Molly's Hocks - An Allergic Reaction? U/D

[KarenM]

Have you tried the suggestions from your recent threads about Molly? I think the latest one mentioned was savlon gel??

 

[Daisy-may]

Oh my god, please think of your little bunny and DONT give up on her, I have recently lost my little baby and even though I was told I would have to consider having her PTS (she was very ill with EC) I never ever once gave up on her.

Rabbits aren't silly, they rely on your strength to get through the tough times. I thought I was going crazy when Daisy was ill as I only got a few hours sleep every night for the last week of her life, but I would do it again and again if it meant I could just have her back safe and well in my arms.

Please love your rabbit as much as it loves you and give her the chance she deserves.

 

[prettylupin]

Can you tell me then what I would have to do to manage it successfully, as I don't know?

Infection can come and go daily, it is possible, in areas of localised white cell activity and an attempt by the body to reach the source of infection, it often seals it off and then it reabsorbs and is broken down again.
The problem with 'chronic' sore hocks is that ongoing inflammation causes skin thickening and fibrosis. Once this has occurred, skin healing and fur regrowth will always be difficult to achieve. You absolutely need to reduce the inflammation by giving a daily anti inflammatory, we used oral metacam at a high dose at the outset, and then tailed off to a maintenance dose until the skin itself has softened and the chronic swelling in the pads and inflammation had subsided. You will need a good vet for this to assess the feet properly both before and after treatment.
If her feet are not healing on the bedding you have given her then you will need to consider using colloidal preparations and bandaging, this takes time and patience. Bandages are easily pulled off by bunny and can become wet, once they do they will be of no benefit so you will need to be prepared to frequently redress them.

Can you run back over everything you are currently doing? Bedding? What ground is she exercising on? are you treating them in any way now? if so what? is she on anti inflammatory pain relief? antibiotics? have they identified which bacteria? where are the sores exactly...front of pad, heel (hock) or running the fulll length? is their fur around them? are they bleeding or just red? I would personally find a very good rabbit vet to support you through her treatment.
I would also agree with Jane that allergy causing sore hocks is very unlikely.

These are a difficult condition to treat....you have to address several things at once as there are many contributing factors.
Pain relief, anti inflammatory meds, antibiotics as a prophylactic or therepeutic intervention, readjusting the foot angle and relieving the pressure/friction which contributes to this - which means getting her to a healthy weight if not already, keeping her nails very short, providing a 'cushioned' envrionment for rest (and play if it affects the front of the feet), keeping the feet clean and dry, hygiene is essential, and if necessary bandaging the feet in order to be able to apply creams without them causing further trauma to the feet.

 

[LionheadLuver]

Infection can come and go daily, it is possible, in areas of localised white cell activity and an attempt by the body to reach the source of infection, it often seals it off and then it reabsorbs and is broken down again.
The problem with 'chronic' sore hocks is that ongoing inflammation causes skin thickening and fibrosis. Once this has occurred, skin healing and fur regrowth will always be difficult to achieve. You absolutely need to reduce the inflammation by giving a daily anti inflammatory, we used oral metacam at a high dose at the outset, and then tailed off to a maintenance dose until the skin itself has softened and the chronic swelling in the pads and inflammation had subsided. You will need a good vet for this to assess the feet properly both before and after treatment.
If her feet are not healing on the bedding you have given her then you will need to consider using colloidal preparations and bandaging, this takes time and patience. Bandages are easily pulled off by bunny and can become wet, once they do they will be of no benefit so you will need to be prepared to frequently redress them.

Can you run back over everything you are currently doing? Bedding? What ground is she exercising on? are you treating them in any way now? if so what? is she on anti inflammatory pain relief? antibiotics? have they identified which bacteria? where are the sores exactly...front of pad, heel (hock) or running the fulll length? is their fur around them? are they bleeding or just red? I would personally find a very good rabbit vet to support you through her treatment.
I would also agree with Jane that allergy causing sore hocks is very unlikely.

