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How do you know when it is time to PTS?

B

Beapig

Mama Doe
I know that putting to sleep is a very personal decision, but I'm so torn about Hamilton and what is right for his welfare. He has been very up and down since the summer.

He had a dental at a RWAF gold rated vet earlier this week. Even though his spurs were only small, they were clearly enough to be bothering him - he is now finally showing some interest in hay again for the first time in a while. He has lost a lot of weight over the past while and I can feel his spine and pelvis too much, so I'd really like to encourage him to put some on. His appetite is up and down too - sometimes he is full of beans and wants to munch on greens non-stop, other times he goes into very tired little old man mode and will just sit there doing nothing all day.

He is on Loxicom twice a day as per vets instruction for the foreseeable future, to help with any potential underlying pain etc. I am concerned about him being an outdoor bun over the winter - it is still quite mild here for now, but won't be forever. I'm worried that the colder weather could exacerbate any joint pain. He is looking a bit iffy today, so back inside for a few hours with his favourite nibbles. He is much happier with his ladies, but I'm truly not sure how I could accommodate the 3 of them inside permanently. The girls have a lot of energy too, and enjoy the huge space they have outside for running around. I don't think it would be fair to split him up from them though. He is particularly attached to Lily, who grooms his head daily.

I'm just not sure how to know when it is time...when he has more good days than bad days? That's how it has been for the past 3 weeks or so. The dental was only on Tuesday, so I'm still hoping that we may see the positive effects of that to come. But he is 9 years old, so not young.

Any advice is much appreciated. He is very much my baby, and I'd like to hold onto him for as long as possible :cry: But I want to do right by him, so will not selfishly hold on too long if he is suffering more than he is enjoying life.

Picture of said boy after his dental, enjoying some greens. His droppings have been looking a lot better the past couple of days.

 
Beapig said:
I know that putting to sleep is a very personal decision, but I'm so torn about Hamilton and what is right for his welfare. He has been very up and down since the summer.

He had a dental at a RWAF gold rated vet earlier this week. Even though his spurs were only small, they were clearly enough to be bothering him - he is now finally showing some interest in hay again for the first time in a while. He has lost a lot of weight over the past while and I can feel his spine and pelvis too much, so I'd really like to encourage him to put some on. His appetite is up and down too - sometimes he is full of beans and wants to munch on greens non-stop, other times he goes into very tired little old man mode and will just sit there doing nothing all day.

He is on Loxicom twice a day as per vets instruction for the foreseeable future, to help with any potential underlying pain etc. I am concerned about him being an outdoor bun over the winter - it is still quite mild here for now, but won't be forever. I'm worried that the colder weather could exacerbate any joint pain. He is looking a bit iffy today, so back inside for a few hours with his favourite nibbles. He is much happier with his ladies, but I'm truly not sure how I could accommodate the 3 of them inside permanently. The girls have a lot of energy too, and enjoy the huge space they have outside for running around. I don't think it would be fair to split him up from them though. He is particularly attached to Lily, who grooms his head daily.

I'm just not sure how to know when it is time...when he has more good days than bad days? That's how it has been for the past 3 weeks or so. The dental was only on Tuesday, so I'm still hoping that we may see the positive effects of that to come. But he is 9 years old, so not young.

Any advice is much appreciated. He is very much my baby, and I'd like to hold onto him for as long as possible :cry: But I want to do right by him, so will not selfishly hold on too long if he is suffering more than he is enjoying life.

Picture of said boy after his dental, enjoying some greens. His droppings have been looking a lot better the past couple of days.

Click to expand...

he is a real beauty :love: he looks bright to me in that photo.

