Geriatric bunny with tooth issues

[gentle giants]

Last night I took in a seven year old buck that was severly feces coated, even all under his belly. So I did a little basic cleanup last night and got him to the vet first thing this morning. He has to wait a few days to get neutered, because his por little boy parts are all infected from all the filth glued to them. Plus,I had been so focused on his filth I hadn't even looked at his teeth, until the vet checked them this am. I wishI had had my camera to take pics of the mess this poor guy's mouth was in. He had little crooked stumps in the bottom, and less than that on top. One piece of his top tooth was sticking almost straight out, too. :shock::X

So the vet clipped off the crooked parts, and I have softened his pellets to make it easier for him to eat. I am kinda worried, he hasn't eaten abite sinceI picked him up around 2pm yesterday. If he hasn't eaten by the time I get home this afternoon, I am breaking out the syringe. Does anyone have any experience with problems like this? I have already tried canned pumpkin, he won't touch it, I think due to stress and nerves.

 

[Carolyn]

What did they give you forthe infection and if so what?

Is he moving around okay?

 

[gentle giants]

Sulfatrim, 1.5 ml twice daily. I'm nost sure about his movement, he is not wantin to move much. What I have seen seem sok, except he doesn't want to sit on his poor butt, kinda holds it up so there is no pressure on it.

 

[Carolyn]

Hi GG,

He's holding up his belly, as you know, because he's uncomfortable. You might try getting some pain med for him. Banamin or metacamareusually safe bets. If they won't,consider baby aspirin. (7 lb. rabbit = 1 baby aspirin per day.) WARNING: If there's any bleeding associated with the soreness, don't give aspirin because it's a blood thinner.

Offer him any treat he likes. Sometimes when they get their teeth worked on, some rabbits, especially older ones, can be sensitive to the anesthesia. Between that and pain, it might be holding him back from eating at this point. At least if you get him eating something, it'll usually stimulate him to move onto other things.

Some rabbits come home from dental work and start eating right away, others do delay.

Poor baby. You guys will be in my thoughts - and I'll most definitely say a prayer for him. Give him a kiss for me. Poor little guy. He's already getting better today than he was yesterday though! Keep up the good work!

 

[Vicky]

Pain relief would be a must, especially for the older bunnies with dental disease as this knocks it out of them quite a bit more. Have you got any pureed baby food? The fruity ones tend to work quite well as they're sweet and its a good bit of encouragement for them to eat by themselves. Herbs are worth a try too, plantain in particular goes down well with my rabbits.

Best of luck with this little one and hope he starts to perk up soon

 

[gentle giants]

How about Motrin for pain? I have children's Motrin.

 

[myheart]

I kind of went through this with Patrick and his first dental at age six. I felt so bad for the little guy because he had to re-learn how to eat because his mouth had to re-align itself to the less pointed teeth.

My vet prescribed metacam for the pain, and he really needed it. She was very unhappy that my other vet prescribed a baby aspirin for pain and expressed it very plainly (made me feel like the worst bunny-mom in the world). I was hesitant to give it in the first place, but I didn't know what to do for him until he could get in to see the rabbit-savvy vet (who yelled about the aspirin). Along with the metacam, she prescribed critical care and lots of wet veggies for hydration, and exercise to keep his tummy working.

It did take Patrick about a day and a half to two days before he could eat "normally" again. He was excited to get his food, but didn't know how to use his "new" teeth. Now he and Luna go in about every eight weeks for dentals. The vet says he will probably have no teeth, except the fronts,in about a year because he is losing his dental material due to age.

Hope this helps,

myheart

 

[Maureen Las]

A visual exam isn't really enough to see what's going on in the rabbits mouth. he really should get a full set of x-rays . he could be having dental problems that just were not apparent.

ibuprofen can be given to rabbits 2-10mg/kg but would also thin the blood like aspirin as it is NSAID

2.2 lbs =1 kg so you could give him a medium dose dependent on his weight.
Also probably good to syringe food into him with the meds.

Do you have critical care?

 

[gentle giants]

He hasn't been sedated for his dental work, this was just a quick look and clip this morning. When he is put under for his neuter in a few days, then he will get a more thorough check. I didn't want to have to sedate him more than once, if at all possible.

