Arthritis- pain management

Question
Hi Dana,

My rabbit (9yo, female, ~3kg) has arthritis in all limbs and splay-leg of the front legs due to muscle wastage over the past year.
She still seems alert and happy to be cuddled and has a good appetite, so apart from lack of mobility (which we address by physiotherapy & massage several times daily) her quality of life is not severely compromised. I have 2 main questions:

1.  I have been prescribed Metacam/Petcam (containing Meloxicam) for her by the vet. We give 0.3ml orally once a day when needed (which is now about 2 times a week)- based on symptoms of discomfort seen that day. We give 0.3ml Zantac along with the Metacam in attempt to prevent gastric ulceration.
I was wondering if Carprofen/ Rimadyl would be a better option for longterm / daily usage in an old rabbit. Does it have any severe side effects and what would you recommend as a suitable dosage?- (online I've found a range of 1.5- 2.2mg/kg twice daily).

2. Also, she has developed sore hocks from her immobility- we keep her on towels now as they are softer and more absorbent. Are there any useful topical analgesics and/or anti-inflammatories I could use directly on her skin? What are your views on effectiveness of spray-on bandages?

Many thanks for your time and help!

Answer
Dear Joanne,

Metacam is considered safer then carprofen for long-term use.  Both are NSAIDs, and both have similar adverse side effects (possible increase of stomach acid leading to ulceration; reduced blood flow to the kidneys, etc.).  But of the two, metacam is beleived to have milder effects.

No one likes to take NSAIDs long term.  But you have to choose between the lesser of two evils, and at this point I would say her comfort takes precedence over the possible-but-not-inevitable side effects.

If the metacam isn't doing the trick alone, ask the vet about adding tramadol. The two drugs work well together, and because Tramadol is a synthetic opioid, it doesn't have the NSAID side effects.

As for splay leg, you might consider trying to brace her legs as described here:

www.bio.miami.edu/hare/splayleg.html

We no longer use the cork in between the legs, and simply pad the wrapped areas, linking them with stretchy VetWrap or other self-adhesive bandage.  But it might help her move more easily and be more comfortable.

I've never tried any spray-on bandages, and would be leery about using them on a bunny.  But instructions for helping sorehocks can be found here:

www.bio.miami.edu/hare/sorehocks.html

I hope this helps.

Dana