Please help! Euthanasia decision to be made :-( Molar extraction, tumours, distraught

Hi,
I'm new here, and was hoping I might be able to get some feedback/advice from fellow bunny owners. I'm very desperate.

In Jan 2008 I adopted Gilbert (aka "Gilby") - a baby lionhead cross bunny. He's my first pet - and has been my much-loved companion through my 20s and 30s. I don't have children and he's always lived in the house. He's always been a sweet-natured, intelligent and highly charismatic bunny, never shown any aggression, I've been so lucky, and has been by my side always, (I suffer from long-term health problems, and have been housebound at times, so we really were joined at the hip!) - that is, until last year, whereby due to a change in my living circumstances, I had to make a very hard decision - to let my mum take care of him as he could no longer live with me. This has been very painful, many tears have been shed and not a day goes past whereby I don't feel guilt and sadness, but it was utterly necessary and I figured that having him live with my family, and therefore getting to see him as often as I see my family, (they live 250 miles away so this is about once every month) was better than giving him up altogether.

The past 18 months have not been easy for Gilbert. On a visit earlier this year I picked him up and noticed his testicle was the size of a large conker - it turned out to be testicular cancer. I was advised by my vet previously to not put Gilby through he stress of an anesthetic as he wasn't showing any signs of aggression/spraying etc, which is why he still had his testicles. The op was a success, and he recovered well. He's also, since living with mum, had one or two episodes of stasis and his first dental burring last year - which he also recovered from. He's really been a trooper.

On Wed afternoon I received a call from my mum. She took him to the vet because he wasn't eating hay, only nuggets, and was dropping weight (which we all know is bad and stasis comes to mind). Upon examination the vet called him in for emergency sedation to look at his teeth as he suspected another dental issue. Then, he found that his back teeth on one side were wobbly, so he anesthetized him and went to remove them - and in doing so, found "cancer" had overtaken his jaw, leading to the issues. I've still not had complete clarification of what was done, but I believe he removed some/all of his back/cheek teeth on one side, cut out as much of the growths as he could, (they appear to have cut from the outside of his jaw, in) and let mum take him home, "for a short while". I called the vet for a bit of clarification as this was a complete shock to me, and I asked how the vet could be sure it was cancer, as opposed to benign tumours, and he said that the only was to find out would be to have a lab test them, but it wasn't worth it anyway as he assumed it to be cancer and that it would return, his teeth were missing on one side, and he would eventually starve to death. I asked if he was suggesting euthanasia, and he said yes. He said that if I wanted to ensure I see my rabbit I'd better come up immediately, as he didn't have high hopes for him even lasing a few days.

So I came up immediately. This is how it's gone:

Thurs night (day after his operation) - he was withdrawn, one ear lopped, not drinking, eating softened pellets, and when I got him out he hopped into the corner, under a cabinet, and didn't interact. He hadn't groomed himself after eating mushy, wet nuggets and recovery. I felt that it was clear that I needed to have him put to sleep as he was showing all the signs of a desperately unhappy bunny in pain. He had just had major surgery though.

Fri - The day started and I continued to think this is bad. One ear still lopped (he's always had uppy ears) and he was still in the corner of his cage, withdrawn. I wondered if letting him out the night before had been too much too soon so I left him to rest in his cage in the day. In the evening (after his metacam I may add), I let him out, sat on the floor, and gave him lots and lots of love. We sat watching a film on my laptop and I stroked him the whole time. He then started grooming me (licking) and also started grooming himself that evening. Then he hopped about and was inquisitive and cheeky - just like himself! As for feeding - he wouldn't touch the recovery at all, but he hoovered up his softened nuggets and even tried to eat hay and greens - although it was utterly heartbreaking to watch him unable to eat those successfully because he couldn't chew.

Sat - even better. He started drinking water from his bottle too (he'd not touched it since his op), he was giving and receiving affection, following me about everywhere, inquisitive, charismatic, huge appetite (soft nuggets). He even hopped right up onto the chair next to me and hopped back down again! In fact, I just totally forgot for a second that he was poorly at all, so I gave him some cabbage. He ran up to it and grabbed it enthusiastically, then I quickly remembered - because try as he might, he couldn't chew it. I started crying. I took it off him and cut it up into tiny bits and he managed that, then started hopping around again.