He isn't bleeding any, this is just irritated/infected raw spots on his boy parts. I do have all kinds of baby food, my youngest is eating solids now. I will probably try soime applesauce here in a little bit. For some reason, baby food hadn't even dawned on me.

I think I may have a dose or two of Metacam left over from another critter, how would I dose him, he is about 6 1/2 pounds? I ned to get the CC, haven't gotten it ordered yet.

 

[Maureen Las]

http://www.medirabbit.com/Safe_medication/Analgesics/safe_analgesics.htm

meloxicam is 0.1-0.2 mg/kg so1 kg = about 2.2 lb so he would be 3 kg. So he could have 0.6 mg but make sure you know the difference between 0.6 ml and 0.6 mg.

The bottle should have how many mg/ml Do you have that on the bottle?

 

[gentle giants]

No, that's not on the bottle. All that is on there is the dosage for the cat I was using it for. I may call and ask the vet.

 

[Maureen Las]

best to call the vet...

 

[EmilytheStrange]

ooh, just imagining what that poor bunny is going through makes my tummy clench up!

 

[gentle giants]

Well, we tried taking a couple of pics, but they came out so blurry you really cant' see anything from them. May try that again later. I did call the vet and he gave me a dosage for the poor guy. I only have about a dose and half, though, so I am going to stop in and try and get some more when I take the kids to school. When we were trying to take the pics this morning, I could tell that his gums on the bottom are kinda inflamed. He is trying to eat for me now, though. He wouldn't even touch it last night.

 

[Maureen Las]

he probably has gum infections ..poor thing ..his teeth are probably really bad.

 

[gentle giants]

I got some more Metacam for him today, they gave me quite a bit, thankfully. It seems to be helping with his eating. He took a little baby food today, too, I gave him a little dab of applesauce, carrots, and pumpkin, the only one he touched was the carrots. I am going to try and start him on Bene-Bac tonight, because he is still having the runny poops. Plus he is on antibiotics, too. Although it's going to be interesting getting it down him, I got the powdered stuff. The label says you are supposed to put it on wet food or greens, both of which he seems uninterested in.

 

[Maureen Las]

I have powdered bene-bac too and I have found that i can take quite a lot of benebac and smoosh it into fresh banana..mine are oblivious to the fact that the benebac is there and just snort the bana down in one bite

 

[ra7751]

Hi All,

I have reading this thread with interest. This is one of those cases when lots go wrong....something we commonly see in some of our more drastic rescues. I suspect this fellow is quite uncomfortable. I suspect more is going on with his teeth (possible abscessing or impaction issues)and I suspect more work will be needed on them. The infection in the genitals creates a lot of pain....and that is something that needs to be addressed. I am going to give some comments here on the various drugs that are being used and offer some suggestions.

Many of the NSAIDs (metacam, banamine, aspirin, ibuprofen, etc.) have all been mentioned. These drugs have a reputation of being totally safe....they are not. These drugs are safe when used properly....but that is the key. These drugs are very rough on the liver at high doses or for extended periods of time. The renal system is also affected by these drugs. They should never be used in an animal (any species) that shows any sign of dehydration. Since we are sure to have some dehydration issues here....I would urge caution. We rarely use NSAIDs for more than 3-4 days and if we do, wedo regular blood panels tomonitor liver and renal values...and we always offer supplemental hydration support. I have horrible thoughts of using aspirin in rabbits at all. We all know that aspirin can cause ulcers...and this is more so in the acidic environment in a rabbit's GI. If you get an ulcer in that very thin stomach and/or intestinal lining....it can easily perforate and that will be the final curtain. Gastric ulcersare quite common in GI events especially stasis....and that is one of the reasons that motility drugs are so dangerous. The contractions they cause can open an ulcer. Because of concern for gastric ulcers....you should never use NSAIDs with steroids (any species including humans). And just for info....regardless of what you hear or read, metacam is dosed in a one time loading dose and then the standard dosing which is .1mg/kg. There are now 3 different concentrations of metacam-->.5mg/ml, 1.5mg/ml and an injectable at 5mg/ml. It is vitally important that you know what concentration is being used so it can be dosed properly. This drug is commonly overdosed and used for too long.