These are a difficult condition to treat....you have to address several things at once as there are many contributing factors.
Pain relief, anti inflammatory meds, antibiotics as a prophylactic or therepeutic intervention, readjusting the foot angle and relieving the pressure/friction which contributes to this - which means getting her to a healthy weight if not already, keeping her nails very short, providing a 'cushioned' envrionment for rest (and play if it affects the front of the feet), keeping the feet clean and dry, hygiene is essential, and if necessary bandaging the feet in order to be able to apply creams without them causing further trauma to the feet.

Thank you for your help.

Bedding: thick hay, with megazorb litter underneath to absorb any wee patches as much as possible and move the urine away from the surface. in litter trays, megazorb litter.

Ground exercising on: grass, run moved daily so the ground is fresh and soft, if the ground is dry, watered daily to soften it.

Treatment: going to start applying salt water again to the sore patches, anti-inflammatory injection given by vet yesterday, and going back in 10 days to see if it's better, if not, what else we can try. haven't done a c+s test, wanted to do one yesterday, but there was no infection. will do one as soon as she gets to a vet and has infection present. sore patches running about 3/4 of the length of the foot, from heel to a quarter away from the toes. toes are affected, as are the front feet (although never have problems with front feet, it's just fur missing there). Fur surrounds the sore patches. They are just red, but bleeding can occur if she cuts herself (from Milly chasing her, or the skin splits).

I don't mind doing bandaging, etc if only it works. The vet that was supposed to be really good (Guy Carter), only offered baytril and that was it, and we went about 3 times, and a couple of times, the infection had disappeared. He didn't seem very helpful, so we went back to our old vet.

 

[Jack's-Jane]

So the Vet has given Molly a steroid injection now..........:shock:

 

[*Spider*]

Am I right in thinking that their run used to be on thick hay?
Why has this stopped and has her sore hocks occurerd now she's on the grass?

 

[abbymarysmokey]

I personally wouldn't have a rex on wet grass all day, but I don't have rexs, so can't really say whether my instincts are right or wrong.

IMO you'd be better to let your lawn grow longer than usual to provide more cushioning and just move the run to a new spot every so often.

 

[MedicatedFluffball]

What's the chances of it being the wet grass causing this, being pretty abrasive to the skin? Kinda like wearing wet jeans all day and ending up wit chafing? I dunno if this is the same kind of thing or not...I've never had a bun with sore hocks

 

[prettylupin]

Thank you for your help.

Bedding: thick hay, with megazorb litter underneath to absorb any wee patches as much as possible and move the urine away from the surface. in litter trays, megazorb litter.

Ground exercising on: grass, run moved daily so the ground is fresh and soft, if the ground is dry, watered daily to soften it.

Treatment: going to start applying salt water again to the sore patches, anti-inflammatory injection given by vet yesterday, and going back in 10 days to see if it's better, if not, what else we can try. haven't done a c+s test, wanted to do one yesterday, but there was no infection. will do one as soon as she gets to a vet and has infection present. sore patches running about 3/4 of the length of the foot, from heel to a quarter away from the toes. toes are affected, as are the front feet (although never have problems with front feet, it's just fur missing there). Fur surrounds the sore patches. They are just red, but bleeding can occur if she cuts herself (from Milly chasing her, or the skin splits).

I don't mind doing bandaging, etc if only it works. The vet that was supposed to be really good (Guy Carter), only offered baytril and that was it, and we went about 3 times, and a couple of times, the infection had disappeared. He didn't seem very helpful, so we went back to our old vet.

I would go for a daily oral NSAID like metacam if your vet agrees, it keeps on top of the pain and inflammation. I know injectable is long acting but I would rather be giving it daily, twice daily at the outset if it is bad. Does she have difficulty sitting or standing on her feet? Chewing them at all? I would also have her on an antibiotic again if your vet agrees - whether there is infection of not it can help prevent infection starting, however, they may prefer to test first to identifiy they most suitable antibiotic rather than just a broad spectrum one.
I would personally avoid bathing the wounds, wet wounds are more likely to become soft and split and bleed, this applies to use of creams. Salt water may also dry the wound until it becomes tight and it will then be more likely to fracture once weight bearing pressure is applied. Wet skin can cause scald and fur to fall out.
The colloidal gel like the Savlon Advanced gel as Jane has used is apparently of great benefit, but I would personally not use any cream without bandaging alongside to protect the foot from further trauma whilst it has been softened by cream, otherwise it will be more open to infection. When you do apply cream you must be careful not to squash the fur surrounding the sore as this fur is actually serving a purpose and protecting the other parts of the foot from pressure/friction. This is why rabbits have furry feet. Sadly Rexes lack this thickened guard hair which is why they are so prone to this condition.