Today is much of the same. It's like there's nothing wrong with him, aside from the fact he clearly can't chew hard food like hay or veg, and can only eat soft food.

I'm very confused. I am obviously delighted to see such an improvement, but have so many questions and doubts. I must make it clear - I know putting your loved one to sleep is the kindest thing to do if the situation calls for it, and I'm prepared to do that, if I must. On the journey up here on Thursday I sobbed and prepared myself for the worst, then prepared some more for the inevitable the first day I was up here and Gilby was so withdrawn and depressed. But these last couple of days are a complete contradiction to that - he's alert, happy, hoppy, hungry, and affectionate. It's also worth noting that the vet said that he didn't have any hopes for Gilby making it even a few days - so what the hell is going on?

Here are my concerns:
1) The vet. I know all too well the importance of finding an experienced rabbit vet. I had a wonderful vet when Gilby lived with me. Once I took him to get his annual pet check and he saw a different vet to my usual. He told me that Gilby was underweight (the other vet praised me for keeping him on the lean side with a diet of 80% hay) and he said he was geriatric when he was 6 at the time, and I should be thinking about what I wanted to do in the future...we all know that buns can live twice as long as that! Unfortunately my mum lives in a rural area, and there's only one veterinary practice nearby. The very fact that this vet said it was cancer as opposed to growths (without having done a biopsy), when cancer in that part of a rabbit is very rare, the fact he said he's very old now, as well as the fact they didn't give mum antibiotics to take home, makes me wonder (unless that's ok?). Then there's his "I wouldn't even expect him to make it a few days" prognosis. They gave him metacam, to be administered once a day, that's all - is that right? I really want to have full confidence in this vet. There's no other choice, and I really want to have full confidence. I hope he's right and I just need telling that.
2) Could the metacam be masking all his pain and leading him to behave "normally"? And if so, can metacam be administered long term / for life?
3) Can rabbits survive without their molars on one side? Is he just unable to chew because he had the op so recently, or is this a permanent thing? Will he eat hay after the wounds have healed, or will he be on mushed pellets forever? If the latter, should I feed him more pellets than usual, as he's not eating hay? But surely he'll get stasis? The vet said "he'll quite happily eat on one side" but also, contradictory said "he's had his teeth removed and his jaw is damaged so he'll starve to death (in days or maybe a couple of weeks)". I cannot find any info on this at all online, aside from mention of one rabbit who has no teeth and is "happy".
4) If the tumours have been cut away, can it get better now? Or is the damage done. Is it going to grow back and cause more trauma for my Gilby in the future.

The vet said Gilby wouldn't make it very long yet Gilby has improved every day. He still can't chew, but loves his mushed food. He is on a small dose of metacam.

I thought this decision would be easy, but it's not. I'm a rollercoaster of emotions. I read online that when making a decision on euthanasia it's helpful to look at appetite, affection and attitude. He has all of these. Then I was criticized for being too scientific, and was told to just go on my heart. Well, my heart on Thurs and Fri morning was to let him go. My heart now is telling me that's surely not the right decision - he seems so happy now and has made such an improvement. I'm going to stay here on the sofa for as long as I need - I can't leave him now.

I'm seeing the vet tomorrow. I don't know what to do. I'm sorry for the essay by the way - but any advice, no matter how big or small, would be so gratefully appreciated. Please help. I don't have any experience of this and really want to make sure I do the right thing.

I am blaming myself for all of this and feel enormous guilt for the fact I "gave him up" to live with my mum. Perhaps he has grown depressed - my mum tries her best, and I am very grateful to her, but is not a natural pet person. I wonder if the tumours could've been caught earlier - I hadn't seen him for the longest stretch ever, 2 months, and now this happens. I'm not suggesting I'm some wonder woman and can prevent tumours - but it adds to the guilt. Learning that he had all those tumours causing his teeth to be loose is just gut wrenching. My poor, poor baby, being in all that pain and masking it well until the point of crisis :-(

What would you do? I want to make the best decision. x

I'm afraid I can't offer any advice but wanted to send you some hugs and vibes for Gilby. Is there a more rabbit savvy vet you could take him to while you're there, or your current vet could consult? xxx

Hey Sibby, welcome to RU. I'm pleased you've come here for some support & advice. He sounds like a wonderful rabbit who is obviously really well cared for.

