urine scald/ fly strike ?

Question
Dear Dana

I regularly check my daughters two rabbits, and turn them over to check tail ends at least every couple of weeks as they have seem to get very clogged up bottoms. I have taken them off shavings and on to straw as this seems to keep them cleaner. The one in question is slightly over weight.
Today I was horrified to find that one of the rabbits had a dirty wet patch on his rear end, so I went to bath this area as I usually do. Upon putting his rear into the water and running my hands round to find the offending matter, a huge handful of hair came away, leaving what I thought to be a bare patch of approx the size of the small orange.
I immediately took him to the vets, who said something to the effect of the fur had slothed away, and the bald patch was in fact skin that needed stitching together. Was I wrong to bath him the the first place? They are going to operate tomorrow to do this and will place him on antibiotics etc, and she has said the prognosis isnt good and she put one down for the same reason last week. She also asked if it was possible he has urine scald, which I thought just caused bareness and bad skin, not the skin to burst open. They are skipped out daily and completely redone weekly anyhow. We are however in the midst of bad weather and I have found a couple of slugs in his cage recently. Would one of them have latched on to him or anything.
He is safe in the right hands and I hope he will pull through, but any advice you can give me would be great.

Answer
Dear Kathy,

You absolutely did the right thing by bathing him, and it may have saved his life.  But there is no reason to think of euthanasia for this!  We have saved many rabbits with myasis (fly strike).  All it takes is patient supportive care.

For the large area of skin that is raw, we have used a plastic, breathable bandage such as Tegaderm:

http://www.hocks.com/Merchant2/merchant.mvc?

Once all the maggots are removed from the rabbit, supportive care is essential.  We administer subcutaneous Lactated Ringer Solution (LRS) twice a day for at least three days after initial strike.  We also put the rabbit on systemic antibiotics, and have found that injectible Penicillin-G Procaine combined with zeniquin (marbofloxacin) or (Dicural) ofloxacin  is a good combination for preventing further infection.  

Daily debridement and re-dressing of wounds is essential to prevent bacterial buildup, so buy plenty of tegaderm to carry you through.  We use a dilute solution of Betadine (povidone iodine) diluted to the color of weak tea.  Apply with clean gauze or cotton balls, and gently remove as much loose discharge/pus as possible.  White material that does not come off readily is probably granular tissue, a sign of healing.

If the bunny stops eating, treat for ileus:

www.bio.miami.edu/hare/ileus.html

It is vital to keep the body temperature normal, as bunnies with myasis tend to go into shock and hypothermia without help.

Please feel free to share this information with the vet, if you think they are amenable to information from strangers.  If you are not sure the vets taking care of your bunny are very experienced with rabbits, please check the list here:

www.rabbit.org/vets

for a vet who can give a second opinion if the prognosis you get from this vet is very dire.  There is no reason a bunny has to die from this.

I hope your bunny will be fine soon!

Dana