(RIP) Kate isn't thriving

[CKGS]

I am not mad at you April. I understand the sentiment and am waging wars within myself about not wanting to be selfish and keep her around if she needs to go. I am going to give it some time and see how Kate responds to her pain meds. If she doesn't respond well then I will cross that bridge and I really don't want to have to.

I am hoping and praying that if the time comes Kate can somehow tell me or show me that she is ready to go. This is how I approached the situation with my GSD. I wanted her to go while she still had some good days and not in pain everyday. She let me know.
I pray I am doing the right thing and think I am at this moment. If I don't give her this chance I will always wonder.... What if I had let her live? That is something I definetly cannot live with.

But no, I am not mad at all..

 

[pumpkinandwhiskersmom]

Janet, you have had more to deal with than any 10 people should have to handle in a year! Kate looks so sweet in her pic! Thanks for sharing it with us. I'll be praying that she can be without pain, but I know that you've already let her know what it is to be loved and cared for. You're doing a great job! Take care, and know that my PM box is always open.:hug2:to you, and lots of noserubs to Kate!

 

[CKGS]

Well as my mom always says- When it rains it pours. But she also always says 'This too shall pass'.

I think we have to live through the rain so that we can enjoy the rainbows when they come our way. Thank god for those!

 

[tonyshuman]

Oh, hun, I'm so so sorry. That pic of Kate made me tear up. She's such a sweet girl and it's terrible when such a painful thing happens to a sweet bunny and a great parent. I don't cry often on the forum--but now I am.

Autumn posted some links that I'll try to translate and pick out the important things from.

First, Dana Krempels: http://www.bio.miami.edu/hare/paresis.html

Spondylosis is a degenerative process, meaning that it may progress and get worse over time. A good treatment will be NSAIDs (metacam/meloxicam). Glucosamine supplements have been reported to help in some cases like Kate's.

Personal opinion: Randy says it's not good to be on NSAIDs for more than 4 days in a row due to stomach upset and kidney damage that can come from Metacam. I think a more appropriate drug might be a narcotic like Tramadol for long term pain. However, Metacam is anti-inflammatory, and spondylosis is not only painful but is also an inflammation, so the anti-inflammatory effects of metacam may outweigh any potential kidney damage. Definitely mention NSAIDs, long-term use of them and how that may affect her kidneys, and glucosamine supplements to the vet.

2. Mary Edwardson's article http://www.mybunny.org/info/paralyzed.htm

I planned first on quoting from this article, but instead I think you should read it. It's very very helpful on how to set up a living space for a disabled bunny, along with recommendations on bedding, how to bathe, and keeping the rabbit interested in life.

3. http://www.rabbitsonline.net/view_topic.php?id=11074&forum_id=16&highlight=paralysis

Links to sites that make dog carts and tips from Pam on how to train a rabbit to use a wheelchair. I think TreasuredFriend can help you find a good dog wheelchair if you're interested.

4. Buffy: http://www.rabbitsonline.net/view_topic.php?id=43522&forum_id=16&highlight=paralysis http://www.rabbitsonline.net/view_topic.php?id=46649&forum_id=16&highlight=paralysis

This little guy had a fall at a young age that led to paresis in the back legs. There are some good comments on it about how to make him comfortable. Also, TreasuredFriend mentions Adequan, which can be used in arthritic bunnies. Now, this spondylosis condition seems to be related to spinal arthritis from what I've read, so it may be useful to mention Adequan to your vet as well.

5. Smitten: http://www.rabbitsonline.net/view_topic.php?id=35839&forum_id=16&highlight=paralysis

A long thread and very emotional. Here's what I gleaned from it that may help: fleece from a fabric store can be used as bedding to wick away urine. Angieluv (who's on hiatus now) had a bunny with spinal arthritis named Babette. When she gets back, she would be a great resource.
http://pets.groups.yahoo.com/group/disabledrabbits/

 

[tonyshuman]

6. A concern: clots in a disabled rabbit's legs http://www.rabbitsonline.net/view_topic.php?id=45624&forum_id=16&highlight=paralysis

Because the paralyzed legs don't move, the blood doesn't circulate as well, and can clot more easily. Blood clots can be fatal. It will be important to try to do some physical therapy with Kate to keep the blood flow going.

7. Susan Brown article: http://www.veterinarypartner.com/Content.plx?P=A&A=490&S=1&SourceID=43

More of the same info, plus a recommendation of massage (not on the spine itself). Also recommends checking the ears for wax buildup. Mentions the use of steroids.

