Advice - one week after teeth clipped

[CraigRobbo81]

Hi everyone, we have a Netherland Dwarf, Willow, who had to have her teeth trimmed last week due to length and to have a couple of spurs removed. She’s had them done before and been fine within 24hrs or so, although this time the vet did say he’d had to do more than usual.

The op was last Monday, so we’re now 8 days on. We only got her back at 6pm and the first night she’s was very lethargic, didn’t each much and didn’t do any wees or poos. We weren’t overly concerned as she did eat a small amount but took her back to the vet on Tuesday for more painkiller and gut stimulant and to be checked for dehydration (she was fine). She went back to the vets Wednesday and Thursday, he checked her over and said her mouth had healed nicely, no cuts, abrasions or abscesses, no blockages and her gut was moving although a bit slower than he’d expect. He gave us antibiotics “just incase”, and said as far as he’s concerned she’s ok, so that was her last “post surgery visit” and we’d have to pay for him to see her if she needed to go back (post surgery we pay for medication not his time).

Our concern is that since the op, she’s only really eating her herbs (coriander and dill) which she’s greedily demolishing, but while she is eating hay it’s only a very, very small amount (probably 10-20% of what she’d usually eat). She’s eating some dandelion mix (bagged) but not eating her pellets or dried beetroot/parsnip/apple treats that she’d usually devour. She is weeing and pooing but the poos are smaller and darker than usual (though not tiny) and not in the usual quantity. She’s chewing her box, and it’s hard to know if she’s actually eating the cardboard or not. Although she’s lively and bright, she’s clearly not right, and we don’t know what to do next.

Do we start recovery food? Do we leave her to it? Is this normal and are we over-worrying unnecessarily? Any advice welcomed, especially if you’ve been in this position! Thanks

Craig

 

[Shimmer]

Will she eat fresh grass? It has the fibre her gut needs and is easier to chew than hay. There's quite a lot of fresh forage at the moment which may also help - dandelion leaves, hawthorm branches, etc. Water in a bowl rather than a bottle also makes it easier to keep hydrated. Have you tried moistening the pellets to make them easier to eat? It does sound like she's having issues with chewing hard, dry stuff.

Personally, I would do top up feeds with a recovery food for a few days to see if it gets her eating properly again.
Eating cardboard is not good and if she's actually ingesting it, it could cause problems.

Just wondering why the vet didn't give her gut mobility drugs and pain relief. Antibiotics shouldn't have been needed from what you described. I would have expected her to be back to normal by now after a routine dental. The problem is that teeth grow quite quickly, so if she's not eating properly she may be developing more spurs as there's nothing to keep the teeth ground down. Is there a possibility that there's still a spur or other dental issue? It's very difficult to see the back teeth in a conscious rabbit, and NDs have such tiny skulls as well, which makes it even more difficult to work on. Has she had any skull X-rays to see what's going on with the tooth roots? The roots grow as well as the crowns. Reducing the crowns will help with roots, but you need x-rays to really check what's going on.

My feeling is that she may need another vet visit. Pain relief can make a big difference. Then look at why she's not eating properly. I would think about x-rays but get her eating again first - even if that's recovery food. I don't like putting rabbits through anaesthetic without a few weeks gap unless it's an emergency. It's not unusual for dentals to be needed every eg 6 weeks, and for the time between to vary from weeks to months. It's also worth asking for a referal to a rabbit specialist as they will have more experience in dealing with dental issues and it can make a big difference if the teeth are burred and shaped by someone with more experience.

 

[CraigRobbo81]

Will she eat fresh grass? It has the fibre her gut needs and is easier to chew than hay. There's quite a lot of fresh forage at the moment which may also help - dandelion leaves, hawthorm branches, etc. Water in a bowl rather than a bottle also makes it easier to keep hydrated. Have you tried moistening the pellets to make them easier to eat? It does sound like she's having issues with chewing hard, dry stuff.

Personally, I would do top up feeds with a recovery food for a few days to see if it gets her eating properly again.
Eating cardboard is not good and if she's actually ingesting it, it could cause problems.

Just wondering why the vet didn't give her gut mobility drugs and pain relief. Antibiotics shouldn't have been needed from what you described. I would have expected her to be back to normal by now after a routine dental. The problem is that teeth grow quite quickly, so if she's not eating properly she may be developing more spurs as there's nothing to keep the teeth ground down. Is there a possibility that there's still a spur or other dental issue? It's very difficult to see the back teeth in a conscious rabbit, and NDs have such tiny skulls as well, which makes it even more difficult to work on. Has she had any skull X-rays to see what's going on with the tooth roots? The roots grow as well as the crowns. Reducing the crowns will help with roots, but you need x-rays to really check what's going on.

