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aftermath

I know I haven’t explained what happened last week, but the answer is nothing drastic: just a steady decline. Frank never started eating on his own after his surgery. We fed him Critical Care every few hours, and watered-down Pedialyte even more often (and meds, and belly massage), but he was losing weight and dehydrating anyway. He lost interest in everything but snuggling, and even then he was listless. His eyes were glassy, he was always in discomfort (if not pain), and he’d given up on the litter box. He just wasn’t living anymore.

Life without Frank has been and continues to be a difficult adjustment. I miss his presence very much.

Coming to accept the events of his life, particularly of these last few months, has also been difficult.

In the aftermath, particularly in looking over this blog, things seem crystallised — I hope somewhat illusorily. Because as I scroll down, past the posts of his final illness, I see a picture of Frank taken in profile a few months before his death, and I see a bump at his throat and I think, my God, how couldn’t I have noticed? And I scroll further down to last October when I found the inflammation on his chin, and I’m afraid to think this could have been going on so long, and that I may have been the cause of it through one incident of accidental rough grooming. And, I must admit, I’m afraid of my readers doing the same, and thinking the same. But I don’t believe it’s really like that. Other pictures that I have reveal Frank always had a slight dewlap; and that, from many angles, the bump in his throat, around March and since then, was not at all distinct; also, he was examined by a vet in May; and, until two weeks ago he showed no signs of discomfort or ill health — so I’m trying not to blame myself for not noticing. And if I had noticed earlier, I’m not at all sure the final outcome would have been any different. As for the inflammation last October, I think I did what I could in response to misfortune. I had Frank examined by the vet, I had a cell sample tested, I kept an eye on it, and the swelling went away. The vet said Frank could well have simply jabbed himself with a sharp piece of hay as he grazed, and she wasn’t very concerned. Maybe my fears are right and it was my rough grooming that did it but, either way, it was a small injury sustained in the normal course of daily life. I don’t know if it’s connected to the tumour or not (the test of which, by the way, came back “undiagnostic”), but if it was, what could I have done about it? This is what I keep asking and I keep answering: Nothing. I can only hope my readers agree with me, but if you don’t, you can learn from my experiences. I won’t be enabling comments on this post and I don’t want feedback on this issue (unless you are a doctor! because I do plan to look into this, some day); rather, I am writing this for the sake of closure. I am closing this blog, tying up loose ends. It is mine to do.

Thank you, everyone, for your comments over the years. In joyous times and difficult times, you have uplifted and sustained me, and Frank as well. Warmest wishes to you and your own beloved bunnies.

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I am not a good nurse. I just had a rough session with force-feeding, and now I feel rather sick to my stomach. How will I be able to keep this up?

Frank has deteriorated somewhat. He’s still in a fine mood, but he didn’t touch his breakfast pellets, so now he’s on Critical Care (followed by force-water, which is really way worse than the force-feeding bit). His poops (fecals) overnight were fine, but we haven’t seen many yet today; nor have we seen any unformed cecotropes/mushy poops, but we have seen a lot of normal cecotropes… normal except for the fact that he’s not eating them! The last ones appeared as I was preparing the CC so I mixed them in. I don’t know if that will even work, as he might have accidentally chewed them before swallowing, and I’ve heard that ruins them. (Also, I think he noticed what I was doing and was not impressed.)

Now S is giving him belly massage while I decompress. We might have to break out the Pedialyte soon. He’s not dehydrated, but he’s resisting the force-water more and more, and the less water in his system, the more likely the onset of GI stasis.

I have to admit, I’m feeling resentful of our vets at this point. Finally we’ve learned enough to catch a problem early on, and what good does it do us? He won’t be seen until Wednesday or Thursday: almost a week after we first noticed something was wrong. And, of course, if we fail in our efforts to keep him stable and he goes into GI stasis, then back we are at the 24/7 emerg, no better off than we were as newbies who didn’t notice a thing until it was too late. Logically speaking, I know I can’t blame them: only I am responsible for the things I’ve taken responsibility for, and I guess it’s nothing but foolishness to think of a vet office as anything other than a business. My problem isn’t really them: it’s my own powerlessness. And really, it’s nothing but bad luck, what’s going on here. But, let me tell you, it doesn’t feel good.