Your post throws up so many things & you're right - its such a personal decision! Rightly or wrongly I compare people to animals so I don't necessarily expect them to be pain free & active once they are older - so long as the pain is managed. I feel like they (perhaps all species) have a really strong will to live much of the time so struggle with PTS (that said I've made that call for 3 rabbits in a 2 year period) but thats me. I'd certainly try Hamilton as a lone house bun first. He might enjoy your company, home comforts & extra treats. That he is starting to pick up is great news. If a spur has been bothering him for some time thats bound to cause weight loss. Am I right in thinking he had recent bloods which were ok?
I can see that there is loads to weigh up. I wish you well with your decision but I don't think it needs making met. With terminally ill or frail pets I've found its under perpetual review. Mouse I was reviewing for over a year. I'm no good at this stuff. Their eyes tell you lots though, its when Mouseys spark in her eyes went it was time (although that wasn't the only thing)

Loads of vibes for Hammy
 
He looks quite bright there. I would definitely give him time to recover from the dental. Feed him up for a couple of weeks as well, to see if he puts on weight. Older animals always feel boney as the fat drops off their back. For winter, he may be better off inside - it's worth considering as it may make it easier for him and he won't be using as much energy to keep warm, although he may miss his girls.

Older animals often need a bit more support and TLC. If he's managing the basics Ok, is eating, drinking, moving around, etc fairly normally and happily (even with some additional maintenance), then he's doing OK.

It's usually obvious when they've had enough. The spark goes out of their eyes.
 
Thank you both, I truly appreciate the support. He is definitely bright when he is feeling well, but when he isn't it is always stasis-like symptoms - lack of appetite, gassy, bloated belly, scrunched up or laid out posture. He was great when he came back from the dental and completely okay all day yesterday. Then looking dodgy again today. He gets like this a few times a week, but it is early days with the freshly trimmed teeth and being on maintenance medication, so maybe that could change.

Is it okay to feed critical care long term, to try and help fatten him up again? He really loves it and will chew the syringe in anticipation if I hold it out to him. It could be a good preventative for stasis too?

I'm definitely thinking along the lines of having him as a house bun until next Summer. Would it be okay to pop him in the run for an hour each day with the girls, or would that be dangerous if he adapts to the warmer temps of the house? I just know how much they love each other, so I don't want to cut them off completely if I can help it. The plan would be to help him gain weight and strength over Winter, so he can be back with them permanently next year.
 
I too think he looks bright in that photo. I think you will know when he's had enough. I agree with j&b and think of elderly animals in the same way as elderly people. Some pain should be expected as a possibility, but that can usually be managed. Chronic pain is sometimes more difficult to eliminate completely and sometimes it's necessary to experiment with different medication. What's his movement like? Whilst an xray would be necessary to diagnose Arthritis accurately, a skilled vet could usually be able to tell just by moving his limbs.

I think it would be perfectly OK to give him top-up feeds of critical care. The composition of it is after all very similar to normal pellets. What I would be careful of though is not to feed too much of it, so that he gets full up and eats a lot less hay, as that would be so good for his tummy. It would be a case of monitoring the situation I think.

I personally would not swap him about between inside and outside during the winter. Firstly it's not ideal to change his temperature too much, but I also wouldn't want to confuse him by sometimes being with the girls and sometimes not. Whilst he won't need to use so much energy to keep warm if inside, I would try if I could to keep them all outside. Three bunnies snuggled together will be warmer than one single one and also his quality of life away from the girls would not be so good. I would try making some adaptions inside the shed to keep it warmer and also on those really cold days, I would shut them inside.

Hoping that he continues to improve after his dental.
 
I'd have no problem topping up with CC. Personally I wouldn't let him out to see the girls for a couple of reasons - I reckon it'd probably be confusing for all buns & advice is not to let inside buns (even healthy ones) go out in deep winter as the temperature change can have negative impact on respiratory function. Re-bonding in Spring sounds fine. If as Omi suggested you can get him all snuggly in their shed that would be a good plan too. Just depends if your other bunnies are off doing their thing or still giving him lots of attention & cuddles. If he wasn't thriving outside I would think about bringing him in.
 