Here's my thoughts on steroids. They are given in arthritis to suppress the immune system, because arthritis is a disease where the immune system attacks the joints. It therefore makes sense to suppress the immune system. However, it's dangerous to suppress the immune system, as you might guess, because it protects you from getting sick. For rabbits in particular, I worry about this because they are so sensitive. Stress can cause them to get sick, and they already carry infections like pasturella that are present but not overwhelming the system at all times. That's called "sub-clinical carrier" of disease x, meaning that the bacteria is living there but isn't causing problems or symptoms of the disease. That's why I worry about using steroids in rabbits. It's something you'd have to consider and talk to your vet about as well. I know Randy doesn't like people to use them in rabbits much at all.

Thanks autumn for the links.

 

[JimD]

I'm just catching this now.

I'm so sorry you and Kate are going through this.

I got my MooShu 2/28/2004. She was about12 weeks old.

Shortly after getting Moosh, we noticed that she was having a hard time getting around and spent most of her time laying in her litter pan.
We took her to the vet and she advised us that Moosh's legs were quite "knock-kneed" (opposite of splayed), and that it was likely a birth defect. She also suspected that Moosh was sight and hearing impaired as well.
She showed no signs of being in pain, so the vet suggested we see how she did for a while before making any other decisions.

Moosh did well.

The first couple of years she lived in a large wire-bottomed cage.
She had a large high-backed litter pan. She chewed the front of it off so she could get in and out easier. She did this to two pans before I figured out what she was doing.***such a smart bunnie***
I use wood pellet litter. I swear by it. I changed hers every day.
She also had cotton baby blankets to lay on....that I had to change out several times a day.
She also got a lot of exercise time. She had a second level cage and I would put a carpeted ramp down to the floor. I had to guide her up and down the ramp at first, but she soon got pretty good atgetting up and down it by herself.

Fortunately, Moosh rarely had a problem with a messy tush. I'm thinking it may have had a lot to do with her initial cage setup.
She wasn't having to sit in her pee/poop because it mostly went through the wire bottom, or was soaked up in a blankie, or was soaked up in her litter.

Moosh has a much larger setup now...a NIC pen with a plastic bottom.
She still pees & poops"where ever"...usually in designated spots... and she avoids sitting in it.
She uses her litter pan when she's up to it.
I go thougha bunchof paper towels cleaning up after her.
She still has a really hard time getting around, but manages to keep herself clean and groomed to the most part.
She's a happy and healthy bun, and I'm glad I never gave up on her.

Hopefully Kate will grow and adapt to her conditions without being in pain.

We'll be keeping you both in our thoughts and prayers.

ray:

 

[CKGS]

Thank all of you so very much. This forum has become home for me and I truly care for and love each and everyone of you on this forum. You guys are awesome!

Claire, I can't thank you enough for posting all of that. I know it took time and some effort for you to post it all and I am so thankful.

 

[naturestee]

Sorry, just joining now! I haven't had time to read the whole thread.

Definitely join the Disabled Rabbits group. You are not alone, and there are many others who can give you good advice on caring for Kate.
http://pets.groups.yahoo.com/group/disabledrabbits/

I've pm'd Treasured Friend. Hopefully she'll have time to comment soon. She has two rabbits that are disabled. They require a lot of work but I've met them both several times and they are very happy little bunners.

If Kate spends much time in the litter box, you could put a grate in on top of the litter, then hay on top of the grate to make it comfy. That would keep the urine away from her body while still having a comfy hang-out in the litter box. Elsewhere in the cage/pen, try using polar fleece (from a fabric store) over absorbent stuff like puppy pads or litter. Synthetic sheepskin, Vet Bed, and similar products are also good choices for the top layer.

ray:

Edit: Also, depending on how much better Kate seems with the Metacam, don't be afraid to ask for stronger pain meds. They can also be used in combination- for example Metacam with Tramadol. Some vets aren't familiar with using anything other than Metacam for rabbits but if you bring them info and other vets they can call and ask about it, they'll probably be willing to give Kate stronger meds. You might need to experiment with them a little, especially if this does end up being degenerative. I know Treasured Friend has used a number of different pain meds to keep her bun Karla pain-free, she might have some good suggestions.

 

[JimD]

CKGS wrote:

This forum has become home for me and I truly care for and love each and everyone of you on this forum. You guys are awesome!

You're part of the herd.... and we look out for each other.

 

[CKGS]

Awww (((Jim))) Thank you again so very much. You always have a way of making one feel included, no matter what.

 

[ra7751]

Wow...what a thread. I was asked to take a look at this one. Things happen for a reason and this might be one of those times. It takes a very special person to undertake something like this. And what a beautiful rabbit. I have the feeling she came to you for a reason....and you are responding to it. While I don't like seeing this rabbit sick....your willingness to help her is really inspiring.