My feeling is that she may need another vet visit. Pain relief can make a big difference. Then look at why she's not eating properly. I would think about x-rays but get her eating again first - even if that's recovery food. I don't like putting rabbits through anaesthetic without a few weeks gap unless it's an emergency. It's not unusual for dentals to be needed every eg 6 weeks, and for the time between to vary from weeks to months. It's also worth asking for a referal to a rabbit specialist as they will have more experience in dealing with dental issues and it can make a big difference if the teeth are burred and shaped by someone with more experience.

Sorry, I should have said that they gave her painkillers during each visit and gave us Meloxicam to bring home on Thursday so she’s been having that once a day since. She had guy stimulant during each visit but they would not give us any to give her at home.

It was my wife who was taking her back and forth last week but I am pretty sure she said he’d done x-rays and they were clear. She was under anaesthetic for the procedure last Monday as he said he’d had to do all of her teeth and he was certain that he hadn’t missed anything. She’s coming up 4 years old and has only needed her teeth doing once per year (approximately) up to now, the first time being when she was around 18 months, so this was her 3rd time. Could she really go from every 12+ months to needing them every few weeks?

She only ever has water out of a bowl (won’t use a bottle) and has been drinking fine since Wednesday so I don’t think she’s dehydrated. She’s doing plenty of wees too.

We’ve tried giving her soft pellets and she won’t touch them (never has, ever! Neither has her sister! They also won’t eat recovery food unless it’s forced by syringe either!).

She’s definitely ok eating the softer herbs, and also been eating dandelion leaves from our garden (2-3 per day) - she’s devouring anything like that. It’s definitely the harder stuff she’s struggling with/avoiding. As I say, she is eating some hay but only a tiny amount (it is a stalky timothy hay). I was worried about the cardboard.

We are going to go to the Range after work and get one of their packs of the softer hay with added marigold or whatever it is. In the meantime will get Laura to give her some grass too. We can’t really afford another vets bill if I’m honest so that will be a last resort.

There aren’t any vets around us who openly say they specialise in rabbits, and we’ve been using this guy for 4 years. He really seems to know what he’s talking about and has nursed both bunnies through several bouts of stasis and previous dentals so I’ve no reason to doubt his experience I don’t think?!

 

[InspectorMorse]

I agree with Shimmer’s advice, antibiotics should never be given ‘just in case’

https://www.bva.co.uk/take-action/our-policies/responsible-use-of-antimicrobials/

https://assets.publishing.service.g...onsible_Use_of_Antibiotics_on_the_cascade.pdf

Can you confirm that skull radiographs were taken ? If she has elongated tooth roots then this can cause ongoing pain after dental treatment. Also, what does your Rabbit weigh and what dose of Metacam is she on ? Many less Rabbit Savvy Vets under-dose metacam. Rabbits metabolise the active ingredient (meloxicam) much faster than other species so require a higher dose to give adequate analgesic cover.

What is her poo output like ?

Personally at this stage I would want to seek a second opinion from an Exotics Specialist/ Rabbit Savvy Vet.

You might find details of one near you on this link

https://rabbitwelfare.co.uk/recommended-rabbit-friendly-vets/

Rather than making her pellet feed wet try crushing the pellets up so they are dry but in crumbs, if you see what I mean.

 

[Shimmer]

If she's readily eating fresh greens, I would give her more. Foraged greens have higher fibre than eg cabbage, so are better for her (and cheaper for you). Grass, willow, hawthorn, dandelions, certain hedgerow weeds etc are abundant now.

https://www.harcourt-brown.co.uk/ar...bits/foraging/wild-plants-to-pick-for-rabbits
And the booklet by Twigs Way (it's only £2 now):
https://shop.rabbitwelfare.co.uk/product/foraging-for-rabbits-by-twigs-way/

 

[CraigRobbo81]

I agree with Shimmer’s advice, antibiotics should never be given ‘just in case’

https://www.bva.co.uk/take-action/our-policies/responsible-use-of-antimicrobials/

https://assets.publishing.service.g...onsible_Use_of_Antibiotics_on_the_cascade.pdf

Can you confirm that skull radiographs were taken ? If she has elongated tooth roots then this can cause ongoing pain after dental treatment. Also, what does your Rabbit weigh and what dose of Metacam is she on ? Many less Rabbit Savvy Vets under-dose metacam. Rabbits metabolise the active ingredient (meloxicam) much faster than other species so require a higher dose to give adequate analgesic cover.