I can't answer all of your questions as the buns I've had with dental issues have not affected their molars. But I have had bunnies do well on metacam long term with no issues. If I were you I wouldn't give up on Gilby as he seems to be on great form now. I really think you have to take things one day at a time, if you see his quality of life deteriorate then have a rethink but for now enjoy your time together.

Regarding his diet I would try more snipped up greens & herbs, dried forage might be manageable for him? Readigrass

I don't feel too confident in what the vets approach was. Maybe s/he was preparing you for the worst but there seem to be a fair few assumptions there.

Do keep us updated. more experienced members will be along shortly. Wishing you & bunny all the best

Rabbits hide everything really well. It sounds like he is doing OK at the moment. Metacam can be given long term as long as there are no issues with kidneys, etc (blood test can check organ function). Rabbits normally love the stuff so there's not usually an issue getting them to take it. If metacam stops working at the maximum dose, there are other pain relief options.

I have had 2 rabbits with severe dental issues. Both were related to jaw abscesses, although one was a strange soft tissue growth initially. Both lost many teeth and bits of jaw bone. They managed about 18 months of good quality life after basically a terminal diagnosis. In our case, there were dentals as required to keep the remaining teeth in good order - missing teeth mean that the opposing ones can't wear down as there is nothing to grind against. The different action these rabbits use to eat can also cause misalignment / overgrowth of any other teeth. Daily medication for ours was metacam, and a penicillin based injection to control the abscesses.

Regular (weekly) weight checks will give you a good idea of how well he is managing to eat. Food such as pellets can be softened or mushed. Water would be better in a heavy ceramic (dog / cat) bowl so he can drink easily. Fresh food can be grated or finely chopped so he can eat it more easily. Grass may be easier than hay, or can be chopped up. One of mine found it easier to eat if leaves were hung at nose height so he could reach up slightly, rather than struggling to pick them up off the floor. Basically, just adapt what he normally has to make life easier for him.

It may also be worth getting a referral to a rabbit specialist. We went to Crab Lane vets in Harrogate when FHB was still doing consults (she's 'retired' now). Prices were comparable with my regular vet, but she was my nearest rabbit expert. It was well worth getting her opinion. There are other specialists around the country if you start a new thread asking for a rabbit specialist in ......(your area).

If he seems bright and happy, willing to eat, good poo output, etc - I would keep going, if you can manage his needs. Rabbits live in the now. You will know when he needs vet attention for a dental (eg weight loss / reduced poo output), or if he has has enough. PTS is always there if needed, but maybe not right now.

Metacam can give given long term and also would help him ad pain free. He may not need it long term though just til the wounds heal. My specialist always recommends it's given twice a day. My mini lop who is 1.2kg has had 0.5ml of the dog one twice a day to give you an idea on dosage but if he's eating that's a good sign. I'm sure rabbits can survive without molars. Someone with more experience will come along. If he's not in pain and is eating I wouldn't make any hasty decisions. Could you start a thread asking about rabbit savvy vets if your area. There may be one closer than you think. Where does your mum live

Sorry I can't offer any advice but please don't feel guilty about thinking you could have caught something sooner. You obviously love him very much and have done your absolute best. He knows you love him. It's heartbreaking when you know there's something wrong and they can't tell you how to help, we all understand here.

I'm so so sorry to hear you & Gilby are going through this. How awful.

I don't have any practical advice having not dealt with anything similar, but you have and will receive great advice from other members here who are very knowledgeable :wave:

The only thing I can say, is that if I put myself in your shoes, I would not be at all happy with the vet you are currently with - sorry. I'm personally very strong on the topic of euthanasia, in the sense I'm probably quicker than a lot to do it if I think an animal is not doing well. This being considered, I actually think your vet is perhaps pushing a bit too hard into it, in that testing growths etc are simply 'not worth it' & that he is geriatric!! Of course, given that he's taken all his teeth from one side, it could perhaps become needed in the future now.

I definitely would have wanted to have the growth tested, at the very least. As someone else said it seems a lot of assumptions are being made with very little investigation which isn't great in my eyes. The vet contradicting themselves on 'being fine to chew on one side' and then not being able to, to the point of 'starving to death' is very concerning to me. This doesn't give me the impression of competence to be honest - and my best advice is for Gilby's sake, to please seek a second opinion with a rabbit savvy vet. It really could mean the difference between life and death for him.