I would really like to take a look at those rads. If they are digital, do you think you could ask the vet to e-mail them to me? I can also send them to my volunteer vets (all experienced exotics specialists) for them to take a look. I have treated this condition in a rabbit a couple of years ago. Some of you may remember "Miracle". She suffered a horrible fate as she was not only severely injured in an auto accident....none of her human family survived. She suffered a traumatic spinal injury....a condition that sounds much like this little rabbit is suffering from. While all of these cases are individual, Miracle recovered to the point to live several years...and was very happy and comfortable...and could run and binky.

This might be a case of treating based on the "lesser of the evils". I am always concerned about using NSAIDs long term....but this might be a case in which they are indicated long term. If your vet goes this route, I would suggest a blood panel now and then at regular intervals to monitor the liver and kidney functions as this class of drug can have a negative effect on those organs. Hydration is paramount if using NSAIDs long term....if you don't know how to do sub-q fluids...learn. NSAIDs provide some degree of pain control but are excellent at inflammation....and that is where the pain is coming from. In this case, I would suggest initially combining the NSAID with a narcotic aspect...at least for a while until things are under better control. Buprenex would be my drug of choice in this instance. As things improve, swith to Tramadol. Tramadol is not a controlled drug so it carries a little less baggage as far as convincing a vet to provide a supply. And it's not very expensive....but it does have to be compounded into a suspension. This is also one of those rare situations that I would at least consider using a steroid....most likely Prednisone. Using steroids in any species is very controversial in the medical community. A steroid works by suppressing immune response to basically prevent the body from attacking itself. But, a rabbit has a very delicate and weak immune system, and by using steroids...it could lead to some undesired infections. And any vet knows this, but NSAIDs and steroids should not be used at the same time.

Husbandry is huge with cases like this. I would closely examine your diet protocols. I might would bump up the quality of the food. While I am not huge on feeding pellets, this is one of those rare cases in which the body will most likely need the supplements and additives found in the upper lever "premium" type foods....especially those supplemented with VitaminsB and D along with the appropriate amount of selenium. A deficiency in selenium can cause some neurological issues. But with like almost everything else, there can be too much of a good thing so a high end properly supplemented diet is essential. And as always, you can never feed enough hay. I have also used Glucosamine. Did it do any good? Don't know....but it didn't hurt either.

Then the next question is quality of life. It seems you have a very close bond with this rabbit. She will let you know when and ifit's time. I have had some of the worst of disabled rabbits here. They feed off your attention. As long as they are responsive to you and eating well....I let them make the call. They have always "told" me when I needed to let them go....and I always honor their wish. The main thing I see here is pain management, which should not be an immediate concern as long as you have a sympathetic vet....and keeping her rear end clean.

I will be checking back as often as possible.....I will be glad to offer advice to you or your vet (especially with the pain meds) if needed. I have had....and still have....rabbits with similar conditions. And like you....I have to give them every chance at a happy life....they deserve it.

Randy

 

[TinysMom]

THANK YOU Randy for coming on here to check this out...

 

[CKGS]

Thank you so very much Randy! The info is wonderful. I will be talking to my vet about the rads. I also will have to look into other feed for her. Mine are currently just on MannaPro and Timothy Hay mostly. They have their leafy greens too but not on a regular basis.
Now I just need to know what qualifies as a premium feed.

 

[JadeIcing]

Pipp wrote:

SweetSassy wrote:

Janet, please do not be mad at me....... If your doctor correctly diagnosised her. do you really want her to live with pain all her life?

I ask cause everything that has been said is negative. It doesn't sound like she's gonna get better.

A lot of ailments from Arthritis to Diabetes don't get 'better', but they can be managed. Some people can deal with them well, other not so well, it's the same with rabbits. It really will be up to Kate.


sas ray:

Could not have said it better.

 

[SweetSassy]

JadeIcing wrote:

Pipp wrote:

SweetSassy wrote:

Janet, please do not be mad at me....... If your doctor correctly diagnosised her. do you really want her to live with pain all her life?

I ask cause everything that has been said is negative. It doesn't sound like she's gonna get better.

A lot of ailments from Arthritis to Diabetes don't get 'better', but they can be managed. Some people can deal with them well, other not so well, it's the same with rabbits. It really will be up to Kate.


sas ray:

Could not have said it better.

I was just worried about Kate, being a Baby Bun and being in pain and being on pain meds the rest of her life. That is all my comment was about. I was just worried about her suffering. With everyone posting, it just didn't sound good. I wasn't being mean or nasty by what I was saying(posting) Janet is a friend and I only want the best for her, her family and her bunnies.

