Why has my rabbit died?

Question
My rabbit died a few months ago, but I am still puzzled by his death.  He was 1 year 6 months old and his name was Blossom, we initially thought it was a girl, hence the name, but then discovered otherwise.  Blossom was an Angora X Lionhead rabbit and very beautiful.  He wasn't the easiest to handle and did used to bite but in the last 6 months of his life, became extremely affectionate.  My partner Julian, went out to feed him in his hutch one day and just noticed he seemed quite lethargic, just sitting there.  When he picked him up, he led like a baby in his arms, and his one ear had flopped to the side.  He kept shaking his head every now and again.  We put him on the carpet and he didn't move.  Not the usual happy hopping bunny.  I immediately took him to the emergency vets.  Wrapped in a blanket on his back in my arms, he was content in just lying like a baby, he would drink a little and also eat small amounts, though it seemed it took him a long time to eat just one rabbit nugget.  The vet initially thought it must be his teeth, though following examination, his teeth were perfectly healthy.  I must admit that I felt the vet did not really take us seriously and as blossom hopped a few steps, he gave him 2 injections, 1 for pain and another to help his gut movements.  He told us to take him home and take him to our normal vets the next day.  I said to Julian, "he'll be dead by then".  Knowing blossom's behaviour, there was something seriously wrong with him.  We took him home and after only being home for half an hour, blossom was trying to eat a little but then started wretching, then he started vomiting.  I immediately called the vet again and they told me to bring him straight back.  My neighbour took me in her car and as we were about half way there, blossom started to jump, I thought this was because he was scared of the car and tried to calm him.  However he kept literally jumping up to my shoulder and then I realised he was in pain.  He jumped up and then immediately died in my arms.  It was very traumatic.  I arrived at the vets and carried in my dead rabbit.  They took him into the back room and then the vet came back out and said "I'm sorry, but he's dead".  I obviously knew that already, but asked him why?  Was it something to do with the injections, were the symptoms typical of something, to which he replied "I don't know but he's dead".  I was so distraught.  I knew that I could have had an autopsy on Blossom but did not want to, I just wanted to take him home and bury him.  Though, it still puzzles me now, whether he had a stroke initially and then maybe a heart attack.  That's what I was hoping you'd be able to help me with, are these signs typical of that?  Should I have stood my ground with the vet initially, please help me bring closure to this.
Thanks, greta  

Answer
Hi Greta,

first, sorry to hear about your little guy.  The whole experience as you describe it is a pet owner's worst fears.  Sorry you all had to go through that.

I am not a vet and I never saw your bunny.  That said, I don't think the vet did enough of an exam to properly determine what Blossom was suffering from.  Lethargy can be a symptom of a gi tract problem, but the ear issue/head shaking may have pointed me somewhere else, perhaps an infection.  Usually here in the USA vets will take an x-ray to confirm a gi tract problem (trapped gas, fluid, or blockage).

A vomiting rabbit almost never happens, as rabbits are physcially designed NOT to vomit - they cannot vomit, but whatever the drugs were doing had such a forceful reaction on him that he actually did.  I don't know if that caused him damage or stressed him out so much, or the gi motility drugs put him in so much pain he died.  I don't honestly know.  The vet may have given him too much, if he was not a good rabbit vet.

I don't want to automatically put it all on the vet, but I would say he/she was not the best or the most thorough at figuring out the problem.  He basically did what most emergency vets would do seeing a bunny in this condition.  Many times that is what they need.  You don't mention any testing the vet did to confirm this was what was going on, and if no xray was done to confirm it, I would say that is what I would have a problem with here.  You don't want to give motility drugs if you don't have to, they can be pretty harsh and have a strong effect on some rabbits.  The pain med was a good thing.  

The fact is without an necropsy there is no way to know what Blossom was suffering from.  He was already weakened physically by illness, infection and/or damage from the illness/infection.  It could have been a small stroke, or a severe infection.  He could have had a gut problem that finally got too big to ignore and he slowed down and reduced or stopped eating, which would account for lethargy (but so would a bad infection).  Often one thing that is wrong causes a second thing to occur: if he had a worsening infection, pain woudl increase and desire to move/eat would decrease, causing gut problems. So it could be more than one thing happening that together really take their toll on an animal (or person, for that matter).

He simply may not have had enough strength left to handle the stress of the medicines.  Especially as they had such a violent effect on him.  Vomiting alone would be extremely stressful since they aren't designed to vomit.  The gut meds may have continued to work even when nothing was left to throw up and that may have been painful.  It sounds like his little heart gave out after being in a lot of pain, as you describe.

Unfortunately you won't (in this life) be able to pin down the initial cause of his problem.  There simply are too many things it could be.  Complicating it is that he is outside, and exposed to different things that can impact his health that he (or you) would have to worry about if he was a house bunny.

But for your own comfort, you guys did the right things.  You took him in quickly and got him care.  You were there with him to the end, he passed away with people who loved him with him.  He didn't die alone.  And, if you're like me you know you will one day see your Blossom again.

Sorry again to hear about your beloved boy.  I hope this can help you to deal with your loss.

Lee