I'm actually wondering now if perhaps this vet has made some sort of mistake during the operation and is trying to cover it by pushing you to have him PTS. The whole 'will be fine to chew on one side' then 'he won't be able to and will starve to death in weeks' is what's making me a bit suspicious. Of course I don't know what period of time the changing of tune in the vet took (ie before/after op etc) but I would definitely be wanting to know why, and getting a second opinion at a completely different vets.

Please don't feel guilty. I can see you are trying your very best for Gilby, and that this is very difficult for you. Be kind to yourself xx

So sorry you're having to go through this. Gilby has clearly found comfort in you being around. Dont feel bad about the choices you made, we have not the gifts to see every stone in our path.
Will your mother be able to care for him now with medication and more specialised diet? That probably is the deciding question and again is not a poor reflection on you or your mother.
As said, be kind to yourself, kind to your mother and kind to Gilby. Whether sooner or later it would be kindest to have those that love him to be there at the end. Be comforted that it really wont hurt him at the end.

I don't have time to write a lengthy reply but metacam is generally fine long term (it can have an affect on the kidneys after a while but in a rabbit who needs it it, and especially one who may have a somewhat more limited lifespan remaining, is somewhat irrelevant). He may well be slower to eat with his teeth missing on one side but once he has finished with the initial healing of the area it may surprise you how fast he can eat! And if he's a single bunny there is nobody else who can steal his food and scoff it down while he takes his time. Bunnies spend so much time eating anyway, it is probably not going to affect his quality of life much.

I am not a vet but whether the tumour is malignant or benign it may well be a terminal diagnosis if the growth cannot be kept under control. However, terminal diagnosis doesn't necessarily mean days - if he can eat pretty well (albeit with a couple of modifications) and enjoys his life and tolerates metacam/medication well without stress then you may have weeks, months or even quite a lot longer with him. I had a bunny who was PTS a few months ago who had a long long battle with a dental abscess and ended up having about 8 or 10 teeth removed but she scoffed down her food like her sister! Her diagnosis was 'terminal' fairly close to the battle but she lived another couple of years with a good quality of life. It was stressful for me, but for her it was not a major bother. It is so dependent on the rabbit though, so you will be able to judge his quality of life and whether it's right fairly quickly. It sounds like he is doing well at the moment and if he maintains that quality of life it sounds good. Metacam is ideally given twice a day and many non rabbit-savvy vets under prescribe the dosage so you may well find an improvement once that is rectified.

Is there definitely no rabbit-savvy vet accessible to you? I had to travel an hour to see mine and they were very good at taking into account the distance, so would ensure I had plenty of medication and didn't always require me to come back into the surgery for check-ups if it was something routine (i.e. minor surgery rather than major). Whereabouts are you, or what is your nearest town/city? Members on here are very good at recommending vets close to them!

Hi lovely people - wow, you have all been so wonderful! Thank you so much for taking the time to share your experiences and thoughts! I'm taking all of this on board, and am so grateful!
Thank you also for reassuring me that metacam is ok to be given long term, and for the other tips. I will reply in more detail when I have a moment - I'm just mushing Gilby some pellets now

My mum lives in Lincolnshire - postcode LN10 6. Is there a thread I can visit here to find a rabbit savvy vet recommendation?

Thanks again! x

Hi lovely people - wow, you have all been so wonderful! Thank you so much for taking the time to share your experiences and thoughts! I'm taking all of this on board, and am so grateful!
Thank you also for reassuring me that metacam is ok to be given long term, and for the other tips. I will reply in more detail when I have a moment - I'm just mushing Gilby some pellets now

My mum lives in Lincolnshire - postcode LN10 6. Is there a thread I can visit here to find a rabbit savvy vet recommendation?

Thanks again! x

Hi Sibby and welcome to the forum :wave:

I feel very privileged that you've decided to share Gilby's story with us and I hope between us we'll be able to help you see a way forward.

First off, your Mum and the vet she saw are doing the very best they can, and a vet that takes so much trouble with a rabbit has to have something good about them. He may not be 'rabbit savvy' as we might use the term, but he got your little one through a big operation and now you are getting him successfully through his recovery. Whether taking the tumours and teeth out was necessary, I don't know and to be honest it doesn't matter now. All that matters is that your little boy has his appetite, his affection and his attitude!