Thanks, April

 

[bobismyturtle]

I am kinda new here, but I followed what you went through with Abby, and now this little sweetie. I can see how you would fall in love with her so quickly. She deserves the long happy life you want to give her, and I hope she gets it. She is special, and lucky to have found someone who loves her very much. :hug:

 

[NorthernAutumn]

I hear ya April, and I totally see where you're coming from. It is a legitimate question, and one that everyone has to ask themselves.
It was right of you to pose that thought... it is a part of Kate's new reality, for sure.

Hugs to you :hug:.. you were being a good friend.

 

[TreasuredFriend]

I don't know what to think about Kate choosing to sit in her urine??? That is perplexing.

You're on top of keeping her clean & dry and that will reduce urine scalding. I can list some of the things we do for our 2 disabled girls and perhaps the feedback will assist Kate. She is adorable.

Karla is on an ordinary super soft bath rug. This works better than fleece or palacepet bedding (because her un-ingested cecotropes would get mooshed in the material). This is not to say that palacepet and other fleece material isn't beneficial for a disabled rabbit. This is what works in our house.

Laura Ashley (bath) rugs, found at Kohl's Dept. Stores, in the sale racks, have worked really well for Karla. Cannon bath rugs from KMart has a low weave, unabrasive surface. Are you able to keep Kate in an area with a soft, plush bath rug underneath?

I express Karla and Tamm's bladders several times a day. That's different than Kate sitting in her pee puddles. When Karla or Tamm get wet, I rinse off with warm water and lightly towel dry their fur. Keep them out of drafts.

Did the vet pinch Kate's toes to check her nerve response? Does Kate pull back?

SSD (silver sulfadiazine cream) gets smoothed onto Karla's reddened, hairless, sensitive skin areas on her hind limbs.

My two cents is don't give up until you are certain... And I see no monumental misery to even suggest giving up right now. You sound devoted to giving her care and being a great disabled bunny mom!!!
... they let you know, as JimD and Randy and other members have mentioned.
The three A's. Appetite, attitude, and affection.

I was just reading something on another forum that mentioned most vets give low dosing of metacam for precautionary factors. The documentation is based on dogs and cats on metacam, and rabbits purportedly do better with slightly higher doses. I'm no vet, so just shrug off that advice. OTOH, by physical observation, Karla always does better on a slightly higher dose.

Quality of life over quantity of life has been mentioned on another forum.

Join the disabledrabbits forum if you have time.

Tramadol can create stomach bleeding so be aware of that in little Kate'ster. See what your vet suggests?

Due to Kate's young age, I am reluctant to mention some of the other pain allevement meds Karla has taken. Kate and Karla are several years apart in age.
Adequan and Buprenex are two injectibles which have improved Karla's hind limb handicap.

Did your vet suggest physical therapy movements you can do with your hands, on Kate's back legs? I have to reread the postings to see what your vet said about the xrays or fragments? that showed up?

How's that sparkle in her eyes?

She'll pick up on your vibes.

 

[maherwoman]

I know you're taking in all the advice from those that know...and I'm so happy to see so many giving their wonderful advice here.

I just wanted to say that I think you're incredibly brave, loving, caring, and have such a beautiful heart for deciding to keep and take care of little baby Kate. I know I would do the same thing. You just keep your chin up, keep Kate's up, and keep on pushin' through.

I can understand it being said that it would be noble if you decided you couldn't do this...and she's right...either way, we would back you up 100%. You are a strong woman, and I know you'll give her all you've got, either way.

I'm proud you're part of this forum...and this herd. I'm here if you need someone to talk to.

 

[Flashy]

Oh what a lot to come back to and read.

I'm so sorry the news is not good but glad you're not giving up on her and also glad you followed your gut and got her to the vets.

I think April's point is valid, however, I too agree that bunnies will illnesses or disabilities can still live happy lives. My best advice on that account is to just take each day as it comes and assess her each day. She will let you know if the time becomes right and, again, it will trigger your gut instinct and you'll also probably know in your heart too. Listen to her and she will tell you.

Not sure what your home set up is but you mentioned about using something that she couldn't get her legs stuck in. Leaf had two very disabled buns (might be worth reading her blog on Holliday and Fiesta) abd I believe she used a paddling pool (like the circular ones with the inflatable sides) which they could get around in with very minimal hazards, she could put appropriate comfy things on the floor of, and also, it was really easy to clean.

I have no knowledge of the condition to offer, just emotional support. Take each moment as a new moment and take each moment as it comes. Don't look too far ahead, take a lot of pictures and enjoy each other.

I'm inclined to agree with Randy that she has come to you for a reason. Maybe she didn't actually come from your parents, maybe Abby sent a needy bunny your way because she knew how loved it would be, or maybe Kate is here to help heal your heart and move forward from all the pain you've been through (disabled and special buns have a great way for doing this).

I do hope you have many happy times together, for however long she is with you.