Netherland Dwarf Bunny, not eating

Question
QUESTION: I have a 3 year old male Netherland Dwarf. His mate (since birth) died last Saturday. We had been caring for her/treating her along with the vet for an unknown illness until 3 weeks before she died, when we believed she was on the road to recovery.

Since last Saturday we realised that he isn't eating and had him checked at the vet on Thurs/Fri. He's always had teeth problems and 1 back 1 was protruding into his cheek and was cut down. Because he'd not been eating we were told to feed him by syringe & give painkillers for 48 hrs in the hope he'd then start feeding. He's not started and has also stopped drinking. (Which is what happened to our other bunny). Between now and me being able to see the vet on Thurs, is there anything else I can do, other than syringe-feed him & syringe some water, to help get him back on track? (I read somewhere earlier about massaging his tummy?)

Many thanks. (Don't want to lose this bunny too!)

ANSWER: Hi Amanda,

Please accept our condolences on your loss.  It is never easy.

Flat faced rabbits such as Netherland Dwarfs and Holland Lops are quite prone to dental issues.  Molar spurs are quite painful and difficult to deal with as you already know.  They can lead to some very seroious consequences such as mandibular abscesses, intrusions into the "sinus" cavity (rabbits don't technically have a sinus but it's a term we can all understand and relate too) and bacterial infections.  I suspect your rabbit is not only suffering from the dental problems but also the depression of losing his mate.  I will give you a short term approach and then a longer term type protocol.  We have many rabbits in our sanctuary with major dental issues.

The most important thing during as event such as this is to maintain hydration.  There are several methods to do this.  The best way is by sub-q fluids (it's difficult to administer IV infusions in an alert rabbit).  Most people do not have that capability...but for long term, it is something that you should ask your vet to teach you how to do it and when.  Unflavored Pedialyte (same stuff you would give a human baby) is the next best way to hydrate.  It contains electrolytes to replace those lost in events like this.  We have found that when syringe feeding Pedialyte or other food that rabbits prefer it warm...like a human baby.  Normal hydration amount (taking into account all methods) is generally considered to be 3%-5% of body weight per day. If he will eat greens....they are mostly water.  Kale and dandelion greens contain a lot of nutrition.  Don't overdo it if he will eat them...there can be too much of a good thing.  But a couple of large dandelion greens every couple of hours will help.  Romaine lettuce would also be a good choice but it doesn't contain the nutrition the other do.  The best choice for syringe feeding is a product offered by Oxbow Hay and is called Critical Care.  Many exotic clinics have this available.  It is a complete food in a powdered form.  It is made specifically for sick herbivores.  You can check their web site for a clinic locator to see if they have some  www.oxbowhay.com  
If you can't get Critical Care....you can make your own "slurry" at home by crushing pellets with a pill crusher and mixing it with warm water.  You can also offer canned pumpkin.  It can be bought at most supermarkets and is usually found in the pie filling section.  Don't get the pie filling...make sure it says canned pumpkin.  It is all natural, low in sugar and high in fiber and nutrition.  Most rabbits will eat it with gusto.  We have also used baby food....apricots or strawberry/banana seems to be favorites...but the canned pumpkin is best and you can mix the crushed pellets or the Critical Care in with it.  What pain meds is your rabbit on?  Some of them suppress the appetite.  

Longer term....an x-ray or MRI should be done of the skull to see what is going on with the molars.  It could just be a hereditary malocclusion.  Could be impacted roots which have formed an abscess.  Some good rads would most likely tell the tale.  It is possible to extract any offending teeth...but keep in mind that the opposing teeth on the other arcade must be extracted also.  It is a very difficult and painful surgery and not all vets can do this procedure.  It helps to intubate the rabbit due to the length of time the rabbit would be under sedation.  Intubating a rabbit is very difficult and has to be done "blind".

If there is no medical condtion causing the spurs, the most likely cause is lack of hay in the diet.  Hay should be the majority of the diet.  Most people know about the benefits of hay with the digestive tract...but few know that hay is the primary way to keep the teeth, primarily the molars, worn down.  Lots of people think they need hard things to chew on.  None of my 60 something rabbits will chew on anything like that....and if they could, it would not affect the molars.  It is the chewy stuff that makes the differene.  Look at the way a rabbit chews.  It goes basically side to side.  They don't crush the hay, they fold it into something like an accordian.  The molars are curved so that works the tips and prevents spurs.  Offering different types of hay also requires different chewing mechanics for each type of hay which results in the teeth being worked in differing ways.

