Inflamed paw pads

Hi All,

My 1 year old black rex doe, Inlé, has got sore toes The pad at the root of the claws on her front paws (both) are quite large and 3 or 4 of them are inflamed/abscesses, one particularly large.

She's been to the vet this morn who drained the abscesses and gave a baytrill injection, some further baytrill for her water (or she suggested syringing mixed with ribena to make sure she actually takes the full dose) and cortavance spray.

The vet said this should treat the symptoms but could not find or suggest the cause. She hadn't seen similar before and is going to ask a colleague and call me later.

Has anyone had something similar with their rabbits? I've done a bit of googling and seen reference to abscesses due to sore hocks, especially in rexes, but I think sore hocks are usually on back paws and there's no other sign of problems with her forepaws. Inlé did have quite long claws a while back as she just refused to have them trimmed, but she seems to have got over this and now allows trimming (although it's not required frequently since she has a good sized run and is quite active). She does sometimes scrabble at the wire mesh fence when she wants attention from a human on the outside of her run, so I wonder if this could have done some harm.

Any suggestions?

Sore hocks can occur on the front toe pads as well as the hocks themselves. I fostered a Belgian Hare X who had sore hocks running the length of his foot on all four feet, the toe pads were invovled.

If your vet does not come back to you with any further info then you need to ask to see a referral vet or find yourself a more rabbit-savy vet. This is a common problem with some rabbits, and some breeds - Rex as you say are particularly prone, but there are many other contributing factors.

Treatment if abcessation has occurred requires antibiotics stronger than baytril really, abcesses are notoriously difficult to treat and the bones and tendons of the feet are very much at risk - osteomyeltits (bone infection) if abcessation has occurred is high risk. Depocillin/penicillin or another equally strong injectable antibiotic may be preferrable to just baytril alone which is really only useful to prevent infection in the first place and rarely cures abceses i'm afraid.

The use of a NSAID such as metacam/meloxicam as a course is essential to reduce inflammation and to control pain that can lead to chewing/biting behaviours and ileus/GI stasis.

Changing the environment is key to managing the condition - and I say managing because this is how it is i'm afraid, especially with a breed prone rabbit such as a Rex. There really is no enduring cure - but the condition can be managed and requires a great deal of owner commitment.
Environmental changes needed are a soft pliable surface that bunny's toes can sink into lifting the weight off the hocks - even if the toe pads are involved a pliable surface will take the pressure off these as well.
For indoor buns the tidiest option is veterinary bedding padded underneath with towels for absorbency if necessary, fleece/blanket bedding, old duvets etc and a soft top whatever your bun prefers. For outside buns you may find deep bedded soft hay more appropriate - either is fine for the condition. Avoid sawdust/shavings and any other substrates and remove any wire and harsh floorings. Perhaps if your bun is abrading her toe pads on the wire you could fix some plastic splash backs to the wire using cable ties?
Bedding must be kept scrupulously clean at all times - urine will scald the wounds and you need to keep risk of infection down.

Unless you are prepared to bandage the wounds (esp if they bleed) then I would avoid putting anything cream or lotion wise on the feet - it will only soften and weaken the skin and make it more prone to fracture, as well as squash any remaining protective fur.
Nails must be kept as short as possible to maintain optimum foot angle.

Hope that helps a bit. Good luck x

Many thanks for your comprehensive reply. I will take it all in and consider what to do re vets in the morning, but to fill in some details on her accommodation:

She has a large 2 storey hutch in a 6x4' shed, all lino'd with vet bed and newspaper in her sleeping area. The lino is a rough/grippy type, however. She has daytime access to a 6x10' run/aviary which had no mesh floor so she's on grass most of the day. I am just finishing off a further run ~3x the size of the aviary to which she'll have access when supervised. She has been in the shed for a few months, previously she was semi-indoor living in a conservatory with concrete floor and allowed to run around in the house (on carpet) when supervised.

