Help making end of life decision

[Crie]

I am really struggling making an end of life decision for my 12yo hospice bunny.

In december she was diagnosed with a tooth abscess. Because of her age, we decided against surgery and started doing palliative care. She quit drinking water, so I began giving her water with a syringe. For the last 4 months it has worked out great, but now she is over it (even when I flavor/sweeten the water, us baby food, etc). SubQs at home have been a nightmare, and the vet charges $50 each time.

Her hay intake has gone down quite a bit, but she still eats it, loves her greens, and once in a while I can get Critical Care in her. We have kept her at a stable weight for 4 months.

Her not being hydrated enough has caused a rollercoaster of nighmares the last 4 months, and I don’t know how much longer I can do it. It is so hard to think about saying goodbye when her quality of life is still good (maintaining weight, grooms herself, gives affection, etc.) She does sleep most of the day, and only gets up to eat/poop/clean herself, then goes and lays right back down.

Her doctor said that animals are programmed to keep trucking through pain, and she will continue to do these “normal” things until she physically can’t.

Another doctor said that her mouth is probably pretty “ouchy”, so even though she’s still eating, I should really consider her quality of life.

I made the end of life appointment earlier this week, and then canceled it today. I am a mess, and feel like if I let her go now, I’m just giving up on her. The other part of me says, “Let her go out like a queen, doing all the things she still loves to do, yes, even controlling her momma.”

I need help, input, anything!!!!

(Edited by Wick – formatting for better visibility)

[Azerane]

End of life decisions are always hard. I have a couple of thoughts, the first is about continuing on if you can alter her diet. Switch out her hay for fresh grass (wet it down before feeding) and feed pellets soaked in water, in addition to her veggies that she’s currently getting. That way almost all her fluid intake can be from food, the hay will be dehydrating her considering at the moment. I understand that sometimes you are feeding critical care, I’ve found that with my Luna she is difficult to feed critical care to, but she will freely eat her pellets soaked in water. They probably triple in size so be mindful of that. I use 1tsp pellets to 3tsp of water.

Ultimately, you obviously were concerned enough about her earlier in the week to consider that she needed to be put to sleep. That’s a tough decision. We always want to give them every chance at life possible but we also need to reasonably assess when it’s simply too stressful or painful for them to continue on. No one can make that decision for you, considering her quality of life is important. How is her behaviour, eating, toileting, grooming, interaction with your other rabbit etc? Those are all contributing factors that need to be considered.

[Crie]

Thanks for the response.

So, I’ve tried wet pellets (hates them). I tried adding pumpkin + banana (doesn’t interest her). I have also tried wet hay (not interested). I have tried EVERYTHING.

I never even considered the fact that the hay that she is eating is dehydrating.

At best I’m getting about 30-40ml of water in her a day. She sleeps all day, only getting up to eat, clean herself, groom her rabbit stuffed animal, and to get cuddles from me, then she goes right back to sleep. She’s definitely getting tired, but doesn’t seem in pain (bur probably is a little uncomfortable). I just can’t get enough water in her.
<p style=”padding-left: 40px;”>I do have one question: say I could get wet pellets in her. They don’t turn to liquid, they just kind of crumble. How would I assess the water intake on that?</p>

[Azerane]

Right, well it seems you really have tried a lot. Though if you do have access to fresh grass, I’d definitely recommend that. In terms of the water intake on wet pellets, I suppose with the way I do mine with 3tsp of water, that’s equivalent to 15ml. Mine end up wet and mushy, not in a liquid state. You could try to get her used to them by slowly increasing the amount of water you add to them each time.

In terms of her behaviour, it does sound like she is struggling a little, rabbits are good at masking their pain. There may be other contributing factors at her age too, potential for small changes in her heart and lungs that are slowing her down as well. I would say that if you are unable to get her fluid intake up, then you may need to consider PTS, living in a state of chronic dehydration is probably not pleasant.

[DanaNM]

I’m really sorry for what you are going through. 🙁  It’s never an easy decision to make. I have a 13 year old bun so I’m thinking about these things constantly. 🙁

I’ve talked about this before with a friend who was a vet tech, and the things the vets went off of were eating, drinking, and eliminating. If one of those things ceases and stops responding to treatment, that usually means it’s time.

Rabbits are so good at masking pain, and sometimes the changes in behavior are so slow and subtle we may not really notice. I also know that people often wish that they hadn’t wait as long as they did when they wait until the animal is clearly in extreme pain. Who would gaining an extra 2 weeks or 2 months be for?