What is her poo output like ?

Personally at this stage I would want to seek a second opinion from an Exotics Specialist/ Rabbit Savvy Vet.

You might find details of one near you on this link

https://rabbitwelfare.co.uk/recommended-rabbit-friendly-vets/

Rather than making her pellet feed wet try crushing the pellets up so they are dry but in crumbs, if you see what I mean.

Thanks. Re x-rays, I am fairly sure Laura mentioned last week that they’d done x-rays but now that I’ve asked her she isn’t sure. I know it’ll vary practise to practise but do you know roughly a ball park cost and we’ll probably know from that vs what we paid!

She weighs around 1.2kg, and the pain relief we got is branded Loxicom Meloxicam rather than Metacam (we have some Metacam branded stuff left from a stasis bout in January too). The label says to “give the dosage for a 4.5kg dog” using the syringe which has both kg and ml markers on. We are going by the 4.5 line.

She is pooing, though smaller and darker in colour than usual (assume due to lack of hay) and less abundant, but there are quite a few.

Thanks for the link. Our nearest one listed on that website is a silver graded one and is about 20 miles away (each direction). She doesn’t like travelling at all so not sure if that sort of journey will stress her too much?

 

[CraigRobbo81]

She’s eating the grass Laura has put down for her and she’ll give her some more dandelion later to tide her over for a bit

 

[Shimmer]

Just go for unlimited grass.

 

[InspectorMorse]

Is she used to eating fresh grass ? If not then personally I would not give too much at first. Grass is extremely rich at this time of year and whilst this is usually not a problem for Rabbits who graze on it daily all year round giving a lot of rich spring grass as a ‘new’ food type might cause bloat.

A Dental under GA including skull radiographs is likely to be at least £250 (London area)

 

[bunny momma]

Sending lots of positive vibes. I have a nd with advanced dental issues and you received good advice. I would remove cardboard.
Wet the greens to increase water intake too. Please keep us updated.

 

[CraigRobbo81]

They usually go out in their run in the garden during summer for a few hours a day, but they are house rabbits so she’s not been outside since last August/September.

Our back garden is still waterlogged from winter and recent rains (heavy clay) so there’s not a lot of new grass growth at the moment because of that. Not sure if that will affect the richness? What do you think?

We are going to the range after work to get some of their Timothy hay with added marigold (or carrot or whatever variety they have). We used this in the past when our other bunny, Trixie, was not eating normal hay and noticed it seemed a lot softer even though it is Timothy hay. We can only give things a try.

Thanks re the cost, I think we will ring the vets to double check anyway. We’re in the north east so I guess it’s not beyond the realms of possibility that they did an X-ray as I think it cost us something like £170 for the dental if I remember correctly.

 

[CraigRobbo81]

Sending lots of positive vibes. I have a nd with advanced dental issues and you received good advice. I would remove cardboard.
Wet the greens to increase water intake too. Please keep us updated.

Thank you. She is drinking a fair bit but we’ve been wetting some of her herbs too, just incase. She’s also having antibiotics which have to be mixed with water (to 1ml) so we know she’s having that too.

 

[CraigRobbo81]

Is she used to eating fresh grass ? If not then personally I would not give too much at first. Grass is extremely rich at this time of year and whilst this is usually not a problem for Rabbits who graze on it daily all year round giving a lot of rich spring grass as a ‘new’ food type might cause bloat.

A Dental under GA including skull radiographs is likely to be at least £250 (London area)

I spoke to the vets and they confirmed they have not done X-rays, only had an ‘exceptionally good look’ visually while she was under anaesthetic. He’s still insistent that he didn’t miss anything. They have quoted £315 for X-rays, excluding an initial consultation fee that we would have to have first, and excluding any dental work / medication that may be needed after X-ray. It seems extortionate based on your London area number and we simply cannot afford it.

The antibiotic is Baytrill and the vet insisted to finish the course (which will be tomorrow). I am still giving the Metacam daily.

We got Willow some of the softer hay from The Range (the one mixed with dried pumpkin, peppers etc mixed in) on Tuesday and pleased to say she’s been eating that willingly - probably still not to the amount she’d have eaten per day before all of this, but much more than she was with her stalky normal hay. She’s also eating all grass, dandelion leaves and herbs without any hesitation at all. She’s still not touching her pellets (either normal or crumbled up) or the dried apple/beetroot treats that she usually loves, she gets excited but then just sniffs them and walks away. But, she is eating the dried “dandelion and meadow mix” stuff without issue and has also eaten a couple of pieces of some different dried apple treats which I got on Tuesday that are a bit softer than the normal ones.