So onto the practical matters. I have nursed and cared for many dental buns. With both incisor and molar issues. What you are doing in cutting food up small is great. I've had rabbits who couldn't even manage one tiny strand of hay or readigrass - not even one inch long. I have a powerful food processor and every day I used to put hay, grass and greens into it and pulverise for my dental buns. They were then able to woof it up. If you haven't a food processor - chop as small as you need to

If you're willing to fight alongside your brave solider, then I think you can both work together on this. High fibre pellets (such as Oxbow bunny basics - Adult) are good and lots of veggies. As much hay or fresh grass (can you still find any this time of year?!) as he can eat.

I think you know for yourself that you both want to fight as long as Gilby is willing and able. However long that may be. The thing now is to put the past behind you - you may feel he's suffered unnecessarily but that's all over now. Metacam for life is quite possible - I have no qualms with that at all Once healed up you may be able to tail that off ...

So now you must conquer your guilt because it's really counterproductive. Put your positive energies into having a happy time with Gilby and know that he's delighted beyond measure to see you again. You truly have a bond made in heaven both of you.

I am wishing you both loads of luck and please stay with us xx Hugs xx

Sibby said:

Hi lovely people - wow, you have all been so wonderful! Thank you so much for taking the time to share your experiences and thoughts! I'm taking all of this on board, and am so grateful!
Thank you also for reassuring me that metacam is ok to be given long term, and for the other tips. I will reply in more detail when I have a moment - I'm just mushing Gilby some pellets now

My mum lives in Lincolnshire - postcode LN10 6. Is there a thread I can visit here to find a rabbit savvy vet recommendation?

Thanks again! x

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Post another thread Sibby, with "Rabbit Savvy vet needed in (your location)" and members will help out where they can.

Also, have a look here:

https://www.harcourt-brown.co.uk/vetfinder/copy_of_county-or-city/england/lincolnshire

Hi, thanks so much for your reply and for your advice on snipped up herbs and greens. He's loving the mushed pellets, but I've been concerned that the lack of hay will lead to another episode of stasis, so this is great advice. I'll check out Readigrass too When he was healthy, I'd only give him a few nuggets in the morning and at night, and kept his diet to 80% hay. Do you think that it's safe to increase the (softened) nuggets ratio now, dramatically, considering he's off hay? I'm concerned it'll lead to stasis, but I also want him to keep eating well.

MightyMax said:

Hi Sibby and welcome to the forum :wave:

I feel very privileged that you've decided to share Gilby's story with us and I hope between us we'll be able to help you see a way forward.

First off, your Mum and the vet she saw are doing the very best they can, and a vet that takes so much trouble with a rabbit has to have something good about them. He may not be 'rabbit savvy' as we might use the term, but he got your little one through a big operation and now you are getting him successfully through his recovery. Whether taking the tumours and teeth out was necessary, I don't know and to be honest it doesn't matter now. All that matters is that your little boy has his appetite, his affection and his attitude!

So onto the practical matters. I have nursed and cared for many dental buns. With both incisor and molar issues. What you are doing in cutting food up small is great. I've had rabbits who couldn't even manage one tiny strand of hay or readigrass - not even one inch long. I have a powerful food processor and every day I used to put hay, grass and greens into it and pulverise for my dental buns. They were then able to woof it up. If you haven't a food processor - chop as small as you need to

If you're willing to fight alongside your brave solider, then I think you can both work together on this. High fibre pellets (such as Oxbow bunny basics - Adult) are good and lots of veggies. As much hay or fresh grass (can you still find any this time of year?!) as he can eat.

I think you know for yourself that you both want to fight as long as Gilby is willing and able. However long that may be. The thing now is to put the past behind you - you may feel he's suffered unnecessarily but that's all over now. Metacam for life is quite possible - I have no qualms with that at all Once healed up you may be able to tail that off ...

So now you must conquer your guilt because it's really counterproductive. Put your positive energies into having a happy time with Gilby and know that he's delighted beyond measure to see you again. You truly have a bond made in heaven both of you.

I am wishing you both loads of luck and please stay with us xx Hugs xx

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Wow, like everyone else who's taken the time to contribute to this thread, you're so helpful and lovely, thank you!