Sending vibes for Hamilton.
I have continued cc, though eventually mix it with ground up pellets to change the taste to get them eating pellets which can help with their weight. Though he may not be that thin, just not as full or muscular as he was before.
He looks bright, no obvious pain, so you have time to decide.
 
Last edited:
I've fed a rabbit almost entirely on CC long term before. It has all the fibre etc for gut health, but the down side is that it does nothing to keep the teeth in trim, so there is a balance to be had. As long as he's eating (hopefully plenty of) hay or readygrass, topping him up with CC or mushy pellets several times a day is fine and will help to avoid gut stasis.
 
I am sorry not to know/ be able to remember much background, but has the Vet run any diagnostics at all to look at possible causes for his pain episodes ?

Whilst a photo cannot give much of a clue as to the true wellness of a Rabbit the one on this thread doesn’t give the impression of a Rabbit at the PTS stage or anywhere near it. But as I said, it’s impossible o judge from a photo.

I would be considering the possibility of/ want to rule out urinary tract problems, renal problems, heart problems being involved in his ‘not well’ episodes.

Apologies again if you have posted another thread where you have said all diagnostics have been done, I am not too well these days and struggle to keep up with everything
 
Thank you everyone, you've given me some food for thought.

Jane, he has had bloods taken, but nothing beyond that. He is not insured and I've spent over £2k on him for vet treatment in the last two months. Unfortunately I really can't afford a £1000 CT scan on top of that :cry:

If he were to have UT issues, renal or heart issues diagnosed, what else could be done other than pain relief?

I'm going to play it by ear as to whether to keep him inside or outside for the foreseeable future. For now he's back out with his girls. He is eating small amounts but is bloated and uncomfortable. Tummy massages seem to help. He has had his meds, critical care and a few dandelions this morning. No interest in hay these past 24 hours. His dental was 3 days ago.

Thanks for the vibes everyone, they are much appreciated.
 
What did the bloods show ?

When you say he is now ‘bloated’, exactly where in his abdominal tract ?

Has the Vet ever mentioned Cecal impaction ? This condition can be insidious in onset, episodes of apparent abdominal pain, a willingness to eat but then dropping the food, craving things like cardboard and newspaper but not eating hay. Bloating in the lower GI tract, small hard fecal poo. As the condition progresses a very full cecum can be palpated in the lower abdomen. It feels like a curled sausage.

https://rabbit.org/disorders-of-the-cecum/

To answer you questions re treatment options should heart or renal problems be an issue. Yes, there are various medications that can be prescribed to improve QOL even if they cannot cure the problem.
 
InspectorMorse said:
What did the bloods show ?

When you say he is now ‘bloated’, exactly where in his abdominal tract ?

Has the Vet ever mentioned Cecal impaction ? This condition can be insidious in onset, episodes of apparent abdominal pain, a willingness to eat but then dropping the food, craving things like cardboard and newspaper but not eating hay. Bloating in the lower GI tract, small hard fecal poo. As the condition progresses a very full cecum can be palpated in the lower abdomen. It feels like a curled sausage.

https://rabbit.org/disorders-of-the-cecum/

To answer you questions re treatment options should heart or renal problems be an issue. Yes, there are various medications that can be prescribed to improve QOL even if they cannot cure the problem.
Click to expand...

The bloods came back mostly within normal levels, with slightly elevated calcium levels.

Thank you for the link, I've just been reading it through and looking at the chart. I don't think it's an impaction, because he's still passing poo. There are loud, gurgle gut sounds when I massage him. The poops have been a mixed bag - some very small and hard, some normal looking, some a weird shape with a small amount of mucus on the surface. I wish I was more experienced as to say exactly where the bloat is. His whole tummy just looks and feels a bit ballooned. When I lift his pelvis up, I can hear and feel the bubbles rising.