A couple of excellent choices for pain, but as with any drug their own side effects, are Buprenorphine (Buprenex) and Tramadol. Buprenex can slow respiration and can cause a slight slow down in the GI but we have never had any major issues with it. Tramadol has been well received by our animals. It is cost effective and very good at controlling moderate to severe pain. It is usually dosed twice a day...but in some cases like this, a third time offers not only pain control but some sedation as well....kinda takes the edge off. The only down side of Tramdol is that it does have to be compounded into a suspension and very few vets are aware of it's usefullness in rabbits. It does have some serious side effects at very high doses...but that type of dosing is many times what is appropriate for rabbits.

Antibiotics are another issue. Enrofloxacins (Baytril) and Suflanomides have also gained a reputation of being totally effective and safe....again, not true. Baytril has been totally overused and abused over the years as it has been considered the "miracle drug". Look at human history.....I think in the '40's that penicillin was considered the "miracle drug" to cure all human diseases. It was so abused that it is no longer effective....the bacteria mutated and became resistant to the drug. Same thing with Baytril and the sulfa drugs. Baytril can also have major effects on the liver and kidneys. And their is some evidence that it can cause some joint issues especially when use in very young rabbits.And in manycase Baytril just doesn't workany longer.The sulfa drugs are sometimes used with skin infections caused by staph and we do use it with fluid ingestion into the lungs...aspiration pneumonia. Other than that...it doesn't seem to do much good. It does dry the eyes out so (in any species) so supplemental lubrication in the form of basic tear drops should be used. Sulfanomides have also been linked to a condition known as Tyzzer's Disease which is an overgrowth of a very stubborn strain of clostridium....and that is the harmfulbacteria that usually is found in the gut of stasis/ileus rabbits.

I suspect this rabbit might be suffering from multliple infections. Since we have appetite issue, I would be leary of using any antibiotic that has to be taken orally. Injectable penicillin might be an attractive option here. But I would lean toward a drug just approved for use in the US (as with everything else, use in rabbits is "off label). That drug is a cephalosporin called Convenia. This family of drugs is chemically similar to penicillin but in labs has shown to be very effective against most of the pathogens commonly seen in rabbits including our arch enemy-pasteurella. The really good thing about this drug is that it is dosed one time by sub-q injection. That opens up an entirely new avenue of treatment for rabbits in which their humans can't do injections. I have not used it in domestics yet but I have in cottontails and I am using it in a rescue tonight. So far, so good. Problem is that only a very precious few vets know of using this drug in rabbits.

If this were my rabbit...here is what I would do. And for those of you that don't know, I am not a vet so this is my non-professional opinion based on my years of experience. And always keep in mind that there is risk in any medical treatment but the key is to determine if the benefits outweigh the risks. The risks are enhanced in this patient due to his already compromised health so it might come down to a "Hail Mary" treatment.I would use one of the injectable antibiotics, most likely Convenia. Since this is a one time dosing, this will also elminate the stress of daily injections. I would get more aggressive with the pain using either Buprenex or Tramadol. Metacam can be used in conjunction with either of these drugs based on normal dosing protocols of metacam (including that little hydration issue). I would offer anything bunny safe to eat...a buffet. This is one time I would use Critical Care (it takes some practice to get the hang of feeding CC). You can make your own version by pulverizing pellets and making it into a slurry. I would probably mix it with an electrolyte like Pedialyte or Lactated Ringers. You can also crush up nutritional veggies like kale or dandelion into the slurry. I would offer supplemental hydration most likely with Lactated Ringers since it does contain electrolytes.Fluids are technically drugs and there is a dosing protocol...there can be too much of a good thing. I would use a probiotic to supportthe gut and stabilize the pH....somethinglike Bene-Bac which has different strains of bacteria that are very useful such as L Casei and Enterococcus. Never use yogurt with a rabbit. I would use a topical like Silver Sulfadiazine on the skin infection. You can also use Baytril Otic (an ear drop) which also contains SSD. The SSD is a burn cream with antibiotic qualities and it is really soothing to angry skin. As the skin infection starts to heal, I would gently bathe it using an oatmeal based shampoo. And I would use one of my wildlife tricks....a little injection of B Comp can really help them out. I would go after the infection first....and get him neutered as soon as possible. Then, get serious with the teeth including rads to see the roots and check for any possible soft tissue (abscess) or root impaction issues.

