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Archive for the ‘first aid’ Category

The vet found irritation on Frank’s tongue on Tuesday, so he went in for surgery on Wednesday, but they didn’t find a molar spur. They found a huge tumour in his throat. It was so big, growing up and over his back teeth (Jesus!). When they found it, they called me and asked if I wanted him put down, because I could not afford the complicated careful removal procedure, and I said okay, but then they looked more closely and said they felt a slash and burn might be successful, so that’s what they did. (I’m sorry, I do not know the technical names of the different procedures at this point.) They’ve sent the thing off to be tested, so we’ve yet to learn whether it’s malignant or benign.

Frank is home now, but he still can’t swallow solid food. Is that because there’s more tumour in there, or because of swelling from the surgery? We won’t know for a few days.

I have worried at times the surgery was a mistake: he’s so old, am I just prolonging his misery? But, no, I’m quite sure the only thing I would be saving if I’d put him to sleep when they found the tumour is money. Frank tried so hard to keep living in spite of this thing. It must have been growing for a long time, and by the end (the vet says) it must have been painful to even close his mouth! But did he ever give up? No, he only stopped eating when he physically no longer could, and even then he stayed happy and active. Both times he returned from the vet he was in such high spirits, running into the kitchen and asking for food, sure (I believe) that he’d been cured. Both times he became (I believe) depressed upon realizing that he hadn’t been, but he bounces back: his mood in the evenings especially is lovely, he tries to nibble greens and hay, and occasionally he eats his own Critical Care and drinks his own water.

The vets said “we gave him a fighting chance” and I think that is right. He has been fighting, and now we’ve given him a chance. If he doesn’t recover, well, at least we tried as much as Frank has been trying. And if he does recover, even if only for another few months before the next disaster strikes, I think it was worth it.

So in the mean time it’s back to force-feeding and force-hydration, but at least he eats his meds on his own (I put them in a ramekin — I’m sure they’re super sugary). Belly massage, belly massage, belly massage! He continues to poo and pee, but his poops still don’t look so hot (understandable), but I think he may have started eating his cecals again! And he’s been struggling with gas (again, understandable considering all the syringe feeding). Yesterday was unbelievable. He was so swollen I thought maybe it was Bloat (and, thus, the end) but I kept rubbing in case it wasn’t. I rubbed and rubbed, and there was much gurgling, and then there was SUCH gurgling, his whole body rumbled, Frank opened his eyes wide and stretched his body out… seriously, I’ve never seen anything like it, even in humans. I never actually heard him pass it but he must have because the bloating went down and the rumbling stopped.

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I guess, at this point, dental trouble could either be the cause or result of Frank’s not eating hay, but I’m very suspicious now about him feeling discomfort or pain in his mouth. I’ve caught him moving his mouth about in odd ways this whole time, and eating in what I thought of as a careful way. Now he’s dropping his food and eating less and less of it. He has great trouble swallowing his cecotropes. He noses around in his food and shows interest but he’ll only take tiny bites, and he’ll take forever to eat them, and as he does little pieces will drop out of his mouth. We’re largely relying on Critical Care at this point, and we’re mixing Pedialyte into his water. His poops are still regular but they’re becoming smaller and conical-shaped.

I’m going to try and get him a vet appointment tomorrow afternoon on grounds of emergency.

If we don’t find any obvious problems in his mouth (irritation on tongue or cheeks, big molar spikes), I wonder if Frank is just getting old, finicky, senile? I wonder if we’d see any improvement with a course of meloxicam (an anti-inflammatory and analgesic)? If so, would this be a for-the-rest-of-his-life situation? It’s hard not going over all the possibilities in my head but, on the other hand, somewhat pointless until I hear what the vet has to say…

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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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As I wrote on Tuesday, Frank was alone today while I went to work. Considering I’ve been spending my days this week switching out his chilled floor tiles, I was very worried about him being alone for so many hours in the hottest part of the day. So, I asked my downstairs neighbours if I could store him in their basement bathroom (in his crate). Aren’t they nice? -they said yes! Frank was not especially happy about this, because normally he is not confined to his crate; in fact, when I first put him in, he was so annoyed he wouldn’t even consider the blueberry I offered. However, by the time I came home, the blueberry was gone and Frank was one cool-bodied bun. One of my neighbours even thoughtfully angled a fan in his direction (on a low setting and from a distance – no worries!).

On a side note, I’ve been time-wasting in one of my favourite ways – namely, reviewing the web presence of domestic rabbits – and I can’t help but wonder once again … why do so many people think that rabbits talk (or would talk, could they talk) with a lisp??

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Yes, I do realize I’ve already posted about the heat, but this past week has really been too much. Throw in a blackout yesterday due to a fire at a transformer station, and the temperature in our apartment reached unbearable levels. (Which goes to show how much of a difference a well-placed fan can make. Keep that in mind, air conditioner users!)

Yet again I am reminded of my fortune in regards to community, because the residents who live downstairs graciously allowed us to bring Frank down to the basement bathroom for cool-down periods. Frank wasn’t exactly happy about it … he’s not the most adventuresome bun, and not a fan of change … but I’m convinced it made a big difference in his comfort levels, possibly staving off heat stroke.

