Re: Geriatric bunny health

Romain Pizzi — Thu, 06 May 2010 01:10:05 GMT

Very last quick additon, sometimes rabbits who suddenly are allowed access to fresh grass (after a long winter on just hay), can get soft stools, and just need a more gradual introduction to the grass to allow their faecal pllets to return to normal!

Re: Geriatric bunny health

Romain Pizzi — Thu, 06 May 2010 01:08:05 GMT

I know rabbit week is over, so a very last post on the forum before I have to get back to everything else..... For those interested in rabbit health, particularly surgery and related topics (including things such as anaesthesia, arthritis, etc), you may find my website www.rabbitsurgery.com useful. It is recently established, and I will continue to add a host of resources, many o which will be useful to nurses interested in rabbits, over the coming few months.

Osteoarthritis is difficult to manage in rabbits, possibly more than dogs and cats, due to their very different mode of ambulation, and the different range of motion of their joint (as an example rabbits spend most of their lives with their stifle in a very deep flexion - imagine you spent your entire life squatting on the floor...). We have found a relatively high incidence in rabbits when reviewing radiographs taken for reasons other than musculoskeletal disorders in rabbits over the age of 3. I suspect many rabbit owners don't notice their rabbits have slightly reduced mobility, and subtle chages in gait are often not noticed due to their different mode of ambulation, incontrat to dogs and cats, that are much more similar to their human owners with their upright gait.

Weight control (more and more rabbits are now obese), encouraging moderate excercise, shown across species to delay progression of osteoarthritis are important tools in management, but we increasingly do have to use pain control, as we know how good rabbits are at masking pain as a prey species. The problem is no one knows exactly what is the ideal dosage of most painkillers in rabbits. The proper peer reviewed published studies on drugs such as Meloxicam and Tramadol have all found that similar dosages used in dogs and cats were insufficient for pain relief in rabbits (one study foung 0.3mg/kg Meloxicam - 3 x a dog dose, was completely insufficient even for 8-12hours), so our current guidelines (it must be pointed out they are annecdotal, based on expereince), is to use Meloxicam at 0.6mg/kg PO BID (6 x a canine dose TWICE daily) initially, then afte an initial treatment period to reduce joint inflammation and inflammatory cytokine production (which makes pain much worse), of 10-14 days, to try and reduce the dosage to half this (either 0.6mg/kg once daily, or 0.3mg/kg BID) as a maintenance dosage. This highlights the sad fact that when vets prescribe rabbits a meloxicam dosage measured in drops (perhaps erroneously believing they are prone to toxicity like cats), they are not providing any pain relief at all.

Lastly, glucosamine is still a very contentious issue in both human and vetrinary treatment of osteoarthritis, and the proof is still remarkably thin on the gound from a scientific point of view, despite all our tendancy to sell as much as possible in practice (I guess at least there is almost no harmful toxicity risk as with NSAIDs, at worst our patients end up with expensive poo!). For those with an interest in the subject, a recent Cochrane review (the gold standard in Human medical literature, they review all published medical literature ona subject, and weight this for how good, poor, biases different studies are), did not really find convincing improvements in glucosamine use over placebos for treatment of ostoearthritis pain (see: http://www2.cochrane.org/reviews/en/ab002946.html) . Some rabbits studies have been perfromed and while they appear to demostrate some difference, they are not particularly robust studies, and may be biased. I am not saying don't use glucosamine (I do, in selected cases), jut encouraging you all to think about what you do, and weight the benifits, versus the costs. Risks are very low, but benifits may be limited and only effective in some patients. the costs can also be quiet high for some of the veterinary products on the market, whcih despite marketing hype, actually have little proven advantage over human formulations.... anyway, enough stirring trouble. For thos who like to think about things, marketing hype etc in general, I would advise the paperback "Bad Science" by Ben Goldacre. While written by a human doctor, and about human health, it does give one pause for thought how much of the same nonsense may go on in veterinary medicine!

Anyway, my final post for the forum - hope it has been useful, despite the occasional rant!

Re: Geriatric bunny health

superdoggie — Wed, 05 May 2010 20:34:36 GMT

Hi. Thanks for reply. It's very frustrating. He's been x rayed too, but I'm reluctant to do anything more invasive as he's well otherwise. He has the run of a safe garden during the day, so has plenty of exercise and doesn't seem stiff.

Do you worm your bunny?

There are now some rabbit foods with glucosamine, but they are also full of rubbish so haven't tried them.

I make sure he's clean obviously. Maybe it's just age bless him!

Any ideas welcome though.

Re: Geriatric bunny health

Shelly vn — Tue, 04 May 2010 11:59:25 GMT

I have the exact same problem with my female bunny! The only difference is that she hasn't had any dental problems. I've moved her inside for the summer to keep a closer eye on her and the problem has improved a bit. I was thinking that may be it is arthritis, but i'm not sure about treatment. Sorry i haven't helped much, but hopefully someone else on here might have some ideas!