I think the fact that she is on palliative care means she isn’t likely to improve and as you said, the last 4 months have been really hard for both of you. Whatever and whenver you decide, I don’t think a decision to PTS at the end of a long and wonderful life is giving up on her at all. In my opinion, it’s a part of responsible pet ownership, and a painless passing is a final gift we can give our animals.

As silly as it sounds, it might help you to have “a conversation” with her. I have a feeling she will let you know when she is ready. <3

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[RabbitPam]

I’m so sorry you’re going through this, and it’s clear she’s had a wonderful life. My only contribution is to try to imagine it from her perspective, rather than your own fears and sense of loss. Is she in intolerable/tolerable pain? Does her tooth situation make every bite hurt? Does she seem to be in unrelieved pain when not eating, or when pooping? Is she sleeping peacefully or hunched or fitfully? A quiet, gentle quality of life is what she’s had up until now. I know it’s very hard to discover her pain level, but I use that as a barometer – will you be giving her relief as far as you know? Loss of some functions is different from suffering. Many bunnies handle disabilities well, so if the above suggestions for her food and water intake are helpful, it’s ok to wait. But if you are avoiding the grief and loss, think of her needs first. Ultimately her system will shut down when it’s her time, such as her kidneys, and it won’t be much longer.

By the way, I know that Critical Care can be made anywhere from liquid via syringe to soft, round golf ball sized blobs that can be nibbled. Maybe try different consistencies and see if she responds to one. Times like this are the cost of years of love. Whatever you decide, whenever, she knows you’re providing the best life she could have wished for.

[RabbitPam]

P.S. She is so adorable – love that photo.

[Crie]

Thank you all for your responses.

As far as her pain level goes, I assume with her tooth abscess it is pretty uncomfortable to eat (hence why she no longer eats hard goods, and her hay intake is very minimal). Also, her tooth as started to shift in her mouth, so sometimes it sounds like she’s chewing on it, and I can see her move her jaw and kind of shift it back into place.

She’s definitely arthritic, her spine has some issues, and she’s on Meloxicam 2x a day.

Our biggest issue is really getting fluids in her. I feel like she’s borderline dehydrated constantly. Before work I can get about 15ml of water in her, 1 teaspoon of soupy cc w/ pumpkin, and some wet greens with Benebac. …but then she’s alone for 9hrs not drinking at all, and eating tiny amounts of hay. …when I get home from work, it’s  a routine of water, cc, greens, water, cc, greens until I go to bed.

In total, I’m getting about 40ml of water in her a day, plus 2 bowls of watery greens, and maybe 1TBSP of critical care.

Is she in excruciating pain, no. Is she uncomfortable, probably. Does she still groom herself, love cuddles, and get a little excited about certain foods, yes. Is it a rollercoaster of a struggle everyday to get fluids in her, YES! And that’s  a big one.

[prince dorian the bun]

I am so very sorry, it is a horrible decision to make . But the fact it is hard for you tells me any choice you make even if not perfect (because they never are, all we can do is try to make the best) is coming from the right place. If you are not ready right this minute that totally makes sense to me. Maybe talk to your vet and see if they can help you establish a line that if she crosses it will be time? Maybe if she no longer grooms herself or wants cuddles, you can’t even get the level of food/water in her that you are now. Or maybe the decision will be if she is the same in a month (or what ever time period feels right) then it’s time to let her pass on. Maybe you can take a week off work to spend some last quality time with her and have a last week together and then let her pass on. If she is alone for 9 hours a day I would worry about her deteriorating in that time and having a painful death alone. This is however such a personal decision that it is for you to decide based on knowing your sweet bun and the advice of the vet who may have a better idea about pain levels and such. I know ideally they would be happy healthy little fluffs for ever, but maybe ask yourself what you would want if you were her and be kind to yourself, this is not an easy one no matter the choice.

[BZOO]

She is so cute!  This will be your last gift to her, try to think a little bit positive here.

Timing is always tricky, and yes, you’ll second guess yourself.

IMHO, I’d let her go before she gets really bad.

When the love of life, Kiya, was starting to collapse, following a two plus year illness that we fought thru tooth and nail, I knew I had to say goodbye.  Did not want her dying alone while at work or whatever.

Hugs to you and yours in this tough time.

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