I'm surprised that the problem has arisen in the new accommodation and not previously when mostly on concrete. It does appear as though the fur has worn off her paw pads, but the paw 'palms' are still well covered in fur and don't appear to have any problems. I'll try to get a photograph tomorrow.

I think it sounds like the surface she is on - I can't add to the excellent advice already given apart from hay hay and more hay on the lino or cover it all in vet bed or a duvet if she isn't a chewer, your aiming to make it soft without friction, you need the foot to sit right. It could be a combination of damaging the paw scratching the mesh too so watch out for that, hang a toilet roll holder stuffed with hay on there to distract or a wooden chew toy. Overgrooming sore hocks doesn't help so lots of things to prevent boredom aswell. Poor baby hope they heal soon, you may need to cage her now and again to restrict the useage to allow them to heal a bit aswell Sending healing vibes.

In my admittedly limited experience - overgrooming sore hocks is often a behavioural symptom associated with the pain they cause.

I personally would not be restricting space - exercise is crucial to maintain good blood flow - to get those healing WBC to the extremities and site of injury, it also prevents bunny sitting around too much on their hocks. However, as there is toe involvement I would suggest padding out the entire hutch area, and watering the grass perhaps overnight to keep it soft by morning - as all this dry weather has certainly turned our lawn to rock! Bun needs to keep her feet dry however so if you can water the grass when she is not using it this should help.

Thanks for the further replies all. I have added vet bed throughout as advised. She is still using the paw but sometimes is obviously keeping weight off it and I've seen her grooming it a few times. Nevertheless she's still happy hopping around and especially pleased with her new run today (wasn't sure whether it was wise to let her out to additional space, but figured she deserves a treat. I did limit her time and the grass is fairly long and so is soft under paw.

Here are the pics as promised:

Right paw:


Left paw (worse):


Another angle of the left paw, showing 2 outer pads have swelled 'sideways':


Also visible from the side, I don't understand how these areas are being irritated:


This one shows where/how the vet drained the outer two, they flammed up again pretty quickly though:


These two are even visible from the top of the paw:


Here's a nicer pic:

Awww they do look a bit sore, tbh that grass she has there is lovely and soft - I would aim to give her access to that as much as possible, there's no chance she has come into contact with any allergens on the lawn or anything? No weed killer or pesticides or anything? I think with the treatment she has now and if she can have access to that grass as much as poss and when contained her area is nice and soft hopefully she might recover, maybe try to put in lots of toys etc aswell, best of luck she is lovely

Thanks for the reply. She has access to the run pictured (~12x6') all day, I'll make sure I get up early and let her out asap and leave her out til nightfall. The new bigger run is now finished and I'll let her out in there as much as poss since that grass is longer, though she needs supervision to be safe in that run. I can't think of anything that has been introduced that could be an allergen. She's not very interested in toys but loves attention so I'll try to spend as much time with her as poss since I'm off work this week. I've got to go out all day tomorrow, but I think I'll plan to take her back to the vet on Thurs if I see no improvement. I'll make sure I book to see their rabbit specialist this time, they ought to be pretty good as they only deal with small animals.

That doesn't look like any sore hocks i've ever seen before, but i've never had a Rex. Hopefully someone like Jane who has Rex bunnies with sore hocks will see this.

To me this looks like something different :? some sort of skin infection or allergic response? The toe pads look swollen as some sort of inflammatory response? :? I think if your vet is still unsure then she should either make an exotic referral or atleast get some exotic advice herself on this - I may be wrong but that doesn't look anything like I was expecting to see.... very odd indeed? :?

Mostly the same today, one of the toes is worse and the abscess looks ready to burst I think I will take her to the vet again in the morning.

I've spotted a couple of earwigs in the shed (not the hutch where I think she spends most of her time in the shed) this evening. I wonder if they could have pinched her?

Hi again.

We've been to the vet again today and saw the rabbit specialist (who has had rabbits herself all her life ) She agreed that baytril was unlikely to sort the problem and so prescribed depocillin by injection every 3 days for a fortnight. She says that this shouldn't be a problem for her gut since it's not being taken orally - you guys agree?

