Need help sorting out behaviors/symptoms in disabled bun

Hello all!

I am dealing with my 8 year old NZW who is newly disabled. We have been to a vet regarding her situation several times now, but I am not satisfied with my protocol for her. I am needing help sorting out what is normal for an old bun, and what is not, so I can better describe her behaviors to the vet.(either our current one or a second opinion) She gets so worked up when I take her in that she musters up some energy and is not showing him some of the things I am concerned about.

So the basic run down is that we had a loss of weight, limited mobility, and incontinence when I took her in first for all this. The vet was pretty certain from the physical exam, but I did get an X-ray done to be sure. The diagnoses were: spondylosis of the spine, arthritic knees, and bladder sludge/urine retention.

I do believe these were accurate diagnoses, but am wondering if they might not be the whole story. I also post on a yahoo group for disabled rabbits, and there I got some advice to pursue panacur for potential E Cuniculi, because there seem to be some neurological components to her loss of rear end mobility. I would like to ask some questions about some things I observe and see what others here can weigh in, so I can figure out how to best describe what is going on to the vets.

Initially, her symptoms were very minor, and I didn't even know that this might be abnormal. For the past couple years, even though she was active and could still binkie, she often lay out to one side. Her front end would be midline, but her rear end would be off to one side. Is this a normal way for relaxed buns to lay out? In addition to laying with the front midline and the back to the side, sometimes she would sleep with her whole body on the side. I remember more than one time thinking she had died when coming home and she was sleeping like this. Laying her head down sideways on the ground. She does not appear to have a head tilt otherwise, but I'd like to know if perhaps this is a partial tilt? What are normal and abnormal postures for buns when relaxing? Looking through old photos of her as a younger bun, I did not see these positions. They showed up within the last three years. I'm trying to figure out if this is common to all buns, buns with spinal problems, or potentially a sign of ECuniculi.

Right now she is only on pain meds: 0.3ml Metacam twice daily (1.5mg/ml) and 5-10mg tramadol, also twice daily, though I could give it to her up to every six hours. She is 3.78kg at her last appointment. I do feel she is perhaps under dosed with the Metacam, but the vet is very set on staying at this dose. Until I get the second opinion, I will mostly follow this dosage. (Sometimes I give her 0.4ml since that is really closer to the low end of her dose per my formulary.)

Thank you for any input or experiences you might share with me! I am trying to make the best decisions for my girl, since the pain meds don't seem to help with her mobility as much as they do with her comfort and appetite.

To me it sounds as though your Vet is spot on. The postures you describe are normal, the lying flat out is often referred to as 'the dead Bunny flop' and is a sign of a very relaxed Rabbit. The more askew posture is also one often seen in relaxed Rabbits. None of what you have described sounds to be EC related to me, far more likely is a degenerative arthritic condition- ie the spondylosis as seen on Xray

The bladder sludge is probably a secondary issue relating to her reduced mobility. In some advanced cases of spondylosis the Rabbit may need daily manual expression of the bladder to try to minimise the build up of calcium deposits (sludge)

Thank you so much for your reply! I had never heard the term "dead bunny flop" before. I looked it up, and that is exactly what she does! I am relieved. My intuition has been that the diagnoses have been correct, but it is an uncertain place when her mobility continues to get worse. There are days that she can't get up on her rear feet at all, despite all the pain management she has. I just love her so dearly, and want to make sure I am giving her the very best care she can possibly get.

And yes, I do express her bladder daily.

hot knox buns said:

Thank you so much for your reply! I had never heard the term "dead bunny flop" before. I looked it up, and that is exactly what she does! I am relieved. My intuition has been that the diagnoses have been correct, but it is an uncertain place when her mobility continues to get worse. There are days that she can't get up on her rear feet at all, despite all the pain management she has. I just love her so dearly, and want to make sure I am giving her the very best care she can possibly get.

And yes, I do express her bladder daily.

Click to expand...

Acupuncture may help with pain management.

Any arthritic condition can fluctuate in how badly it effects the sufferer. I know that myself as I have arthritis and some days are much worse than others. If her mobility issues were EC related you would be very unlikely to see her symptoms seem a bit better occasionally. It really does sound to be all due to her spondylosis/ arthritis.

A higher dose of Metacam may afford her better anti-inflammatory cover. The dose she is on at the moment is tiny. Whilst I understand a Vet's concerns re higher doses, in chronic degenerative conditions the benefits of better pain control far out-weigh the risks of adverse side effects. I would rather the Rabbit had 6 more months of good quality comfortable life than a year of discomfort. I have several very elderly (10+ years) Rabbits on daily Metacam at a much higher dose. Some have been on it for almost a year and not one has had any adverse side effects.

Yes, this is why I am considering a second opinion. I live near Dr Carolynn Harvey, which I just found out, so I will be seeking a second opinion with her. When I bumped the Metacam up to 0.4ml twice daily, my vet sort of scolded me. Not rudely, but he was firm that he did not want to exceed 0.3ml twice daily. And like you said, I'd rather her have comfort over (uncomfortable) longevity. I have been reading all over that progressive vets are using higher doses of Metacam in cases like this. Plus, my friends who work in exotics are saying to go as high as 0.3mg/kg during an episode if she needs it. So we will see what more we can do.

And that is interesting to know about EC versus arthritic conditions, and the progression of symptoms. We do have good days. Not perfect, normal, binkie days, but days when she can get around on her own better. And interestingly enough, sometimes her bad days coincide with my bad hip days. Usually when we have cold weather coming in.

My EC recovered bun cannot flop out, or doesn't due to retained instability caused by nerve/brain damage. ?
As for acupuncture I reccomend it as helped my bun regain a fair bit of stability, enough to run, jump and binky again. No idea what it does or howvit works but certainly worth trying I should think.

We have an appointment on Wednesday for our second opinion and will know more then. Right now she is on day five of not being able to get up at all. My poor bun. Hopefully we can find ways to get her moving, or help her adjust happily.