bunny joint pain--follow up

Question
hi there...another expert was kind enough to answer my below question but is now on vacation and i'm wondering if you could answer some further questions that i have. below is my origional question, her response and my new questions. thanks so much in advance!
dawnie

Question -
hi there, i'm so excited to have found this website, and would like your opinion. i have a 6.5 year old mixed breed 2.6kg domestic rabbit. (he looks like a dalmation). recently he started to non-weightbare on his front left paw. when he did weightbare, he would knuckle. we took him to the vet (not our regular as he was booked solid for days) and she said it was likely nerve damage. she gave him an NSAID injection and wanted to see him the next day. at that time (9 days ago) she took some xrays and determined that he has arthritis in the elbow of the left front leg. (she assured me that there was no indications of any other joint having this problem on the xrays). she splinted the leg and gave us dexamethasone to give him every day. after 8 days now, there is no improvement at all. i've tried to give him some asprin to ease in any pain and it's near impossible to get him to ingest it. we have an appointment for a second opinion for treatment options as this vet pretty much said if the dexamethasone isn't working, amputation is really the only other option...which seems very invasive and drastic to me! is there something i can give him? even injection wise...i'd be comfortable injecting him if need be. please help!
thanks so much!

Answer -
Dear Dawnie,

It sounds as if the vet you saw was more familiar with treating dogs and cats for arthritis than rabbits.  The amputation does sound pretty drastic to me, too.

I hope the vet did not give an NSAID *and* dexamethasone together.  That could really put your bunny at risk of intestinal ulcers!  There are good NSAIDs that could help.  I would ask about Rimadyl and meloxicam.  And I also would find a rabbit-savvy vet for a second opinion:

www.rabbit.org/vets

Some vets have found that a very low dose of torbugesic (an opioid) can really help with arthritis pain.  Amazing results in individuals who are receptive to it!  So I would at least give that a try, too.

I hope this helps.

Dana

follow up questions:
we do have an appointment for him to be seen by our regular vet who is wonderful and experienced with rabbits on monday. this vet did give him an injection of an NSAID on the wednesday and then started him on the dexamethasone on the thursday. i called her yesterday to let her know that the treatment does not seem to be working and we'd be seeing our regular vet from now on, and she asked us to bring him back in again. i hestitated and told her that that would now be 3 exam fees to have her see him for the same problem and that i was a bit disapointed in the options she was providing so she told us to bring him in for an assessment today free of charge. upon arriving, she very forcefully told my fiance that amputation is something they do for arthritis in rabbits "all the time" and that there is really no other 'logical' or 'practical' option. she apparently was very forceful even trying to bargain a price for the amputation. we decided as before that this is NOT an option at this point and will see our regular vet monday. *sorry for the long version above...the short one is that basically we are still in the same boat and unfortunetly have to start from scratch with our regular vet whom we hadn't been able to get in with...i hope that this vet will at least fax over his chart so they might not re-charge us for everything*.

may i ask a few more questions though? if our regular vet does suggest long term medical intervention...is injectable or oral a better option for bunny? he eats the little dexamethasone no problem in a prune or banana chunk, but anything bigger he might not. i'm an RN and don't at all mind injecting him if that's a better option for him. also...how long should be wear the splint? are there long term bad effects from wearing it too long such as overcorrecting with accessory muscles or atropy? and finally...is there anything we can do diet wise to help with this problem? *the vet today had also very curtly told us that the pellets we buy from a local farm supply/pet pharmacy are not good and we should be buying a brand of pellets sold by the vet called "oxbo" ($15.50/5KG bag as opposed to our $12.95 50KG bag...BIG time price difference). is there really any difference? she said we'd see a difference in everything about him especially fur (he's a bit mangy on the rump).
thanks!

Answer
If your vet suggests long term treatment, which I hope will include painkillers, either injectable or oral will work. Most bunnies do better with shots, and as long as you vary the site it shouldn't cause issues.

If the front foot always goes under when he walks, then the splint may have to remain on indefinitely.  Certainly the muscles will start to atrophy, so you can consider doing exercises with him.

If your bunny likes the pellets he is getting, then keep him on those.  He may not like the Oxbow pellets.  There are supplements you can give for arthritis, such as glucosamine.  Many bunnies with arthritis get glucosamine and a painkiller and do fine.

I wouldn't consider an amputation either, not for this condition.  Then if he gets it in another joint, what then?  

You can see about more treatments for arthritis at http://homepage.mac.com/mattocks/morfz/rabrefs.html#arthritis

Kim