Yesterday when he lost his appetite, I just let him have whatever he was willing to eat. Herbs, salad, broccoli, forage. Maybe he had too much of the carbs and starchy veg. Usually when he has stasis, I just present every option to him and hope that he at least picks something to eat independently. Any gut movement feels like a win. But maybe now, I need to be more cautious. Maybe I should buy lots of dried forage for him and see if that improves things.
 
Beapig said:
The bloods came back mostly within normal levels, with slightly elevated calcium levels.

Thank you for the link, I've just been reading it through and looking at the chart. I don't think it's an impaction, because he's still passing poo. There are loud, gurgle gut sounds when I massage him. The poops have been a mixed bag - some very small and hard, some normal looking, some a weird shape with a small amount of mucus on the surface. I wish I was more experienced as to say exactly where the bloat is. His whole tummy just looks and feels a bit ballooned. When I lift his pelvis up, I can hear and feel the bubbles rising.

Yesterday when he lost his appetite, I just let him have whatever he was willing to eat. Herbs, salad, broccoli, forage. Maybe he had too much of the carbs and starchy veg. Usually when he has stasis, I just present every option to him and hope that he at least picks something to eat independently. Any gut movement feels like a win. But maybe now, I need to be more cautious. Maybe I should buy lots of dried forage for him and see if that improves things.
Click to expand...

With a CECAL impaction FECAL output continues, but is abnormal. Odd shapes, mucus etc.
 
InspectorMorse said:
With a CECAL impaction FECAL output continues, but is abnormal. Odd shapes, mucus etc.
Click to expand...

Thanks Jane. On the link you sent me in the chart, it says that a cecal motility impaction will lead to no fecal output and complete loss of appetite? He has been eating throughout the day, but has had several episodes of being gassy/bloated/uncomfortable, straight after eating. Then some time will pass and he will be okay and eat again. It could be hypomotility, but going by the chart it doesn't sound like an impaction.

This is quite 'new' for us, as past stasis episodes have very much been all or nothing - complete loss of appetite, completely lethargic etc. Now he seems to bob between the two. Could being gassy immediately after eating indicate an imbalance in gut flora? Some poops from today:



Gassy belly (please excuse the dirty feet, he digs a lot when outside!)



Then okay again and eating hay



I know that he isn't blocked because he is still pooping, but not sure whether I should keep giving critical care with him being gassy. Any advice from anyone much appreciated as always, thank you.
 
It might also be worth noting that I've seen him posing to eat his cecotropes today. He has very much been favouring dandelions, plantain and grass. He has only eaten a smidge of hay, which isn't much of a change than from before his dental.
 
i see a lot of hairs in those poops? Might be worth giving a thourough daily brush now, I have rabbits shedding like crazy too.
 
Preitler said:
i see a lot of hairs in those poops? Might be worth giving a thourough daily brush now, I have rabbits shedding like crazy too.
Click to expand...

He's no longer moulting from what I can see, but it's definitely still worth me grooming him daily, just to be sure.
 
it must be v frustrating not being able to establish the cause. if the episodes follow eating it suggests somethings awry with his digestive system or there are some foods he is not tolerating. I know from experience its difficult to strip back rabbits diets when you just want them to eat anything..but...it would be useful to see if its anything particular. I wish I had some useful advice for you Beapig
 
joey&boo said:
it must be v frustrating not being able to establish the cause. if the episodes follow eating it suggests somethings awry with his digestive system or there are some foods he is not tolerating. I know from experience its difficult to strip back rabbits diets when you just want them to eat anything..but...it would be useful to see if its anything particular. I wish I had some useful advice for you Beapig
Click to expand...

It is indeed frustrating. I'm going to try giving him just fresh and dried forage and see if that makes any difference. Although he has had plenty of leafy greens from our garden over the years with no issues. I'm definitely going to avoid pellets at the moment and see if that helps. He is pretty much the same as yesterday right now, although looking less bloated. Still only a small appetite with a small output, poor little lad. He's enjoying the snugglesafe though, it must feel nice on his tummy :love:
 
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