Inadequate pain relief? X-ray photo added

Yesterday, one of my rabbits had surgery for facial abscess. He had long acting pain shot after then I was instructed to resume oral meloxicam the next evening. I gave 2kg dose of 0.5mg/ml strength (cat type) [edited]. That was 6hrs ago. I found him in the litterbox before and his ears felt cold and he's occasionally grinding his teeth. I've warmed him up and am wondering if I can give him more pain relief?? It's 1am here so I cannot verify with vet.

They were supposed to do follow-up call with me today but it didn't happen. I asked about dosage increase when I collected him but a lot was going on at the clinic and the nurse never followed up my query. I figured I'd sort it today on the follow-up call. Kicking myself I didn't call them instead.

I'm reading possible to give 0.7mg/kg 3 times daily. (http://wildpro.twycrosszoo.org/S/00dis/Bacterial/FacialAbscessesRabbits.htm)
I'm not suggesting I take him up to that without checking with vet first. But that info tells me I'm probably giving him minuscule pain relief with the current dose.

Sorry to ramble so long! I guess what I'm asking is- do you think it's okay to give him a conservative dose tonight until I can speak with clinic tomorrow??

ETA: he has eaten a little today and is drinking water. He hasn't been eating hay though.

ETA(2) : Mistakenly wrote 5mg/ml in initial post. Was meant to be 0.5mg/ml

Hi there! I can't give advice I am afraid but someone will hopefully be along shortly. I always get dog Metacam and the normal dose is .o6ml. I hope your bunny recovers well from his abscesses. By the way, I noticed your name - you don't have a Father on the Isle of Wight do you?

Thanks tonibun! It's funny about the metacam because that what vet nurse said too, that it's normally dog one they give. it was something she was going to clear up, but by time we went through and looked at X-rays then she took his temp etc, it got forgotten about. The vet that did the surgery had already gone so she was checking in with another who was with another client.

Re the name Jersey, this was the name I gave my first rabbit due to her colouration. Strangely enough though, apparently my grandfather had relatives in the Jersey isles. I don't know much more then that. I'm Australian, as was he. Sorry if I've misunderstood your question. My sense of geography & history is poor!

jerseygirl said:

Thanks tonibun! It's funny about the metacam because that what vet nurse said too, that it's normally dog one they give. it was something she was going to clear up, but by time we went through and looked at X-rays then she took his temp etc, it got forgotten about. The vet that did the surgery had already gone so she was checking in with another who was with another client.

Re the name Jersey, this was the name I gave my first rabbit due to her colouration. Strangely enough though, apparently my grandfather had relatives in the Jersey isles. I don't know much more then that and he passed away over 20 years ago. We're Australian.

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Yes I'd echo what Tonibun says, usually the dog metacam is used. Well here in the UK anyway!

Cat Metacam is a much weaker concentration (0.5mg/ml) than Dog Metacam (1.5mg/ml) as I'm sure you know!

Your vet should be the person to advise, as he's got all the details of weight etc, and also the range of prescribing he's happy with. There may be a good reason he's keeping the dose low, for example with possible underlying kidney issues.

You could explain your rabbits is still experiencing severe pain and they may consider adding Tramadol to the mix?

Yes, in that link I pasted above, there was mention of using dual analgesics. Thanks MightyMax.

I'm not sure he's aware what strength med I had at home. (Even though he gave it to me at another time.) Plus, he's the one that was telling me how ridiculous the dose on the cat metacam box is for rabbits. Also at a previous visit.
Ideally, I should have seen him when my rabbit was discharged yesterday.

Bit of a communication breakdown yesterday. Just hope my rabbit doesn't pay for it.

jerseygirl said:

Yesterday, one of my rabbits had surgery for facial abscess. He had long acting pain shot after then I was instructed to resume oral meloxicam the next evening. I gave 2kg dose of 5mg/ml strength (cat type). That was 6hrs ago. I found him in the litterbox before and his ears felt cold and he's occasionally grinding his teeth. I've warmed him up and am wondering if I can give him more pain relief?? It's 1am here so I cannot verify with vet.

They were supposed to do follow-up call with me today but it didn't happen. I asked about dosage increase when I collected him but a lot was going on at the clinic and the nurse never followed up my query. I figured I'd sort it today on the follow-up call. Kicking myself I didn't call them instead.

I'm reading possible to give 0.7mg/kg 3 times daily. (http://wildpro.twycrosszoo.org/S/00dis/Bacterial/FacialAbscessesRabbits.htm)
I'm not suggesting I take him up to that without checking with vet first. But that info tells me I'm probably giving him minuscule pain relief with the current dose.

Sorry to ramble so long! I guess what I'm asking is- do you think it's okay to give him a conservative dose tonight until I can speak with clinic tomorrow??