She is drinking and weeing, and although her poos are darker and a little bit smaller than normal, she’s probably doing about 80+% of her usual amount which is a lot better than a few days ago.

What do you think?

 

[InspectorMorse]

I spoke to the vets and they confirmed they have not done X-rays, only had an ‘exceptionally good look’ visually while she was under anaesthetic. He’s still insistent that he didn’t miss anything. They have quoted £315 for X-rays, excluding an initial consultation fee that we would have to have first, and excluding any dental work / medication that may be needed after X-ray. It seems extortionate based on your London area number and we simply cannot afford it.

The antibiotic is Baytrill and the vet insisted to finish the course (which will be tomorrow). I am still giving the Metacam daily.

We got Willow some of the softer hay from The Range (the one mixed with dried pumpkin, peppers etc mixed in) on Tuesday and pleased to say she’s been eating that willingly - probably still not to the amount she’d have eaten per day before all of this, but much more than she was with her stalky normal hay. She’s also eating all grass, dandelion leaves and herbs without any hesitation at all. She’s still not touching her pellets (either normal or crumbled up) or the dried apple/beetroot treats that she usually loves, she gets excited but then just sniffs them and walks away. But, she is eating the dried “dandelion and meadow mix” stuff without issue and has also eaten a couple of pieces of some different dried apple treats which I got on Tuesday that are a bit softer than the normal ones.

She is drinking and weeing, and although her poos are darker and a little bit smaller than normal, she’s probably doing about 80+% of her usual amount which is a lot better than a few days ago.

What do you think?

My money is on tooth root elongation which can be very painful. Nethies are very prone to this condition due to being brachycephalic. The only way to confirm or rule out TRE is from skull radiographs. Does your Rabbit ever have runny eyes and/or episodes of sneezing ? Another two pointers to the possibility of TRE

TRE cannot be cured, it is a case of life long management which usually involves ongoing analgesia, regular Dentals under GA and as TRE predisposes the Rabbit to tooth root abscesses treatment to address that situation would be needed too- ie further surgery and antibiotics.

Some further reading about what Dental treatment in Rabbits can involve, it’s not just a case of dealing with what can be seen in the mouth.

http://www.medirabbit.com/EN/Dental_diseases/Differential/Rabbit_dentistry.pdf

https://todaysveterinarynurse.com/dentistry/rabbit-dentistry/

https://lbah.com/rabbit/rabbit-teeth-conditions/

http://www.medirabbit.com/Radiography/anatomical_lines.pdf

 

[CraigRobbo81]

My money is on tooth root elongation which can be very painful. Nethies are very prone to this condition due to being brachycephalic. The only way to confirm or rule out TRE is from skull radiographs. Does your Rabbit ever have runny eyes and/or episodes of sneezing ? Another two pointers to the possibility of TRE

TRE cannot be cured, it is a case of life long management which usually involves ongoing analgesia, regular Dentals under GA and as TRE predisposes the Rabbit to tooth root abscesses treatment to address that situation would be needed too- ie further surgery and antibiotics.

Some further reading about what Dental treatment in Rabbits can involve, it’s not just a case of dealing with what can be seen in the mouth.

http://www.medirabbit.com/EN/Dental_diseases/Differential/Rabbit_dentistry.pdf

https://todaysveterinarynurse.com/dentistry/rabbit-dentistry/

https://lbah.com/rabbit/rabbit-teeth-conditions/

http://www.medirabbit.com/Radiography/anatomical_lines.pdf

Thanks for that. She’s not sneezing or got runny eyes at the moment. She had a blocked tear duct a couple of months ago but that was just one side and the vet flushed it and it’s been fine since. I guess this is to add to the things to keep an eye on.

We are away this weekend from late afternoon today, and my in-laws are going to pop to ours morning and night to sort the rabbits until we’re back on Monday. Willow is currently having Meloxicam at the dose for a 4.5kg dog (she’s 1.2kg), which the vet had initially said to give her for 4-5 days starting last Thursday. There’s still some left so I have just continued giving her it, figuring it will do more good than harm. My in-laws won’t be able to administer it while we’re away so I was wondering if I can give her a bigger dose today before we leave to see her through until Monday or is that something we should not do? Do you have any recommendation on this? I know you guys questioned earlier in the thread of if she was being under-dosed.

