Rabbit with Cancer on Prednisone - need Pain Relief

Question
My vet is closed tomorrow Sunday. Rabbit, 9 or 10 years old, has been on
Prednisone for 1 month+ 2 weeks now (1/4 of a tablet), along with .36
Panacur and a Probiotic.  She has a lymphoma that is in remission with
Prednisone (or so I'm told). She started with a rattle in her chest which since
being on Prednisone, has gone away.  However she has had loose stools and
her health has been declining rapidly. To me it's the Prednisone but it could
be the cancer instead.  Today she is showing signs of pain with some teeth
crunching and is unresponsive to most of her veggies except Dandelions.  I've
also been giving her Critical Care since her cancer diagnosis at advice of dr. to
help keep her weight up.  Not working well.  Until I can locate a vet tomorrow,
can I give her Tramadol for pain?  I've read it is NOT an NSAID, and NSAIDs
cannot be used with Prednisone.  Of course with the cancer she has lost a lot
of weight, and the dr. did not seem alarmed by the loose stools and so
prescribed her a probiotic.  Vet wanted me to do another round of Bayatril (1
week per month), but I feel rabbit is so thin, and with the loose stools, it
would do more harm than good, especially feeling like it would deplete her of
any nutrients in her body.  Are these drugs doing bunny more harm than
good?  What is your advice on this treatment my bunny is on?  Thank you for
your consideration of my questions...
Pam

Answer
Dear Pam,

Our vets commonly prescribe Tramadol (2-6mg/kg) for pain in rabbits.  We suspend it by crushing a tablet with a mortar and pestle (very fine powder) and adding it to a solution of diluted molasses.  A bit of simethicone measured to be part of the molasses carrier can help suspend the tramadol, but isn't absolutely necessary.  And yes, tramadol can be used alongside NSAIDs and corticosteroids.

Prednisone is a nasty drug that can make her feel a LOT better, but it will certainly take a toll.  Most experienced rabbit vets I know will not use corticosteroids on a rabbit, but in a case like this, where the choice is death by cancer or some degree of remission, the choice was probably pretty clear.  At least you have bought her some time.

If you need help with the tramadol dilution and dosing, please write to me again and tell me (1) the size tablets (in mg) of tramadol you have and (2) your bunny's weight. (Please write this privately on AllExperts)   It would be best if you can contact your vet for this, but I can't stand to think that she is in terminal pain without relief just because your vet can't be reached today.  :(

Sending healing thoughts.

Dana