Recent neutered bunny wont eat

Question
I have a white, albino male rabbit.  I have had him for a little over two years now.  I found him (someone had obviously either "let him go" or he escaped) and the vet "guessed" that he was about 10 months at the time which would put him turning 3 in January.  I had him neutered yesterday.  They also had to drimmel his front teeth and a molar on the right side.  He would not eat anything yesterday, not surprisingly, but did drink a little bit of water.  Now he has not eaten anything today.  He did try to eat some parsley but couldn't seem to chew it.  I am not sure if his mouth is sore because of how wide they have to make it to get to his back teeth or if something else is wrong.  I put some of his veggies in a food processor and got them down to a very small size (not watery though) but he just pushes the bowl away.  I am very worried because I know he needs to eat.  Do you have any suggestions?  Other than not eating and being a little stand-off-ish he seems to feel pretty good.  I called the vet office but they don't seem to know exactly what I should do.  They did tell me to call them back in the morning if he still has not eaten but I was hoping you might have an idea that would work.

Answer
Hi Sheila,

I am concerned here.  Did your vet not send home pain meds for this rabbit?  He is probably uncomfortable at both ends.  I have no problem pulling the trigger on pain meds at any sign of pain.  We do not let out rabbits tolerate any amount of pain.  The trimming of the teeth itself isn't painful but a rabbit's mouth is small and must be opened wider than normal to access molars to trim them.  The stretching of the muscles can lead to some discomfort.  And it's possible the dremel nicked some soft tissue in the mouth.  It's a small area in which you must use a sharp tool that is rotating very fast.  If this rabbit had maloccluded teeth....keep a close watch on his teeth as this will most likely be an ongoing issue.

But I am more concerned with pain from the neuter.  I have no patience with vets that don't send home pain meds.  I am not a huge fan of Metacam (it's a NSAID and is in the same class of drugs as out Tylenol) but it's better than nothing.  I prefer narcotics post-op (and more so with spays).  The absolute best drug to deal with moderate to severe pain in a rabbit is Buprenorphine (Buprenex).  It is a synthetic opiate that is very effective.  It can be administered orally or by sug-q or IM injection.  It takes effect in less than 15 minutes and can last up to 12 hours.  It is a scheduled controlled drug and some vets hesitate about sending it home...but you need such a small amount that it can't possibly be abused.  Another acceptable option is Tramadol.  Few vets are aware of the benefits of Tramadol but it is a very effective analgesic for rabbits.  It is normally dosed by mouth twice a day...and if you need pain relief and sedation, it can be given 3 times per day.  The upside of this drug is that it is very effective and very reasonable in cost.  The downside is that it comes only in a 50mg tablet so it does have to be compounded into a suspension.

Your rabbit being "stand offish" is an indication of pain.  They usually hunker down sometimes with their ears back.  If the pain gets severe, he will start grinding his teeth very loudly.  Even the domestics still retain some of their wild traits and one of these it the ability to hide pain until it becomes unbearable.  They don't want to appear weak to a predator....perceived or real.

If he is healthy...don't stress him out by trying to force food on him.  We have had rabbits not eat for a week for various issues.  But do offer him a buffet of his favorite foods....anything rabbit safe.  Dandelion greens are a fav around here post-op.  It might make him feel better with some heat.  If you have a heating pad, place him in a carrier and place it with part of the carrier on the heating pad.  This will allow him to move away if it gets too hot.  Place the heating pad on the lowest setting.  Closely monitor him since even on low, it can become very hot and cause burns.  Keep him as quiet as possible.  Some may suggest aspirin or ibuprofen but I suggest staying away from them.  Aspirin is a blood thinner and is contraindicated post-op....ibuprofen and similar type drugs can cause gastric ulcers.  

I would be on the phone first thing in the morning insisting on pain meds....preferably one of the narcotics.  If they don't know the dosing, they will have access to the VIN and that information is readily available.  If on the outside chance they can't locate the dosing info, if you provide me with their phone number, I will call them personally.

I am more than a little concerned that the vet office didn't know exactly what to do.  Pain in rabbits is not something to take lightly and can cause serious secondary health issues....or worse.  If someone at the front desk or even a tech told you they didn't know what to do....maybe it's time for some training.  It's no good if the doctor can treat the animal but the support staff doesn't know about them.  If the vet himself/herself told you that....I would be looking at other options for my rabbit health care.  This is not intended to "flame" the doctor.  I have the utmost respect for vets and even though I am not a vet, the doctors that assist me with my rescue treat me as an equal.  So I know quite well that most vet schools provide very little, if any, exposure to exotics.  And rabbits are much different medically than dogs or cats....totally different world.

And as a rescue myself, I give you huge props for rescuing this little fellow.  You are a very special person and a responsible "rabbit slave".

Don't hesitate to contact me if you need additional info.