 

[InspectorMorse]

Thanks for that. She’s not sneezing or got runny eyes at the moment. She had a blocked tear duct a couple of months ago but that was just one side and the vet flushed it and it’s been fine since. I guess this is to add to the things to keep an eye on.

We are away this weekend from late afternoon today, and my in-laws are going to pop to ours morning and night to sort the rabbits until we’re back on Monday. Willow is currently having Meloxicam at the dose for a 4.5kg dog (she’s 1.2kg), which the vet had initially said to give her for 4-5 days starting last Thursday. There’s still some left so I have just continued giving her it, figuring it will do more good than harm. My in-laws won’t be able to administer it while we’re away so I was wondering if I can give her a bigger dose today before we leave to see her through until Monday or is that something we should not do? Do you have any recommendation on this? I know you guys questioned earlier in the thread of if she was being under-dosed.

Metacam given at a higher dose won’t last any longer, it will be metabolised and excreted out of the body at the same rate so it won’t give long acting cover. So if no-one can administer it daily she will be without anti inflammatory analgesia when not having the dose. I would be concerned about leaving a not 100% well Rabbit just being checked on twice a day. Especially if no pain relief is being given when it has apparently previously been needed. A Rabbit in pain is likely to eat less or stop eating. This can rapidly lead to reduced gut motility/gut stasis.

Metacam is a POM, only a qualified Vet can give you advice re dose rates. But here is some information about the drug, Metacam being a brand name for the drug Meloxicam

https://rabbitwelfare.co.uk/drug-fo...Meloxicam is a non,term, eg for arthritis etc.

Blocked tear ducts often occur when tooth roots are elongated. The tooth root presses on the duct and prevents it from draining properly. This can lead to weepy eyes and tear duct infections

 

[CraigRobbo81]

Thank you

Oh, we know this is far from ideal!! They may also pop in during the day, but so far all they’ve fully committed to is twice p/d. Her parents have had rabbits for 25+ years and know our rabbits well, so I think they will recognise straight away if she seems different to normal, and in that case they would either ring the emergency vet or us and we’re only 90 mins from home so could get back quite quickly.

If that were the case we have the Meloxicam we can give her straight away, and I think we have a small amount of Emeprid left from her stasis in January too, if her gut had slowed. The main reason her folks won’t be able to administer it is that they both have physical movement issues that would make it difficult and unsafe to try and get in and out of the pen without falling and injuring themselves or the bunny! (Whereas they can easily reach over the top to reach the litter tray and water bowl etc).

I guess up to this point we have continued giving her the Meloxicam without being sure if she really needs it or not, so the only way to know for sure is to stop giving it? She had been having it at 7am each morning up to Wednesday, then yesterday I didn’t give her it until the evening (working to the theory that I’d then give her some before we leave this evening to keep her going into Saturday, then can get back on it when we’re home mid-Monday). The extra gap between doses at 7am Wednesday to 10pm Thursday didn’t seem to have an adverse effect, so I am hoping beyond hope that it means she doesn’t necessarily need it, and we’re perhaps just giving her it for our own peace of mind more than anything.


Sent from my iPhone using Tapatalk

 

[InspectorMorse]

Don’t give Emeprid again without consulting a Vet. It is not always appropriate or safe to administer a prokinetic drug to a Rabbit who has reduced gut motility. A Vet needs to rule out any risk of an obstruction within the GI tract. Giving a prokinetic to an obstructed Rabbit is likely to have a very bad outcome.

Is the Rabbit passing normal size/quantity of fecal poo ? This is something that needs to be monitored very carefully. A reduction in the size and/or quantity of fecal poo indicates a reduced gut motility which always needs Veterinary attention, even if the Rabbit seems OK within themselves and is still eating a bit. Being a prey species Rabbits hide any illness well. By the time there is a noticeable change in behaviour they are often already quite unwell. Hopefully the people who will be attending to your Rabbits are aware of this and will check for poo output and not just rely on how the Rabbit is behaving.

 

[Shimmer]

Will she not come for the metacam straight from the syringe? Or from some food that it's soaked into? I tend to use a small cube of bread if I can't get a syringe in their mouth. Metacam is usually liked by rabbits and they often come straight for it, unlike most other meds. You can always leave it pre-drawn up in the syringe. Store it somewhere safe and in the dark - it is unstable in light.

 

[Shimmer]

Emeprid / Metaclopramide - apart from the advice IM gave, I seem to remember from a conversation with a pharmacist that it doesn't keep for very long, so you may need a new prescription dispensing if your vet says to give it.