control Clostridium. It also has some very beneficial anti-inflammatory properties which is beneficial in GI events. It is effective against somewhat limited spectrum of aerobic bacteria and some protozoan parasites.

I would really want a much closer look at those molars and inside that mouth. I have been doing rabbits for decades and I have never seen anything other than a dental problem cause drooling. In each and every case here, it has been related to the molars either with spurs or an impaction abscess.

If it is an abscess....and understanding here that the jury is still out on a root cause....it needs to be hit with the big guns immediately. The problem with dealing with an abscess is getting the drugs to get to the core of the infection. Most drugs used by vets are not up to the job. My drugs of choice in working an abscess is either a combination of Penicillin and Zithromax at the same time....or Chloramphenicol. There will be aerobic bacteria in an abscess....but the core is full of anaerobic bugs. These drugs are very good at penetrating the pus and getting to the core to pay a visit to these bacterium.

While I fully expect to find a dental issue....the root cause of this concern needs to be determined and I would pushing your vet to add to the urgency of this situation. It appears that your bunny's health is declining pretty rapidly so time is something that has a limit.

I would also suggest another full blood panel. Metacam for four weeks? I'll bet the liver is begging for mercy. Something has to show up in there.....and if you can swing another CBC....request a titer for EC as that might also be a concern especially in a rabbit with a stressed immune system.

I would think being at UPenn would be about as good as it gets. One of my vets graduated from there. But there are always other options....and a second opinion is never a bad thing. I would suggest Cummings Vet School at Tufts University. Another of my vets is a graduate of there. Here is a link.

http://www.tufts.edu/vet/sah/

Keep us posted.

Randy

 

[hototbunny]

I've had her almost her entire life. Someone posted that their bunny was pregnant on a website and 8 weeks after she was born, I went to pick her up. I don't know what her full genetics are, but she looks like a hotot and most of her siblings did, except for a few that were all black. She was born in September of 2004.

The vet mentioned something about seeing a certain digestive issue only (or primarily) in hotot's and mentioned that they haven't had much luck when they've enountered it. She didn't go into much detail about it, and out of fear, I didn't really ask, which I know is dumb, but this was a few weeks ago I had a lot more hope then.

I've been looking for changes in her behavior, and there are a few: she was completely litter box trained (unless marking a new area) and now that's gone; she's been picking around her genitals and they are a little red and inflammed (that issue and the unrinating on her legs evolved at the same time); she likes to sit on high places, like suitcases and up on boxes and I've noticed her readjusting herself like she's slightly off balance or tired. Andas a precaution,I removed them from her, but she never has a balance issue on the ground. Other than those, her changes seem related to the pain she's in, like she no longer lays down and lounges and doesn't run around jumping up in the air. (Although I did put up a babygate the other day and she jumped over it twice, which I found amazing in her condition.)

I can't tell if she's peeing more than she used to, since she used to go exclusively in her box. She pees about the same amount every day, usually I find two/three puddles over night, another two/threewhen I come home from work, and 1/2 when we're together, but I don't know if that's an increase or not.

I just emailed my vet to see if we can schedule a rad for her mouth/head. If drooling is so often associated with mouth problems, then she has to have something they missed at her last visit, cause even though they filed down some points that were bothering her and did a visual exam, the drooling hasn't subsided at all.

Again, I can't tell you how much I appreciate your imput. Thank you so much for reading and responding.

 

[Maureen Las]

She could have developed urine scald on her genitals from having urine on herself.; maybe thisis why she is picking at herself . I know that Randy knows of specific veterinary salves and cremes that are excelllent for this condition but some of us wash the area with gentle small animal soap and apply either neosporin or desitin ointment if the area is red and inflamed or else give cornstarch baths and then apply something soothing

it may not have reached that point yet but something to keep an eye on.


http://www.bio.miami.edu/hare/urinary.html



http://www.medirabbit.com/EN/Uro_gen_diseases/Differentials/Incontinence.htm

http://www.bio.miami.edu/hare/buttbath.html


http://www.rabbitsonline.net/view_topic.php?id=11932&forum_id=10

Ijust posted several different library articles that may be helpful.

I am also wondering if she is shifting her position because she has gas. Does her stomach feel hard and distended. Did any of the vets ever suggest giving her simethicone in the form of infant liquid gas drops like gas x or mylicon. Most of us use it regualrly when our rabbits have gas and it usually works fast . you can buy it at a drugstore and give 1 ml up to 3 doses several hours apart.
can't think of anything else right at this moment but keep us updated on her condition.
I am wondering if she would eat pellets if you wet them with hot water or possibly offered her some pumpkin in a bowl. if she tends to want to eat the soft food that is really an indicator that it hurts for her to chew.

 

[ra7751]

I usually treat urine scald by bathing with an oatmeal based shampoo and then applying pure corn starch...no talc...just plain corn starch. Scald is very painful and can get infected. I would try to get some pain meds (Metacam would be good for this) and watch carefully for signs of infection.

Randy

 

[hototbunny]

Eventhough I've doubled her feedings, and she's eatinh pellets and veggies on her own,she's lost so much weight this week. I can see the pronounced definition of her ribs and spine. I've made an appointment at the vet to talk about any possibility of teeth problems so I hope there's more we can do in that area.

Oddly enough, th drooling has stopped. I've started cutting up extremely tiny pieces of her timothy hay and adding it to the critical care. it's almost like dust. butI thought it might be helpful. A soon as I get her medical records, I'll post them.

Thank you all again for the advice, I'm so glad I came upon this site.