baby bun...sick?

Question
QUESTION: I think so...but the vet gave her a clean bill of health last month.
She was sitting in her box a good part of the time breathing in a manner I would call (being a people nurse!) "dysnneic" A slow ant, if you will. Sometimes it seemed her nose was higher than normal. Remainder of the time was spent hopping around normally, appetite good, ect. This has always been an unusually shy bun, and we have raised she and her littermate since thir unexpected birth  roughly a year ago. (we were told we had 2 bucks!!)
My research led me to heart and/or kidney issues, hence the vet visit.
Since then, she has had one little sneezing fit (10-20 short tiny sneezes accompanied by her whole body twitching)after which there was some clear nasal discharge.
However, today she is markedly worse within the last hour. Of course the vet is now closed, and I am FERVENTLY trying to find another to see her.
She is showing less normal bun behavior, and is exclusively sitting, head higher than usual, panting. 90 resps per minute, nares flare with breaths. Eyes half closed, seems to be focused on just breathing itself. No grinding or posturing. Appetite was normal as of 11pm last night, water intake good. No pellets to any of our buns, just grass hay for bedding, timothy to eat, and greens every other day at a minimum. have 4 other buns  of varying ages who all appear to be fine.Today, also new to te mix, she seems uncoordinated....wobbly...leading me to think she is suffering form a vestib. disturbance and/or vertigo. No tilting of the head at all.
I have been through...and successfully rehabbed...buns with torticollis secondary to severe otitis, stroke, 2 episodes of stasis, mycotoxin poisoning, and physical injury....NONE resembled this.
Today she most resembles one we lost a while ago to chronic snuffles.
As I write, she just tried to climb out of her box and "rolled"
I have video clips of her breathing and posture if it will help.
Thanks

ANSWER: Hi Suzanne,

First, I am impressed.  I an not a vet but do very advanced medical work and research.  I routinely train vet students doing clinicals and I am considered the "go to" person for difficult rabbit issues including those difficult to treat cottontails.  It is always a pleasure to work with someone that "knows the deal" so to speak.

Based on your comments, my first thought is Pulmonary Edema.  I have heard of several rabbits that have been lost recently due to CHF and the rabbit's humans thought it was "snuffles".  One of the first clinical signs I see with this is stretching of the neck and flaring of the nostils in an attempt to open their airway.  Resps will be noticably labored.  There will most likely be a sense of panic in her face as we would expect.

I lost my first encounter with this issue but not the recent ones. I would try to get her in O2 as soon as possible.  I do try to sedate them a bit just to relax them.  If I have to do this at home, I generally use Tramadol since it's not a controlled drug.  If I can get to the vets, either diazapan or ketamine.  I use a diuretic, my vet is partial to Lasix, to try to get some of the fluids out.  The dosing on that is basically a "shotgun" approach.  As you know, any drug therapy carries risks and so does this one.  Not only is the dosing a guess...that drug can rapidly deplete the electrolytes and quickly dehydrates a rabbit and that walks you into another problem.

And if you can't get her in O2 therapy....we have had some success with using cool humidity believe it or not.  We shut them up in the bathroom and turn on the cold shower and let it run.  I have absolutely no idea why this works...but I have used it in desperate times and it's worked.  Steam humidity, as expected, seems to make the condition worse.

This is a case of if you can find a vet....your medical knowledge may have to take over.  As I'm sure you know, most e-vets cringe at the mention of a rabbit.  I have been in this type situation myself...wish I could be of more help to you.  But I think your diagnosis may be correct.  All I can suggest is try to get her O2 level up and body fluids down.  Good luck.

Randy

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

QUESTION: Thanks Randy...funy because I was just telling my Mom on the phone that the way her nores are flaring and the little "puff out" of what I would (very unscientifically) call her lips put the dx of CHF in my head....pobably because of the 3 pt position and pursed lip breating I look for in my humans, I suppose.
Would the wobbling and rolling go along with that? that was my only wildcard symptom. She definitely appears to have some vertigo. Intuition and human nursing exp. would say "yes", possibly secondary to O2 shortage to the brain. I am having no luck with finding an emergency vet, so I will have to try the cold humidity here at home (((SIGH))). And at moment all I have on hand for buns is Buprenex (inj). I'm concerned with giving that o sedate her r/t it's resp. depressive qualities if it IS a resp. issue. What do you think? If you think it would help, are my calculations of 0.02ml accurate? I based it on the 10/50 mg/kg formulary I found, and a 1.5lb bun.
Would Benadryl help w/ fluid? I usually have lasix, but don't at the moment. As far as diuretics go I only have anhydrous caffeine or pamabrom...but I know Benadryl has a slightly diruretic effect in humans.
Now that you mention CHF and/or pulmonary edema, she does appear to have some swelling of the face.
She tries to eat the greens I just offered, but grinds terribly and gives up.
(((SIGH)))
how I hate to see her suffer.
Any idea what causes this in cavies?


ANSWER: Hi Suzanne,

All those symptoms are typical.  Something to remember in  a prey aniaml...even a domestic animal...is that they are naturally conditioned to hide their "weakness" until they absolutely have no will to hide it further.  Many people don't quite understand that and wait until things have progressed beyond the point of no return.

I have never had Buprenex depress the respiratory system and we use that drug a lot due to the conditions I treat.  It does seem to slow the GI transit time but it's generally the lesser of the evils.  And your dosing calculation is exactly what I use.  You can administer Buprenex PO, SQ or IM.  I personally prefer SQ. Seems to work within 15 minutes, I know the correct dosing is administered and it's less painful than IM.  If you do it orally, it is absorbed into the membranes of the mouth.  Oddly, I have heard of a couple of rabbits that would not absorb it orally.  I have used Benedryl some time ago.  Actually used it due to a reaction to some intestinal parasites.  It made this rabbit very hyper.  My concern with using an antihistimine in a rabbit is that a stressed rabbit already has an elevated heart rate and the adrenalin is pumping.  That just adds more stress to the mix.  All of my vets I use now are teaching professors and they generally prefer to stay away from using these drugs.  Might try to offer her some dandelion greens.  Canned pumpkin is also something to offer her...not the pie filling, the canned pumpkin.  Lots of nutrition.

As far as the piggies..they get the same bacterial infections in the respiratory system as rabbits.  They will also get bordetella.  Rabbits carry it subclinically but we have seen cavies with kennel cough.  They are sometimes more difficult to treat than rabbits.  We were transporting one to a rescue in VA.  We didn't know it when we picked him up but he was being eaten alive by mites.  We quickly discovered it when he started passing out from pain and seizures.  We learned quickly how delicate they are too.

But I think at this point, I would do the buprenex since you have it....might not hurt to do a round of metacam if you have it.  I don't use that much with domestics but I use it a lot with wildlife...especially birds.  Have to be careful with it since it is very rough on the liver and kidneys.  And I would give the cool humidity a shot...don't see how it could be harmful at this point.  I would keep trying to find a vet if there is any way possible.  Keep me posted.

Randy

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

QUESTION: just finished a round of cool humidity....assume this is simlar to sool mst for croup, right? Didn't seem to have a huge effect...I thought it helped some but I might be willing it. My Buprenex is from Aug of this year, should be okay, right? Giving the Buprenex now...I'll keep you posted. Thanks so much...

Answer
Croup??  I haven't heard that term in ages.  Do doctors now even know what that is?  We do the cool mist for hours.  We have had a bun in the cool mist for days.  We bought one a Wal Mart that has a hydrometer of it so we can monitor the levels.  We also have to use it for our Short Tailed Opossums.  Let me know how things are going.

Randy