Sick Bunny-Our Vet Stumped

Question
QUESTION: Our bunny started out with what I thought was statis 6 weeks ago.  We've had her 3 years, she was a rescue, so have no clue on her age, but definitely a mature adult.  She was a little wobbly, and our other rabbit had done well on Panacur, so we started her on .8 Panacur, .3 pencillin, .2 Metacam, simethicone and fluids as needed.  We thought maybe she had an ear infection.  By the next week, she was eating greens pretty well.  I was also syringe feeding her Critical Care to help her out.  By week 3, she started getting runny poop and was back to not eating.  She's always had a very sensitive digestive track, if she gets anything rich like a piece of carrot, she gets runny poop.  About Week 4 she went back in the to see our vet and he ended up doing a dental exam, found molar spurs.  They said they've never had a bunny who started eating so quickly coming out of anesthesia!  She ate that night and the next morning, and by the next evening, she was back to not eating.  I would think she had additional dental issues, but sometimes she does eat quite heartily, sometimes she eats more slowly.  

On November 30th, I had blood and fecal testing, and an xray of her body.  Fecal test negative, kidney function good, protein low, albumin and globulin low, glucose was 175.  WBC was 3.7, RBC was 3.4, HGB 7.8 and HCT was 23.  Platelets high 1182.  So many numbers.  

She took the Panacur for 28 days, it didn't seem to work, so we stopped that.  After blood work, we took her off the penicillin, and the Metacam.  She doesn't seem to have much pain and the runny poop was quite stinky.  That has cleared up.  After some thought and reading online, including some of your posts, I thought she might have an ulcer.  At my vet's suggestion, started her on 1/8 of a Pepcid AC tablet once a day.  She's had 4 doses of that, and I think she's better, eating a little more on her own.  Through all this though, she has lost a good amount of weight, at least a pound and a half.  She's under 5 pounds now, when she was at one point a little overweight.  She started looking like she was peeing the other day, when I noticed that sometimes nothing comes out.  I'm really at a loss as to what to do next, or how to help her.  She is still active, plays with me, and is trying so hard.  

Thank you.

ANSWER: Dear Tracy,

These cases are awful, not knowing what's going on.  

The hiking up to pee with no success could be a clue.  Sludge or stones will usually show up on a radiograph, but not always.  I wonder whether she might have an anaerobe infection in her bladder.  These bugs are very difficult to culture, as most die on contact with air.  But there are ways to collect pee anaerobically (carefuly cystocentesis) that might help.  OR your vet could try treating for such an infection without confirming it, just to see if it helps.

If you suspect an ulcer, then sucralfate might help with healing.

And it wouldn't hurt to ask if maybe there was a molar spur waaaaaaay back that perhaps got missed?  Some bunnies are extremely sensitive to even the tiniest point.

As long as she's active, eating well and happy, things are not dire.  But yes, it would be good to  know what the heck is going on.  I hope this gives you some ideas.


Dana

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response.  
Our bunny is slowly improving.  She still seems to squat sometimes to pee with nothing coming out, and other times is normal.  She started eating greens and shredded carrots on her own about two weeks ago.  I know carrots aren't the best thing for rabbits, but in response to her eating nothing, eating some shredded carrots was a good start.  It seemed to jump start her.  She will also eat greens like dill, cilantro, parsley, but usually leaves the stems.  She doesn't really seem interested in hay or hasn't touched a pellet.  I don't see her drinking any water, but I never did before she got sick either.  

Whereas before I could sometimes hear her gut sounds or gas, or whatever from across the room, her sounds have quite diminished.  I took her back to the vet this past week, and in the 10 days since our last visit she had gained 3 ounces!  This was quite a success, since she had been steadily losing weight since the end of October.  

I continue syringe feeding her a mixture of Critical Care and Critter Be Better (by American Pet Diner which seems less rich but is hard to get through a syringe) 2 to 3 times a day so that she gets extra calories and fiber.  I am still giving her the Pepcid AC that we started her on about 3 weeks ago.  

I'm not sure what caused it, or what really has brought her back.  I did take her to a second vet who did get a good set of dental x-rays.  They only looked at them quickly and wanted us to come back.  I took the x-rays to our regular vet who took the time to review them with me and explained what they showed and why he didn't think it was dental.  I can say, I agreed with him.  

I'm heartened that she's improved, but worried that she will never fully recover from this ordeal.  Any other thoughts greatly appreciated!  Thank you!

Answer
Dear Tracy,

Just a thought:  Ask the vet about trying Banamine for a day or three.  This is a *powerful* analgesic that many vets won't use because it causes ulcers in dogs and cats and other carnivores.  But it is approved for horses, and appears to work safely in rabbits.  NOTHING stops pain like Banamine.

If you can stop the inflammation/pain cycle with a shot of Banamine, then this will at least tell you that pain is contributing to this problem, and act accordingly.  If the Banamine doesn't help, then something else weird is going on.

Dana