This sounds like a challenge here but I am sure your experience and compassion will get this little fellow thru this. Hope my comments are of assistance.

Randy

 

[Maureen Las]

What Randy so brilliantly said (as always) is that a person cannot just go to medirabbit, look up a safe drug and then begin to give it. No it will not poison or kill the rabbit immediately but i have just learned that NSAIDS are way more dangerous than I knew.

I think that what we try to do here in the infirmary is help people help their rabbits until they can get professional help. If a rabbit needs a pain med it's Ok (i think ) to give a baby aspirin once or twice) until we can get to a professional. What we cannot do is self-medicate and then continue to do it.

i should clarify this in my posts and as of today i will start doing this.

meanwhile i hope we can archive randy's brilliant info on NSAIDS somewhere in the library...

and i sure hope that poor older bun get the help he needs

 

[gentle giants]

Ok, whew. *deep breath* I hope I can clearly reply to all this, LOL. I shortened Randy's statement a little, since I am not going to use aspirin for him anyway.

ra7751 wrote:

Hi All,

I have reading this thread with interest. This is one of those cases when lots go wrong....something we commonly see in some of our more drastic rescues. I suspect this fellow is quite uncomfortable. I suspect more is going on with his teeth (possible abscessing or impaction issues)and I suspect more work will be needed on them. The infection in the genitals creates a lot of pain....and that is something that needs to be addressed.

I agree totally. He does appear to be very uncomfortable, and I think that is his main issue with eating. I have seen some improvement with the Metacam, but not as much as I had hoped.

Many of the NSAIDs (metacam, banamine, aspirin, ibuprofen, etc.) have all been mentioned. These drugs have a reputation of being totally safe....they are not. These drugs are safe when used properly....but that is the key. These drugs are very rough on the liver at high doses or for extended periods of time. The renal system is also affected by these drugs. They should never be used in an animal (any species) that shows any sign of dehydration. Since we are sure to have some dehydration issues here....I would urge caution. We rarely use NSAIDs for more than 3-4 days and if we do, wedo regular blood panels tomonitor liver and renal values...and we always offer supplemental hydration support. If you get an ulcer in that very thin stomach and/or intestinal lining....it can easily perforate and that will be the final curtain. Gastric ulcersare quite common in GI events especially stasis....and that is one of the reasons that motility drugs are so dangerous. The contractions they cause can open an ulcer. Because of concern for gastric ulcers....you should never use NSAIDs with steroids (any species including humans). And just for info....regardless of what you hear or read, metacam is dosed in a one time loading dose and then the standard dosing which is .1mg/kg. There are now 3 different concentrations of metacam-->.5mg/ml, 1.5mg/ml and an injectable at 5mg/ml. It is vitally important that you know what concentration is being used so it can be dosed properly.

I honestly don't know which I am using right now. The buck is 6.15 pounds, and he is getting 0.6ml once a day.

A couple of excellent choices for pain, but as with any drug their own side effects, are Buprenorphine (Buprenex) and Tramadol. Buprenex can slow respiration and can cause a slight slow down in the GI but we have never had any major issues with it. Tramadol has been well received by our animals. It is cost effective and very good at controlling moderate to severe pain.

Could my vet prescibe this for him? I have it for my own migraines, but using it for him would mean that I don't have it--I doubt my doctor would give me extra on the grounds that my rabbit needs it too.

Antibiotics are another issue. Enrofloxacins (Baytril) and Suflanomides have also gained a reputation of being totally effective and safe....again, not true. Baytril has been totally overused and abused over the years as it has been considered the "miracle drug". Look at human history.....I think in the '40's that penicillin was considered the "miracle drug" to cure all human diseases. It was so abused that it is no longer effective....the bacteria mutated and became resistant to the drug. Same thing with Baytril and the sulfa drugs. Baytril can also have major effects on the liver and kidneys. And their is some evidence that it can cause some joint issues especially when use in very young rabbits.And in manycase Baytril just doesn't workany longer.The sulfa drugs are sometimes used with skin infections caused by staph and we do use it with fluid ingestion into the lungs...aspiration pneumonia. Other than that...it doesn't seem to do much good.