It's very helpful indeed to hear from someone who has experience in nursing buns with dental problems, and I'm grateful for your advice. I've just cut up some hay into tiny pieces and have mixed it in with his mushy pellets to see if he'll eat it. What great advice, thank you.

As soon as I've had some sleep I'll spend the time replying in more detail to you and everyone here, but I just wanted to thank you in the meantime.

You're all such a wonderful bunch, and I wish I'd joined this forum years ago. Thank you! Xx

Sent from my Redmi 3 using Tapatalk

I am sorry to read of Gilby's problems. I once had a Rabbit, 'Uncle Albert' aged 9, who had an oral Fibrosarcoma and as a result he lost several molar teeth. Because he was such a bright, happy 'life is great' Rabbit my Vet wanted to give him the chance of enjoying a few more months. Whilst we knew that removing the tumour (which was confirmed as a fibrosarcoma from lab testing) would not cure Uncle Albert, it would buy him more time.

Uncle Albert remained on daily analgesia, antibiotic cover and he was only able to eat soft food. But he still LOVED life and lived every day to the full. He got to enjoy another 7 months before the fibrosarcoma returned and me and my Vet agreed that more major surgery was not an option.

I dont think anyone can tell you what decision to make for Gilby, every case is unique and what would be 'right' for one Rabbit could be 'wrong' for another Rabbit.

I would say look into Gilby's eyes, they will tell you what he wants. If the eyes still have that 'sparkle' then the Rabbit is not wanting to give up yet. If the eyes look dull and flat, then the Rabbit is probably saying 'it is my time'.

You may not think you will know what to do, but you will xx

I have no experience of what Gilby and you are going through, but I just wanted to add my vibes for Gilby and good wishes for you. I'm pleased that other members have been able to share their personal experiences with you and give you some good advice. I understand your concern regarding his diet and would hope that with chopped hay and possibly Readigrass too, there will be less of a need in time to increase the percentage of pellets. Chopped up herbs would be quite tasty for him too and if you can find anything outside at this time of the year, chopped grass, Dandelions etc would be worth trying.

Stay with us and I'm sure there will be lots of people willing to provide further advice and support.

Sibby said:

Wow, like everyone else who's taken the time to contribute to this thread, you're so helpful and lovely, thank you!

It's very helpful indeed to hear from someone who has experience in nursing buns with dental problems, and I'm grateful for your advice. I've just cut up some hay into tiny pieces and have mixed it in with his mushy pellets to see if he'll eat it. What great advice, thank you.

As soon as I've had some sleep I'll spend the time replying in more detail to you and everyone here, but I just wanted to thank you in the meantime.

You're all such a wonderful bunch, and I wish I'd joined this forum years ago. Thank you! Xx

Sent from my Redmi 3 using Tapatalk

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You're very welcome Sibby

If you can learn from our experience then that's all to the good. I really hope you'll be a bit easier on yourself now xx

Hi Sibby, welcome to the forum. I'm sorry that it's not under better circumstances. It's obvious you love Gilby very much.

Unfortunately I cant offer any advice, as it's not something I'm familiar with, but I would say that sometimes opinions about what can or can't be done can differ so much between vets. I've read stories on here where all hope seemed lost, but thankfully there was a good outcome. One of my rabbits, Sydney has been ill for a couple of weeks and the first vet we saw were of the 'well what would you like us to do' thinking and appeared to have written him off. While another agreed that there were things we could try. Hes still poorly, but he's still fighting and still has a quality of life.

Thinking of you x

You will probably find that Gilby is coping better than you initially. He will just be getting on with living, while you are wondering how to cope and it's all new to you. It's about managing day to day and week to week. The little things are manageable and you find different ways round them to suit your situation. If he is happy today, just go with it. Keep him eating and pain-free. Monitor input / output / weight etc.

I always considered if they were a bit better / same / bit worse than eg a couple of days ago and a couple of weeks ago, and adjust things as necessary. It helped to get a perspective on how we were doing, especially if considering quality of life and PTS. Keep a daily record so you can be more objective about it. eg tried chopped cabbage - he ate some of it. Needs to be v. finely chopped, or try broccoli / cauliflower florets instead. Coarse grated apple / carrot: OK. Ate all pellets (soaked). Maintaining weight (xx kg). Poo - normal size, colour and quantity. Bright and lively.