Otherwise, we’ve been switching out his ceramic tiles with regular (neurotic? no) frequency, and administering ice rubdowns (but only for very short periods – we’ve noticed that when his fur gets too wet, he grooms compulsively, and this is not the time for a fur-ball; not that any time is the time for a fur-ball, but this really is not the time). He’s also been staying well-hydrated, and aside from a brief stint yesterday upon his first return from the basement (he ran straight to his litter box, and upon investigation I found two cecotrope bunches and one big but mushy poop – I think this was simply, straightforwardly, the result of stress from the heat and from the trip downstairs), his G.I. and urinary functions have been consistent.

Luckily, I was home yesterday, am today, and will be tomorrow, but on Thursday and Friday, Frank will be on his own for a number of hours… the temperature’s been forecasted as lowering somewhat by then, but I still don’t like it.

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When I came home last Wednesday afternoon, Frank jumped up to say a quick hello before running down the hall, around the corner, and under our bed. Nothing unusual about that exactly except for the hour, because at that time of day (I guess around 4) he is usually pretty zonked out. When I checked on him soon afterwards I found him a little hunchy, with a look in his eyes that made me nervous. I checked on him a few other times, finding him unmoved, and then I heard some telltale tooth-grinding – crunchy, loud, irregular, and not at all purr-like. My thought was: gas; so, I went to his room to prepare the simethicone (0.3cc of a 20mg/0.3cc liquid suspension). While I was doing so, he came tearing around the corner, ready to hump my leg. I felt relieved, but I decided to administer the simethicone anyway, along with a lengthy stomach massage that he tolerated very well. A couple of hours later, I gave him another dose and massage – in the mean time, he had varied between fine (loungy and responsive) and uncomfortable (hunchy and slightly glass-eyed). His second dose was around 6 or so p.m., a normal time for him to rise for the evening, and this he promptly proceeded to do. So, either he was fine the whole time, or he did have a little gas and I, bravely, came to the rescue and averted disaster. (I, of course, suspect the latter.)

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Frank’s follow up with the vet went alright. Weight and temperature are normal, and his physical revealed nothing to worry about; his broken nail has healed fine, and I had the others clipped. He had blood taken (twice actually, because there was a clot in the first sample; he went home with a self-adhering bandage wrapped around his hind leg, to limit bruising – I was told to remove it within the hour, and had a bit of a struggle with Frank over that). The results from his last blood test, from when he was sick, showed really messed up liver functions and somewhat off kidney functions, so they’re going to look for those results especially. His kidney results may still be off, however, because dehydration can mess with that, and he hasn’t been drinking much.

That’s the latest problem: dehydration. He’s not severely dehydrated, but he’s not drinking as much water (or peeing as much) as he should be. This has been since Monday or Tuesday. The first day we were actually administering water by feeding-syringe, and we gave him a 1cc dose of water last night, too. We’ve been giving high ratios of juice to water in his bowls (1 juice to 6 water, sometimes 1:5). The vet said, if necessary, the normal maintenance-level water to administer per day is 30cc per 1kg of body weight, but some say with rabbits that should be 60cc, and really 100cc wouldn’t be a problem. Frank weighs 1.79kg, so going by the 60cc/kg ratio that means 107.4cc of water per day.

The vet suggested we do a urine analysis but, at this point, we’re limiting that kind of stuff. Let’s say we do the test, and his urine reveals a problem; what then? Are we going to put him through surgery? Another round of meds? And then what? Something else goes wrong, and we do it all over again. We don’t have the funds to maintain that kind of life for him, and we’re not sure it would be the right thing to do anyway. At this point, we’re looking to provide for his comfort and support him here at home. He is still a happy, active rabbit, so I guess we’ll have some tough choices to make next time he isn’t.

He’s such a good bun though. Now he is under the sofa, napping, which is usual for this time of day. This is probably his time for deepest-sleeping. Oh, no, as I write he ran to his crate. This morning we were cuddling together on the bed before I served him breakfast. Last time he drank was just before then, and he hasn’t peed all day. Oh, no, he just peed the tiniest bit.

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The new year so far has been terrible. I fell ill on the 28th, and as I started to feel better on the 31st it was only to realize something was wrong with Frank. We don’t yet know why, but he sunk into ileus on the 1st. I suspect this isn’t about a straightforward blockage. We’re still nursing him through the ileus, and we won’t discover the real problem for awhile. Here’s the timeline:

31-DEC-09

  • Mid-morning: A full litter box is scooped and replenished; Frank eats his breakfast and joins us in the bedroom for play-time; a perfectly normal bun.
  • Midday: Frank settles down to sleep as usual.
  • Afternoon: Frank rises briefly to drink some water.
  • Evening: Frank doesn’t rise for dinner or play and hasn’t pooped all day; this is unusual but we’ve seen him like this before only to rise normally overnight, so we aren’t very concerned.