In my opinion creams and bandaging is a last resort for severe sore hocks....you may find that a course of NSAID and the correct antibiotic is enough...or it may be that dressing the feet and using colloidal gel is appropriate in this case, it is hard to know really. I would also keep her nails short and encourage her to have a good hop around on the soft lawn....exercise stimulates circulation and will get the blood to the site of infection which in extremeties like the feet takes longer to heal.

Is she using her tray or is she in too much discomfort with her feet and widdling around the hutch and on the hay? We found with our sore hock bun that megazorb was too uncomfortable for him to stand on and as a result he wouldn't use the tray and was therefore more at risk of standing on soiled bedding and urine scald which will make the problem worse. Megazorb did not give him enough cushioning - he wouldn't go near it. We actually cut strips of vet bed up and put them in the litter tray on top of the megazorb and changed it twice a day sometimes....always removing the droppings as well so he didn't stand on them. When his feet improved he was able to use the megazorb alone in the tray. You could try this or more hay in the litter tray also.
http://www.vet2pet.co.uk/pethealth/rabbithealth/sorehocks_rabbit.asp

 

[prettylupin]

So the Vet has given Molly a steroid injection now..........:shock:

It could have been an injectable NSAID? :?

 

[prettylupin]

I just wanted to add something really important. This condition is not necessarily something Molly will ever be free from....this is sadly often a chronic condition, and therefore treatment is all about, as Jane says, correct management of the condition in order to give a good quality of life, which is entirely possible in most cases.
At the point that infection becomes recurrent and involves bone and tendon deformities and osteomyelitis then obviously achieving a good quality of life is not always possible, however it doesn't sound like Molly has reached this stage at all yet.

The owners we took our foster bun on from were kind and conscientious and loved their bunny very much, but were ill prepared for this condition and overall felt that they simply could not give him the care and environment he needed for long-term management of his hocks....so we took him on and rehomed him through a good rabbit rescue. He was found a home with an experienced vet nurse and was bonded with her female bun. I have had updates on him and I must tell you that he does still suffer from sore hocks to some degree....but with the correct care and environment he is able to live a good happy life and is full of beans, his hocks are under control. I'm sorry Molly is suffering so, dealing with this condition takes an awful lot of energy and commitment but it is manageable in most cases. I would also not consider PTS at this stage. The vet that our foster bun was taken to by his owners said he should be PTS - my vet was shocked! and he did indeed make a good enough recovery to enjoy his life with the right treatment. I'm just trying to warn you that this will be an ongoing thing....but it's not a death sentence.

Good luck with Molly and whatever you decide.

 

[LionheadLuver]

I would go for a daily oral NSAID like metacam if your vet agrees, it keeps on top of the pain and inflammation. I know injectable is long acting but I would rather be giving it daily, twice daily at the outset if it is bad. Does she have difficulty sitting or standing on her feet? Chewing them at all? I would also have her on an antibiotic again if your vet agrees - whether there is infection of not it can help prevent infection starting, however, they may prefer to test first to identifiy they most suitable antibiotic rather than just a broad spectrum one.
I would personally avoid bathing the wounds, wet wounds are more likely to become soft and split and bleed, this applies to use of creams. Salt water may also dry the wound until it becomes tight and it will then be more likely to fracture once weight bearing pressure is applied. Wet skin can cause scald and fur to fall out.
The colloidal gel like the Savlon Advanced gel as Jane has used is apparently of great benefit, but I would personally not use any cream without bandaging alongside to protect the foot from further trauma whilst it has been softened by cream, otherwise it will be more open to infection. When you do apply cream you must be careful not to squash the fur surrounding the sore as this fur is actually serving a purpose and protecting the other parts of the foot from pressure/friction. This is why rabbits have furry feet. Sadly Rexes lack this thickened guard hair which is why they are so prone to this condition.

