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