ETA: he has eaten a little today and is drinking water. He hasn't been eating hay though.

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Unfortunately as Meloxicam is a prescription only medication only the Vet can advise you about increasing the dose. I hope you will soon be able to get in touch with him/her to confirm that it is OK to do so. You are right in thinking that the current dose is exceptionally low. In the initial days after surgery it is often necessary for the Vet to prescribe at the higher end of the dose range. This can then gradually be reduced as the surgical wounds heal. If the highest dose of Meloxicam does not provide good constant analgesic cove the Vet may introduce a different type of analgesic aswell such as Tramadol or in more major surgical cases than may apply for your Rabbit a transdermal fentanyl patch may be used.

I expect that your Rabbit is also on antibiotics ?

I hope that he will make a good recovery.

jerseygirl said:

Yes, in that link I pasted above, there was mention of using dual analgesics. Thanks MightyMax.

I'm not sure he's aware what strength med I had at home. (Even though he gave it to me at another time.) Plus, he's the one that was telling me how ridiculous the dose on the cat metacam box is for rabbits. Also at a previous visit.
Ideally, I should have seen him when my rabbit was discharged yesterday.

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Ah you're welcome Jerseygirl

Yeah once you speak to someone knowledgable it should sort itself out.

Despite avoiding the hay, is he eating and drinking OK?

Thanks Jane. Yes, we did daily penicillin shots the week before and then brought in oral baytril. Post surgery; continuing baytril, doing baytril ear drops and wound was packed with sponge soaked in abx also. My invoice tells me he got another penicillin shot yesterday also.

The vet rang after the X-rays yesterday to tell me he thinks it's tumour, not abscess due to damage to bulla of ear. But there obviously was infection as I'm told he had to remove a lot of pus. As far as I understand, pus can do damage also...

@MightyMax, he's not eating as much as I'd like. He's eaten a little pellets and is liking dried willow. I've given pellet mush a few times and he's been eating that more readily. He's been drinking well.

Seems to have perked up a bit in last 15 minutes and is eating some willow now.

jerseygirl said:

Thanks Jane. Yes, we did daily penicillin shots the week before and then brought in oral baytril. Post surgery; continuing baytril, doing baytril ear drops and wound was packed with sponge soaked in abx also. My invoice tells me he got another penicillin shot yesterday also.

The vet rang after the X-rays yesterday to tell me he thinks it's tumour, not abscess due to damage to bulla of ear. But there obviously was infection as I'm told he had to re I've a lot of pus. As far as I understand, pus can do damage also...

@MightyMax, he's not eating as much as I'd like. He's eaten a little pellets and is liking dried willow. I've given pellet mush a few times and he's been eating that more readily. He's been drinking well.

Seems to have perked up a bit in last 15 minutes and is eating some willow now.

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Indeed it can.

jerseygirl said:

Thanks Jane. Yes, we did daily penicillin shots the week before and then brought in oral baytril. Post surgery; continuing baytril, doing baytril ear drops and wound was packed with sponge soaked in abx also. My invoice tells me he got another penicillin shot yesterday also.

The vet rang after the X-rays yesterday to tell me he thinks it's tumour, not abscess due to damage to bulla of ear. But there obviously was infection as I'm told he had to remove a lot of pus. As far as I understand, pus can do damage also...

@MightyMax, he's not eating as much as I'd like. He's eaten a little pellets and is liking dried willow. I've given pellet mush a few times and he's been eating that more readily. He's been drinking well.

Seems to have perked up a bit in last 15 minutes and is eating some willow now.

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Yes, the pus is a symptom of the underlying infection, that will not have gone away.

I should make sure there are enough injectables going in to make a difference, as Baytril probably won't (though it's the only one licensed for use in rabbits as you know). Obviously would only make a difference in the case of an abscess, but with pus, I would suspect that. Just an unqualified opinion ..

Thank you RU-ers for lending an ear. I'm feeling better about how he is now. He put up with me holding him for 2 hrs. He's returned to his room & showing some interest in food. I'm going to try catch some zzz's!
Definitely will be calling the clinic asap in the morning.

MightyMax said:

Yes, the pus is a symptom of the underlying infection, that will not have gone away.

I should make sure there are enough injectables going in to make a difference, as Baytril probably won't (though it's the only one licensed for use in rabbits as you know). Obviously would only make a difference in the case of an abscess, but with pus, I would suspect that. Just an unqualified opinion ..

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I was surprised I wasn't to continue with penicillin. I suspect the oral baytril is what is affecting his appetite, so I do want to go over this with vet also. It'll be case of phone tag tomorrow as I think it's his day off. :/
Thanks again.

jerseygirl said:

I was surprised I wasn't to continue with penicillin. I suspect the oral baytril is what is affecting his appetite, so I do want to go over this with vet also. It'll be case of phone tag tomorrow as I think it's his day off. :/
Thanks again.