In my opinion creams and bandaging is a last resort for severe sore hocks....you may find that a course of NSAID and the correct antibiotic is enough...or it may be that dressing the feet and using colloidal gel is appropriate in this case, it is hard to know really. I would also keep her nails short and encourage her to have a good hop around on the soft lawn....exercise stimulates circulation and will get the blood to the site of infection which in extremeties like the feet takes longer to heal.

Is she using her tray or is she in too much discomfort with her feet and widdling around the hutch and on the hay? We found with our sore hock bun that megazorb was too uncomfortable for him to stand on and as a result he wouldn't use the tray and was therefore more at risk of standing on soiled bedding and urine scald which will make the problem worse. Megazorb did not give him enough cushioning - he wouldn't go near it. We actually cut strips of vet bed up and put them in the litter tray on top of the megazorb and changed it twice a day sometimes....always removing the droppings as well so he didn't stand on them. When his feet improved he was able to use the megazorb alone in the tray. You could try this or more hay in the litter tray also.
http://www.vet2pet.co.uk/pethealth/rabbithealth/sorehocks_rabbit.asp

Thank you for your help guys. She had an injectable anti-inflammatory, not a steriod injection.

The run was on thick hay during the winter because the grass became too muddy, allowing infection to enter the hocks. We are currently thinking of putting her on thick hay permanently all year round, because we don't think the grass/soil is soft enough, it has no spring in it, and we think this could be part of the problem. Is this a good idea? Her hocks have got worse since she came off the hay run, and we went through a very bad spell of sore hocks when she was on very dry, cracked soil, which was like concrete so would have caused the sore hocks to flare up. We also think that wet grass is not good, and we get dew on the grass often. we cover the run completely on all sides when it rains, but strangely, the grass in the run still gets wet sometimes. Again, having her on hay permanently will stop this.

She can stand on her hind legs comfortably, and she sits comfortably too on them. She does lick them, but this isn't obsessive, looks more like she's cleaning them more than being irritated by them. Both of our vets only gave us antibiotics if there was obvious sign of infection or there were any pussy abscesses. :? Should I not use salt water then? Both vets suggested this, along with vaseline and sudocrem, but unfortunately, she reacts to these. She uses her tray, and does sometimes sit in it, although, not often. I am thinking of buying some squares of vetbed to put into the litter tray, so if she does sit in the litter tray, she's not sitting in urine. Is this a good idea? She wees in specific areas of the hutch and run, same with Milly too, and these are all cleaned daily.

 

[LionheadLuver]

I just wanted to add something really important. This condition is not necessarily something Molly will ever be free from....this is sadly often a chronic condition, and therefore treatment is all about, as Jane says, correct management of the condition in order to give a good quality of life, which is entirely possible in most cases.
At the point that infection becomes recurrent and involves bone and tendon deformities and osteomyelitis then obviously achieving a good quality of life is not always possible, however it doesn't sound like Molly has reached this stage at all yet.

The owners we took our foster bun on from were kind and conscientious and loved their bunny very much, but were ill prepared for this condition and overall felt that they simply could not give him the care and environment he needed for long-term management of his hocks....so we took him on and rehomed him through a good rabbit rescue. He was found a home with an experienced vet nurse and was bonded with her female bun. I have had updates on him and I must tell you that he does still suffer from sore hocks to some degree....but with the correct care and environment he is able to live a good happy life and is full of beans, his hocks are under control. I'm sorry Molly is suffering so, dealing with this condition takes an awful lot of energy and commitment but it is manageable in most cases. I would also not consider PTS at this stage. The vet that our foster bun was taken to by his owners said he should be PTS - my vet was shocked! and he did indeed make a good enough recovery to enjoy his life with the right treatment. I'm just trying to warn you that this will be an ongoing thing....but it's not a death sentence.

Good luck with Molly and whatever you decide.

I am grateful for your honesty, and I am very happy that it seems that Molly is not near PTS yet. We want to be able to manage it successfully, this is what we really really want, it's just we seem to be failing. If we could manage it successfully, I would be so so happy. Even if it took up all my time, if she could be happy, we'd do it.

 

[LionheadLuver]

This is what they looked like today, without any salt water added:

right hock:

left hock:

And no white stuff showing, although a week ago, they were really white. :?

 

[*Spider*]

My first thought would have been to instantly put them back on deep hay.