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Well, poor Frankie’s in cecal dysbiosis. Maybe. Or he’s tottering on the edge. Or he’s okay?

I apologise for the amateur diagnosis, I’m just trying to understand what’s going on. My cause for concern? Frank’s not eating any (or hardly any) hay. This has been going on at least three days now. And I’m concerned because a diet low in fibre (whatever its reason) will lead to a sick rabbit, yes? Other signs of ill health I’ve observed are:

  • Reduced appetite (I already mentioned he’s ignoring his hay, but he’s also been sluggish with his greens, pellets, and water)
  • Occurrence of unformed cecals (i.e. mushy poops, some large like fecals but they’re not fecals, they smell and feel like cecals — this does make sense, considering the lack of hay consumption; I found a pile of five or so found yesterday; today, only one so far)

We’re not in emergency mode. He’s still peeing and pooping fine (aside from those mushy cecals). His mood, mobility, and energy levels are normal. But I am worried.

My first plan is to stave off ileus, for which my ideas consist of:

  • Forcing water (which I’ve already started doing)
  • Belly massage (started yesterday evening)
  • Papaya enzyme tablets (he’s been on “moult-levels,” i.e. 60mg/day, since his vet appointment last month when the vet felt a little something, maybe fur, in his belly)
  • Simethicone if I suspect gas (I did give him one dose yesterday)
  • Forcing Critical Care, Pedialyte (if he stops eating, drinking)
  • Maybe the vet will give me some pain meds tomorrow (like Torbugesic) in case ileus sets in over the weekend? (I already have some leftover motility drugs, i.e. Metoclopramide)
  • And, of course, encourage encourage encourage!! (I even went out and bought more grass hay today, so now we have four varieties!)

My second plan is to figure out WHY he’s gone off the hay.

  • My first idea is: dental trouble
  • I don’t have a second idea, but I know it could be any number of things

Obviously I need a vet to help me with my plans, but the long weekend is coming up and both my vets are booked solid tomorrow. If it turns into emergency, I’ll go by the closer of the two and they’ll try to squeeze him in. And there’s always (God forbid) the 24/7. Tomorrow I’ll call the vet and ask for a brief consultation, at least.

These two links have informed me:

If you have insight into what’s going on here, please share it with me!

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We tried Frank out on a new vet last month. It’s much, much closer to home than our regular vet’s (I actually walked Frank home! in a carrier, of course; and picked up hay on the way!), so I’ve been eager to test them out ever since I found out they take rabbits now. Turns out their rabbit vet used to work at our regular vet’s! I came prepared with a list of screening questions but I only asked two or three, he so clearly knew what he was doing.

The new place is smaller and more informal than our regular place, which admittedly has its drawbacks (e.g. efficiency is not exactly prioritized, so everything took a long time), but for me they’re greatly outweighed by the benefits (so far).

Our regular vet’s is a large hospital and while the doctors and techs are always willing to answer our questions, I can feel their anxiety about keeping to schedule and getting the next patient in. They don’t always review Frank’s file beforehand so I find myself explaining things I’d already explained and referring to things from previous visits they didn’t remember. At times it’s been like pulling teeth to get them to help us to help Frank at home; they’ve been condescending at times (not so much in tone, but in their approach). I understand of course that many rabbit owners are irresponsible and don’t know what they’re doing, but I should think that if you approach me without prejudice as an individual and consider the things I’m saying and doing, it would be clear that I’m not a rabbit-ignorant fool. They’re also a teaching hospital with a lot of tech turnover, which I understand the need for but don’t enjoy at all: Frank has been occasionally mishandled and three times almost dropped.

Conversely, at our visit to the new place, the vet sat on a stool and did most of the physical with Frank on his lap, and for the rest of the time I held him in the typical pose instead of a tech doing it. I liked that a lot and I think Frank did, too; the “front paw shakes” never set in once! He also suggested taking a sterile urine sample (cystocentesis), which had never been done before (I’d always collected the urine myself), and he recommended I have him send the urine out for an extra test when he saw the results (he found some bacteria but, long story short: false alarm, hoorah!). I don’t think of it as a waste of money. I’m happy to switch up the normal procedures for Frank’s diagnostics now and then. You never know what one test will miss, or one set of eyes! And, overall, this vet’s is a little less expensive than the hospital. We also got the results back from his basic tests (urine and blood) way faster, within a day or two! I guess they have testing facilities on-site? I did notice, however, the exam room wasn’t equipped with the fancy-pants deep-scope-and-screen that the hospital has (which has been used a number of times on Frank’s mouth and ears).