Tummy massages won't hurt at all.  That is generally when a rabbit has gas due to a GI concern....most of the time it's called GI stasis.  It basically means the rabbit is constipated and can be life threatening.  The signs of stasis are smaller than normal poops...or worse yet, none at all.  That is a very serious condition called ileus.  Usually the rabbit will hunch up in obvious discomfort and it's ears will be cold to the touch.  Dental issue can cause stasis.  Again, hydration is the key to overcoming this issue.  And the one on one TLC by offering tummy massages always help with the desire to fight whatever is going on.

If you could let me know what his diet is and what the pain meds is that he is taking....I might can offer a possible stimulant that might could help him out....but it would have to be administered by a vet clinis....a tech could do it if the vet approves it.  Make sure his bowels and bladder are moving normally....if not, treatment needs to escalate to a more critical type level immediately.  In a stasis/ileus situation, time is everything. I will keep checking often for this info and any other questions you might have.

Randy

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

QUESTION: Thanks so much for your swift response.

Merlin has a choice in his hutch of pellets, grated carrot and complementary food. Since I sent the first question I tried massage and syringing some water. Very quickly he produced poo and in the last hour I heard him drinking for himself. He has also made an ever-so small well in his pellets, so I think he's eaten a little.  We have Recovery Liquid Feed, and enough packets to take me to Thursday.

He's on Metacam painkiller - 1 drop once a day.

As for his teeth, he has always had problems and they're normally filed down on regular vet visits. Unfortunately - and to our shame - after 3 months of trying to heal our other bunny, Merlin's teeth had gone unchecked, so ordinarily they're well-controlled.

Provided he's going to the toilet and I'm getting fluids and food into him, do I have urgent need to worry? He's still looking healthy to the eye, bounding around the living room when I take him out of the hutch, and cleaning himself. (And his scrapping at my tops has reduced considerably in the last two days, as it was out of hand in the last week).

Again, many thanks for your help and advice.

ANSWER: Hi Amanda,

I take it by your terms that you are most likely in the UK...am I close?  I had to do some research on the Recovery Liquid.  It appears to be a probitic which is good.  It's not the bacteria that is going in...it does contain lactobacillus acidophilus...that is not a naturally growing bacteria in a rabbit's gut...but it helps by stabilizing the pH in the gut to allow a more favorable climate for good bacteria to grow.  I would be very cautious about the carrots.  Contrary to popular belief, they are not really healthy for rabbits.  They contain a lot of sugar and since Merlin has a GI problem....sugar is not going to help matters.  At this point, I would let him have free choice pellets....really push the hay...the more grass hay the better and offer him the green leafy veggies in moderation.  And if he feels like running...let him run.  Movement always helps a gut.

I am concerned about the dosing of Metacam.  I am not a huge fan of that drug basically because here in the US it has a reputation of being perfectly safe.  That is not totally true.  I don't think that one drop is going to hurt him...unfortunately, it is not going to help him either.  Do you know what his weight is?  I can calculate the dosing.  I do not use that drug for more than 4 days due to some liver and kidney issues.  If I do go more than that, I support the liver and renal system with supplemental fluids.

But if he is starting to eat and drink on his own....that is a good sign.  Let him have at it and continue watching the movement of his bowels and bladder.

Randy

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

QUESTION: Yes, I'm in the UK.

At last weigh in, he was only 910 grams (having lost just under 100 grams).

He seems to have eaten a little of his pellets overnight, which is encouraging.

Again, many thanks for your help.
Amanda.

Answer
Hi Amanda,

That is tiny.  That is almost the size of a Brittania Petite (known here in the US as a Polish).  I thought of something this morning that a lot of breeders use here in the US to add weight.  They use rolled oats.  They are sometime hard to find and you might have to find somewhere that does birds.  If you use this, do so in moderation and start out with only a few of them...and watch for any GI upset.  Something else we use here sometimes (but you have to be really careful with this stuff) is something called Nutri-Cal.  I don't know if it's available in the UK or if it is, what it would be called.  We find it in the cat section and most vets have it.  We fondly call it "fat in a tube" but it does help add weight.  We usually give about a gram per day but I might would cut that back a little for his size....wouldn't want to overdo it.  I'll do some research in a bit and see if something like this is available in the UK.

A little OT...but I would love to visit the UK.  My wife has a friend that had to move from the US back to the UK (stupid immigration laws here) and lives about an hour from London.  I am also a huge history buff and love to learn and see things from WWII.  Maybe one day I will actually make it there.

Randy