 

[Jack's-Jane]

Personally I would not use salt water on those hocks. They are looking very dry which may be part of the problem

Did you ever bother to try the treatment I PM'd you about weeks ago ?

I think your expectations of a 'cure' are unrealistic. I have a 7 year old Rex who has had no fur on her hocks since she was about 10 months old. The condition evolves and treatments have to do the same. She has never required more than one course of antibiotics for her hocks in all of her 7 years. But she has gone through phases where dressings were required, along with topical medications and DAILY systemic anti-inflammatories.

IMO the thing to try to acheive in Molly's case is the prevention of infection.
Hence familiarising yourself with when dressings are required, for how long and what type of dressing. Also what topical treatment to use depending on whether ther is just inflammed skin, dry skin, or if ulcers are occuring.

Hence my previous comment about managing the condition being a daily lifelong commitment.

Has any Vet assessed Molly's gait as she hops and when she has her hind feet on the floor when at rest are her feet 'flat' to the floor or clawed inwards?

What was the name of the anti-inflammatory injection Molly had ?

 

[Dustyrabbit]

Hi, Just wanted to say sorry that you are having these worries about Molly. I don't have any real experience although we did have a Rex bunny some years ago but I would think it would be best to keep her on the thick hay etc in the run - perhaps you could just leave a small area open as such to the grass or give trays of grass to munch.

I may be way off but what does everyone think about giving something to support the imune system, believe they can have Echinacea(?), to help her deal with the infection?

I do remember Daisy, our rex, having slightly sore hocks when we had to keep her on paper as she had Pasturella and so respiratory problems, and I remember being tempted to douse them with Surgical Spirit to toughen the skin like the ballet dancers do - I never did it though! I keep picturing little bunny slippers made out of vet bed too...mmmm where's the number for Dragons Den...:lol:

I know your not far from me and use Medi-vet, I'm surprised Guy Carter wasn't much help, I don't know any of the other vets there - I usually use The Park Veterinary Centre and see Mr Star who is the exotics man or Mel who is especially interested in bunnies.

 

[areia]

I personally wouldn't have a rex on wet grass all day, but I don't have rexs, so can't really say whether my instincts are right or wrong.

IMO you'd be better to let your lawn grow longer than usual to provide more cushioning and just move the run to a new spot every so often.

my mini has reoccouring hock sore in the same place were janes rex does, his hocks preferes dry grass not wet and as he spends his day times 7am till 8/9am most of it flopped feet out hes not so bad his hocks seem to come sore after wet weather,
the white pus i assume like us is the white blood cells working hard to heal the area, im not sure salt water would be good if you dont put some sort of barrier cream on after, salt draws out infection yes but also dries skin causeing it to harden and crack , just my thought, from other peoples rexes they are indeed hard work no matter were they come from, it maybe time really to confess you cant cope and offer her to someone who can look after her, you are obviously finding it to hard and are stressed about it no-one will judge for not being able to cope, you are stressed and it shows this is why your getting a hard time

ops jane beat me on the salt comment will shush now

 

[LionheadLuver]

I'm not stressed about it, I'm just struggling to find a management solution. Once we can manage it successfully, then it'll be fine. We'll put her back onto the hay run then ASAP.

Hence familiarising yourself with when dressings are required, for how long and what type of dressing. Also what topical treatment to use depending on whether ther is just inflammed skin, dry skin, or if ulcers are occuring.


How do I know when to do this?

And I'm still trying to prevent infection, that's what I am trying to achieve.

Should I use salt water to draw out infection, and then put on some vaseline to prevent the water drying it out?

No vet has seen Molly's gait.

She sits (at rest) mostly on the back of her heel, tilted backwards, so toes are nearly off the ground, although on hay, she sits normally.

He didn't tell me what the name of the injection was.

 

[Hugo's There]

I haven't read the whole thread through, but as you are not far from me I have offered help before and the offer still stands If you need help with bandages or any other type of management you only have to ask.

Moses came here with very sore hocks due to his disability but I have worked hard on them for 6 months and they are now nearly completely healed, although I am aware they will flare up in the future, but hopefully we are on top of it now

Please just give me a shout if I can help in anyway:wave: