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trying to do the right thing

22 9:40:49

Question
Dear Dana,

Last week we took our rabbit to the vet because her anus had swelled up as large as an apricot. I was afraid that it was cancer, because she's 7 and not spayed. I live in Eastern Europe, and when I adopted her, we couldn't find a vet who was confident enough to do a spay, so that's why she isn't spayed. The vet said that it was just an infection. He gave us some betadine and some cream and sent us home. The swelling went down, but she stopped eating. When we took her back in, the vet said that she needed to be hospitalized for dehydration. She stayed in for 4 hours and definitely felt better afterwards but still was not eating as normally.The vet then said that it was her teeth, so he put her under and it seems that there was  the start of molar spurs, so they filed them down. She stayed in the hospital for 10 hours because they wanted to see if she would eat.  When I picked her up they said that she hadn't had anything to eat the whole time and blamed it on her. She had an e collar on, because she was chewing the catheter. They said she needed to keep it on, because they left the catheter in in case she needed to be rehospitalized. When I brought her home, it was clear that the e collar was WHY she hadn't eaten. I checked around online and it seems you shouldn't use them on rabbits. I took it off and tried to get her to eat, but she was so stressed out she only ate a very little.

I took her back 2 days later and saw a different vet. She told me that they shouldn't have sent her home with the e collar and also said they should have made sure she'd had at least some food through a syringe. I insisted on an ultrasound to check for obstructions in the GI tract. When they did the ultra sound she found masses near the urinary bladder and another one near the intestines. She told me that it is very possible that it's malignant and had metastasized
into the intestines and elsewhere, given her age, and so she said it's better not to operate. I agreed. However, she said that we could try to get the GI stasis under control so that she could have a happy life for a little while longer. I brought her in for injections (Baytril, motility, and B12 vitamins) every days for 4 days, and syringe fed her a few times when she wouldn't eat for a few hours or more. She gets very upset when she's held and when she goes to the vet, so every time I did this, it seemed to set her progress way back. Yesterday, I asked the vet if I could do the injections at home. She agreed and made up the syringes for me and had me do them in the office to see if I was doing it correctly. Then she sent me home with 3 more for today.

My bunny seemed to be progressing very well until I took her to the vet yesterday. She had begun to eat more and her energy was good. Since then she hardly eats at all. I syringe fed her once last night and now she's become even less enthusiastic about eating and being around me. Then this morning I gave her one of the injections (Baytril, I think) and right away she started acting strangely like she was hyper and then her backside tensed up. Now her muscles are trembling like she's in pain. What could I have done wrong? I've tried so hard to do the right thing, but it seems like everything I do makes her worse. I'm afraid to give the other injections and I'm afraid to take her back to the vet, especially today becasue it's windy and raining and it's a 7 minute walk away. I really don't know what I should do anymore. Thank you for any advice you can give me.

Answer
Dear Julie,

This is made even more difficult by your location, which probably is not teeming with experienced rabbit vets.  For now, please see:

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

and

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

I cannot diagnose what's wrong without seeing her.  But her tensing her rear ends suggests she is having discomfort.  Whether from the masses or from some other problem (urinary tract infection?  bladder stones or sludge?) is impossible for me to say.

Pain management and GI motility protocols (as outlined in the ileus article above) may be helpful.  I would certainly try to get her some metacam (1mg/kg every 24 hours) and/or tramadol (2-6mg/kg every 8 hours) to keep her comfortable.  Eliminating or reducing pain is the most important first step in getting her on the road to recovery.

I wish you had an experienced rabbit vet who could look at the radiographs and see if the masses in her abdomen are restricted to her uterus; if so, it might be worth spaying her, since she is not that old.  But for now, I hope the above will help.

Dana