Should I also continue with the baytril in her water and daily cortavance spray?

:wave: Hi, can't comment on the medication as have no experience on it, JacksJane is the best port of call on this one I think.

Those front paws do look like sore hocks but on the front paws to me. My rex has slightly sore hocks but, I am lucky that the fur around them still cushions them and providing he is on grass a lot and the shed is packed with at least an inch of hay on the floor, grass mats, vet bed etc he is managing alright, they seem a bit better since I got him bonded with Ness my doe who was living next door for a while though, not sure why maybe because he is grooming them less? Why don't you try PM'ing Jane to see what her advice is, she is very good with Rex buns and might not see this, copy the link and just say hope you don't mind but, if you can offer any advice on this thread and paste the link at the top to this thread in the message for her.:wave:

jamp said:

Hi again.

We've been to the vet again today and saw the rabbit specialist (who has had rabbits herself all her life ) She agreed that baytril was unlikely to sort the problem and so prescribed depocillin by injection every 3 days for a fortnight. She says that this shouldn't be a problem for her gut since it's not being taken orally - you guys agree?

Should I also continue with the baytril in her water and daily cortavance spray?

Click to expand...

I have heard of Depocillin and baytril is a general cure all med, cortavance spray is a new one on me, it's not steroid based is it? Only on the paws if she can ingest it I would wait for a second opinon, even if only an amateur opinon, sometimes experience does overweigh medical training in terms of medication.:wave:

Goodness poor Bunny, that does look painful
I do hope te Vet has prescribed an anti-inflammatory analgesic such as Metcacam aswell as the Depocillin ?

Depocillin is more likely to get on top of the infection than Baytril. But in my experience it can take consderably longer than just 2 weeks. 2 months is a more likely scenario.

I really would not be happy using Corvatance Spray for this :?

Has the Vet suggested taking Xrays of her feet to see if the infection is actually in her bones now ?

Do you have any other animals that have access to the same terrain as your Rabbit ?

Have you checked her back feet/hocks too ?

Thanks both.

Cortovance is 'cutaneous spray' and is based on hydrocortisone aceponate. Why would you not be happy using it Jane? Should I stop?

The vet did suggest that this was just the first 2 weeks of treatment and she will want to see her again afterwards.

No x-rays or anti-inflammatory suggested by the vet. I will phone them about whether to continue the baytril and especially the cortovance later, so will also put these ideas to them.

No other rabbits or other pets kept with her, she's an only rabbit for the time being and will stay so until this is cleared up. Back paws seem fine.

Many thanks.

Quick update: one of the front paw pads is less swollen, not sure about the others. Unfortunately though we've now found sore hocks on the heels of the back paws, some of the pads at the root of the claws on the back paws also look somewhat inflamed, and there is a noticable lump at the base of each claw although they are all well covered in fur, as is almost all of the paw (except these small sore hocks on the heels).

We have some paving slabs piled up to make a step to make it easier for her to access the cat/rabbit flap in her shed. Obviously these are fairly abrasive but she only hops onto them to get between the shed and run so we didn't think this would be a problem. We'll put a square of turf on the top in case.

Would still appreciate any feedback on whether the Cortavance is acceptable as an anti-inflammatory or whether we should seek something else from the vet.

jamp said:

Quick update: one of the front paw pads is less swollen, not sure about the others. Unfortunately though we've now found sore hocks on the heels of the back paws, some of the pads at the root of the claws on the back paws also look somewhat inflammed, and there is a noticable lump at the base of each claw although they are all well covered in fur, as is almost all of the paw (except these small sore hocks on the heels).

We have some paving slabs piled up to make a step to make it easier for her to access the cat/rabbit flap in her shed. Obviously these are fairly abrassive but she only hops onto them to get between the shed and run so we didn't think this would be a problem. We'll put a square of turf on the top in case.