I guess I’ll use the nearby place for regular visits, and keep the hospital as a back-up for second opinions and for times when high-tech could be useful.

A healthy Frank!… To be honest, I was almost hoping Frank did have a bladder infection, somehow missed all these years, and that it would explain his messy habits and nipple obsession. I don’t like not knowing. I’m afraid of hearing, down the road, a much more terrible explanation than something a simple course of antibiotics could fix…

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The results are in about the lump: no cancer cells, no signs of an infectious cause – just inflamed tissue. (“Just,” ha! Seriously though, I am greatly relieved.) The vet thinks perhaps Frank was stuck in the chin with a sharp piece of hay and his natural defences walled it off with a cyst. I suspect that rather I was too rough in my grooming one day (he gets small knots in his chin fur from drinking juice-water from a bowl). The lump is getting smaller, so it looks like we’ll be able to avoid surgery. Very good news! (And Frank, of course, continues otherwise in perfect health.)

So please, let this be a lesson to any companions out there to buns with messy fur problems: be very careful! I thought I was avoiding all dangers by avoiding scissors. Not so! Even a tiny tear in the skin – not one large enough to expand (for rabbit skin is very elastic, and a small cut can expand to a frightening size quite quickly), not one large enough to be noticed – is enough to result in a cystic inflammation which can potentially grow, requiring surgery. Even our best-case-scenario (fingers crossed that it continues to be so) meant travel for our bun (always somewhat stressful) and a $300+ bill.

(Disclaimer: I don’t mean to treat messy fur as commonplace. If your rabbit has knots or stained fur, seek veterinary attention! Poor grooming is usually a sign of something far more serious.)

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On Monday night I found a lump on Frank’s chin during a routine check-out. I’ve read enough horror stories to know this warranted a visit to the vet.

I brought him to the vet’s Tuesday evening – what an ordeal! Never has Frank given such a chase to avoid his carrying case, and when I finally got him in there he really struggled to get out. I mean, I felt a force in his body I had never felt before. This kind of worried me – was he scared because he knew the depth of the problem? Maybe not… I know I give him too much credit.

All in all, we did not have the best vet visit ever, but the long and short of it is the lump is just in his skin (not bone; Yay!). The vet thinks it could be a sebaceous cyst. (She said skin tumours aren’t as likely in rabbits as they are in dogs/cats.) So, she took a sample and we’ll get the results soon. If it is a cyst, it could just go away on its own. If it starts to grow, though, she’s recommended surgery. (Gulp)

Frank is still eating/drinking/peeing/pooping/playing per normal. The two problems from previous vet visits (inflamed nipple, enlarged toe) were fine, just fine. Good…

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Today we brought Frank to see the vet. He was due for a general, as well as parasite (feces) testing and nail-clipping, but we also wanted them to check out one of his ears, as he’s been holding it cocked out at an angle for a few days now, and shaking his head and excessively digging in there with his foot. The vet used a deep scope to look in his ear all the way up to the drum (which looks shiny, almost like metal – I got to watch on the monitor). We found a bit of wax in there, but no mucus or redness, no swelling, nothing. (Nor were there signs of infection in his nose, mouth, eyes; nor has he been sneezing, etc.) The vet did say that Frank’s ear canals are a little smaller than those she’s seen in other rabbits, so maybe that little bit of wax would bother him more than it would others. She squirted some cleaning fluid into his ears, massaged around the base of his ears a bit, and that was that. Of course, once we were at the vet, Frank had stopped cocking his ear or shaking his head… probably he got rid of the problem before we even left! He seems fine now – a little angry, but fine.

Sadly, we did notice a potential problem with one of Frank’s toes. One of the nails that he lost awhile back is growing back a little funny, and the skin underneath it is a little larger than it is on his other toes. The skin wasn’t inflamed and didn’t seem especially sensitive, so she told me to keep an eye on it and bring him in immediately if I notice a problem. “Better to amputate a toe than a foot,” she said. Eeek! Better to amputate nothing at all, of course, so please keep your fingers crossed for Frank!

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