The antibotic he is getting is Sulfatrim, 1.5ml twice daily. I remember you telling me that the Sulfa can be hard on the kidneys, is that correct? And the Metacam can be hard on the liver? That does sound like a bad combintaion, especially in an elderly rabbit.

I suspect this rabbit might be suffering from multliple infections. Since we have appetite issue, I would be leary of using any antibiotic that has to be taken orally. Injectable penicillin might be an attractive option here.

If I can't get my vet to give me the Convenia, how much of the pennicillin would I give him? Because not only do I have Pen-G on hand, but I am betting my vet won't try anything new on him.

But I would lean toward a drug just approved for use in the US (as with everything else, use in rabbits is "off label). That drug is a cephalosporin called Convenia. This family of drugs is chemically similar to penicillin but in labs has shown to be very effective against most of the pathogens commonly seen in rabbits including our arch enemy-pasteurella. The really good thing about this drug is that it is dosed one time by sub-q injection. That opens up an entirely new avenue of treatment for rabbits in which their humans can't do injections. I have not used it in domestics yet but I have in cottontails and I am using it in a rescue tonight. So far, so good. Problem is that only a very precious few vets know of using this drug in rabbits.

If this were my rabbit...here is what I would do. And for those of you that don't know, I am not a vet so this is my non-professional opinion based on my years of experience. And always keep in mind that there is risk in any medical treatment but the key is to determine if the benefits outweigh the risks. The risks are enhanced in this patient due to his already compromised health so it might come down to a "Hail Mary" treatment.I would use one of the injectable antibiotics, most likely Convenia. Since this is a one time dosing, this will also elminate the stress of daily injections. I would get more aggressive with the pain using either Buprenex or Tramadol. Metacam can be used in conjunction with either of these drugs based on normal dosing protocols of metacam (including that little hydration issue). I would offer anything bunny safe to eat...a buffet. This is one time I would use Critical Care (it takes some practice to get the hang of feeding CC). You can make your own version by pulverizing pellets and making it into a slurry. I would probably mix it with an electrolyte like Pedialyte or Lactated Ringers. You can also crush up nutritional veggies like kale or dandelion into the slurry. I would offer supplemental hydration most likely with Lactated Ringers since it does contain electrolytes.Fluids are technically drugs and there is a dosing protocol...there can be too much of a good thing. I would use a probiotic to supportthe gut and stabilize the pH....somethinglike Bene-Bac which has different strains of bacteria that are very useful such as L Casei and Enterococcus. Never use yogurt with a rabbit. I would use a topical like Silver Sulfadiazine on the skin infection. You can also use Baytril Otic (an ear drop) which also contains SSD. The SSD is a burn cream with antibiotic qualities and it is really soothing to angry skin. As the skin infection starts to heal, I would gently bathe it using an oatmeal based shampoo. And I would use one of my wildlife tricks....a little injection of B Comp can really help them out. I would go after the infection first....and get him neutered as soon as possible. Then, get serious with the teeth including rads to see the roots and check for any possible soft tissue (abscess) or root impaction issues.

I have Brewer's Yeast, which I am planning on giving to him today. I think with the hydration issues, I will mix it with Pedialyte, and I'm sure will have to syringe it to him as I can't seem to get him to eat well. I have tried applesauce, pumpkin, and pureed carrots on him, he would only take a lick or two of the carrots and didn't touch the other stuff at all. I am going to the store and get some banana and the like today, too, haven't tried those yet.

This sounds like a challenge here but I am sure your experience and compassion will get this little fellow thru this. Hope my comments are of assistance.

Randy

I hope you are right aboutme being able to pull him through this Randy. I gotta tell you all, this guy really has me frustrated. I have spent some serious tears on him. Just when I start to think I've seen it all, I get thrown for a loop again. If I can get him all fixed up, I doubt I will even offer him for adoption, I think this guy will stay with me for whatever time he has left.