Would still appreciate any feedback on whether the Cortavance is acceptable as an anti-inflammatory or whether we should seek something else from the vet.

Click to expand...

I think the concern is because it is a corticosteroid, however, IMO being topical and not systemic the side effects will be much reduced. The problem with corticosteroids is that buns are very susceptible to their side-effects, more so than other mammals I believe.
Over use of topical corticosteroids can also thin the skin - for me this would be a concern on an area of a lot of weight bearing pressure and friction and may make the sores more liable to fracture and then risk of infection. Perhaps you could ask your vet to get a 2nd opinion on using topical corticosteroids from an exotic vet?

Personally if the skin is unbroken I would not apply anything to the callouses/sores but I would be requesting a course of NSAID's orally as I said in my first post and as Jane also said. These can be invaluable at reducing the swelling and inflammation and reducing skin thickening that occurs with chronic inflammation. They also help a great deal with the ongoing pain.
For open or bleeding wounds then I understand that colloidal savlon advanced gel or silver along with bandaging the foot can be of benefit but I have no experience of signifcantly open or bleeding hocks.

Hi there,

My rabbit Cloe recently developed what looks to be extremely similar inflammation around her two front paws, she was playing in our backyard exactly one week ago, but aside from that shes just been roaming around inside the house. Have they gone away on your rabbit? Any help would be much appreciated, we went to the vet today but they weren't sure as to what it was. How's your rabbit doing?

thanks,
-ben

I have a miniature white and black pure bred Rex female with this problem. With much care and monitoring, along with some stuff from the vet called vetgold, I have got her back feet better. However her front paws/pads are proving to be a real problem, so much so, I am considering having her put down. It's sad really as she is only one year old. However, the ongoing treatment she is going to need, and the stress it causes her every time I have to treat her, has brought me to this decision. In about 6 weeks, I am treating a 4th abscess on her front paws. Last night I discovered she had another anscess and laid her on her back (this is what stresses her). Aplied a little pressure and out came quite a big blob of thick white stuff (puss). There is another pad that is swollen and red and not ready yet to burst. I treat them myself as I don't think there is much more the vet can do. What I do is bathe her sore foot in fairly warm salty water. Afterwards dry with paper towel and then I apply a very tiny spot of bettadine ointment to the sore pad. After it bursts and is well drained, I clean again with saline and add more betadine to the pin ***** hole where the puss came out. I then hold her for a while so she cannot lick it off. This gets the pad better, but of course she will keep getting them. So the future doesn't look good for her, but for now I am treating and not putting her down. She is bonded with a chocolate Rex boy which saddens me as he will miss her if she is put down. But I am concerned about her suffering all the time and the stress caused by the handling for treatment. I wish I had known about this problem before I bought my rabbits. I really bought them in ignorance without doing my homework (have 6 Rex rabbits - all neutered and spayed and kepts as pets). I wanted to put up a photo of her feet but can't see how to do it on this site :? ... I must just say that I have also used spray plaster on her back feet and this has possibly played a big part in healing them and allowing 'some' hair to regrow. But no good spraying onto an abscess that has not burst yet.

Hi,

So sorry I haven't updated this until now. Unfortunately the issue isn't yet resolved although it is much better. I'm sorry to hear of other buns suffering the same, but at least we can pool experiences and ideas.

Back in August when I started this thread was the worst my rabbit's paws got. The vets sent away a sample of the puss and baytrill was shown to be the best treatment in this case. She had several cycles of injections and slowly improved. Meanwhile she moved back inside to be a house rabbit (as this problem occurred after moving to the shed and run outside, despite the lack of obvious abrasive surfaces). We got to the state where the pads are still larger, pinker and balder than normal, but much better than the previous photos and now not infected, and they seem not to be causing her any problems. They've been more or less the same ever since. I'll try to take a pic tomorrow.

We can't understand how she's what can be causing this now. She gets to roam on carpet 24/7 at the moment but we're not aware of her scrabbling excessively to wear the paw fur.