I’m very sorry, that’s a very hard decision to be going through. 11 years is a wonderful life for a bunny, so congratulations on taking such good care of him so far!

One thing that jumped out to me is that every 2 months for molar trims is pretty frequent. Usually older buns teeth don’t grow as fast, so it’s possible that he might not need them that regularly? My vet mentioned that sometimes when the teeth shift in age, the bun sometimes really only needs a trim or two to get things back on track.

It’s important to think about quality of life. Aside from his teeth, is he in pain? Is he on any pain management? Is his eye condition very painful?

If the main issue really is his teeth, you might consider just trying 1 trim, with the possibility that he might pass in anesthesia. There have been members here who have had to do similar surgeries, and they say their goodbyes before hand incase it doesn’t go well. Perhaps you could aim to get his teeth sorted out, and some regular pain management for his eyes, and see how he does? I agree that a complicated invasive surgery is prob not a great idea, but something simple like a molar trim and some pain meds might help him be more comfortable for a good bit of time more.

Is he already blind from the glaucoma? I’ve read about using gentamicin injections to destroy the ciliary body. This permanently reduces pressure in the eye. It also leads to blindness if they are not already blind in that eye.

Yes, you most commonly hear about the procedure being used on dogs with glaucoma. The Missouri HRS has an article that does mention it briefly: https://mohrs.org/rabbit-eye-health/

There are also some scientific articles out there that mention using it. However, there do not appear to be any studies ON using it. At least none that I know of. As with many things with rabbits, treatments are often “off label”. There are tons of medications, for example, that are not officially approved for use in rabbits. And yet our vets prescribe them all the time.

Ah, I see. That’s very hard regarding the teeth. Does he tend to “bounce back” after his trims very quickly? I think that would also factor into my decision personally. Some bunnies snap right back to eating normal, other’s take days of recovery and practically go into stasis. All of those things affect quality of life.

The treatment that @LBJ10 mentioned for his eyes sounds promising. There are also stronger pain medications than metacam available, so that might also be something to ask about.