Arthritis and kidney failure

Question
Hi dan
I have an 8 year old rbbit who has suffered with dental disease, arthritus and spodolosis of the spine for serveral years. He has now been diagnosed with chrontic kidney failure.  I have a few questions if you can help.
1. he has metacam for his pain but have now stopped this beacuse of his kidneys...would it be safe to give an opiet based pain killer and if so how oten can that be safely given?
2. i am looking into a glucosimine supplement but most are tablets...a liquid would be much easier for us..can you recomend one?  
3. I am struggling to find enough veggies that he likes and that are low in calcium and phosphate...can i give a small amount of carrot or must i cut it out altogether.
4. Do vitamin injections help?
5. are anabolic steroids a good idea?


many thanks for your time
kind regards Lisa


Answer
Dear Lisa,

1. he has metacam for his pain but have now stopped this beacuse of his kidneys...would it be safe to give an opiet based pain killer and if so how oten can that be safely given?

Opiates such as Tramadol might be helpful for him, since NSAIDs would be contraindicated if he is in renal failure.  The vet can prescribe them and tell you the dose and frequency to use in your bunny's particular case.

2. i am looking into a glucosimine supplement but most are tablets...a liquid would be much easier for us..can you recomend one?

I don't use glucosamine supplements.  But I have heard that Cetyl-M is very helpful.  It comes in a sweet, granulated form that bunnies love, especially if you sprinkle it on a banana slice or other treat.

3. I am struggling to find enough veggies that he likes and that are low in calcium and phosphate...can i give a small amount of carrot or must i cut it out altogether.

Carrots are probably fine.  And truly...at this point, diet is not going to make a huge difference, especially in fresh food.  The amount of calcium is going to be diluted by the water in the fresh stuff.  I would avoid alfalfa hays, and perhaps things very high in calcium salts, such as brassicaceous veggies, spinach, and a few others.  But carrots are not going to hurt him.  If he's not eating much, then I'd just give him whatever he *will* eat, since it's important for him to keep his strength up.

4. Do vitamin injections help?

Might help, probably won't hurt.  Ask the vet for his/her opinion on this.  Vitamin B supplements can help stimulate appetite.

5. are anabolic steroids a good idea?

I would not think so.  Inflammation is not his problem, and I'm not sure what good they would do.

I hope you can keep him happy and comfortable as possible for as long as you have time together.

Take care,

Dana