1-JAN-10

  • Morning: Frank ate his dinner greens overnight but left his pellets and papaya tablet untouched; only a few poops in the litter-box; only a little water was consumed and urine output is on the low end; his mood is still reclusive, although he’s more responsive and relaxed than he was the last time (and only other time) we saw him in distress, so I feel hopeful.
  • Day: No change; I begin treating Frank for gas: Simethicone (three doses of 20mg over 3-4 hours) and stomach massage.
  • Early Afternoon: Frank lays down in his play-box for awhile, something he’s never done before, and panic is starting to set in; he hasn’t pooped, and now we’re finding cecotropes; I begin treating him for dehydration with watered-down Pedialyte and posting on discussion boards.
  • Afternoon: Frank stops taking the Pedialyte so we bring him to the emergency vet hospital where they give him a physical exam (he has a normal temperature and a yucky-feeling belly), sub-q fluids, a small shot of pain meds (Torbugesic 0.3mg/kg), and a motility agent (Metoclopramide 0.5mg/kg); total cost $202.13.
  • Night: Frank’s mood/behaviour doesn’t improve and he isn’t pooping or eating, although he’s peeing well and drinking some; we keep him warm with a heat-pack wrapped in a towel, and we sleep in his room on the sofa-bed.

2-JAN-10

  • Morning: We call the vet when they open and bring him in immediately; they give him a physical exam (still a normal temperature) and outline a treatment plan consisting of meds and fluids, 3 days stay, and diagnostics (blood work, x-ray), costing a total of $2,000; we decline, and they outline plan B: meds to go home with us (Torbugesic, Metoclopramide, and Cisapride; and Critical Care), blood-work, and fluids administered that day and the next, to a total cost of $8-900; we agree and pay $609.09 for the day.
  • Day to Evening: Frank’s mood/behaviour slowly improves; some water consumption and lots of peeing; he’s pretty obedient with taking his meds; no poops yet, he eats some cecotropes and leaves others behind.

3-JAN-10

  • Morning: Frank poops overnight, small little things; we return to the vets for more sub-q fluids; poops are consistently coming, although still very small and misshapen; blood test results show low red blood cells and poor liver functions, so after a quick re-test we agree to a shot of iron and an appointment for the 11th to re-test for liver functions; a more in-depth exam of the mouth (involving a scope in the back-room) reveals some tooth spurs but no ulcers in the mouth (yet); possible causes of this bout of GI Stasis are described as liver problems (although this could also be as a result of the GI Stasis – hence the re-test scheduled for next week), dental discomfort (if Frank slips back after we stop the pain meds, that would be a sign), or physical blockage; bill comes to $180.94.

Since then I’ve been nursing Frank at home (luckily I have the week off work anyway). It’s been very exhausting and stressful, but Frank is slowly recovering. For awhile he was eating his Critical Care from a spoon, but yesterday, with his improving mood, he started resisting his meds and we’re back to syringe-feeding; he also started misbehaving last night, biting at baseboards and wire-guards. His activity levels are getting better, but he still isn’t really cuddling with us; although, he has started spending more time on his usual outlooks/places around the room. He’s been wary of us since getting sick, as we’ve been “bothering” him frequently with meds and belly massage.

Water, greens, and hay consumption, and urine output, have returned to normal or near-normal levels. He’s still not eating many pellets, just a bite or two here and there. His feces is looking more normal every day (in size, amount, shape, and consistency – they were a little mushy for awhile there). On the 4th and 5th we spoke with the vets on the phone, but today there hasn’t been a need. We’ve been slowly reducing his Critical Care. We’re still spending nights in his room.

It’s down to waiting, now, to see what happens when he goes off his meds and has another blood test. If this is about a dental problem, we’ll give him the surgery to grind down the spurs (although the last time he was put to sleep for surgery he had a bad reaction and gave the vets a good scare). If it’s about a liver problem, there isn’t much we can do for him. The vet started talking about ultrasounds and this and that, which we can’t afford, so she switched to talking about milk thistle (I think) and other things we can do to “support” liver function. That is what it will come down to. He is an old bun and anyway you can’t squeeze money from a rock (we’re the rock), no matter how much you want to.

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The other day, Frank ripped a piece of vinyl off a trunk and began to eat it. I responded in my usual way, which is to gently hold his mouth open with the tips of my fingers at the sides of his mouth, because when I do this he immediately starts working his tongue, I guess to get my fingers out of his mouth, but with the actual effect of producing the piece of non-food (which does then get my fingers out of his mouth, so it’s successful for the both of us). It worked this time as usual, but just before I got the vinyl he lifted his paws to swipe at my hand, which was covering his nose, and I got the distinct impression that he couldn’t breathe so I moved my hand even though I thought it couldn’t be true since his mouth was wide open.

He’s fine by the way, this all happened over the course of maybe 1 or 2 seconds, and I didn’t think of it again until I was scanning a page of rabbit anatomy just now and came across this:

“rabbits must normally breathe through their nose. It is therefore a grave sign if a rabbit must resort to mouth-breathing” (http://www.exoticpetvet.net/smanimal/rabanatomy.html).

So, he probably couldn’t breathe! It was good of me to act on my impulses even when I thought, logically, I knew better. And I’m happy to know this new sign and symptom of rabbit ill-health.

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