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I hope you get hold of the vet and make a plan together.

Injectables (eg penicillin, etc) don't usually upset the digestive system as much as baytril, I find.

Hey Jerz, I'm so sorry I am only seeing this now. Thanks to how I just don't pop into BB as often, I have missed what's going on.
I wish I had been on earlier but I would've suggested a snugglesafe for him as well, if he would want to feel heat (not sure how hot it is down there) because I know that is good for bunnies who are feeling pain. The dog metacam would've been preferable of course but I can relate to how crazy things get after an involved surgery and sometimes both owner and vet/assistants can forget to ask about or relate the more delicate details. I really hope that things are going better for you and bunny now and that you've managed to get some rest.
Thinking of you and sending healing and peace of mind vibes your way! xxxxxxxxx

No change in dose. No added in analgesics/anti inflammatories.
Been told "really can't increase the dose of loxicom in rabbits".
Just to clarify again; they did not send loxicom home with me on the day. I already had some they'd given me at another time. They'd checked what I had. I also specified again today that it was cat loxicom.

They apparently rang vet I'd seen (his day off) & he's said the same. I have my doubts.
So basically he's getting 0.1mg per 24hrs if my calculation is right.

Idk.. I'm feeling like they're not as up to date on pain management for rabbits as I previously had thought.

I'm also stressing and overthinking things!

Happy to report bun is more himself today. I'm yet to give the oral baytril though which might be upsetting him. Time will tell..

@Mimz, thank you for your support, always. I had to go to work after I collected him Monday. Another reason why things got hectic at that time. I ended up taking him with me. At one point I put a wheat heat bag in with him.
Last night he had my body temp, which seemed to help.

I haven't heard of any rabbits being made ill by Baytril - it's just not adequate enough for certain complaints. Good luck with bunny - hope he continues to improve.

jerseygirl said:

No change in dose. No added in analgesics/anti inflammatories.
Been told "really can't increase the dose of loxicom in rabbits".
Just to clarify again; they did not send loxicom home with me on the day. I already had some they'd given me at another time. They'd checked what I had. I also specified again today that it was cat loxicom.

They apparently rang vet I'd seen (his day off) & he's said the same. I have my doubts.
So basically he's getting 0.1mg per 24hrs if my calculation is right.

Idk.. I'm feeling like they're not as up to date on pain management for rabbits as I previously had thought.

I'm also stressing and overthinking things!

Happy to report bun is more himself today. I'm yet to give the oral baytril though which might be upsetting him. Time will tell..

@Mimz, thank you for your support, always. I had to go to work after I collected him Monday. Another reason why things got hectic at that time. I ended up taking him with me. At one point I put a wheat heat bag in with him.
Last night he had my body temp, which seemed to help.

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I don't know how much he weighs, but Mimzy is around 3 lbs or less and he gets 0.5 mls of dog metacam twice a day and has been for many years now. :? Considering what your bun is dealing with, that sounds like far too little to cover his pain. Are there no other rabbit savvy vets nearby? It might be time for a second opinion?

tonibun said:

I haven't heard of any rabbits being made ill by Baytril - it's just not adequate enough for certain complaints. Good luck with bunny - hope he continues to improve.

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Actually, Fiver recently had a bad experience with Baytril, besides giving him gut stasis he also had some kind of limb paralysis with it. It was the weirdest reaction my vet had ever seen.

I do agree that a stronger abx might be called for if it is indeed infection. There is a drug that penetrates the deeper tissues called chloramphenicol, but it has strict handling guidelines due to the possibility of causing anemia in people.

He's 2.1kg, MM. So about 4 1/2 pounds.

I may have even over reacted last night. I was on hyper alert.
Much later on, his ears felt cool again, yet he was munching away on hay. If I'm suspicious he's unwell again, I'll take his temp I think.

I don't think he's suffering much currently. He's allowed me to clean wound tonight then accepted treats after. He made a few tooth noises but he's done this a bit since the op. I wonder if his jaw was not aligning properly. He had his teeth examined while he was under.

It's sort of weird, the vet started out treatment with more high risk abx and now it's just baytril.

I have a recheck appt in Frii and the sponges are to be changed. I want to see if he can go back on penicillin as he was coping well on this. Much as I hate the stuff!
I did notice he stopped "sneezing" after going on it. Though it could be coincidence.
It's not exactly sneezing. More like his attempts to clear something bothering him in nasal passages. I've long suspected something was brewing there.

I've read about something before (on here) that helps flush the wound and heal. Is that C10??

I'm not exactly sure what would be appropriate until have better idea of exactly what we're dealing with. But I'd like to ask vet about things like this or packing with Manuka honey etc.